Abortion

Abortion

An abortion is the removal or evacuation of an embryo or fetus from a pregnant woman. A miscarriage, also known as a “spontaneous abortion,” it occurs in approximately 30% to 40% of pregnancies. An induced abortion, or less commonly, an “induced miscarriage,” is when deliberate efforts are made to end a pregnancy.

The term “abortion” in its original form refers to an induced abortion. It is not commonly considered a birth control method, despite the fact that it prevents the birth of a child (another term for contraception). When performed properly, it is one of the safest medical procedures when performed. Yet unsafe abortion is a leading cause of maternal death, particularly in developing countries, whereas making safe abortion legal and accessible reduces maternal deaths. It is safer than delivery, which in the United States carries a 14-fold higher chance of mortality.

Abortions are now performed via medication or surgery. During the first and second trimesters of pregnancy, the medication mifepristone in combination with prostaglandin looks to be as safe and successful as surgery. Dilation of the cervix and utilizing a suction device is the most common surgical procedure.

Following an abortion, birth control such as the pill or intrauterine devices can be used. Induced abortions do not increase the risk of long-term mental or physical problems when performed legally and safely on a woman who wants one. Unsafe ones, on the other hand, result in 47,000 fatalities and five million hospital admissions each year. They are conducted by untrained personnel using hazardous equipment or in dirty facilities.

Abortion

According to the World Health Organization, access to legal, safe, and complete abortion treatment, including post-abortion care, is “important for achieving the best possible level of sexual and reproductive health.” Every year, around 56 million abortions are conducted around the world, with roughly 45 percent being performed in a hazardous manner. Abortion rates remained relatively stable between 2003 and 2008, after declining for at least two decades as access to family planning and birth control improved.

As of 2018, 37% of women worldwide had unrestricted access to legal abortions. Countries that allow abortions have varying restrictions on how late in pregnancy they can be performed. Abortion rates are comparable in nations that prohibit it and those that permit it.

Abortions have been tried in the past with the use of herbal remedies, sharp tools, strong massage, and other conventional means. Around the world, abortion legislation and cultural or religious perspectives on abortion vary. It is only authorized in some areas if there is rape, fetal deformities, poverty, a threat to a woman’s health, or incest. The moral, ethical, and legal concerns surrounding abortion are hotly debated.

Opponents of abortion frequently argue that an embryo or fetus has a right to life and hence compare it to murder. Proponents of abortion legalization frequently argue that it is a woman’s right to make decisions about her own body. Others advocate for it to be legal and accessible as a public health strategy.

Abortion

Types:

Induced

Every year, over 205 million pregnancies occur around the world. Over a third of pregnancies are unplanned, and roughly a fifth of those result in induced abortions. The majority of these are caused by unwanted pregnancies. In the United Kingdom, 1 to 2% of abortions are performed owing to fetal genetic abnormalities. A pregnancy can be terminated in a variety of ways. The method chosen is frequently determined by the embryos or fetus’ gestational age, which grows in size as the pregnancy advances. Legality, regional availability, and a doctor’s or a woman’s personal desire may all influence which procedures are chosen.

Induced abortions are often classified as either therapeutic or elective procedures. When an abortion is performed to save the pregnant woman’s life, to prevent harm to the woman’s physical or mental health, to terminate a pregnancy where there are indications that the child will have a significantly increased risk of mortality or morbidity, or to selectively reduce the number of fetuses to reduce the health risks associated with multiple pregnancy, it is referred to as a therapeutic abortion.

When an abortion is conducted at the request of the woman for non-medical reasons, it is referred to as an elective or voluntary abortion. The word “elective surgery” is commonly misunderstood because it refers to any scheduled surgery, whether or not it is medically necessary.

Spontaneous:

Miscarriage

Miscarriage, also known as spontaneous abortion, occurs when an embryo or fetus is unintentionally expelled before the 24th week of pregnancy. A “premature birth” or “preterm birth” is a pregnancy that ends before 37 weeks of gestation and results in a live-born infant. “Stillborn” refers to a fetus that dies in pregnancy after viability or during birth. Premature births and stillbirths are not normally considered miscarriages, though the phrases are frequently used interchangeably.

