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The answers all come from an analysis published today in the Lancet, and the findings help quantify the need for better access to reliable birth control, especially in the developing world. They also suggest that, for policymakers who wish to minimize abortions, punitive laws aren't the answer. When the research team, including reproductive health scientists from the United States and Switzerland, compared the abortion rates of different countries, the researchers found only a small difference between abortion rates in nations where abortion was illegal under all circumstances and nations where abortion is available to everyone who requests it. In punitive countries, 34 out of every 1,000 reproductive-age women get abortions every year. In permissive countries, the rate is 37 per 1,000 women. The global rate of abortions is 35 per 1,000 women annually.
Making contraceptives, such as condoms, pills, and IUDs, more available could help. Given access to contraception, women seem to tend to prefer it over abortions: After modern birth control became available in Romania, the country's abortion rates dropped by half. Plus, a previous study has estimated that providing 90 percent of those who need it with family-planning services would save the lives of hundreds of thousands of women and infants in the next year by preventing unwanted, high-risk pregnancies and unsafe abortions.
That said, contraception access won't solve everything. Surveys in developing countries show that women who don't want to get pregnant and could obtain birth control nevertheless often choose not to, as demographer Diana Greene Foster reports in an essay in the Lancet. Why not? They may think they're not likely to get pregnant (if they don't have sex frequently, for example); they may be personally opposed to birth control; or they may worry about the side effects. In those cases, Foster writes, communities might need family-planning education programs centered on the needs and concerns of women. We also need continuing research on new birth-control technologies that will better appeal to these communities.