The Forgotten Tragedy Of Unsafe Abortion

Jun 29, 2023
By Amanda Seller, President MSI United States

In the half a century that Roe v. Wade protected the right to choose in the United States, the risks of unsafe abortion became a distant memory. But in countries that liberalized their abortion laws more recently, the deadly consequences of abortion restrictions are still recent. Their experiences are an important reminder that banning abortion endangers women’s lives.

MSI Reproductive Choices is one of the world’s largest providers of sexual and reproductive healthcare, including safe abortion and care after unsafe abortions. Three providers in Cambodia, Ethiopia, and Nepal shared memories of the impact restrictive laws had on women in their countries.


Abortion Providers From Around the World Share the Dangers of Practicing Under Bans


Over the last 30 years, 59 countries have relaxed abortion restrictions. This includes 18 countries that have overturned complete bans on abortion. In stark contrast, with Roe v. Wade overturned, the U.S. joins the ranks of only three other countries to have restricted access in that time: Poland, El Salvador and Nicaragua.

So, while the news from the U.S. is cause for alarm, it also reminds us of how far we’ve come, and why we cannot turn back the clock in countries that have liberalized abortion. The following stories of abortion providers in Cambodia, Ethiopia and Nepal of life before their countries legalized abortion show the U.S. how restricting abortion rights can endanger women’s lives.


Cambodia – As stigma wanes, abortions rise

December 1, 2020
Rhea Mae Soco / Khmer Times

More Cambodians have openly accepted the idea of safe abortion despite the social stigma women are facing, according to Marie Stopes Cambodia, an organisation that promotes women’s health.

The prevalence of abortion increased significantly among women between the ages of 15-49 from five percent in 2010 to seven percent in 2014, based on the Cambodia Demographic Health Survey.


Cambodia – Nat’l body finds 40% of abortions illegal

Long Kimmarita

Publication date 22 July 2020

The National Maternal and Child Health Centre (NMCHC) said seven per cent of
Cambodian women of reproductive age have had an abortion in the past five
years, and 40 per cent of the procedures were performed by unlicensed

The figures were revealed at a three-day workshop organised by the Reproductive Health Association of Cambodia (RHAC) and funded by the Safe Abortion Action Fund (SAAF) to destigmatise abortions.


This Is How Contraception Saves Women’s Lives In The Asia-Pacific

This Is How Contraception Saves Women's Lives In The Asia-Pacific

"Being able to avoid an unwanted pregnancy could be the difference between life and death.”
Posted on November 21, 2017
Gina Rushton, BuzzFeed News Reporter, Australia

Around 214 million women of reproductive age in developing regions across the world want to access modern methods of contraception but can’t, estimates Marie Stopes International (MSI) Australia, a non-profit social enterprise providing access to reproductive health services in the Asia Pacific region.

Around 43% of pregnancies in developing regions are unintended and 13% of global maternal mortality is due to unsafe abortion.

Continued at source:

Safe Abortion Services in Cambodia and Safe Abortion with Quality of Care in Nepal

Jan 13, 2017, by Safe Abortion

The Asian-Pacific Resource and Research Centre for Women (ARROW) has been working since 1993 to champion women’s sexual and reproductive health and rights (SRHR). They try to achieve this through interlinked strategies of information and communications for change, monitoring and research for evidence-based advocacy, strengthening partnerships for advocacy and organisational development.

Their January 2017 e-newsletter, Issue 1, highlights five short videos on SRHR issues in Cambodia, China, India, Nepal, and Philippines. We highlight two of them here, which are on safe abortion in Cambodia and Nepal, both countries that have legalised early abortions, highlighting the fact that many women are not yet aware of this. You can view the whole newsletter here. You can watch the two videos at the links below:

Safe Abortion Services in Cambodia

The Reproductive Health Association of Cambodia shows that while access to safe abortion services is legal in the country, there is still a need to raise awareness on this to ensure that women have access to sexual and reproductive health and rights.

Safe Abortion with Quality of Care, Nepal

The Beyond Beijing Committee in Nepal’s video shows that while access to safe abortion services is legal in the country, there is still a need to raise awareness on this to ensure that women have access to sexual and reproductive health and rights.

Publication of the video coincides with a report they have just published, entitled Report on status of abortion stigma in Nepal.pdf. Based on the finding of the report we had very good policy dialogue at the central level with the government, non -government and with Ipas-Nepal.