Only 30 to 50% of pregnancies survive the first trimester. Many pregnancies are lost before medical practitioners can detect an embryo, and the vast majority of those that do not proceed are lost before the woman is aware of the conception. Depending on the age and condition of the pregnant mother, between 15% and 30% of known pregnancies end in clinically evident miscarriage. Eighty percent of spontaneous abortions occur during the first trimester.

Abortion

Chromosomal abnormalities of the embryo or fetus are the most common cause of spontaneous abortion during the first trimester, accounting for at least half of all early pregnancy losses studied. Vascular illness (such as lupus), diabetes, various hormonal issues, infection, and uterine anomalies are among the other causes. The two main factors linked to a higher risk of spontaneous abortion are maternal age and a woman’s history of past spontaneous abortions. Accidental trauma can cause a spontaneous abortion; purposeful trauma or stress to create miscarriage is referred to as an induced abortion or feticide.

Methods:

Medical

Abortions produced by abortifacient medications are known as “medical abortions.” With the emergence of prostaglandin analogs in the 1970s and the antiprogestogen mifepristone (commonly known as RU-486) in the 1980s, medical abortion became an alternate technique of abortion.

Mifepristone in combination with misoprostol (or occasionally another prostaglandin analog, gemeprost) up to 10 weeks (70 days) of gestational age, methotrexate in combination with a prostaglandin analog up to 7 weeks of gestation, or a prostaglandin analog alone, are the most common early first-trimester medical abortion regimens.

Mifepristone–misoprostol combination regimens are more successful than methotrexate–misoprostol combination regimens at later gestational ages, and combination regimens are more effective than misoprostol alone. In the second trimester, this regimen is beneficial. When conducted before 70 days of gestation, medical abortion regimens using mifepristone followed by misoprostol in the cheek between 24 and 48 hours later are effective.

Medical abortion with a mifepristone–misoprostol combination regimen is regarded to be more effective than surgical abortion (vacuum aspiration) in very early abortions, up to 7 weeks of gestation, especially when clinical practice does not entail careful analysis of aspirated tissue. Up until 9 weeks of gestational age, early medical abortion regimens utilizing mifepristone followed by buccal or vaginal misoprostol are 98 percent effective; from 9 to 10 weeks, efficacy drops to 94 percent. If medication abortion fails, the operation must be completed through surgical abortion.

Abortion

In the United Kingdom, France, Switzerland, the United States, and the Nordic nations, medical abortions account for the majority of abortions before 9 weeks of pregnancy.

Medical abortion regimens using mifepristone in combination with a prostaglandin analog are the most common method for second-trimester abortions in Canada, most of Europe, China, and India, whereas surgical abortions by dilation and evacuation account for 96 percent of second-trimester abortions in the United States.

According to a Cochrane Systematic Review published in 2020, supplying women with drugs to take home to finish the second stage of an early medical abortion results in a successful abortion. More research is needed to see if self-administered medical abortion is as safe as provider-administered medical abortion, in which a health care professional is present to assist with the procedure. Allowing women to safely self-administer abortion medicine has the potential to increase abortion access. Other study gaps were discovered, such as how to effectively help women who chose to take the medicine home and perform an abortion on their own.

Surgical

Suction-aspiration or vacuum aspirations are the most popular surgical methods of induced abortion up to 15 weeks of pregnancy. A fetus or embryo, placenta, and membranes are suctioned out using a manual syringe in manual vacuum aspiration (MVA), while an electric vacuum pump is used in electric vacuum aspiration (EVA). Both of these methods can be employed very early in pregnancy. MVA can be used for up to 14 weeks, but it is most commonly used sooner in the United States. EVA can be employed in the future.

Abortion

MVA, also known as “mini-suction” and “menstrual extraction” or EVA, is a procedure that can be utilized in the early stages of pregnancy when cervical dilatation is not necessary. Dilatation and curettage (D&C) and suction or sharp instruments are used to open the cervix (dilation) and remove tissue (curettage). A D&C is a common gynecological operation used for a variety of reasons, including cancer screening of the uterine lining, irregular bleeding investigation, and abortion. Sharp curettage is only recommended by the World Health Organization when suction aspiration is not possible.

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After 12 to 16 weeks, dilation and evacuation (D & E) involves using surgical instruments and suction to open the cervix and empty the uterus. D&E is a vaginal procedure that does not require an incision. When removing an intact fetus enhances surgical safety or for other reasons, intact dilatation and extraction (D&X) is a variation of D&E that is sometimes employed after 18 to 20 weeks.

