Legal abortion worldwide: incidence and recent trends.In recent decades, abortion has received considerable attention, and its legality le·gal·i·ty
n. pl. le·gal·i·ties
1. The state or quality of being legal; lawfulness.
2. Adherence to or observance of the law.
3. A requirement enjoined by law. Often used in the plural. and availability have often generated controversy. Even in countries where abortion is not a contentious issue, contraception contraception: see birth control.
Birth control by prevention of conception or impregnation. The most common method is sterilization. The most effective temporary methods are nearly 99% effective if used consistently and correctly. is usually a less expensive and less taxing means of avoiding unintended births. Accurate information on abortion levels and trends can help donors, policymakers and program planners assess the extent to which women experience unintended pregnancies, and can facilitate the development of policies and programs to respond to unmet un·met
Not satisfied or fulfilled: unmet demands. need for effective contraceptive contraceptive /con·tra·cep·tive/ (-sep´tiv)
1. diminishing the likelihood of or preventing conception.
2. an agent that so acts. services. Accurate measures of abortion can also inform the public discourse by providing impartial Favoring neither; disinterested; treating all alike; unbiased; equitable, fair, and just. , empirical evidence of abortion prevalence.
The last assessment of abortion levels in countries where legal abortion is generally available * was conducted nearly a decade ago. (1) According to according to
1. As stated or indicated by; on the authority of: according to historians.
2. In keeping with: according to instructions.
3. that study, up to the mid- mid-
Middle: midbrain. 1990s, legal abortion rates had been falling in many parts of the world, either as contraceptive prevalence was increasing or as contraceptives were being used more effectively. The investigators speculated that although the legalization LEGALIZATION. The act of making lawful.
2. By legalization, is also understood the act by which a judge or competent officer authenticates a record, or other matter, in order that the same may be lawfully read in evidence. Vide Authentication. of abortion may initially result in an increase in the number of reported abortions in countries where desired fertility fertility: see infertility.
Ability of an individual or couple to reproduce through normal sexual activity. About 80% of healthy, fertile women are able to conceive within one year if they have intercourse regularly without contraception. is low, abortion rates will eventually decline as access to family planning family planning
Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources. education and contraceptive services increases. (2) Updated information on abortion incidence is needed to assess recent trends and current patterns in induced abortion in·duced abortion
Abortion caused intentionally by the administration of drugs or by mechanical means.
induced abortion across countries and regions and in different age-groups, and to document abortion incidence in countries in which legal abortion has recently become available.
In this article, we present statistics on the level of induced abortion in 60 countries and territories in which legal abortion was generally available in 2003. ([dagger]) We assess the completeness of the available abortion data, and wherever statistics of comparable quality are available for 1996 (the most recent year for which similar statistics have been published (1)), we report trends in abortion incidence. In addition, for countries with sufficiently complete data on legal abortion, we provide recent age-specic abortion rates, which can help identify groups of women who are experiencing the greatest difficulties in preventing unintended pregnancy.
We employed methods similar to those used in the last review of the incidence of abortion worldwide. (1) For each country or territory with a population of at least one million in which legal abortion was generally available in 2003, we sought data on the total and age-specific numbers of abortions. Several sources of data were used: published abortion data from national statistical offices or relevant government agencies; for countries that lacked such data, responses to a standardized standardized
pertaining to data that have been submitted to standardization procedures.
standardized morbidity rate
see morbidity rate.
standardized mortality rate
see mortality rate. questionnaire or formal inquiry that we sent to appropriate government agencies, sometimes with the help of local contacts; for a few countries, abortion data from the Council of Europe Council of Europe, international organization founded in 1949 to promote greater unity within Europe and to safeguard its political and cultural heritage by promoting human rights and democracy. The council is headquartered in Strasbourg, France. or the European European
emanating from or pertaining to Europe.
European bat lyssavirus
European beech tree
see cryptococcosis. Region of the World Health Organization; (3,4) and for countries whose official statistics were deemed incomplete or unavailable, abortion estimates from nationally representative population surveys.
Most of the statistics presented here are based on official reports of the numbers of induced abortions performed according to the laws of the countries. However, the available abortion statistics are not always complete. For example, providers do not always report all abortions they perform, even if legally required to do so. In some countries, only abortions performed at public facilities are reported, whereas large proportions of abortions are performed at private facilities. In addition, medication abortions or early surgical procedures Surgical procedures have long and possibly daunting names. The meaning of many surgical procedure names can often be understood if the name is broken into parts. For example in splenectomy, "ectomy" is a suffix meaning the removal of a part of the body. "Splene-" means spleen. may be underreported in some countries.
We asked local experts to assess the extent to which the reported statistics represented all legal abortions that had been performed. These experts included researchers, officials from government agencies involved in abortion data collection, and program administrators and providers who were familiar with abortion reporting practices. We also ensured that published statistics did not include spontaneous abortions spon·ta·ne·ous abortion
A naturally occurring termination of a pregnancy. Also called miscarriage.
spontaneous abortion , and confirmed that they included menstrual menstrual /men·stru·al/ (men´stroo-al) pertaining to the menses or to menstruation.
men·stru·al or men·stru·ous
Of or relating to menstruation. regulations (or "mini-abortions") where these are recorded separately. Furthermore, we drew upon any available studies that assessed the quality of a country's abortion data. All of this information was used to classify clas·si·fy
tr.v. clas·si·fied, clas·si·fy·ing, clas·si·fies
1. To arrange or organize according to class or category.
2. To designate (a document, for example) as confidential, secret, or top secret. countries according to whether their abortion data are complete (defined as including at least 80% of all legal abortions) or incomplete, or whether the completeness of the available data is in doubt.
We obtained data for 60 of the 66 countries eligible for inclusion in this study. ** For 33 of these countries, published or local sources indicated that the statistics included at least 80% of the actual number of legal abortions performed in that year. For 16 countries, local experts determined that the statistics were incomplete; for 11, we were unable to obtain a reliable assessment about the completeness of reporting. Survey-based estimates, while at times superior to government reporting systems, were always assumed to be incomplete because some women do not report their abortions, particularly in face-to-face (jargon, chat) face-to-face - (F2F, IRL) Used to describe personal interaction in real life as opposed to via some digital or electronic communications medium. interviews, (5,6) and surveys are subject to sampling error and random variation.
