Hesperian Health Guides
Safe and Unsafe Abortion
Contents
Abortion is very safe when it is done:
- by a trained health worker, with MVA or D&E, or with support from an experienced accompanier, with medical abortion (pills).
- with the proper medicines or instruments.
- under clean conditions, so that anything that goes into the vagina and womb must be sterile (without any germs).
- up to 5 months (24 weeks) after the last period
Abortion is unsafe when it is done:
- by someone who lacks the training necessary for MVA or D&E, or the information and experience needed to support medical abortion.
- with the wrong instruments or medicines.
- under unclean conditions.
- after 5 months (24 weeks) of pregnancy, unless it is done in a health center or hospital that has special equipment.
Death from unsafe abortion
People will always find ways to end pregnancies when they are desperate. But unsafe abortions can cause death or serious problems including infection, lasting pain, and infertility. Do not use the following methods. They are too dangerous.
Try to prevent unwanted pregnancy before it happens. See Chapter 13, “Family Planning.”
- Do not put sharp objects like sticks, wire, or plastic tubing into the vagina and womb. These can tear the womb and cause dangerous bleeding and infection.
- Do not put herbs or plants in the vagina or womb. These can burn or irritate badly, causing injury, infection, and bleeding.
- Do not put substances such as bleach, lye, ashes, soap, or kerosene in the vagina or womb. Also, do not drink them.
- Do not take medicines or traditional remedies in large amounts to cause abortion (either by mouth or in the vagina). For example, taking too much of the medicines for malaria (chloroquine) or to stop bleeding after childbirth (ergometrine, oxytocin) can kill you before they cause abortion.
- Do not hit your abdomen or throw yourself down stairs. This can cause injury and bleeding inside your body, but may not cause abortion.
Access to safe abortion
Anyone who is facing an unwanted pregnancy should be able to get a safe and legal abortion. But laws about abortion differ from one country to another.
Legal abortion. Where abortion is legal, a person can often walk into a health center or hospital, pay an affordable amount, and have a safe abortion. In countries where this happens, almost no one gets sick or dies from complications of abortion.
Legal abortion in some cases. In some countries an abortion is only legal for certain reasons, such as:
- when a pregnancy is caused by rape or incest (sex with a close family member).
- when a doctor says pregnancy will harm the person’s health.
But abortion is often difficult to get, even for those reasons. Doctors and health workers may not be sure what the law really says. They may be unwilling to do abortions openly, or they may charge a lot of money. People may not know if abortion is legal or available in their country.
Even if abortion is illegal, someone can usually get medical help for complications after an abortion. It is often difficult to tell the difference between abortion and miscarriage, unless instruments cause injury to the womb, or pills are found in the vagina.
Illegal abortion. Where abortion is not legal, both those who get abortions and those who perform them can face penalties of different kinds, from fines to imprisonment, depending on the country. But whatever the legal penalties, where abortion is against the law, more people die from unsafe abortion and dangerous pregnancies. Money that could be spent on reproductive health services is spent instead on treating complications of unsafe abortion.
Never assume abortion is illegal. Try to find out about the laws in your own country. It may be easier to work around the laws than to try and change them. Even if abortion is illegal, there may be people providing safe abortions. Finding a safe abortion may mean the difference between staying alive and dying.
Other Barriers to Finding a Safe Abortion:
Legal or not, it can be hard to get a safe abortion because it is too costly, too far away, or because there are confusing rules or papers to fill out.