A hysterotomy or gravid hysterectomy can also be used to perform an abortion medically. Hysterotomy abortion is a procedure that is performed under general anesthesia and is similar to a caesarean section. It has a smaller incision than a caesarean section and can be performed later in pregnancy. The term “gravid hysterectomy” refers to the removal of the whole uterus while the pregnancy is still contained.

Maternal morbidity and mortality rates from hysterotomy and hysterectomy are significantly higher than those from D&E or induced abortion. Treatments in the first trimester can usually be done with local anesthesia, but procedures in the second trimester may require severe sedation or general anesthesia.

Abortion

Abortion during labor

In places where medical skill for dilation and extraction is insufficient, or where practitioners desire, an abortion can be done by first producing labor and then, if required, inflicting fetal death. On occasion, this is referred to as an “induced miscarriage.” This operation can be done anywhere between 13 weeks and the third trimester of pregnancy. Although it is uncommon in the United States, labor-induced abortions account for more than 80% of induced abortions in the second trimester in Sweden and other adjacent countries.

There is a scarcity of data comparing this procedure to dilatation and extraction. Labor-induced abortions after 18 weeks, unlike D&E, may be complicated by the occurrence of brief fetal survival, which can be legally classified as a live birth. As a result, in the United States, labor-induced abortion is considered illegal.

Other methods

A variety of herbs with abortifacient qualities have been utilized in folk medicine in the past. Tansy, pennyroyal, black cohosh, and the now-extinct silphium are among them.

When two women in Colorado sought to end their pregnancies with pennyroyal oil in 1978, one died and the other suffered organ damage. Physicians do not suggest using herbs as abortifacients indiscriminately since they might induce serious—even fatal—side effects such as multiple organ failure.

Abortion

Abortion is occasionally attempted by inflicting abdominal trauma. If the impact is high enough, it can inflict serious internal injuries without necessarily causing a miscarriage. There is a historical custom in Southeast Asia of attempting abortion by using strong belly massage. A demon executing such an abortion on a woman who has been transported to the underworld is depicted in one of the bas reliefs that decorate the temple of Angkor Wat in Cambodia.

Misuse of misoprostol and insertion of non-surgical tools such as knitting needles and clothes hangers into the uterus have been reported as techniques of hazardous, self-induced abortion. “Induced miscarriage” refers to these and other techniques of terminating a pregnancy. In places where surgical abortion is legal and available, such procedures are rarely employed.

Safety

The health risks of abortion are mostly determined by whether the procedure is carried out safely or not. Unsafe abortions, according to the World Health Organization (WHO), are those conducted by untrained people, using dangerous equipment, or in filthy conditions. Those performed legally in the industrialized world are among the safest medical procedures. Abortion was predicted to be 14 times safer for women in the United States in 2012 than childbirth.

In 2019, the CDC estimated that pregnancy-related mortality in the United States was 17.2 maternal deaths per 100,000 live births, while abortion-related mortality was 0.7 maternal deaths per 100,000 procedures. According to the Royal College of Obstetricians and Gynecologists in the United Kingdom, women should be advised that abortion is generally safer than carrying a pregnancy to term. Abortion is, on average, safer than carrying a pregnancy to term around the world.

According to a 2007 study, “induced abortion terminates 26% of all pregnancies worldwide,” but “deaths from incorrectly executed abortion operations account for 13% of maternal mortality internationally.” In 2000, it was estimated that 2 million pregnancies in Indonesia resulted in abortion, 4.5 million pregnancies were carried to term, and abortion was responsible for 14–16 percent of maternal fatalities.

Abortion

Abortion had a mortality rate in the United States between 2000 and 2009 that was lower than plastic surgery, lower or comparable to running a marathon, and roughly equivalent to driving 760 miles in a passenger car. Women who gave birth after being denied an abortion reported poorer health five years later than women who had abortions in the first or second trimester. The risk of death from abortion rises with gestational age, yet it is still lower than the chance of death from childbirth. From 64 to 70 days of pregnancy, outpatient abortion is just as safe as it was before 63 days.