For all but four of the 33 countries considered to have complete counts, the data were government statistics. For Puerto Rico Puerto Rico (pwār`tō rē`kō), island (2005 est. pop. 3,917,000), 3,508 sq mi (9,086 sq km), West Indies, c.1,000 mi (1,610 km) SE of Miami, Fla. (7) and the United States United States, officially United States of America, republic (2005 est. pop. 295,734,000), 3,539,227 sq mi (9,166,598 sq km), North America. The United States is the world's third largest country in population and the fourth largest country in area. , (8) data collected through surveys of all providers were used; the U.S. estimate for 2000 was projected to 2003. (9) For Australia Australia (ôstrāl`yə), smallest continent, between the Indian and Pacific oceans. With the island state of Tasmania to the south, the continent makes up the Commonwealth of Australia, a federal parliamentary state (2005 est. pop. , we used a published estimate based on insurance claims and hospital statistics. (10) For Switzerland Switzerland (swĭt`sərlənd), Fr. Suisse, Ger. Schweiz, Ital. Svizzera, officially Swiss Confederation, federal republic (2005 est. pop. 7,489,000), 15,941 sq mi (41,287 sq km), central Europe. , we used data compiled by a private organization using reports from local government offices. (11)
Government statistics were available for 24 of the 27 countries with estimates that are incomplete or of unknown completeness. For South Korea Korea (kôrē`ə, kə–), Korean Hanguk or Choson, region and historic country (85,049 sq mi/220,277 sq km), E Asia. , Turkey and Turkmenistan Turkmenistan (trkmyĕ'nyĭstän`), republic (2005 est. pop. 4,952,000), 188,455 sq mi (488,100 sq km), central Asia. , only survey-based estimates were available. The survey in South Korea was administered to married women only, and the survey in Turkey was administered to ever-married women only. In 11 countries where both official statistics and nationally representative survey data were available, both sets of findings are shown. In all but one of these countries, survey estimates were based on women's reports of their induced abortions obtained in the one-, three- or five-year period prior to the survey. The abortion estimate for India India, officially Republic of India, republic (2005 est pop. 1,080,264,000), 1,261,810 sq mi (3,268,090 sq km), S Asia. The second most populous country in the world, it is also sometimes called Bharat, its ancient name. India's land frontier (c. is derived from a facility-based survey. In eight countries with incomplete reporting or reporting of uncertain completeness (China, Georgia Georgia, country, Asia
Georgia (jôr`jə), Georgian Sakartvelo, Rus. Gruziya, officially Republic of Georgia, republic (2005 est. pop. 4,677,000), c.26,900 sq mi (69,700 sq km), in W Transcaucasia. , Hong Kong Hong Kong (hŏng kŏng), Mandarin Xianggang, special administrative region of China, formerly a British crown colony (2005 est. pop. 6,899,000), land area 422 sq mi (1,092 sq km), adjacent to Guangdong prov. , India, Japan, Romania Romania (rōmān`ēə, –yə) or Rumania (r–), republic (v), 91,699 sq mi (237,500 sq km), SE Europe. , Turkey and Vietnam Vietnam (vēĕt`näm), officially Socialist Republic of Vietnam, republic (v), 128,400 sq mi (332,642 sq km), Southeast Asia. Occupying the eastern coastline of the Southeast Asian peninsula, Vietnam is bounded by China on the north, by Laos ), abortion estimates from the same data source are available for 1996, and these are presented as well.
We also obtained estimates of the population of women aged 15-44 in five-year age-groups and numbers of live births to calculate abortion rates and ratios for 2003. When available, we used data from country statistical offices. For countries where population estimates were not available, we used estimates published by the Council of Europe or the United Nations. We interpolated interpolated /in·ter·po·lat·ed/ (in-ter´po-la?ted) inserted between other elements or parts. where necessary to obtain midyear mid·year
1. The middle of the calendar or academic year.
a. An examination given in the middle of a school year.
b. midyears A series of such examinations. population estimates.
We calculated age-specific abortion rates (the number of abortions per 1,000 women in each five-year age-group), the general abortion rate (the number of abortions annually per 1,000 women aged 15-44), the total abortion rate (the number of abortions a woman would be expected to have over a lifetime at current age-specific rates age-specific rate
a rate which specifies the age parameter for the rate. ) and the abortion ratio abortion ratio Obstetrics The number of spontaneous and induced abortions/100 live births/yr. See Abortion. (the number of abortions per 100 live births) for each country. When age-specific abortion data were not available, the total abortion rate was estimated from the general abortion rate. ([dagger]) Some fertility surveys report only the total abortion rate; in these cases, we estimated the general abortion rate and number of abortions from the total abortion rate. Where complete and comparable abortion statistics were available for two time periods, we present the average annual change in the general abortion rate during the interval between the two estimates.
To calculate abortion rates for women aged 19 or younger, we used information on abortions among these women and the population aged 15-19. Similarly, for abortion rates among women aged 40 or older, we employed information on abortions obtained by these women and the population aged 40-44.
Countries with Complete Statistics
* Overall levels and trends. Of the 33 countries with relatively complete counts, *** the numbers of legal abortions were greatest in the Russian Federation Russian Federation: see Russia. and the United States--more than one million each in 2003 (Table 1). At the other extreme, eight countries reported fewer than 15,000 abortions in 2003. The number of legal abortions per 1,000 women of reproductive re·pro·duc·tive
1. Of or relating to reproduction.
2. Tending to reproduce.
subserving or pertaining to reproduction. age was highest in Cuba (57) and the Russian Federation (45). The legal abortion rate was lowest in Nepal (five) and South Africa South Africa, Afrikaans Suid-Afrika, officially Republic of South Africa, republic (2005 est. pop. 44,344,000), 471,442 sq mi (1,221,037 sq km), S Africa. (six), both countries where abortion was recently legalized and unreported, illegal abortions are still common. Other than rates in these two countries, abortion rates were lowest in Belgium, Germany, Switzerland and Tunisia (7-8), where reported rates more accurately reflect the level of abortion because illegal abortions are rare.
Cuba and the Russian Federation, which had the highest official abortion rates, also had the highest number of abortions per 100 live births: Their abortion ratios of 109 and 104, respectively, reveal that more abortions than births occur annually. Aside from Nepal and South Africa, Tunisia had the lowest abortion ratio (nine).
In four countries with relatively complete data--Belarus, Cuba, Estonia and the Russian Russian
associated in some way with Russia.
a breed of cats with short, dense, silver-tipped blue-colored coat and vivid green eyes. Federation--the total abortion rate was greater than 1.0, indicating that at current rates, the average woman would have more than one abortion in her lifetime. In the countries with the lowest total abortion rates, 0.2 abortions occur per woman over a lifetime, or one abortion for every five women.
Since 1996, abortion rates declined by at least 2% per year in 12 of the 28 countries with complete abortion complete abortion Obstetrics An abortion or miscarriage in which all tissues have been expulsed; an abortion may be completed by curettage to eliminate necrotic decidual tissue in the uterus, which might act as a nidus for infection. Cf Abortion. counts and trend data, and rates increased by this much in two countries. Abortion rates were relatively stable in the remaining countries.
