FACT SHEET Abortion in Asia Incidence and Trends roughly the same since 1990–1994. It Obstacles include difficulty finding ■■ During 2010–2014, an estimated 36 ranges from 22% in Western Asia to providers willing to perform abortion, million induced abortions occurred 33% in Eastern Asia. substandard conditions in health each year in Asia. The majority of these facilities, lack of awareness of the abortions occurred in South and Central Legal Status of Abortion legal status of abortion and fear Asia (16 million), which includes India, ■■ Because abortion is broadly legal in the of stigmatization for terminating a and Eastern Asia (13 million), which region’s two most populous coun- pregnancy. includes China. tries—China and India—the majority of women in Asia live under liberal Unsafe Abortion and Its ■■ The annual rate of abortion, estimated abortion laws. Consequences at 36 abortions per 1,000 women of ■■ In Asia in 2014, at least 6% of all childbearing age (i.e., those 15–44 ■■ Abortion is not permitted for any maternal deaths (or 5,400 deaths) were years old), fell from 41 per 1,000 in reason in three Asian countries: Iraq, due to unsafe abortion. 1990–1994. However, the decline was Laos and the Philippines. not statistically significant. ■■ The proportion of abortions performed ■■ Seventeen countries allow abortion under unsafe conditions in Asia is not ■■ The abortion rate is roughly 36 for without restriction as to reason. All of known. However, it is estimated that married women and 24 for unmarried these countries impose gestational 4.6 million women in Asia (excluding women. limitations, with the exception of Eastern Asia) are treated each year for China, North Korea and Viet Nam, of complications from unsafe abortion. ■■ Abortion rates are generally the same which have different regulatory across Asia’s four subregions (Eastern, mechanisms. ■■ The most common complications Western, Southeastern, and South and from unsafe abortion are incomplete Central). ■■ In some Asian countries—notably abortion, excessive blood loss and Cambodia, India and Nepal— infection. Less common but very ■■ The proportion of pregnancies ending abortion laws are liberal, but many serious complications include septic in abortion in Asia each year, estimated women continue to face barriers shock, perforation of internal organs at 27% in 2010–2014, has remained to obtaining safe, legal procedures. and inflammation of the peritoneum. ■■ Because poor and rural women tend TABLE 1: NUMBERS AND RATES to depend on the least safe methods and providers, they are more likely than Regional and subregional estimates of induced abortion, other women to experience severe Asia, 1990–1994 and 2010–2014 complications from unsafe abortion. Region No. of abortions % of pregnancies ■■ and subregion (millions) Abortion rate† ending in abortion Some women with untreated complications experience long-term 1990–1994 2010–2014 1990–1994 2010–2014 2010–2014 health consequences, such as chronic Asia 31.2 35.5 41 36 27 pain, inflammation of the reproductive Eastern Asia 14.8 12.8 43 36 33 tract, pelvic inflammatory disease and infertility. South and Central 9.9 15.7* 35 37 25 Asia ■■ Unsafe abortion has negative Southeastern Asia 5.1 5.1 46 35 27 consequences beyond its immediate Western Asia 1.4 1.9* 42 34 22 effects on women’s health. For *Difference between 2010–2014 and 1990–1994 is statistically significant. †Abortions per 1,000 women aged 15–44. example, complications from unsafe SOURCE: Sedgh G et al., Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends, abortion may reduce women’s The Lancet, 2016, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)30380-4/abstract. productivity, increasing the economic AUGUST 2017 TABLE 2: LEGALITY OF ABORTION, 2016 SOURCES Most data in this fact sheet Countries and territories in Asia can be classified into are from Sedgh G et al., six categories, according to the reasons for which abortion Abortion incidence between is legally permitted. 1990 and 2014: global, regional, and subregional levels and trends, The Lancet, 2016, Reason Countries http://www.thelancet.com/ Prohibited altogether, or no Iraq, Laos, the Philippines journals/lancet/article/PIIS0140- explicit legal exception to save 6736(16)30380-4/abstract. the life of a woman Additional resources can be To save the life of a woman Afghanistan, Bangladesh, Bhutan (a,b,d), Brunei Darussalam, East Timor found in the fully annotated (e), Indonesia (a,c,f), Iran (c), Lebanon, Myanmar, Oman, Sri Lanka, Syria version available at https:// (e,f), United Arab Emirates (e,f), West Bank and Gaza, Yemen www.guttmacher.org/fact- To preserve physical health (and Jordan, Kuwait (c,e,f), Maldives (f), Pakistan, Qatar (c), Saudi Arabia (e,f), sheet/facts-abortion-asia. to save a woman's life)* South Korea (a,b,d,f) To preserve mental health (and Israel (a,b,c,d), Malaysia, Thailand (a,c) all of the above reasons) The study on which this fact sheet is based was made possible by grants from the UK Socioeconomic reasons (and all Cyprus (a,c), Hong Kong (China) (a,b,c), India (a,c,e,h), Japan (a,f), Taiwan of the above reasons) (b,c,e,f) Government, the Norwegian Agency for Development Without restriction as to reason Armenia (e), Azerbaijan, Bahrain, Cambodia (e), China (g,i), Georgia (e), Cooperation and the Dutch Kazakhstan, Kyrgyzstan, Mongolia, Nepal (g), North Korea (i), Singapore, Ministry of Foreign Affairs. Tajikistan, Turkey (e,f), Turkmenistan, Uzbekistan, Viet Nam (i) The findings and conclusions *In*Includes countries with laws that refer simply to “health” or “therapeutic” indications, which may be interpreted more broadly than contained within do not physical health. NOTES: Some countries also allow abortion in cases of (a) rape, (b) incest, (c) fetal impairment or (d) other grounds. Some restrict abortion by requiring (e) parental or (f) spousal authorization. Two countries (g) have abortion laws that prohibit sex-selective necessarily reflect the positions abortions, and one (h) bans sex-selective abortion as part of a separate fetal imaging law. Countries that allow abortion on socioeconomic and policies of the donors. grounds or without restriction as to reason have gestational age limits (generally the first trimester); abortions may be permissible after the specified gestational age, but only on prescribed grounds. A few countries (i) do not specify gestational limits, and regulatory mechanisms vary. Because their abortion laws differ from those of China, Hong Kong (China) and Taiwan are listed as separate entities. SOURCE: Center for Reproductive Rights (CRR), The World’s Abortion Laws 2016, New York: CRR, 2016. burden on poor families, and unintended pregnancy, ■■ A liberal abortion law result in considerable costs programs and policies that does not ensure safety of to already struggling public improve women’s and abortions. Service guidelines health systems. men’s knowledge of, access must be written and to and use of contracep- disseminated, providers ■■ The extent to which tive methods are critical must be trained, and misoprostol, with or without in reducing the need for governments must be mifepristone, is used to abortion. committed to ensuring that induce nonsurgical abortions safe abortions are available in Asian countries is not ■■ To reduce the high levels within the bounds of the law. known. However, evidence of morbidity and mortality indicates that the sales of that result from unsafe both drugs have increased abortion, the provision of in the region in the past postabortion care should be decade. improved and expanded. Recommendations ■■ To reduce the number of ■■ Most women undergoing clandestine procedures, the abortion do so because grounds for legal abortion they became pregnant in the region should be Good reproductive when they did not intend to. broadened, and access health policy starts with Because contraceptive use to safe abortion services credible research is the surest way to prevent should be improved for women who meet legal 125 Maiden Lane criteria. New York, NY 10038, USA 212.248.1111 [email protected] www.guttmacher.org AUGUST 2017.