In early first-trimester abortions up to 10 weeks of gestation, there is minimal difference in terms of safety and efficacy between medical abortion utilizing a combination regimen of mifepristone and misoprostol and surgical abortion (vacuum aspiration). Medical abortion with the prostaglandin analog misoprostol alone is less effective and painful than medical abortion with mifepristone and misoprostol together or surgical abortion.

The safest technique for surgical abortion is vacuum aspiration in the first trimester, which can be done at a primary care office, an abortion clinic, or a hospital. Uterine perforation, pelvic infection, and retained products of conception, which require a second treatment to remove, are all unusual complications. Infections are responsible for one-third of all abortion-related fatalities in the US.

Whether the procedure is performed in a hospital, surgical center, or office, the rate of complications associated with vacuum aspiration abortion in the first trimester is similar. Antibiotics (such as doxycycline or metronidazole) are commonly administered before abortion procedures to lower the risk of uterine infection after the surgery.

Abortion

However, antibiotics are not frequently given with abortion tablets. Whether the abortion is performed by a doctor or a mid-level practitioner, the rate of failed procedures does not appear to differ considerably. Second-trimester abortion complications are comparable to first-trimester abortion complications, and they vary depending on the procedure used.

The risk of death from abortion falls to almost half that of childbirth as a woman’s pregnancy progresses, from one in a million before 9 weeks to nearly one in ten thousand at 21 weeks or more (as measured from the last menstrual period). It indicates that previous surgical uterine evacuation (whether for induced abortion or miscarriage therapy) is associated with a slight increase in the risk of preterm birth in subsequent pregnancies. The studies that back this up didn’t account for things other than abortion or miscarriage. Therefore, the causes of this link are unknown, although several theories have been postulated.

Some alleged abortion dangers are promoted primarily by anti-abortion organizations, but they lack scientific backing. For example, the possibility of a link between induced abortion and breast cancer has been thoroughly examined. Abortion does not cause breast cancer, according to major medical and scientific agencies such as the WHO, National Cancer Institute, American Cancer Society, Royal College of OBGYN, and American Congress of OBGYN. In the past, illegality did not always imply that abortions were dangerous.

“In reality, illegal abortions in this nation have a remarkable safety record,” historian Linda Gordon said of the United States. A related fallacy, propagated by a wide range of people concerned about abortion and public policy, is that abortionists were filthy and hazardous back-alley butchers before legalization. However, historical data contradicts such assertions.

Abortion

Mental health

Abortion and mental health

According to current evidence, there is no link between most induced abortions and mental health issues other than those that would be expected from any unwanted pregnancy. According to an American Psychological Association report, a woman’s first abortion is not harmful to her mental health when performed in the first trimester, with such women having no more mental-health issues than those who carry an unwanted pregnancy to term. However, the mental-health outcome of a woman’s second or subsequent abortion is less certain. Some older studies found that abortion was linked to an increased risk of psychiatric issues, but they lacked a suitable control group.

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Although some studies demonstrate that women who choose abortions after the first trimester due to prenatal abnormalities have bad mental health outcomes, more rigorous research is needed to prove this convincingly. Anti-abortion activists have coined the term “post-abortion syndrome” to describe some of the alleged harmful psychological repercussions of abortion, although it is not accepted by medical or psychological specialists in the United States.

Five years after having an abortion, approximately 99 percent of women in a long-term study of women in the United States believed they had made the right decision. The most common reaction was relief, with few women experiencing sadness or shame. Years later, social stigma was found to be a significant predictor of unpleasant emotions and regret.

Abortion

Unsafe abortion

Women seeking abortions may resort to risky procedures, especially if the procedure is prohibited by law. They may try to self-induce abortion or seek assistance from someone who lacks medical expertise or facilities. This can result in serious complications such as an incomplete abortion, infection, bleeding, and organ damage. Abortion is a leading source of injury and death among women all over the world.

Despite the lack of specific data, it is estimated that approximately 20 million unsafe abortions occur each year, with 97 percent of them taking place in developing countries. Millions of people are thought to have been injured as a result of unsafe abortions. Estimates of mortality have ranged from 37,000 to 70,000 in the last decade, depending on methodology; unsafe abortion deaths account for roughly 13% of all maternal deaths.

Since the 1990s, the World Health Organization considers that mortality has decreased. Public health organizations have usually advocated for legalizing abortion, training medical professionals, and assuring access to reproductive-health services to lower the frequency of unsafe abortions. Opponents of abortion argue that abortion restrictions have little impact on prenatal care for women who choose to bring their fetus to term. According to the Dublin Declaration on Maternal Health, signed in 2012, “the restriction of abortion does not impact, in any way, the availability of optimal care to pregnant women.”

