Abortion is a public health concern besides being a sensitive issue with religious, moral, cultural and political dimensions. More than a quarter of the world’s people live in countries where the procedure is permitted only in cases of rape, incest, fetal abnormalities or to save the pregnant person’s life. Abortions still occur in these countries, nearly half of them are unsafe, performed by unskilled practitioners or in unhygienic conditions, or both.

Abortions performed in unsafe conditions claim the lives of tens of thousands of women around the world every year and leave many times that with chronic and often irreversible physical and mental health problems becoming a drain on the resources of public health systems. Controversy, however, often overshadows the public health impact. An estimated 73 million abortions occur globally each year. Unsafe abortions accounts for up to 13 percent of deaths related to pregnancy and childbirth worldwide. Globally, at least 7 million women are treated every year for complications from unsafe abortions.

The US Supreme Court has recently overturned Roe v Wade, the landmark 1973 ruling that established a constitutional right to an abortion. Now the matter will be settled on a state-by-state basis. 22 states are considered likely to quickly ban most abortions. Some states have since then passed laws to restrict late-term abortions, require parental notification for minors and mandate the disclosure of abortion risk information to patients prior to the procedure.

Abortion has long been a contentious issue in the United States and one that sharply divides Americans along partisan, ideological and religious lines. According to a Gallup May 2022 update on Americans’ abortion views, 35 percent of the US adults believe abortion should be legal “under any circumstances,” 50 percent say it should be legal “only under certain circumstances” and 13 percent say it should be illegal in all circumstances. In a recent survey by Pew Research Centre, 61 percent of US adults said abortion should be legal all or most of the time, while 37 percent said it should be illegal all or most of the time.

In the Western world, the debate on abortion is predicated both on whether a woman is entitled to control over her body and fertility and whether the fetus should be regarded as a ‘person’ with the same rights as other people or merely an organ or a collection of cells.

In English-speaking countries, the debate most visibly polarises around supporters of the self-described “pro-choice” and “pro-life” movements. The pro-choice emphasise a woman’s right to bodily autonomy, while the pro-life argue that a fetus is a human deserving of legal protection, independent of the will of the mother.

Since abortion is legal only in extraordinary circumstances, women seeking abortions frequently subject themselves to back-street clinics where the services are often provided with unsafe procedures. It is feared that the poor women, in particular, are forced to rely on untrained practitioners. 

According to the World Health Organisation, roughly 73 million induced abortions occur worldwide each year. It says 61 percent of all unintended pregnancies and 29 percent of all pregnancies in general end in an abortion. The WHO also keeps a database of each country’s abortion laws, policies and levels of abortion support in the health care system. The past 50 years have been characterised by an unmistakable trend towards a liberalisation of abortion laws, particularly in the industrialised world.

Access to safe abortion has been established as a human right in numerous international frameworks. At the 1994 International Conference on Population and Development in Cairo, 179 governments signed a programme of action that included a commitment to prevent unsafe abortions. The WHO first recognised unsafe abortion as a public health problem in 1967. In 2003, it developed technical and policy guidelines that include a recommendation that states pass abortion laws to protect women’s health. Almost 90 percent of abortions in countries with liberal abortion laws are considered safe, compared with just 25 percent of abortions in countries where abortion is banned. According to the WHO, approximately 5–13 percent of maternal deaths worldwide are due to complications from unsafe abortions, the vast majority of which occur in developing countries.

Abortions have been legal in India in various circumstances for the last 50 years since the introduction of the Medical Termination of Pregnancy (MTP) Act in 1971. The Act was amended in 2003 to enable women’s access to safe and legal abortion services. Taking advantage of this permission, over 2,000 unborn girls are illegally aborted every day in India. As a result, there are less than 93 women for every 100 men in the population. Poverty, the dowry system, deformed infants, famine and lack of support services are counted among the causes of female infanticide in India.

In 2002, there were about 2.4 million unintended pregnancies in Pakistan. Nearly 900,000 of these were terminated by induced abortion. Since abortions are legal only in specific circumstances, women seeking abortions subject themselves to back-street clinics where the services are often provided with unsafe procedures. Poor women, in particular, it is feared are forced to rely on untrained practitioners. A national survey of public-sector facilities estimated that about 200,000 women were hospitalised for abortion complications in 2002. Many other women possibly suffered complications but never reached hospitals or reported those to health providers.

It is claimed that many married women and their husbands have difficulties obtaining contraception or using it effectively. Abortion is then resorted to when unintended pregnancies occur.

The writer is a playwright and freelance journalist and can be reached at pashajaved1@gmail.com and his blogging site: soulandland.com