Prevention of unsafe abortion in countries of Central Eastern Europe and Central Asia

Despite permissive laws and a well-developed network of facilities, the incidence of unsafe abortion and the resulting maternal mortality is unacceptably high in Central and Eastern Europe and Central Asia, with one-quarter of all maternal deaths reported to occur as a consequence of abortion. Among the reasons that oblige women to submit themselves to risky procedures are new legislative barriers to accessing pregnancy termination, the unequal distribution of abortion services and healthcare providers, the increased costs of abortion services or unofficial payments, coupled with an increase in the number of impoverished and disadvantaged individuals. The quality of abortion services remains very poor. Safe abortion techniques, including manual vacuum aspiration under local anesthesia and medical abortion, are slowly being implemented. Less safe methods such as dilatation and curettage and general anesthesia are widely used. Unsafe techniques are also practiced extensively in the case of second trimester abortions. Many women from these regions of the world still rely on and accept abortion as a means of fertility control. Although abortions have fallen significantly in Eastern Europe over the last decade, both in absolute numbers and as rates, this region continues to have the highest abortion rates in the world. Concerted efforts by governments, professional associations, and international donors are needed to reduce the consequences of unsafe abortion.