Abortion

Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. The unmodified word abortion generally refers to induced abortion, or deliberate actions to end a pregnancy. Abortion occurring without intervention is known as spontaneous abortion or "miscarriage", and happens in roughly 30–40% of all pregnancies. Common reasons for inducing an abortion include timing the birth, limiting family size, maternal health, inability to afford a child, domestic violence, lack of support, feeling too young, wanting to complete education or advance a career, and not wanting to raise a child conceived as a result of rape or incest.

When done legally in industrialized societies, induced abortion is one of the safest procedures in medicine. Modern methods use medication or surgery for abortions. The drug mifepristone (also known as RU-486) in combination with prostaglandin is safe and effective during the first and second trimesters of pregnancy. Self-managed medication abortion is highly effective and safe throughout the first trimester. The most common surgical technique involves dilating the cervix and using a suction device. Birth control, such as contraceptive pills or intrauterine devices, can be used right after an abortion. When performed legally and safely, an induced abortion does not increase the risk of long-term mental or physical problems.

However, unsafe abortions performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities cause many deaths and hospital admissions each year — responsible for some maternal deaths, especially in low-income countries. The World Health Organization says that access to legal, safe and comprehensive abortion care, including post-abortion care, is essential for good sexual and reproductive health. Public health data show that making safe abortion legal and accessible reduces maternal deaths.

Around 73 million abortions happen each year in the world, with about 45% done unsafely. Abortion rates changed little between 2003 and 2008, after decreasing for at least two decades as access to family planning and birth control increased. As of 2018, 37% of the world's women had access to legal abortions without limits as to reason. Countries that permit abortions have different limits on how late in pregnancy abortion is allowed. Abortion rates are similar between countries that restrict abortion and countries that broadly allow it.

Since 1973, there has been a global trend towards greater legal access to abortion, but there remains debate with regard to moral, religious, ethical, and legal issues. Those who oppose abortion often argue that an embryo or fetus is a person with a right to life, and thus equate abortion with murder. Those who support abortion's legality often argue that it is a woman's reproductive right. Others favor legal and accessible abortion as a public health measure. Abortion laws and views of the procedure are different around the world. In some countries abortion is legal and women have the right to make the choice about abortion. In some areas, abortion is legal only in specific cases such as rape, incest, fetal defects, poverty, and risk to a woman's health. Historically, abortions have been attempted using herbal medicines, sharp tools, forceful massage, or other traditional methods.

Types

An induced abortion is a medical procedure to end a pregnancy. In everyday language, the word abortion usually means induced abortion. The method used depends on how far along the pregnancy is, as well as laws, availability, and the preferences of the woman and her doctor.

Abortions can be either therapeutic, done for medical reasons such as saving the woman's life or health, or elective, done at the woman's request for non-medical reasons. About one in five pregnancies worldwide ends with an induced abortion.

Miscarriage, also known as spontaneous abortion, is when a pregnancy ends naturally before the 24th week of gestation. Most miscarriages happen very early, often before a woman even knows she is pregnant. Chromosomal problems in the embryo are the most common cause, but other factors like health conditions or injuries can also play a role.

Methods

Medical

Main article: Medical abortion

Not to be confused with Emergency contraception.

Medical abortions use special medicines to end a pregnancy. These medicines became common in the 1970s and 1980s. The most common way uses a medicine called mifepristone with another medicine called misoprostol. This method works well and is often used in the early weeks of pregnancy. It is used in many countries around the world.

Surgical

Up to 15 weeks of pregnancy, surgical abortions are often done using suction to remove the pregnancy. This can be done with a small syringe or an electric pump. Another method, called dilation and curettage, opens the cervix and removes tissue with suction or instruments. Later in pregnancy, a method called dilation and evacuation is used, which also involves suction and special tools.

Labor induction abortion

In some places, abortions are done by starting labor to end the pregnancy. This method is used more in some countries than in others. It can be used from about 13 weeks of pregnancy until later stages.

Other methods

Historically, some people have used special herbs to try to end pregnancies. However, these herbs can be very dangerous and are not recommended. Some people have also tried other unsafe methods, but these can cause serious harm and are not recommended either.

Safety

The health risks of abortion depend mainly on how and where the procedure is done. The World Health Organization describes unsafe abortions as procedures done by people without proper training or in places without good medical standards. Legal abortions in developed countries are among the safest medical procedures.

Studies show that abortion is generally safer than continuing a pregnancy. For example, in the United States, the risk of death after an abortion is much lower than after giving birth. Worldwide, abortion is also often safer than carrying a pregnancy to term. The safety of abortion depends on how far along the pregnancy is, with earlier abortions being safer than later ones.

Safety of abortion methods

There is little difference in safety between medical abortion (using medicines) and surgical abortion (using a small vacuum) in early pregnancies up to 10 weeks. Medical abortion using one medicine alone is less effective and more painful than using two medicines together or having a surgical abortion.

Safety and gestational age

Vacuum aspiration in early pregnancy is the safest surgical method and can be done in different settings like offices or clinics. Rare complications can include infection or issues with the uterus. Infections are one of the main causes of death related to abortions in the United States. Preventive antibiotics are often given before surgery to reduce infection risk. The chance of complications is similar no matter where the procedure is done.

