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FACT SHEET Abortion in

Incidence and trends Legal status of abortion Unsafe abortion and its ■■ During 2010–2014, an estimated 35.5 ■■ Because abortion is broadly legal in the consequences million induced abortions occurred ’s two most populous countries, ■■ Induced abortion is medically safe each year in Asia. and , the majority of women when WHO-recommended methods in Asia live under liberal abortion laws. are used by trained persons, less safe ■■ The annual rate of abortion for the when only one of those two criteria is region is an estimated 36 per 1,000 ■■ Abortion is not permitted for any rea- met, and least safe when neither women of reproductive age (15–44), son in three Asian countries: , is met. which is down slightly from 41 per and the . 1,000 in 1990–1994. ■■ As of 2010–2014, the majority (89%) ■■ Seventeen out of 50 countries and ter- of abortions in Eastern Asia—which ■■ The regional abortion rate is roughly 36 ritories in Asia allow abortion without includes China—are safe. In Southern per 1,000 for married women and 24 restriction as to reason. and together, less than per 1,000 for unmarried women. half of abortions are safe. ■■ Even where abortion is broadly legal, ■■ Abortion rates in four of Asia’s five many women continue to face barri- ■■ In 2012, approximately eight per 1,000 (Eastern, Southern, South- ers to obtaining safe, legal procedures. women of reproductive age in Asia eastern and Western) are close to the Obstacles include difficulty finding pro- (excluding Eastern Asia) were treated overall regional rate; the rate in Central viders willing to perform abortion, sub- for complications from unsafe abortion. Asia is higher (42 per 1,000 women). standard conditions in health facilities, In all, about 4.6 million women in the lack of awareness of the legal status of region are treated for such complica- ■■ The proportion of all pregnancies in abortion and fear of stigmatization for tions each year. Asia ending in abortion each year, terminating a pregnancy. estimated at 27% in 2010–2014, has ■■ In 2014, at least 6% of all maternal remained roughly the same since deaths (or 5,400 deaths) in Asia were 1990–1994; by , the propor- from unsafe abortion. tion ranges from 22% in to 33% in Eastern Asia. ■■ The most common complications from unsafe abortion are incomplete abortion, excessive blood loss and TABLE 1: RATES AND PERCENTAGES infection. Regional and subregional estimates of induced abortion, ■■ Some women with untreated compli- Asia, 1990–1994 and 2010–2014 cations experience long-term health Region % of all pregnancies consequences, such as chronic pain, and subregion Abortion rate* ending in abortion inflammation of the reproductive tract, pelvic inflammatory disease and 1990–1994 2010–2014 2010–2014 infertility. Asia 41 36 27 Eastern Asia 43 36 33 ■■ Poor and rural women are the most Central Asia 54 42† 26 likely to experience an unsafe abortion and severe complications thereof. Southern Asia 35 37 25

Southeastern Asia 46 35 27 ■■ Unsafe abortion has negative conse- Western Asia 42 34 22 quences beyond its immediate effects on individual women’s health. Treating *Abortions per 1,000 women aged 15–44. †Difference between 2010–2014 and 1990–1994 is statistically significant. complications from unsafe abortion

MARCH 2018 TABLE 2: LEGALITY OF ABORTION, 2017 SOURCES Most data in this fact sheet Countries and territories in Asia can be classified into can be found in: Singh S six categories, according to the reasons for which abortion et al., Abortion Worldwide is legally permitted. 2017: Uneven Progress and Unequal Access, New York: Guttmacher Institute, 2018; Reason Countries and territories special tabulations of updated Prohibited altogether, (no Iraq, Laos, the Philippines data from Sedgh G et al., explicit legal exception) Abortion incidence between 1990 and 2014: global, To save the life of woman , , (a,b), Darussalam, regional, and subregional levels (a,c,e), (c), , , , , (d,e), - and trends, Lancet, 2016, Leste (d), (d,e), West Bank and Gaza, 388(10041):258–267; Ganatra To save life of woman/preserve , (c,d,e), (e), , (c), B et al., Global, regional, and physical health* (d,e), South (a,b,c,e) subregional classification of To save life of woman/preserve (a,b,c), , (a,c) abortions by safety, 2010–14: physical or mental health estimates from a Bayesian hierarchical model, Lancet, 2017, 390(10110):2372–2381; To save life of woman/preserve (a,c), (China) (a,b,c), India (a,c,d,g), (a,e), physical or mental health/socio- (a,b,c,d,e) and Bearak J et al., Global, economic reasons regional, and subregional trends in unintended pregnancy Without restriction as to reason (d), , , (d), China (f,h), (d), and its outcomes from 1990 , , , (f), (h), , , (d,e), , , (h) to 2014: estimates from a Bayesian hierarchical model, *Includes countries with laws that refer simply to “health” or “therapeutic” indications, which may be interpreted more broadly than physical Lancet Global Health, 2018, health. Notes: Some countries also allow abortion in cases of (a) rape, (b) incest, (c) fetal anomaly. Some restrict abortion by requiring (d) parental or (e) spousal authorization. Two countries (f) have abortion laws that prohibit sex-selective abortions, and one (g) bans sex-selective 6(4):e380–e389. Additional abortion as part of a separate fetal imaging law. Countries that allow abortion without restriction as to reason have gestational age limits resources can be found in the (generally the first trimester); for legal abortions in categories 2 through 5, gestational age limits differ by prescribed grounds. A few countries fully annotated version available (h) do not specify gestational limits. at https://www.guttmacher.org/ fact-sheet/abortion-asia. increases the economic ■■ Most women who have an to reduce illness and death burden on poor and abortion do so because they from unsafe abortion. incurs considerable costs become pregnant when to already struggling public they do not intend to. As ■■ The grounds for legal abor- health systems. of 2010–2014, the rate of tion should be broadened unintended pregnancies in and access to safe abortion ■■ The extent to which medi- Asia is 54 per 1,000 women services improved to reduce cation abortion is used to aged 15–44. the number of clandestine induce abortions in Asia is procedures and the negative not known; however, evi- ■■ An estimated 53.8 million consequences that often dence indicates that sales of unintended pregnancies result. these drugs have increased occur each year in Asia. in the region in the past Of these, nearly two-thirds ■■ Liberal abortion laws alone decade. (65%) end in abortion. do not ensure procedures will be safe. Service provi- Unintended pregnancy Recommendations sion guidelines must be and unmet need ■■ Programs and policies that adopted and disseminated, ■■ As of 2017, almost 132 mil- improve women’s and providers must be trained, women of reproductive men’s knowledge of, access and governments must be age in Asia have an unmet to and use of contraceptive committed to ensuring that need for modern contracep- methods must be imple- safe abortions are available. Good reproductive tion—that is, they want to mented to reduce unin- health policy starts with avoid a pregnancy but are tended pregnancies—and credible research either not practicing contra- the abortions or unplanned 125 Maiden Lane ception or are using tradi- births that often follow. New York, NY 10038, USA tional methods, which are 212.248.1111 less effective than modern ■■ The provision and quality [email protected] methods. of postabortion care should www.guttmacher.org be improved and expanded 2018