Difficulties in Obtaining Information on and Measuring the Practice of Abortion

It is widely acknowledged that the legal reforms for expanding access to abortion have an impact that may reduce the number of unsafe abortions in the medium or long term. The existing evidence clearly shows that “contrary to popular belief, countries that have legalized abortion and created affordable family planning programs, combined with effective access to information, show a marked decline in the number of abortions performed”. However, this tendency is not universal, as shown by the case of Cuba, where, despite the existence of liberal abortion legislation, the abortion rate continues to be high “due to the lack of sufficient information services and access to contraceptive methods” (Center for Reproductive Law and Policy, 1999).

At the same time, as mentioned earlier, in countries where abortion is illegal, there is a higher rate of under-reporting and under-registration of the relevant data. In addition to the legal and penal sanctions imposed on those performing an abortion, moral, ethical or religious reasons may also discourage women from reporting the interruption of a pregnancy (Llovet, 1998). Health institutions and providers may, for the same or other reasons, fail to report, under-report or register abortions as miscarriages, thereby contributing to the under-registration of induced abortions.

Likewise, not all women that experience abortion complications are treated in hospitals, particularly if they live in rural zones or experience less serious side effects and therefore have less need to seek medical care. This means that women hospitalized for abortion complications only constitute a small share of the total,  but they are the visible part of a much larger number of women whose abortions have negatively affected their health (Allan Guttmacher Institute 1994). The study cited estimated that one out of every five women in Peru and Colombia and 70% of women in Brazil that had had an abortion experienced complications that could merit hospitalization. In Chile and Mexico, the proportion is approximately one out of every four women. These estimates reflect the importance of abortion care services in hospital systems as a whole. This study also shows that a large number of cases in which women provoke their own abortions are not registered, since they do not need or seek treatment at a hospital.

The under-registration of these cases is also due to other reasons. Nicaragua, for example, has recently seen a large number of women dying from poisoning after consuming pesticides. This is due to women consuming inexpensive products in order to provoke bleeding that will interrupt their pregnancy, but they end up being poisoned, often fatally. Although records on abortion should include all women seeking to put an end to their pregnancy, deaths like these are registered as suicides or accidental deaths, rather than attempted abortions. This shows that statistics on maternal mortality often fail to include deaths due to this practice (McNaughton et al., 2003; Rayas and Catotti, 2004;Rayas et al., 2004).

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