Clandestine induced abortion is a significant public health issue in many countries where access to abortion is severely legally restricted. Abortions are often available only in cases of rape or incest or when a pregnancy threatens the health or life of the woman, causing many women to pursue clandestine abortions, which are often unsafe. Forty percent of women live in countries where abortions are legally restricted.

As comprehensive official statistics are lacking, this study provides valuable public health data.

The researchers conducted a population-based survey of almost 8000 women aged 18-29 years in 20 Peruvian cities. They found that 11.6% of women reported having abortions and 7.5% of sexually experienced 18-year-olds - the youngest age surveyed - reported having had abortions.

"We hope that this study will contribute to increased awareness of the scale of the problem and political willingness to address it, for which there is public support in Latin America," write Dr. Bernabé Ortiz from the Universidad Peruana Cayetano Heredia in Lima, Peru and coauthors.

They state that provision of contraception and education needs to be greatly improved and will lead to reduced abortion rates as half of the sexually-active women in the study did not use birth control.

In a related commentary http://www.cmaj.ca/press/pg272.pdf, Professor Rebecca Cook of the University of Toronto's Faculty of Law writes that laws limiting access to abortion do not reduce the number of abortions but reduce safety.

"When governments ignore evidence, such as that presented in the study by Bernabé Ortiz and colleagues, and refuse to collect official statistics on abortion or ensure transparent access to legal abortion services, they are increasingly held accountable by national, regional and international human rights courts and tribunals for the arbitrary exercise of their power," states Professor Cook. "They are also increasingly held accountable for causing preventable deaths and disabilities of women."

A summary of abortion policies around the world, compiled by the UN Department of Economic and Social Affairs Population Division, can be obtained from http://www.un.org/esa/population/publications/2007_Abortion_Policies_Chart/2007_WallChart.pdf .

Source: Canadian Medical Association Journal