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Clinical reviews

Unintended pregnancy and abortion

What students should know

By: Katharine Elliot, Joanna Speedie, Richard Lyus

Unintended pregnancy and abortion are important issues for all clinicians: nearly half of all pregnancies in developed countries are unintended, despite the availability of contraceptive services, and half of these unintended pregnancies end in elective abortion.1 Globally, about 44 million abortions are carried out each year. In 2011, 190 000 abortions were performed in England and Wales.2

In developed countries abortion is safe, with a mortality rate of less than 1 per 100 000 procedures. In such countries, the mortality rate for women continuing a pregnancy and giving birth is about 10/100 000.34 The global abortion mortality rate is estimated to be 220 per 100 000 procedures; this variance in mortality rate seems to be because of the dramatic rise in abortion mortality in certain areas of the world such as Sub-Saharan Africa, where the mortality rate is 460 deaths per 100 000 procedures. In developing countries, unsafe abortion is an important cause of maternal

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