Shanta Laxmi Shrestha, lead researcher on the Beyond Beijing Committee report, is going to speak on “How SDGs can be translated into actions, especially to assure SRHR in Nepal + situation of abortion stigma” on 16 January 2017 in the national consultation on “Achieving universal access to sexual and Reproductive Health and Rights: Leaving no one behind” .

Lastly, she advises that the Guidelines on Free Abortion Service in Public Health Facilities in Nepal in place and  women in need of free services can now request these. (Guideline in Nepali with some text in English)

Source: International Campaign for Women's Right to Safe Abortion

Cambodia’s garment workers vulnerable to unsafe abortions

Workers in a textile factory in Thanaut Tee village, in Cambodia’s Takeo province, in 2014. Photograph: Friedrich Stark/Alamy Stock Photo

Women in the garment industry – away from their homes and support networks – are inhibited from accessing healthcare, including abortion services

Marta Kasztelan in Phnom Penh

Wednesday 13 July 2016 07.00 BST

Sopheak, a young woman employed at one of Cambodia’s many garment factories, is sitting on her bed, crying. She has just learned she is pregnant – and her boyfriend left her the minute he heard the news.

“No boyfriend, no husband, no money, nothing but a baby coming,” she laments as her friends try to console her. She is adamant she’ll go “to one of those secret places, where they can take the baby out”. Looking up at her friends, she adds: “I should have never told you.”

While this scene is from a video series produced by the NGO Care, the drama that unfolds on screen is a reality for many Cambodian garment workers.

The garment industry is the linchpin of Cambodia’s economy, and the single biggest employer of women. Some 500 factories hire almost 500,000 female workers, many of whom are young and have migrated to the city from the countryside.

Away from their homes and support networks, and with low levels of education and income, these women are particularly vulnerable (pdf) and may be inhibited from accessing healthcare information and services, including abortion, according to the UN population fund, UNFPA.

Although Cambodian law allows women to terminate a pregnancy up to 12 weeks, studies suggest that many garment workers are not aware the procedure is legal. As a result, they do not know how to access safe abortion services and predominantly choose expensive and potentially unsafe services from the private sector.

A 2014 survey (pdf) published by Partnering to Save Lives – a collaboration of three NGOs – found more than 90% of women working in garment factories didn’t know abortion was legal. It also found that out of 900 garment workers interviewed for the study, 18% said they had had an abortion. The national average at the time (pdf) was 5%. Almost 75% of women couldn’t indicate where to seek a safe abortion.

Dr Chok Chanda, a manager of 13 years at a small Phnom Penh clinic run by Reproductive Health Association of Cambodia, a non-profit, admits she has treated many patients, including garment workers, who went to “unsafe places”.

“Most patients with post-abortion complications visiting the clinic have incomplete abortions, from incorrectly taking the medical abortion pill or the Chinese pill – a traditional medication,” she says. “They buy the pill at the pharmacy and take it at home but they don’t know how to use it – that they need to take it twice and come for a medical check-up.”

Many women, Chanda says, go to private clinics, some of which are unlicensed or charge high fees, or to pharmacies, because they don’t know where to seek abortion services or because these facilities are closer to where they work.

Women who are unmarried – the notion of pre-marital sex is still frowned upon – Chanda says, choose to travel long distances to terminate their pregnancy to avoid the shame. “They go to unsafe places, and afterwards they come to us with complications,” she says.

In 2008, the World Health Organisation estimated that each year unsafe abortions account for 47,000 deaths globally and leave millions of women temporarily or permanently disabled.

Julia Battle, the sexual reproductive maternal health and rights adviser at Care, acknowledges that “there is a lot of confusion around abortion”. This is one of the reasons why, she says, her organisation trains female garment workers in 16 factories in the capital and in Kandal province to raise awareness about sexual and reproductive rights.

Aside from screening an educational mini-drama series, which can be shared on smartphones and has been well received by workers, according to Battle, the training sessions “move from discussion of sex, modern contraception and emergency contraception to safe abortion”.

There is evidence the training is raising the level of knowledge at the factories – the mid-term review (pdf) this year showed that almost 45% of workers knew at least one place where to obtain safe abortion, compared with 27% two years ago (pdf).

However, with the number of factories in the country, Battle acknowledges that many women are likely to fall through the cracks. “There are hundreds of factories. I do think that those we are not reaching probably are less aware of how to prevent unplanned pregnancy and how and where to access safe abortion,” she says.

Asked what the government was doing to facilitate access to safe abortion, a ministry of health spokesperson referred the Guardian to Professor Tung Rathavy, director of the National Maternal and Child Health Centre, who declined to comment.

Source: The Guardian