Correlation between abortion rates and illegality

Christina here…

Lookit: somebody recently released an observational study on abortion rates, which the media reported with headlines such as, “Abortion Rates Are Higher In Countries Where Procedure Is Illegal, Study Finds.”

I love it when researchers release new studies!

… but I hate it when secondary sources like the one above don’t bother to link to the actual study, forcing people like me to hunt around the ‘tubes for it. Citation needed, Lazy BoLazyface.

Here it is. You can even download this particular study free if you register with the Lancet. I couldn’t imagine any negative repercussions to joining the Lancet (Excepting if they publish another fraudulent study leading millions of people to the absurd conclusion that vaccines cause autism…) so I joined, just for you, so that we may science together.

In the study, researchers looked at worldwide incidence of abortion between 1995-2008, finding rates of abortion of 35(in 1995), 29 (in 2003) and 28 (in 2008) per 1000 women aged 15-44 years. Between 1995-2003, the rates of abortion declined around 2.4% each year, but the decline has leveled off to almost nil between 2003-2008.

Despite this decline in abortion rates, the rates of unsafe abortions are on the rise, moving from 44% of abortions being unsafe to 49%. Researchers also found that abortion rates are lower in regions with more liberal abortion laws.

Let’s talk definitions:

When the WHO describes an abortion as “unsafe”, they mean:

a procedure for termination of an unintended pregnancy done either by people lacking the necessary skills or in an environment that does not conform to minimum medical standards, or both.

“Safe”, abortions are defined as:

those that meet legal requirements in countries with liberal laws, or where the laws are liberally interpreted such that safe abortions are generally available.

And here’s what they mean by “liberal laws”:

Countries with liberal laws were defined as those where abortion is legal on request or on socioeconomic grounds, either with or without gestational limits; and countries whose laws allow for abortion to preserve the physical or mental health of the woman, if these laws were liberally interpreted, as of 2008.

They don’t spell out the definition of “non-liberal” abortion laws, so I can only presume those laws to be laws in which abortion is not legal upon request, or countries which do not allow abortion for mental of physical health preservation.

By these definitions, the North America is mostly liberal. Abortion is legal upon request with gestational limits. Our rate of abortion is 19 per 1,000 women.  Compare that to Africa, whose laws are highly restrictive (abortion is mostly illegal) abortion rate is 29 per 1,000 women.

There is another frightening statistic about Africa: 49% of all abortions in the world are unsafe. 97% of those in Africa are unsafe. Comparatively, less than .5% of abortions are unsafe in North America.

What this means is that in Africa, where abortion is largely illegal, more women are having abortions, and almost all of those abortions are unsafe.

The researchers conclude:

We found that the proportion of women living under liberal abortion laws is inversely associated with the abortion rate in the subregions of the world. Other studies have found that abortion incidence is inversely associated with the level of contraceptive use, especially where fertility rates are holding steady, and there is a positive correlation between unmet need for contraception and abortion levels. The unmet need for modern contraception is lower in subregions dominated by liberal abortion laws than in those dominated by restrictive laws, and this might help explain the observed inverse association between liberal laws and abortion incidence.

In other words, women get fewer abortions in countries in which abortions are easier to obtain and legal. Women also get fewer abortions in countries that favor contraception use. Women get more abortions in countries that use fewer contraception methods.


Photo: A sign reading, "Keep abortion safe and legal!"

Let’s have a conversation, pro-lifers. Pay attention. I’m about to science you.

If you’d like to see the abortion rate fall, then you are not wise to think that increasing restrictions will cause abortion rates to fall, because we do not see such an association. We see the opposite.

Criminalizing abortion or restricting a woman’s right to a legal abortion does not stop her from having an abortion. Arm yourselves with that information, pro-lifers.  If you’re a pro-lifer and a “small government” conservative, this information should be doubly important. Restrictive laws do not correlate with preventing women from obtaining abortions. You therefore have no reason to lobby for those restrictions in the name of reducing abortions, leaving your pro-choice foes a wide berth with which to speculate your motives.

I know, one’s knee-jerk reaction to “I want activity X to stop” is to make activity X illegal. If activity X is illegal, we reason, people will be less likely to engage in that activity for fear of the repercussions. We raise our children and our dogs this way, teaching them to avoid punishment by avoiding activity X if activity X causes punishment.

However, abortion (and other activities deemed wrong by others) is more complicated than this. The criminalization of abortion does not reduce the number of abortions. Evidence has shown this repeatedly. Yet you can’t shake the idea that if you just spank those naughty aborting women, they will learn their lesson.

We won’t, not because women are belligerent children, not because we are selfish, not because we lack moral character. It’s because your position is wrong.

However even if your position weren’t wrong, you’re doing it wrong by ignoring evidence.

If you care about maternal health, especially if you’re a pro-lifer who wrings your hands over (supposed) increase in rates of cancer,  depression  or other morbidities associated with abortion, you should note that liberalization of abortions laws decreases mortality.


We found that abortions continue to occur in measurable numbers in all regions of the world, regardless of the status of abortion laws. Unintended pregnancies occur in all societies, and some women who are determined to avoid an unplanned birth will resort to unsafe abortions if safe abortion is not readily available, some will suffer complications as a result, and some will die. Measures to reduce the incidence of unintended pregnancy and unsafe abortion—including improving access to family planning services and the effectiveness of contraceptive use, and ensuring access to safe abortion services and post-abortion care—are crucial steps toward achieving the [UN Millennium Development Goal].

So, pro-lifers. Shall we follow where the evidence leads or continue to lobby for abortion laws based on your hunches and emotions?

P.S. I hope you noticed my meticulous avoidance of confusing correlation with causation.


Sedgh G, Singh S, Shah IH, Åhman E, Henshaw SK, Bankole A. Induced abortion: incidence and trends worldwide from 1995 to 2008. The Lancet 2012(11)61786-8

Learn more about Christina and follow her @Ziztur.

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