* Eastern Europe Eastern Europe
The countries of eastern Europe, especially those that were allied with the USSR in the Warsaw Pact, which was established in 1955 and dissolved in 1991. . Many of the most dramatic declines in abortion incidence between 1996 and 2003 occurred in Eastern Europe, which includes several countries of the former Soviet Union. These countries had some of the highest abortion rates in 1996, and despite significant declines, they continued to have the highest rates in 2003. The average annual decreases in the abortion rate ranged from 4% in Hungary to 12% in Bulgaria, which represent net declines of 26% and 58%, respectively. ([dagger]) The declines in this region represent a continuation of a trend that began in the early 1990s. (12) Although in-country informants estimated that the official statistics are complete, an increasing number of abortions are paid for privately, and these procedures are often not reported. (13,14) The magnitude of the downward trend may therefore be exaggerated by measures based on official statistics in some of these countries. In most countries in this region, the declines coincided with increases in access to and use of modern methods of contraception in place of traditional methods (which have played a prominent role in family planning in these countries) and nonuse. (14-16)
* Northern, Western and Southern Europe Southern Europe or sometimes Mediterranean Europe is a region of the European continent. There is no clear definition of the term which can vary depending on whether geographic, cultural, linguistic or historical factors are taken into account. . The 2003 abortion rates in the Northern European countries of Denmark, England and Wales England and Wales are both constituent countries of the United Kingdom, that together share a single legal system: English law. Legislatively, England and Wales are treated as a single unit (see State (law)) for the conflict of laws. , Finland, Norway, Scotland and Sweden changed little compared with rates in 1996, and ranged from 11 to 20 per 1,000 women. The rates were also low in Western Europe Western Europe
The countries of western Europe, especially those that are allied with the United States and Canada in the North Atlantic Treaty Organization (established 1949 and usually known as NATO). , where they ranged from seven (in Switzerland) to 17 (in France).
The abortion rate increased in the Netherlands by 31% over seven years, partly because of a growing demand for terminations from women in ethnic minority groups residing in the country. (17,18) Abortion rates otherwise changed minimally in Western Europe between 1996 and 2003. Medication abortion (using mifepristone Mifepristone Definition
Mifepristone is a pill that can be taken as an alternative to a surgical abortion.
This medication most often is used for ending early pregnancies. ) was introduced in a number of European countries before or during this period. It was approved in France in 1988, in Great Britain Great Britain, officially United Kingdom of Great Britain and Northern Ireland, constitutional monarchy (2005 est. pop. 60,441,000), 94,226 sq mi (244,044 sq km), on the British Isles, off W Europe. The country is often referred to simply as Britain. and Sweden in 1992, and in Belgium in 1999; mifepristone was registered and approved in Denmark, Finland, the Netherlands and Germany in 1999 in accordance Accordance is Bible Study Software for Macintosh developed by OakTree Software, Inc.
As well as a standalone program, it is the base software packaged by Zondervan in their Bible Study suites for Macintosh. with the European Union's principle of mutual recognition. Regulatory mechanisms and insurance reimbursement Reimbursement
Payment made to someone for out-of-pocket expenses has incurred. policies for medication abortion have affected the availability of this procedure to varying degrees in all of these countries. (19) The steady abortion rates in these countries (except the Netherlands) suggest that medication abortion is substituting for surgical abortion at the national level, and that its availability has not resulted in increased incidence of abortion.
Italy's abortion rate of 11 per 1,000 women was apparently unchanged since 1996 (not shown), but the more recent statistical report indicated that the 1996 count was less complete than the 2003 count. (20) A separate report indicated that abortions decreased among Italian-born women and increased among immigrants in the late 1990s. (21)
* Oceania and North America North America, third largest continent (1990 est. pop. 365,000,000), c.9,400,000 sq mi (24,346,000 sq km), the northern of the two continents of the Western Hemisphere. . The abortion rate decreased slightly in Australia, to 20 per 1,000 women in 2003. However, it increased by nearly 3% per year (21% over seven years) in New Zealand New Zealand (zē`lənd), island country (2005 est. pop. 4,035,000), 104,454 sq mi (270,534 sq km), in the S Pacific Ocean, over 1,000 mi (1,600 km) SE of Australia. The capital is Wellington; the largest city and leading port is Auckland. , where the rate declined slightly among women of European descent descent, in anthropology, method of classifying individuals in terms of their various kinship connections. Matrilineal and patrilineal descent refer to the mother's or father's sib (or other group), respectively. and increased substantially among women of Asian ethnicity ethnicity Vox populi Racial status–ie, African American, Asian, Caucasian, Hispanic . (22)
The abortion rate in the United States declined by 8% between 1996 and 2003 to 21 per 1,000 women, but remained higher, and in some cases substantially higher, than the rates in many Northern and Western European countries. However, within the United States, abortion levels differed widely by racial or ethnic group. In 2000, the abortion rate was 12 among white women, 31 among Hispanic Hispanic Multiculture A person of Mexican, Puerto Rican, Cuban, Central or South American, or other Spanish culture or origin, regardless of race Social medicine Any of 17 major Latino subcultures, concentrated in California, Texas, Chicago, Miam, NY, and elsewhere women and 57 among black women. (12)
* Developing countries. Legal abortion is generally available in relatively few developing countries or territories, and abortion rates vary widely across them. Cuba had one of the highest rates among countries with complete counts in 2003, though its rate has fallen in the past decade (from 78 to 57 per 1,000 women). It has been reported that the family planning program in Cuba has sought to expand the range of methods available beyond the IUD IUD Definition
An IUD is an intrauterine device made of plastic and/or copper that is inserted into the womb (uterus) by way of the vaginal canal. One type releases a hormone (progesterone), and is replaced each year. , which has long been the predominant pre·dom·i·nant
1. Having greatest ascendancy, importance, influence, authority, or force. See Synonyms at dominant.
2. method, and to improve the quality of family planning services. (23)
In contrast, the abortion rate in Puerto Rico was 18 in 2001, having declined from 23 in 1991. (7) Surveys of women indicate that the use of modern contraceptives in this territory was widespread and continued to increase over this period. (24,25) The rate was also low in Tunisia, where government investment in family planning has been long-standing. (26)
The legal abortion rate in South Africa was very low (six per 1,000 women), but many abortions are performed outside the legal sector, despite liberalization lib·er·al·ize
v. lib·er·al·ized, lib·er·al·iz·ing, lib·er·al·iz·es
To make liberal or more liberal: "Our standards of private conduct have been greatly liberalized . . . of the abortion law Abortion law is legislation which pertains to the provision of abortion. Abortion has at times emerged as a controversial subject in various societies because of the moral and ethical issues that surround it, though other considerations, such as a state's pro- or antinatalist in 1997. (27) The estimated rate of unsafe (primarily illegal) abortions for the Southern Africa
Legal abortion became available in Nepal in March 2004, and the count in Table 1 represents legal procedures in 2005-2006. Access to legal abortion has so far been constrained con·strain
tr.v. con·strained, con·strain·ing, con·strains
1. To compel by physical, moral, or circumstantial force; oblige: felt constrained to object. See Synonyms at force.
2. by the cost of services, uneven access to approved health facilities and lack of awareness about the law. As in South Africa, this count probably represents a small portion of the total number of abortions that are occurring, and the reported abortion rate will likely increase as more abortions are performed in the legal sector.
Countries with Incomplete Statistics
In the 27 countries for which reporting is incomplete or the level of completeness is unknown, **** the true incidence of abortion is likely higher than the reported incidence. Very low reported abortion rates are often not meaningful, since they may represent severe underestimations.
* Eastern Europe and Central and Western Asia. Survey-based estimates as well as government statistics are available for Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Romania, Ukraine and Uzbekistan (Table 2). The contrast between the abortion counts from the two sources in all countries but Romania indicates that abortions are highly underreported in the official statistics. For example, in Azerbaijan, six abortions per 1,000 women aged 15-44 were reported in official statistics for 2003, but the 2001 fertility survey estimated an annual rate of 116. ***** Official statistics are likely to also seriously undercount un·der·count
tr.v. un·der·count·ed, un·der·count·ing, un·der·counts
To record fewer than the actual number of (persons in a census, for example). abortions in some countries with incomplete reporting but without survey data.
