Many experts have raised concerns about people relying on unsafe abortion methods in order to terminate pregnancies. But what makes an abortion unsafe? And how do you define “safe abortion”?

According to the World Health Organization (WHO), about 73 million abortions take place worldwide every year. About 29% of all pregnancies end in an induced abortion.

The WHO also estimates that 45% of all abortions are unsafe, and about 97% of unsafe abortions take place in developing countries.

While safe abortions seldom cause complications, Doctors Without Borders notes that unsafe abortions are a leading cause of death in pregnant people — and it’s almost entirely preventable.

For an abortion to be considered safe, it needs to fit the following criteria:

  • the method is recommended by the WHO and is appropriate to the gestational period (how “far along” you are in pregnancy)
  • the procedure is done by a trained professional

An unsafe abortion is one that does not fill all of the above criteria.

Some experts use three different tiers to categorize abortions: safe, less safe, and least safe.

  • Safe abortions fill both of the above criteria.
  • Less safe abortions fill one, but not both, of the above criteria.
  • Least safe abortions fill neither of the above criteria.

People often use the terms “safe abortion” and “legal abortion” interchangeably, but safe abortions are not always legal and vice versa.

In an area where abortion is illegal, it’s still possible to have a safe abortion as long as the procedure adheres to a recommended method and is conducted by a trained professional.

With that said, restrictive abortion laws can make it harder to access safe abortion care, which is why unsafe abortions are more prevalent in countries where abortion is illegal.

Safe abortion care is done:

  • using a WHO-recommended method
  • using a method that is appropriate for the gestational period
  • by a skilled and trained individual

Common safe abortion methods include:

  • medication abortion, which involves taking pills that terminate a pregnancy
  • vacuum aspiration, which is an in-clinic or surgical abortion procedure involving gentle suction to remove tissues
  • dilation and evacuation (D&E), another in-clinic or surgical abortion procedure that involves dilating (or opening) the cervix and removing tissue from the uterus

“Less safe” abortion care only fills one of the following two criteria:

  • It’s done using a WHO-recommended method appropriate to the gestational period.
  • It’s conducted by a trained professional.

For example, an abortion may be categorized as “less safe” if:

  • someone has an abortion using a WHO-recommended method but without the guidance and support of a skilled professional
  • a trained medical professional does the procedure but uses an outdated method like sharp cutterage
  • a trained medical professional does the procedure using a WHO-recommended method, but the method is not appropriate for the gestational period (for example, attempting to use abortion medication to induce a third-trimester abortion)

“Least safe” abortion care fits neither of the above-mentioned criteria for safe abortions.

In other words, it’s done using a method that is not recommended by the WHO for the gestational period, and it’s not conducted by a trained professional.

For example, someone might attempt a “home remedy” abortion on their own, without support from a trained professional.

However, it’s important to note that self-managed abortion isn’t necessarily unsafe. Telehealth abortion services, for example, allow you to order abortion medication and use it in the comfort of your own home.

People who get “less safe” or “least safe” abortion care may do so because it’s difficult to access safe abortion care.

The following barriers make it harder to access safe abortion care:

  • Legal restrictions: Legal restrictions can include making abortion altogether illegal, making abortion illegal past a certain point in pregnancy, or requiring parental involvement.
  • Lack of funding: If someone is unable to afford abortion care or the costs associated with abortion (such as transport to or from a clinic or child care), they may resort to less safe options.
  • Lack of trained medical professionals: Some medical professionals may also refuse to provide abortion care.
  • Lack of abortion facilities: In some parts of the world, abortion facilities are few and far between, especially in rural areas. Overloaded clinics may not be able to keep up with demand.
  • Shaming from abortion providers: Out of fear of stigma, people may opt to avoid clinics and hospitals and have abortions at home.
  • Lack of knowledge: Disinformation, misinformation, and low quality sex education may mean that people don’t know their rights or how to access abortion care.

Extensive research has shown that making abortions illegal leads to a higher number of unsafe abortions.

Several organizations, including the WHO and the American College of Obstetricians and Gynecologists, have called for the repeal of laws that restrict access to safe abortion, as these laws result in more people resorting to unsafe abortion practices.

According to Doctors Without Borders, unsafe abortion is a leading cause of death in pregnant people. The WHO estimates that between 4.7 and 13.2% of maternal deaths are due to unsafe abortion.

In developed regions, it’s estimated that 30 people die for every 100,000 unsafe abortions. In developing regions, 220 people die for every 100,000 unsafe abortions.

Death isn’t the only potential risk of less safe and least safe abortions.

People who receive unsafe abortion care may experience:

These complications can lead to:

In addition to being dangerous, unsafe abortion practices may be ineffective — in other words, they may not actually terminate the pregnancy.

When abortions are done using safe, proven methods, there’s a very low risk of complications.

You can learn more about obtaining safe abortion care at the following Healthline links:

If you would like to learn more about abortion in general, these Healthline articles may be helpful:

The following resources may also help:

If you or a loved one need abortion care, try to avoid crisis pregnancy centers. Although they look like legitimate health clinics, crisis pregnancy centers are designed to talk people out of having an abortion.

A 2014 study found that 80% of crisis pregnancy center websites shared misleading information. Additionally, these centers are often unregulated and unlicensed.

While safe abortion care practices have a low risk of complications, unsafe abortion care is a leading cause of death among pregnant people. Unsafe abortion care can also result in infertility and other complications.

As abortion access becomes increasingly restricted in the United States, it’s important to be aware of your rights and your options for obtaining safe abortion care.

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.