Some 68,000 women die each year from unsafe abortions, while another 5.3 million suffer temporary or permanent disability as a result, a World Bank report released Thursday said.
The report, Fertility Regulation Behaviors and Their Costs, said many poor women turn to abortion as a last-resort means of birth control.
Despite a huge increase in contraception globally, 51 million unintended pregnancies in developing countries occur every year to women not using contraception.
The report also noted that another 25 million pregnancies occur because women's contraception methods fail or they use a contraceptive incorrectly.
Some 35 poor countries in Sub-Saharan Africa and other regions have the world's highest birth rates (more than five children per mother), and also reflect some of the world's poorest social and economic results, with low levels of education, high death rates, and extreme poverty, the report said.
"It's simply tragic that so many leaders in poor countries and their aid donors have allowed reproductive health programs to falloff the radar, especially at a time when population issues are also front and center of climate change, and the food and fuel crises," said Joy Phumaphi, the World Bank vice president for human development, and a former health minister of Botswana.
She warned that falling birth rates would not be achieved through better health programs alone.
Improved education for girls, equal economic opportunities for women in society, and fewer households living below the poverty line are also vital parts of a strategy to achieve sustainable reductions in birth rates, Phumaphi said.