Abortion rates estimated from surveys of women in Armenia, Azerbaijan and Georgia (81, 116 and 103, respectively) were the highest rates recently reported for any country with complete or incomplete data. Women in these countries will have an average of three abortions each if current levels prevail throughout their reproductive lives. These persistently high rates are explained by small desired family size, early completion of childbearing child·bear·ing
Pregnancy and parturition.
childbearing adj. and continued reliance on traditional methods of family planning, which have high failure rates. (30) Use of modern contraceptives is low in these countries relative to use in other countries of the former Soviet Union. (16)
Abortion estimates are available for earlier years for Georgia, Romania and Turkey. According to reproductive health Within the framework of WHO's definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene surveys in Romania, the abortion rate decreased by more than 60% from 1999 to 2004, while the total fertility rate The total fertility rate (TFR, sometimes also called the fertility rate, period total fertility rate (PTFR) or total period fertility rate (TPFR)) of a population is the average number of children that would be born to a woman over her lifetime if she remained stable at about 1.3 births per woman. (31) Although the downturn Downturn
The transition point between a rising, expanding economy to a falling, contracting one.
A decline in security prices or economic activity following a period of rising or stable prices or activity. in abortion in these countries is generally associated with increased contraceptive use, the rise in modern contraceptive use from 48% to 58% among Romanian women aged 15-44 is unlikely to fully account for a decline of this magnitude. (31) An increase in the effectiveness of contraceptive use may partly explain the large decline in abortions, but data are not available to assess this hypothesis. Changes in the administration of the survey might have caused a decline in the completeness of abortion reporting over time. Furthermore, the reporting of abortion experiences in face-to-face interviews might have decreased if opinion regarding abortion has become more conservative.
Similarly, recent surveys indicated a modest increase in the use of modern contraceptives in Turkey between 1998 and 2003, from 38% to 43% among ever-married women aged 15-44, but this does not seem to account for the 31% decrease in abortions among these women, particularly since the total fertility rate also decreased over this period, from 2.6 to 2.2. (32) Informants have suggested that the effectiveness of method use, including the use of traditional methods, has increased over time. It is also possible that reporting has become less complete.
* Southern and Northern Europe. In Southern Europe, the official abortion rate was moderate in Macedonia (25 per 1,000 women) and low in Serbia and Montenegro Serbia and Montenegro (sûr`bēə, mŏn'tənē`grō), Serbian Srbija i Crna Gora, former country of SE Europe, in the Balkan Peninsula, a short-lived union (2003–6) of the republics of Serbia and the much (15) and Albania (nine). Local experts indicate that the true abortion level is much higher in Albania, and a 2002 survey showed that the use of traditional contraceptives prevails over modern method use. (33) The low abortion rate in Croatia (seven) has been attributed to the influence of conservative forces, state efforts to restrict access to abortion and high fees for the procedure, in addition to incomplete reporting. (34)
Estimates of abortion rates for Ireland (seven) and Northern Ireland Northern Ireland: see Ireland, Northern.
Part of the United Kingdom of Great Britain and Northern Ireland occupying the northeastern portion of the island of Ireland. Area: 5,461 sq mi (14,144 sq km). Population (2001): 1,685,267. (four) were limited to data on women who obtained abortions in England and Wales and gave addresses in Ireland or Northern Ireland. They excluded Irish women who gave non-Irish addresses, those who had abortions in other countries and the probably small number of women who had legal abortions in Northern Ireland.
* South Asia This article is about the geopolitical region in Asia. For geophysical treatments, see Indian subcontinent.
South Asia, also known as Southern Asia . According to Ministry of Health statistics, the legal abortion rate remained unchanged in India between 1996 and 2001 (three per 1,000), even though the absolute number of abortions increased dramatically during that time. Abortion is legal under broad grounds in India, but regulations require that abortions be performed by registered physicians in certified See certification. facilities, and official statistics include only procedures that meet these regulations. Because of the difficulties in meeting all official requirements, a large number of safe abortions by qualified physicians are not reported. (35) It is also likely that some physicians who are certified to perform legal abortions do not report or underreport un·der·re·port
tr.v. un·der·re·port·ed, un·der·re·port·ing, un·der·re·ports
To report (income or crime statistics, for example) as being less than actually is the case. the number of procedures they perform. According to estimates using findings from a facility-based survey conducted in six states, (35) about 2.4 million safe abortions are performed annually in India by formally trained providers in approved facilities, and the safe abortion rate is 10 per 1,000 women. However, the survey also estimated that nearly two-thirds of abortions are not performed at approved facilities, indicating that the overall abortion rate is about three times the safe abortion rate.
The abortion rate for Bangladesh was based on official statistics and included only menstrual regulation procedures, which are legally permitted. Surgical abortions past 10 weeks' gestation GESTATION, med. jur. The time during which a female, who has conceived, carries the embryo or foetus in her uterus. By the common consent of mankind, the term of gestation is considered to be ten lunar months, or forty weeks, equal to nine calendar months and a week. are prohibited pro·hib·it
tr.v. pro·hib·it·ed, pro·hib·it·ing, pro·hib·its
1. To forbid by authority: Smoking is prohibited in most theaters. See Synonyms at forbid.
2. under most conditions and are not registered. Menstrual regulation procedures are estimated to account for more than half of all abortions in Bangladesh, (36) but most go unreported. (37) Hence the official abortion rate of four per 1,000 women likely is an underestimate; the actual rate, including safe and unsafe abortions Unsafe abortion is a significant cause of maternal mortality and morbidity in the world, especially in developing countries (95% of unsafe abortions take place in developing countries). , was estimated to fall between 26 and 30 in 1995. (36)
* East and Southeast Asia Southeast Asia, region of Asia (1990 est. pop. 442,500,000), c.1,740,000 sq mi (4,506,600 sq km), bounded roughly by the Indian subcontinent on the west, China on the north, and the Pacific Ocean on the east. . Abortion counts for China were obtained from the Ministry of Health. (In the past, abortion data were also collected by the Family Planning Commission; however, experts indicate that reliable estimates are no longer available from this source.) Medication abortions, which are estimated to account for up to a third of induced abortions in China, are missing from the abortion statistics for at least some provinces, and they may be missing from the national count altogether. Informants also indicated that some private clinics that do not have government permission to perform abortions do not report the abortions they perform, and some providers or districts might over-report abortions to meet quotas or obtain government compensation. The year-to-year fluctuations in the number of abortions reported (not shown) suggest that there is some error in the data.