Mental health

Current evidence shows no link between most abortions and mental health problems, except for those expected with any unwanted pregnancy. Women who have abortions in early pregnancy usually do not have more mental health issues than those who continue with the pregnancy. However, women denied an abortion may feel more anxious afterward.

Unsafe abortion

Main article: Unsafe abortion

When abortion is restricted by law, women may try to end pregnancies unsafe ly, leading to serious health problems. Unsafe abortions happen mostly in developing countries and can cause injury or death. Making abortion legal and improving access to medical training and reproductive health services can help reduce unsafe abortions.

Incidence

There are two main ways to measure how often abortions happen:

• Abortion rate – the number of abortions each year for every 1,000 women aged 15 to 44.
• Abortion percentage – the number of abortions compared to every 100 known pregnancies, which includes births, abortions, and miscarriages.

Worldwide, about 43 million abortions happen each year. The rate is about 28 abortions for every 1,000 women, but it is lower in developed countries and higher in developing ones. Having access to birth control can help lower the number of unsafe abortions.

The number of legal abortions changes a lot in different countries. Some places have fewer abortions per woman, while others have more. Often, women who have abortions were using some kind of birth control, but it wasn’t used correctly or at all. Better birth control options could help lower unintended pregnancies and abortions.

Motivation

The reasons why people choose to end a pregnancy vary widely. Some choose to do so because they cannot afford to raise a child, face domestic violence, or feel too young. Others want to finish their education or advance their careers. In some cases, the pregnancy is the result of rape or incest, making the decision even more difficult.

Societal pressures also play a role. These can include preferences for children of a certain sex or race, disapproval of single or early motherhood, or lack of economic support for families. In some cultures, there is a strong preference for male children, leading some to seek abortions based on the sex of the fetus. Health concerns for the mother or potential problems with the fetus can also be reasons for choosing an abortion. For example, if a mother develops cancer during pregnancy, doctors may recommend ending the pregnancy to protect her health or because certain treatments could harm the fetus. Similarly, if prenatal tests show serious health issues in the fetus, some parents choose to end the pregnancy.

Main article: Population control

Main articles: Roe v. Wade, Doe v. Bolton

Main article: Cervical cancer

History

Main article: History of abortion

Abortions have been performed since ancient times using various methods, including herbal medicines, sharp tools, and traditional medicine practices. Evidence of abortion can be found in many ancient cultures, such as China, India, Egypt, and the Roman Empire. Over time, views on abortion have changed, and laws regarding it have varied greatly. Some countries legalized abortion in the 20th century, while others maintained strict laws against it.

Religion

Main article: Religion and abortion

Different religions have varied views on abortion. In the Catholic Church, abortion has been opposed strongly since the 19th century, and it is considered wrong from the moment of conception. In Judaism, abortion is permitted when a woman's life is in danger, as the fetus is not seen as having a human soul until it is born.

In Islam, abortion is often allowed only up to a certain point in pregnancy, depending on when Muslims believe the soul enters the fetus. Hindu views on abortion differ, but many consider it morally wrong, though exceptions may be made to save the mother's life. Some Christian groups, such as the United Methodist Church and the Episcopal Church, support abortion rights with certain limits.

Society and culture

Further information: Societal attitudes towards abortion

Abortion debate

Induced abortion has been a topic of debate for a long time. Discussions often involve ethical, moral, philosophical, biological, religious, and legal questions. People have different views based on their values, especially regarding fetal rights, government roles, and women's rights.

Arguments for and against abortion laws focus on whether ending a pregnancy is morally acceptable or should be allowed by law. Some groups that want stricter laws against abortion call themselves "pro-life," while those who want fewer restrictions call themselves "pro-choice."

Modern abortion law

See also: History of abortion law debate

Laws about abortion vary widely around the world. Beliefs and cultures shape these laws. In places where abortion is legal, there are often rules about when and how it can happen. These rules may depend on how far along the pregnancy is or a doctor's opinion about the fetus's health.

Some countries have very strict laws against abortion, but may allow exceptions in certain cases. In places where abortion is banned, women sometimes travel to other countries for the procedure or may try unsafe methods.

Sex-selective abortion

Main article: Sex-selective abortion

With modern technology, parents can sometimes find out the sex of a baby before birth. This has led to some parents choosing to end a pregnancy if the baby is not the sex they want, especially in places where boys are preferred over girls. This practice has caused an imbalance in the number of male and female babies in some countries. Many countries have tried to stop this practice by making laws and working to reduce inequality between genders.

Anti-abortion violence

Main article: Anti-abortion violence

Some people who oppose abortion have used violence against clinics and workers. This includes attacks and threats. Laws in some countries aim to protect access to abortion services and prevent such violence. These laws create safe zones around clinics and punish those who try to stop people from getting abortions.

Non-human examples

Further information: Miscarriage

See also: Miscarriage § animals

Many animals can experience pregnancy loss naturally. In sheep, stress or physical activity can cause this to happen. In cows, diseases like brucellosis or eating certain plants can lead to pregnancy loss, but vaccines can help prevent it. Horses may lose a fetus if it has certain genetic conditions.

In dogs, viruses can cause pregnancy loss, and cats can lose pregnancies due to hormonal issues. Sometimes, veterinarians help pregnant cats by performing a procedure to end the pregnancy to prevent unwanted litters, especially in trap-neuter-return programs. Rodents may end their pregnancies if they smell a new male.