An estimated 39,000 women die each year from complications of unsafe abortions, according to the World Health Organization. That makes unsafe abortion one of the leading preventable causes of maternal death worldwide, with sepsis and severe hemorrhage as the primary killers. The vast majority of these deaths occur in low- and middle-income countries where access to safe procedures is limited.
What Counts as an Unsafe Abortion
The WHO classifies abortions into three safety categories. A safe abortion uses a medically recommended method appropriate for the stage of pregnancy and is performed by someone with the necessary training. A “less-safe” abortion meets only one of those criteria, perhaps using the right medication but without proper guidance. A “least-safe” abortion meets neither: it involves untrained people using dangerous, invasive methods.
Of all unsafe abortions globally, roughly one third fall into that least-safe category. These are the procedures most likely to cause fatal complications, including uncontrolled bleeding, infection that spreads to the bloodstream, and damage to internal organs. Even among women who survive, unsafe procedures can lead to chronic pain, infertility, and long-term reproductive health problems.
How Safe Abortion Compares
When performed under proper medical conditions, abortion is remarkably safe. In the United States, the death rate for legal abortion is less than 1 per 100,000 procedures. At eight weeks of pregnancy or earlier, that rate drops to 0.3 deaths per 100,000. Risk does increase with gestational age, rising to 6.7 deaths per 100,000 at 18 weeks or later, but even at that stage the procedure remains far safer than the alternative in countries where unsafe methods are common.
To put this in perspective: in 2021, five women in the U.S. died from complications of legal induced abortion. Compare that to the 39,000 annual deaths globally from unsafe procedures, and the gap between safe and unsafe access becomes starkly clear.
The Link Between Abortion Laws and Maternal Death
Restricting legal access to abortion does not eliminate the procedure. It pushes it underground, where conditions are more dangerous. This pattern is now visible even within the United States. A 2025 analysis published in The BMJ found that women living in states with abortion bans are nearly twice as likely to die during pregnancy, childbirth, or shortly afterward compared to women in states where abortion remains accessible.
The numbers tell a striking story. In the 24 states where abortion remained accessible after the Supreme Court’s 2022 decision, maternal mortality dropped 21%, falling from 17.7 deaths per 100,000 live births in 2022 to 13.9 per 100,000 in 2023. In the 13 states that enforced bans at six weeks or earlier, maternal mortality moved in the opposite direction, rising 5% from 23.9 per 100,000 in 2019 to 25.1 per 100,000 in 2023.
Texas offers a case study. After the state implemented its abortion ban in 2021, maternal mortality rose 33%, climbing from 18.3 to 24.2 deaths per 100,000 live births. By 2023, a woman in Texas was more than 2.5 times as likely to die of pregnancy-related causes as a woman in California, where abortion is legal and maternal mortality sits at 9.5 per 100,000.
Where Deaths Are Concentrated
The global burden of unsafe abortion deaths falls overwhelmingly on women in sub-Saharan Africa, South Asia, and Latin America, regions where legal restrictions, poverty, and limited healthcare infrastructure converge. In many of these settings, women who develop complications after an unsafe procedure have no access to emergency care, turning survivable conditions like incomplete abortion or infection into fatal ones.
Treating the aftermath of unsafe abortions also strains healthcare systems that are already under-resourced. Across countries where unsafe procedures are common, the annual cost of treating abortion complications reaches $1.56 billion, according to the Guttmacher Institute. That money goes toward emergency surgeries, blood transfusions, and intensive care, expenses that would largely disappear if safe procedures were available in the first place.
Who Is Most at Risk
Young women and adolescents face disproportionate danger. They are more likely to delay seeking care, less likely to have the financial resources to travel for a safe procedure, and more likely to turn to untrained providers. Women in rural areas, those with lower incomes, and those in countries with the most restrictive laws consistently show the highest rates of unsafe abortion complications.
The one-third of unsafe abortions performed under the most dangerous conditions, by untrained individuals using invasive methods, account for a disproportionate share of deaths and serious injuries. These are not rare edge cases. They represent millions of procedures each year, driven almost entirely by lack of access to safe alternatives.
What Reduces Unsafe Abortion Deaths
Two interventions have the strongest evidence behind them. The first is access to modern contraception, which prevents unintended pregnancies before they occur. Globally, hundreds of millions of women who want to avoid pregnancy still lack access to effective birth control. Meeting that demand would sharply reduce the number of abortions overall.
The second is access to safe abortion care itself. Countries that have expanded legal access and trained providers have seen dramatic declines in abortion-related deaths. The safety data is unambiguous: when abortions are performed using recommended methods by trained providers, the risk of death approaches zero. The 39,000 women who die each year are not dying because abortion is inherently dangerous. They are dying because safe options are not available to them.