Abortion incidence appears to have decreased in China, which accounted for more than a third of legal abortions worldwide in 1996. (1) According to Ministry of Health reports, the rate declined by 21%, from 29 to 23 per 1,000 women, between 1996 and 2003, though the fertility rate Noun 1. fertility rate - the ratio of live births in an area to the population of that area; expressed per 1000 population per year
birth rate, birthrate, fertility, natality also declined slightly during this interval. (38) Contraceptive prevalence was already high at the start of this period, yet contraceptive failure rates were also high, (39) and 70% of abortions in China were attributed to contraceptive failure. (40) The failure rate associated with the IUD--the most prevalent method in China--decreased significantly in the 1990s, when the copper IUD was introduced and began to replace less effective devices. (40) Therefore, the abortion and fertility rates might have declined simultaneously. The decline in abortion incidence has also been linked to the Family Planning Commission's increased emphasis on quality of care in family planning services, including the expansion of contraceptive options, in the past decade. (41) In addition, some research has indicated that greater use-effectiveness, stemming from the growing desire for small families and stronger motivation among couples to prevent births, could explain some of the decline in the abortion rate. (42)
According to official reports, more than half a million abortions were performed in Vietnam in 2003, and the abortion rate was 26 per 1,000 women. Official statistics show a 69% decline in the rate over seven years, from 83 in 1996. However, the total fertility rate declined from 2.7 to 1.9 births per woman, and contraceptive prevalence did not change substantially in that time. (43) The total abortion rate among ever-married women did not decrease according to the Demographic and Health Surveys of 1997 and 2002, although abortions were seriously underreported in those surveys. (44) In Vietnam, the "semiprivate sem·i·pri·vate
Shared with usually one to three other hospital patients: a semiprivate room.
Adj. 1. " sector, in which abortions are performed in public hospitals but not recorded, and the private sector, in which abortions are performed in private facilities, have grown in recent years. (45,46) Abortions performed in these sectors are said to offer greater anonymity, better options for pain control and shorter waiting times. (45) Because information for these sectors is unavailable, it is difficult to assess abortion levels or trends in Vietnam.
In South Korea, the survey-based abortion rate of 26 per 1,000 women is for married women only, and the estimated number of abortions assumes that this rate applies to unmarried women as well. Official statistics in Japan suggest an abortion rate of 13; however, some researchers have indicated that the actual rate is likely higher than reported. (47) Higher rates are possible, given that an estimated 60% of married couples use modern contraceptives, and 80% of these couples rely on condoms, which generally have a high use-failure rate. (48,49) Trend data suggest, however, that the overall abortion level has been fairly stable since the early 1990s, following a long period of decline.
Age-Specific Abortion Rates
Age-specific abortion rates were calculated for 21 countries; for 18 of these, comparable rates could be estimated for 1996 and 2003 (Table 3).
In many countries, a general pattern emerged, in which the abortion rate was low for women younger than 20, peaked among those aged 20-24 and declined with each successive age-group. In Eastern Europe, abortion rates remained high for women aged 25-34 and descended more gradually with successive age-groups than rates in Western Europe and other developed countries. Survey findings for the Western and Central Asian countries Noun 1. Asian country - any one of the nations occupying the Asian continent
country, land, state - the territory occupied by a nation; "he returned to the land of his birth"; "he visited several European countries" , where abortion rates were among the highest in the world, show that rates tended to peak among women aged 25-34 (not shown). (14) The age-specific abortion pattern in these regions reflects that many women have abortions to limit family size rather than to delay the start of childbearing. (30)
The abortion rate among 20-24-year-olds was higher in the United States than in other developed countries; however, U.S. rates among women aged 30 or older were lower than those in many developed countries. By 2003, the teenage abortion rate in the United States (22 per 1,000 women) was comparable to that in England and Wales (23) and Sweden (25). This situation marks a change from the mid-1990s, when this rate was substantially higher in the United States (29) than in these countries (22 and 18, respectively); the change is due in part to a decline in the adolescent ad·o·les·cent
Of, relating to, or undergoing adolescence.
A young person who has undergone puberty but who has not reached full maturity; a teenager. abortion rate in the United States between 1996 and 2003. Over the same period, however, the adolescent abortion rate rose in Sweden--a trend that Swedish researchers attribute partly to cuts in funding for sex education and increases in the incidence of casual sex without contraceptive use. (50) Nevertheless, the English-speaking developed countries have higher adolescent abortion rates than many other developed countries with the exception of the former Soviet states. This difference is ascribed to the more pragmatic approach to adolescent sexuality in other developed countries, including easier access to contraceptive services for adolescents. (51-53)
Trends in the abortion rate differed for various age-groups in some regions and countries. In the Netherlands, Finland and Sweden, rates increased by 33-65% among women aged 19 or younger; the rate also increased by about 50% among 20-24-year-olds in the Netherlands. In Eastern Europe, where abortions were especially prevalent among women aged 20-34, rates decreased dramatically throughout this age span. In North America, the teenage abortion rate declined by 23% in both the United States and Canada between 1996 and 2003.
The prevalence of legal abortion varies widely across the countries in which it is generally available. Where the abortion rate is high, it likely reflects that levels of contraceptive use are not sufficient to meet the fertility desires and family planning needs of women and couples.
Many abortion rates in Eastern Europe and Western and Central Asia remain among the highest in the world. In Armenia, Azerbaijan, Georgia and the Russian Federation, more abortions than births still occur each year; this may also be the case in other countries of these regions with incomplete reporting. Abortion levels in Northern Europe and parts of Western Europe are among the lowest in countries with legal abortions. Abortion rates in the United States, while moderately low, are higher than rates in many developed countries outside of the former Soviet region, particularly among women younger than 30.
Since 1996, more countries have experienced a decline in abortion rates than an increase, among those with complete abortion counts and trend data. The downward trend in reported legal abortions is most marked in Eastern Europe, and the incomplete statistics suggest that this trend was also strong in Central and Western Asia. The actual decrease in abortion rates is probably smaller than suggested by the data, because in these regions, abortions are increasingly being paid for privately (in either public or private facilities), and such procedures are less likely than others to be reported to be spoken of; to be mentioned, whether favorably or unfavorably.
See also: Report . These countries, along with Cuba, have a legacy of an "abortion culture" that characterized char·ac·ter·ize
tr.v. character·ized, character·iz·ing, character·iz·es
1. To describe the qualities or peculiarities of: characterized the warden as ruthless.
2. the Soviet era, when abortion was freely available but contraceptive options were limited and supplies not always available. (54) In recent years, contraceptives have become more accessible and use has increased, though supplies and the range of methods available are often limited and the cost is sometimes high. Changes in contraceptive use have been slowest in Western Asian countries, where use of modern methods is lower than it is in most of the other former Soviet areas.
Abortion incidence is also reportedly declining in China. Possible causes of such a decline include more effective contraceptive use and improvements in the quality of family planning services. However, if medication abortions and abortions procured in the private sector are underreported, and if increasing proportions of abortions fall in either or both of these categories, the actual decline could be smaller than the statistics suggest.
In Vietnam, reported abortion incidence was very high in the mid-1990s (83 abortions per 1,000 women), even though reporting was incomplete. The sharp decline in officially reported abortions since 1996 conflicts with the small increase in incidence suggested by nationally representative surveys in the same interval. The surveys, however, appear to greatly underestimate abortion levels. As a result, no conclusions can be drawn regarding current abortion incidence or recent trends.