The legal status of abortion is a crucial determinant of whether or not abortions are performed safely. When compared to countries where abortion is legal and available, countries with restrictive abortion laws had greater rates of unsafe abortion and similar overall abortion rates. The legalization of abortion in South Africa in 1996, for example, had an immediate favorable influence on the frequency of abortion-related complications, with abortion-related mortality falling by more than 90%. Other nations, such as Romania and Nepal, have seen similar reductions in maternal mortality after liberalizing their abortion laws.

Abortion

According to a 2011 study, anti-abortion policies at the state level in the United States are linked to lower abortion rates in those states. However, the study did not account for abortions obtained in jurisdictions where such regulations do not exist. Furthermore, the lack of efficient contraception contributes to unsafe abortions.

If modern family planning and maternal health care were widely available around the world, the number of unsafe abortions could be reduced by up to 75% (from 20 million to 5 million per year).Because such abortions can be reported as miscarriage, “induced miscarriage,” “menstrual regulation,” “mini-abortion,” and “regulation of delayed or suspended menstruation,” rates of such abortions may be difficult to calculate.

Within gestational limits, 40% of the world’s women have access to therapeutic and elective abortions, while another 35% have access to legal abortion if they meet particular medical, mental, or social conditions. While safe abortions seldom result in maternal mortality, unsafe abortions cause 70,000 deaths and 5 million disabilities each year.

Unsafe abortion complications account for about an eighth of maternal deaths worldwide; this varies by area. An estimated 24 million women suffer from secondary infertility as a result of an unsafe abortion. Between 1995 and 2008, the percentage of unsafe abortions increased from 44% to 49%. To address this issue, health education, access to family planning, and improvements in health care during and after abortion have been advocated.

Abortion

Incidence

There are two main approaches to calculating the rate of abortion:

The abortion rate is the number of abortions performed annually per 1,000 women aged 15 to 44.

The number of abortions per 100 known pregnancies is known as the abortion percentage (pregnancies include live births, abortions, and miscarriages).

Medical reporting of abortion is unreliable in many locations where abortion is outlawed or has a high social stigma. As a result, estimations of the rate of abortion must be made without regard to standard error.

On average, nations with restrictive abortion laws and those with more liberal abortion access have equal rates of abortion. Restrictive abortion laws, on the other hand, are linked to an increase in the number of unsafe abortions. The lack of access to modern contraceptives is partly to blame for the high rate of unsafe abortions in developing countries. According to the Guttmacher Institute, providing access to contraceptives would result in about 14.5 million fewer unsafe abortions and 38,000 fewer deaths from unsafe abortions each year globally.

The rate of lawful, induced abortion varies greatly over the world. According to a report by Guttmacher Institute staff, in nations with complete statistics in 2008, it ranged from 7 per 1000 women per year (Germany and Switzerland) to 30 per 1000 women per year (Estonia).In the same group, the proportion of pregnancies ending in induced abortion ranged from roughly 10% (Israel, the Netherlands, and Switzerland) to 30% (Estonia), but it could be as high as 36% in Hungary and Romania, where figures were deemed inadequate.

According to a study published in 2002 in the United States, almost half of women who had abortions were using contraception at the time of conception. Half of those who use condoms and three-quarters of those who use the birth control pill reported inconsistent use; 42 percent of condom users reported failure due to sliding or breakage.

Abortion

According to the Guttmacher Institute, “most abortions in the United States are obtained by minority women” because they “had significantly higher rates of unwanted pregnancy.”While people of color make up 44% of the Mississippi population, 59 percent of the Texas population, 42% of the Louisiana population, and 35% of the Alabama population in 2022, they account for 80%, 74%, 72%, and 70% of those who have abortions.

The total abortion rate is the average number of abortions a woman has during her reproductive years; it is also known as the abortion rate (TAR).

Gestational age and method

The number of abortions performed varies depending on the stage of pregnancy and the procedure used. In 2003, the Centers for Disease Control and Prevention (CDC) reported that 26% of reported legal induced abortions in the United States were obtained at less than 6 weeks’ gestation, 18% at 7 weeks, 15% at 8 weeks, 18% at 9 through 10 weeks, 10% at 11 through 12 weeks, 6% at 13 through 15 weeks, 4% at 16 through 20 weeks, and 1% at more than 21 weeks.

