From Unsafe to Safe Abortion in Sub-Saharan Africa: Slow but Steady Progress

Abstract

This report represents the first comprehensive compilation of information about abortion in Sub-Saharan Africa and its four subregions. It offers a panorama of this hard-to-measure practice by assembling data on the incidence and safety of abortion, the extent to which the region’s laws restrict abortion, and how these laws have changed between 2000 and 2019. Many countries in this region have incrementally broadened the legal grounds for abortion, improved the safety of abortions, and increased the quality and reach of postabortion care. There is still much progress to be made, however, including enabling the region’s women to avoid unintended pregnancies and unsafe abortions. The report concludes with recommendations for a broad range of actors to improve the sexual and reproductive health and autonomy of the region’s 255 million women of reproductive age.

‘If She’s Pregnant, then that Means that Her Dreams Fade Away’: Exploring Experiences of Adolescent Pregnancy and Motherhood in Rwanda

“…Over a fifth (22%) of all pregnancies in Rwanda are estimated to end in induced abortion (Basinga et al 2012) and a study on maternal near-misses among women of all ages in the capital, Kigali, showed that abortion was related to nearly half (45%) of all severe morbidities and over a quarter (28%) of mortalities (Rulisa et al 2015). There are no age-disaggregated data or estimates on adolescent abortion-related care-seeking in Rwanda, but evidence from elsewhere in Africa suggests that adolescents are more likely to seek less safe abortion methods than older women (Bankole et al 2020).…”

Women Deprivation Index and Family Planning Utilisation in Urban Geography of West African Countries

“…Our findings support existing evidence on the myriads of sexual and reproductive health challenges confronting disadvantaged women populations in urban settings in sub-Saharan Africa ( 5 , 67 , 68 ). Coupled with their high concentration in the informal urban settlements, the highly deprived urban women often had to contend with unequal access to and high unmet needs for modern family planning services, especially the long-acting reversible methods that offer better protection against unwanted pregnancies and unsafe abortion ( 5 , 69 ).…”

“If the Woman Doesn't Prevent, You Will Become Pregnant”: Exploring Male Involvement in Contraceptive Use Preceding Unplanned Pregnancy in Sierra Leone

“…This is concerning because unplanned pregnancies carry substantial risks for poor health outcomes. It is estimated that approximately eight million abortions occur each year as a result of unplanned pregnancy in Sub-Saharan Africa, of which about three-quarters (77 percent) are considered unsafe (Bankole et al 2020). Women experiencing unwanted pregnancies are also less likely to receive optimal antenatal care (Amo-Adjei and Tuoyire 2016) and are more likely to suffer from mental health problems (Faisal-Cury et al 2017;Manikkam and Burns 2012) and poor treatment outcomes related to HIV/AIDS (Brittain et al 2019).…”

“…It is estimated that approximately eight million abortions occur each year as a result of unplanned pregnancy in Sub‐Saharan Africa, of which about three‐quarters (77 percent) are considered unsafe (Bankole et al. 2020). Women experiencing unwanted pregnancies are also less likely to receive optimal antenatal care (Amo‐Adjei and Tuoyire 2016) and are more likely to suffer from mental health problems (Faisal‐Cury et al.…”