The abortion rate increased, albeit modestly, in the Netherlands and New Zealand. Demand for abortion increased among residents of non-European descent in the Netherlands, which may reflect lower levels of contraceptive use among immigrant women. (17) Similarly, the increase in abortions in New Zealand may be attributable to trends among women of Asian descent. (22) Abortion rates have remained relatively stable in Northern and Western Europe. In most of these countries, abortion is available without restriction, and contraceptives are widely available at low cost and are considered acceptable to use. In North America, the abortion rate remained steady in Canada and declined by a little more than 1% annually in the United States.
Studies have demonstrated that abortion levels are strongly linked to contraceptive use patterns. (15,16) The past few decades have been a significant period in the history of family planning, marked by improved contraceptive technology and growing and widespread acceptance of contraception throughout many regions of the world. It appears that where couples desire to limit their fertility and services are available, contraceptive use is eventually widely accepted. This phenomenon has been borne out in the former Soviet bloc during the past 15 years. In the United States, improvements in use have been shown to account for most of the decline in adolescent pregnancy adolescent pregnancy See Teenage pregnancy. rates in recent years. (55)
Where contraceptive use is widespread, unintended pregnancy and abortion rates will likely continue to decrease if the quality of contraceptive services improves and the effectiveness of use increases. This seems to be the case in China, where declines in abortion incidence coincided with increased use of a more effective IUD, and with other improvements in the quality of contraceptive services. Improvements in contraceptive technology could result in further reductions in abortion rates, even in countries where the most effective methods currently available are already widely used.
In societies or demographic subgroups in which contraceptives are not widely available or their use has not yet become a culturally accepted practice, but many women wish to avoid childbearing, abortions are likely to occur at higher-than-average levels. In traditional societies where the age at marriage is increasing and sex before marriage is becoming more common, rates of unintended pregnancy and abortion could increase among young, unmarried women. Barriers to contraceptive use among unmarried women, including discomfort Discomfort may refer to pain, an unpleasant sensation, or to suffering, an unpleasant feeling or emotion. associated with seeking contraceptives, can exacerbate these circumstances CIRCUMSTANCES, evidence. The particulars which accompany a fact.
2. The facts proved are either possible or impossible, ordinary and probable, or extraordinary and improbable, recent or ancient; they may have happened near us, or afar off; they are public or . The European experience, however, demonstrates that societal so·ci·e·tal
Of or relating to the structure, organization, or functioning of society.
Adj. acceptance of adolescent sexual relationships, combined with comprehensive information about contraceptives, can result in low pregnancy rates among young adults. (53)
In developed countries where contraception is accepted socially and family planning services are generally available, the abortion rate ranges from about seven to 20 per 1,000 women. In some subpopulations, the rate has been as low as 3-4 per 1,000, as among the Dutchborn population of the Netherlands in the recent past. (56) Evidence suggests, however, that unwanted pregnancies unwanted pregnancy Obstetrics A pregnancy that is not desired by one or both biologic parents. See Teen pregnancy. and induced abortions occur to some degree in every society, for a number of reasons--contraceptive methods fail on occasion, couples do not always use their methods correctly or consistently, some women have partners who oppose contraceptive use, some become pregnant as a result of coerced sex and some seek abortion for health reasons or because of changes in their circumstances.
Unwanted pregnancies cannot be entirely avoided, but their incidence can be reduced through various means, such as improvements in the social acceptability of and access to contraception, the development of new contraceptive technologies, education and counseling to reduce partner violence and increase self-efficacy self-efficacy (selfˈ-eˑ·fi·k in contraceptive choice for women, and service improvements that facilitate continuous and effective contraceptive use.
Research on the association between abortion trends and trends in unmet need for contraception, availability of family planning services, desired family size and fertility rates can provide further evidence of how these factors may influence abortion levels at the regional and national levels, as well as among subgroups in each country.
The authors thank Evert e·vert
To turn inside out or outward.
to turn inside out; to turn outward. Ketting for his role in obtaining data, providing technical assistance with assessments of data quality and reviewing drafts of this article; and Erin Carbone for her assistance with data collection and management. Funding for this research was provided by the World Health Organization and the World Bank.
Ed. note: This article was first published in International Family Planning Perspectives, 2007, 33(3):100-116.
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monstrous sea creature; devours human beings. [Ital. Lit.: Orlando Furioso]
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pertaining to or emanating from analysis.
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* Countries are included in this category if abortion is allowed for social or economic reasons or without specification as to reason. A few countries with more restrictive formal laws are included because sources indicate that legal abortion is broadly available: Australia, Hong Kong, Israel, New Zealand and Spain, where abortion is permitted to protect the woman's mental health, and South Korea, where it is permitted to protect her physical health.
([dagger]) Dependent territories with separate abortion statistics or legislation are treated as countries.
** Official estimates for Austria and Greece represent a negligible This article or section is written like a personal reflection or and may require .
Please [ improve this article] by rewriting this article or section in an . proportion of all abortions and are not included. We were unable to obtain abortion statistics for Bosnia and Herzegovina Bosnia and Herzegovina (bŏz`nēə, hĕrtsəgōvē`nə), Serbo-Croatian Bosna i Hercegovina, country (2005 est. pop. 4,025,000), 19,741 sq mi (51,129 sq km), on the Balkan peninsula, S Europe. , North Korea, Taiwan or Zambia.
([dagger]) To estimate the total abortion rate, we divided the general abortion rate for women aged 15-44 by 1,000, and multiplied mul·ti·ply 1
v. mul·ti·plied, mul·ti·ply·ing, mul·ti·plies
1. To increase the amount, number, or degree of.
2. Mathematics To perform multiplication on. the result by 30 (the number of years in this range).
*** Since 1996, five countries have been reclassified as having complete statistics: Lithuania and Russia, because of new information about the accuracy of the data; France, because of a new, more complete data source; and Italy and South Africa, because of improvements in data collection. Additionally, Nepal is now included because abortion was legalized in 2003.
([dagger]) Net changes were calculated using unrounded abortion rates and so may differ from calculations based on the rounded rates listed in tables.
**** Zambia was included in the prior round of estimates but was excluded here because of a lack of recent information; Northern Ireland has been added. Abortion reporting in Kazakhstan was considered complete in 1996, but is now classified as incomplete because a nationally representative survey revealed that abortion levels exceed the official count. The former Yugoslavia is now Serbia and Montenegro.
***** This is an annual rate, based on abortions reported in the three years preceding the survey.
Gilda Sedgh is senior research associate, Stanley Stanley, town (1991 pop. 1,557), capital of the Falkland Islands, S Atlantic Ocean, on East Falkland island. It is the main port and trading center of the islands. The name is sometimes written as Port Stanley. K. Henshaw is senior fellow, Susheela Singh is vice president of research, Akinrinola Bankole is director of international research and at the time of writing Joanna Joanna, in the Bible
Joanna, in the New Testament.
1 Wife of Herod's steward Chuza. She was a follower of Jesus and was one who found the tomb empty.
2 Ancestor of St. Joseph. Drescher was research associate--all at the Guttmacher Institute, New York New York, state, United States
New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of .