91% were done through “curettage” (suction-aspiration, dilation and curettage, dilation and evacuation), 8% through “medical” means (mifepristone), > 1% through “intrauterine instillation” (saline or prostaglandin), and 1% through “other” means (including hysterotomy and hysterectomy). According to the CDC, statistics must be treated as provisional due to data collection challenges, and some fetal deaths reported after 20 weeks may be natural deaths mistakenly categorized as abortions if the dead fetus is removed using the same process as an induced abortion.

Motivation

Personal

Women get abortions for a variety of reasons, which differ from country to country. Inability to afford a child, marital violence, a lack of support, a belief that they are too young, and a desire to complete college or develop a job are all possible factors. Other causes include the inability or unwillingness to raise a kid born as a result of rape or incest.

Abortion

Societal

Some abortions are carried out due to societal pressures. These could include preferences for children of a particular gender or race, stigmatization of people with disabilities, insufficient economic support for families, lack of access to or rejection of contraceptive treatments, or population control initiatives (such as China’s one-child policy). Compulsory abortion or sex-selective abortion can occur as a result of these causes.

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Maternal and fetal health

Another issue is maternal health, which was cited as the primary cause by approximately a third of women in three of the 27 nations and around 7% of women in the remaining seven. After television personality Sherri Finkbine discovered she had been exposed to thalidomide during her fifth month of pregnancy, public opinion in America transformed. She flew to Sweden after being unable to have a legal abortion in the United States. A measles outbreak in Germany caused 15,000 babies to be born with severe birth abnormalities between 1962 and 1965.

The American Medical Association actively advocated abortion law reform in 1967. According to a 1965 study by the National Opinion Research Center, 73 percent of respondents supported abortion when the mother’s life was in danger, 57 percent when congenital abnormalities were apparent, and 59 percent for pregnancies caused by rape or incest.

Cancer

At a rate of 0.02–1% during pregnancy, and in many situations, the mother’s cancer leads to the contemplation of abortion to protect the mother’s life or to avoid potential harm to the fetus during treatment. This is especially true for cervical cancer, which affects one out of every 2,000–13,000 pregnancies and for which treatment “cannot coexist with fetal life preservation (unless neoadjuvant chemotherapy is adopted).”

Cervical cancers in the early stages (I and IIa) may be treated with a radical hysterectomy and pelvic lymph node dissection, radiation therapy, or a combination of the two, but cervical cancers in the later stages are treated with radiotherapy. Chemotherapy can be used in conjunction with other treatments. Because lumpectomy is discouraged in favor of modified radical mastectomy until the pregnancy is late-term and follow-up radiation therapy can be performed after the birth, treatment of breast cancer during pregnancy also entails fetal considerations.

Abortion

The risk of teratogenic effects on the fetus from a single chemotherapeutic medication is estimated to be 7.5–17 percent, with higher risks associated with multiple drug treatments.Radiation treatment of more than 40 Gy generally results in spontaneous abortion.

Exposure to significantly lower dosages during the first trimester, particularly between 8 and 15 weeks of development, might result in intellectual impairment or microcephaly, and exposure during this or later periods can result in reduced intrauterine growth and birth weight. IQ is reduced dose-dependently at doses of over 0.005–0.025 Gy. Depending on how far the area to be treated is from the fetus, abdominal shielding can significantly limit radiation exposure.

The mother’s safety may potentially be jeopardized during the birthing process. “Vaginal delivery may result in neoplastic cell dissemination into lymphovascular channels, haemorrhage, cervical laceration, and implantation of malignant cells in the episiotomy site, whereas abdominal delivery may postpone non-surgical treatment.”

Abortion debate

Induced abortion has been the subject of heated controversy for a long time. Value systems play a role in the ethical, moral, philosophical, biological, theological, and legal difficulties surrounding abortion. Abortion opinions can range from fetal rights to governmental authority to women’s rights.

Arguments given in favor of or against abortion access in public or private debates center on either the moral permissibility of an induced abortion or the validity of legislation authorizing or prohibiting abortion. Circumstances bringing the interests of a mother into conflict with the welfare of her unborn child create a dilemma and raise the question of whether or not the pregnancy should be purposefully terminated, according to the World Medical Association Declaration on Therapeutic Abortion.

Groups advocating one of these two perspectives are frequently at the forefront of abortion issues, particularly when it comes to abortion regulations. Proponents of stricter legal limitations on abortion, including complete prohibition, are referred to as “pro-life,” while opponents refer to themselves as “pro-choice.” In general, the proponents of the first position claim that a human fetus is a human being with a right to life, making abortion morally equivalent to murder. The latter viewpoint asserts that a woman has some reproductive rights, including the ability to choose whether or not to carry a pregnancy to term.

Abortion

Modern abortion laws

Abortion laws currently exist in a variety of forms. Abortion laws continue to be influenced by religious, moral, and cultural issues all across the world. The rights to life, liberty, and security of person, as well as the right to reproductive health, are key human rights issues that are sometimes used to justify the existence or absence of abortion regulations.

Certain prerequisites must frequently be completed in places where abortion is legal before a woman can have a legal abortion (an abortion conducted without the woman’s consent is deemed a feticide). These standards are normally dependent on the fetus’ age, with a trimester-based system commonly used to regulate the legality window, or, as in the United States, on a doctor’s assessment of the fetus’ viability.

Some states mandate a waiting period prior to the procedure, mandate the release of fetal development information, or mandate that parents be notified if their minor daughter desires an abortion. Other jurisdictions may require that a woman obtain the consent of the fetus’ father before aborting the fetus, that abortion providers inform women of the procedure’s health risks—sometimes including “risks” that are not supported by medical literature—and that the abortion is either medically or socially necessary. In an emergency, many restrictions are lifted. China, which has discontinued its one-child policy in favor of a two-child program, has used forced abortions as part of its population control plan on occasion.

Other jurisdictions outright prohibit abortion. Many of these, but not all, allow for legal abortions in a range of situations. These circumstances differ by jurisdiction but may include whether the pregnancy is the product of rape or incest, whether the fetus’ development is impeded, whether the woman’s health or mental well-being is jeopardized, or whether socioeconomic factors make childbirth difficult.

Medical authorities in countries where abortion is completely prohibited, such as Nicaragua, have reported an increase in maternal mortality caused directly or indirectly by pregnancy, as well as deaths caused by doctors’ fear of being prosecuted if they treat other gynecological emergencies. Some countries that ostensibly prohibit abortion, such as Bangladesh, may subsidize facilities that perform abortions under the pretense of menstrual hygiene.

Abortion

This is a term used in traditional medicine as well. Pregnant women may engage in medical tourism and go to countries where abortion is allowed or has a high social stigma in order to terminate their pregnancies. Women who do not have the financial resources to travel can turn to illegal abortion providers or attempt to execute an abortion on their own.

Since 1999, the organization Women on Waves has been educating people about medical abortions. The NGO built a mobile medical clinic within a shipping container, which then sails to countries with severe abortion restrictions on rented ships. When the ship is in international waters, Dutch law applies because the ship is registered in the Netherlands. The organization offers free courses and education while in port, and medical personnel can legally prescribe medical abortion medicines and counseling while in international waters.

Sex-selective abortion

Parents can determine sex before labor via sonography and amniocentesis. Sex-selective abortion, or the termination of a fetus depending on its gender, has resulted from the advancement of this technique. The most prevalent method is to selectively terminate a female fetus.

In some countries, sex-selective abortion is partly to blame for the obvious discrepancies in the birth rates of male and female offspring. In many parts of Asia, there is a preference for male children, and abortion is utilized to decrease female births in Taiwan, South Korea, India, and China. Despite the fact that the country in question may have officially banned sex-selective abortion or even sex-screening, this departure from the standard birth rates of boys and females happens. The one-child policy, which was imposed in 1979, has exacerbated a historical preference for male children in China.

Abortion

Many countries have passed legislation to limit the use of sex-selective abortion. Over 180 countries agreed in 1994 at the International Conference on Population and Development to end “all forms of discrimination against the girl child and the root causes of son preference,” conditions that were also condemned by a PACE resolution in 2011. According to the World Health Organization and UNICEF, as well as other UN organizations, steps to decrease abortion access are significantly less effective at reducing sex-selective abortions than measures to alleviate gender inequality.

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