Author contact: firstname.lastname@example.org
TABLE 1. Measures of legal abortion in countries where reporting is relatively complete, by country and year Rate ([dagger]) Country No. * 2003 1996 2003 1996 Average annual % change Eastern Europe Belarus ** 80,200 u 35 u u Bulgaria 34,700 89,000 22 51 -11.7 Czech Republic 27,100 46,500 13 21 -6.9 Hungary 53,800 76,600 26 35 -4.2 Russian Federation 1,504,000 2,284,600 45 69 -6.0 Slovakia 16,200 25,200 13 20 -6.1 Northern Europe Denmark 15,600 18,100 15 16 -1.6 England and Wales 181,600 167,900 17 16 0.9 ([double dagger]) ([double dagger]) Estonia 10,600 16,900 36 56 -6.1 Finland 10,700 10,400 11 10 1.1 Latvia 19,000 23,100 29 44 -6.0 Lithuania 11,500 27,800 15 34 -11.0 Norway 13,800 14,300 15 16 -0.5 Scotland ([section]) 12,600 12,300 12 11 0.5 ([section]) Sweden 34,400 32,100 20 19 1.1 Southern Europe Italy 132,800 u 11 u u Slovenia 6,900 10,400 16 23 -5.2 Western Europe Belgium * ([dagger]) 16,200 14,800 8 7 1.7 France 208,800 189,800 17 15 1.6 Germany * ([dagger]) 129,300 130,900 8 8 0.2 Netherlands 28,800 22,400 9 7 4.0 ([double dagger]) ([double dagger]) Switzerland 10,500 u 7 u u North America Canada * 104,200 111,800 15 16 -0.3 ([double dagger]) United States * 1,287,000 1,360,200 21 22 -1.2 ([section]) Oceania Australia 84,500 89,100 20 22 -1.3 New Zealand 18,500 14,800 21 17 2.8 South/Southeast Asia Nepal ([dagger]) * 33,100 u 5 u u Singapore 12,300 14,400 15 16 -0.9 Western Asia Israel ([dagger]) 20,800 17,400 14 14 0.6 ([double dagger]) Caribbean Cuba ([dagger]) 151,500 209,900 57 78 -3.8 ([section]) Puerto Rico 15,600 19,200 18 23 -2.2 ([double dagger]) * Africa South Africa 70,100 u 6 u u Tunisia 16,000 19,000 7 9 -6.1 ([double dagger]) ([dagger]) Ratio Total Country ([dagger]) abortion 2003 rate, ([section]) 2003 Eastern Europe Belarus ** 91 1.1 ([dagger]) ([dagger]) Bulgaria 52 0.6 ([dagger]) ([dagger]) Czech Republic 29 0.4 Hungary 57 0.7 Russian Federation 104 1.3 Slovakia 31 0.4 ([dagger]) ([dagger]) Northern Europe Denmark 24 0.4 England and Wales 29 0.5 ([double dagger]) ([double dagger]) Estonia 82 1.1 Finland 19 0.3 Latvia 69 0.9 Lithuania 38 0.5 Norway 25 0.5 Scotland ([section]) 23 0.4 ([section]) Sweden 34 0.6 Southern Europe Italy 25 0.3 Slovenia 40 0.5 Western Europe Belgium * ([dagger]) 14 0.2 France 26 0.5 ([dagger]) ([dagger]) Germany * ([dagger]) 18 0.2 Netherlands 14 0.3 ([double dagger]) ([double dagger]) Switzerland 15 0.2 ([dagger]) ([dagger]) North America Canada * 31 0.5 ([double dagger]) United States * 31 0.6 ([section]) Oceania Australia 34 0.6 ([dagger]) ([dagger]) New Zealand 33 0.7 South/Southeast Asia Nepal ([dagger]) * 4 0.2 ([dagger]) ([dagger]) Singapore 31 0.4 ([dagger]) ([dagger]) Western Asia Israel ([dagger]) 14 0.4 ([double dagger]) Caribbean Cubat ([section]) 109 1.7 ([dagger]) ([dagger]) Puerto Rico 28 0.5 ([dagger]) ([dagger]) ([double dagger]) * Africa South Africa 6 0.2 ([dagger]) ([dagger]) Tunisia 9 0.2 ([dagger]) ([dagger]) ([double dagger]) ([dagger]) * Rounded to the nearest 100. ([dagger]) Abonions per 1,000 women aged 15-44. ([double dagger]) Abortions per 100 live births. ([section]) The number of abortions that the average woman would have during her reproductive lifetime, given present age-specific abortion rates. ** May include spontaneous abortions. ([dagger]) ([dagger]) Estimated by dividing the general abortion rate by 1,000 and multiplying by 30. ([double dagger]) ([double dagger]) Residents only. ([section]) ([section]) Includes abortions residents obtained in England or Wales. * ([dagger]) Includes abortions residents obtained in the Netherlands. * ([double dagger]) Includes abortions residents obtained in selected US. states. * ([section]) Estimates are provisional and may change as more data become available. ([dagger]) ([double dagger]) Abortions from March 2005 to February 2006. ([dagger]) ([double dagger]) Abortion applications approved, as reported to the Central Bureau of Statistics. ([dagger]) ([section]) Estimates are for 1996 and 2004. ([double dagger]) * Estimates are for 1991 and 2001. ([double dagger]) ([dagger]) Estimates are for 1996 and 2000. Note: u=unavailable. TABLE 2. Measures of legal abortion in countries where reporting is incomplete or uncertain, by country and year Country Year No * Eastern Europe Moldova 2003 13,600 2005 ([dagger]) 30,600 ([dagger]) Romania 2003 166,700 2004 ([dagger]) 134,100 ([dagger]) 1999 ([dagger]) 374,100 ([dagger]) Ukraine 2003 315,800 1999 ([dagger]) 589,200 ([dagger]) Northern Europe Ireland ([section]) 2003 6,300 ([section]) Northern Ireland 2003 1,300 ([section]) ([section]) Southern Europe Albania 2003 6,900 Croatia 2003 5,900 Macedonia 2000 * ([dagger]) 11,400 Serbia and Montenegro 2002 33,600 Spain 2003 79,800 Central Asia Kazakhstan 2003 127,200 1999 ([dagger]) 176,100 ([dagger]) Kyrgyzstan 2003 * ([dagger]) 19,200 1997 ([dagger]) 54,300 ([dagger]) Tajikistan 2003 10,500 Turkmenistan 2000 ([dagger]) 28,500 ([dagger]) Uzbekistan 2003 27,700 2002 ([dagger]) 166,200 ([dagger]) East Asia China 2003 7,215,400 1996 8,834,200 Hong Kong 2003 17,400 1996 25,000 Japan 2003 319,800 1996 338,900 Mongolia 2003 10,500 South Korea 1999 ([dagger]) 212,300 ([dagger]) South/Southeast Asia Bangladesh * 2000 119,600 ([section]) India 2001 723,100 1996 570,900 2002 ([dagger]) * 2,400,000 Vietnam 2003 540,400 1996 1,520,000 2002 ([dagger]) 367,500 ([dagger]) 1997 ([dagger]) 325,100 ([dagger]) Western Asia Armenia 2003 7,800 2000 ([dagger]) 61,500 ([dagger]) Azerbaijan 2003 12,000 2001 ([dagger]) 244,400 ([dagger]) Georgia 2003 * ([dagger]) 13,800 2005 ([dagger]) 103,700 ([dagger]) 1999 ([dagger]) 128,600 ([dagger]) Turkey 2003 ([dagger]) 146,800 ([dagger]) 1998 ([dagger]) 270,600 ([dagger]) Total Ratio abortion ([double rate Country Ratet dagger]) ([section]) Eastern Europe Moldova 16 37 0.5 ** 35 62 1.1 ** Romania 35 78 1.0 28 ([double dagger]) 64 0.8 ([double dagger]) 74 150 2.2 ** Ukraine 30 77 0.9 ** 54 110 1.6 Northern Europe Ireland ([section]) 7 10 0.2 ([section]) Northern Ireland 4 6 0.1 ([section]) ([section]) Southern Europe Albania 9 15 0.3 ** Croatia 7 15 0.2 Macedonia 25 39 0.7 ** Serbia and Montenegro 15 26 *([dag- 0.5 ** ger]) Spain 8 18 0.2 ** Central Asia Kazakhstan 35 51 1.0 ** 47 76 1.4 Kyrgyzstan 15 ([double dagger]) 17 0.5 ** ([double dagger]) 51 27 1.5 Tajikistan 7 7 0.2 ** Turkmenistan 26 27 0.9 Uzbekistan 4 5 0.1 ** 28 28 0.9 East Asia China 23 41 0.7 ** 29 44 0.9 ** Hong Kong 10 37 0.3 15 40 0.5 Japan 13 28 0.4 13 28 0.4 Mongolia 16 18 0.5 ** South Korea 26 ([double dagger]) 38 0.7 ([double dagger]) South/Southeast Asia Bangladesh * 4 3 0.1 ** ([section]) India 3 3 0.1 ** 3 2 0.1 ** 10 9 0.3 ** Vietnam 26 33 0.8 ** 83 78 2.5 ** 20 ([double dagger]) 22 0.6 ([double dagger]) 18 ([double dagger]) 17 0.5 ([double dagger]) Western Asia Armenia 10 22 0.3 ** 81 156 2.6 ** Azerbaijan 6 11 0.2 ** 116 203 3.2 Georgia 14 30 0.4 103 ([double dagger]) 224 3.1 ([double dagger]) 135 264 3.7 Turkey 12 ([double dagger]) 10 ([double ([double dagger]) dagger]) 0.4 18 ([double dagger]) 19 0.4 ([double dagger]) Rounded to the nearest 100. ([dagger]) Abortions per 1,000 women aged 15-44. ([double dagger])Abortions per 100 live births. ([section]) The number of abortions that the average woman would have during her reproductive lifetime, given present age specific abortion rates. ** Estimated by dividing the general abortion rate by 1,000 and multiplying by 30. ([dagger]) ([dagger]) Based on a nationally representative survey of all women aged 15-44, except in South Korea (married women aged 20-44), Vietnam (ever married women aged 15-49) and Turkey (ever married women aged 15-44). The estimated number of abortions in South Korea assumes that the rate for married women applies to all women aged 20-44. Data reflect average annual incidence and rates for the three years preceding the survey, except in South Korea, Vietnam and Turkey (preceding five years) and in Ukraine (preceding one year). Total number of abortions was calculated from the abortion rate and may include illegal abortions. ([double dagger]) ([double dagger]) Estimated by multiplying the total abortion rate by 1,000 and dividing by 30. ([section]) ([section]) Abortions in England and Wales obtained by women who gave Irish addresses. * ([dagger]) May include spontaneous abortions. * ([double dagger]) Based on live births in 2001. * ([section]) Menstrual regulations. ([dagger]) * Based on a survey of health facilities. ([dagger]) ([double dagger]) Abortions obtained by married women per 100 live births to all women. Notes: Estimates are known to be incomplete for all countries except the following, for which the level of completeness is uncertain: Aloania, China, Croatia, Japan, Macedonia, Moldova, Mongolia, Romania (2003), Serbia and Montenegro, Spain and Tajikistan. For each country, official statistics pre- cede survey-based estimates where both are available. TABLE 3. Age-specific legal abortion rates, by country and year [less than or Country Year equal to] 19 * 20-24 25-29 Eastern Europe Czech Republic 2003 8 14 15 1996 12 27 31 Hungary 2003 20 33 33 1996 30 47 49 Russian Federation 2003 25 69 70 1996 44 144 145 Northern Europe Denmark 2003 15 21 18 1996 15 23 21 England and Wales ([double dagger]) 2003 23 31 22 1996 22 28 20 Estonia 2003 28 53 51 1996 43 93 83 Finland 2003 15 17 12 1996 11 15 14 Latvia 2003 17 42 42 Lithuania 2003 7 21 23 Norway 2003 16 27 19 1996 16 26 21 Scotland 2003 20 23 15 1996 18 21 14 Sweden 2003 25 31 24 1996 18 28 25 Southern Europe Italy 2003 7 15 14 Slovenia 2003 9 18 21 1996 11 26 28 Western Europe Belgium 2003 8 13 11 1996 7 11 10 Germany 2003 7 13 11 1997 6 11 11 Netherlands ([double dagger]) 2003 9 14 12 1996 5 9 9 North America Canada 2003 17 31 21 1996 23 34 23 United States ([section]) 2003 22 43 31 1996 29 49 32 Oceania New Zealand 2003 27 41 26 1996 22 31 23 Western Asia Israel ** 2003 11 15 15 1996 10 16 17 [greater than or equal to] Country Year 30-34 35-39 40 ([dagger]) Eastern Europe Czech Republic 2003 16 13 7 1996 28 19 10 Hungary 2003 31 24 9 1996 44 31 13 Russian Federation 2003 58 38 15 1996 94 55 31 Northern Europe Denmark 2003 17 13 6 1996 20 13 6 England and Wales ([double dagger]) 2003 15 10 4 1996 14 9 3 Estonia 2003 43 32 14 1996 63 43 19 Finland 2003 11 8 3 1996 11 7 3 Latvia 2003 37 26 11 Lithuania 2003 21 15 7 Norway 2003 15 11 4 1996 16 10 4 Scotland 2003 9 5 2 1996 9 5 2 Sweden 2003 21 16 7 1996 21 15 7 Southern Europe Italy 2003 12 10 5 Slovenia 2003 21 19 9 1996 32 27 15 Western Europe Belgium 2003 9 6 2 1996 8 5 2 Germany 2003 9 6 3 1997 9 7 3 Netherlands ([double dagger]) 2003 9 7 3 1996 8 5 2 North America Canada 2003 14 9 3 1996 14 8 3 United States ([section]) 2003 19 10 4 1996 18 10 3 Oceania New Zealand 2003 18 12 5 1996 15 9 4 Western Asia Israel ** 2003 16 15 9 1996 17 16 10 * Based on abortions obtained by women aged 19 or younger and the female population aged 15-19. ([dagger]) Based on abortions obtained by women aged 40 or older and the female population aged 40-44. ([double dagger]) Residents only. ([section] Based on total abortion incidence presented in Table 1 and age distributions reported to the Centers for Disease Control and Prevention. ** Based on abortion applications approved, as reported to the Central Bureau of Statistics.