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Reverted 1 edit by BigCheddah (talk): Not even an article, no idea why you think that's useful to readers and not clearly misleading if anything |
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{{short description|Termination of a pregnancy}}
{{other uses}}
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{{use dmy dates|date=November 2019}}
{{use American English|date=September 2016}}
<!-- Note to Editors: This article has a long history of intense terminology debates. Please review the talk page before making changes to lines to see if there is a previous established consensus or compromise. Thank you. -->
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'''Abortion''' is the termination of a [[pregnancy]] by removal or expulsion of an [[embryo]] or [[fetus]].{{refn|For a list of definitions as stated by [[obstetrics and gynecology]] (OB/GYN) textbooks, dictionaries, and other sources, see ''[[Definitions of abortion]]''. Definitions of abortion vary from source to source, and language used to define abortion often reflects societal and political opinions, not only scientific knowledge.<ref>{{cite web| url=http://www.oxfordbibliographies.com/view/document/obo-9780199756797/obo-9780199756797-0090.xml?rskey=tygpVh&result=1| title=Abortion|website=[[Oxford Bibliographies]]|access-date=9 April 2014| vauthors = Kulczycki A |url-status=live| archive-url=https://web.archive.org/web/20140413132203/http://www.oxfordbibliographies.com/view/document/obo-9780199756797/obo-9780199756797-0090.xml?rskey=tygpVh&result=1|archive-date=13 April 2014}}</ref>|group=nb}}<ref>{{cite web |last1=Rao |first1=Radhika |title=Abortion |url=https://oxcon.ouplaw.com/display/10.1093/law:mpeccol/law-mpeccol-e67 |website=Oxford Constitutional Law |date=2016 |publisher=Oxford University Press |doi=10.1093/law:mpeccol/e67.013.67 |access-date=27 September 2024}}</ref> The unmodified word ''abortion'' generally refers to [[induced abortion]],<ref>{{cite web |title=abortion |url=http://www.oed.com/view/Entry/503?rskey=TpobDi&result=1#eid |url-access=subscription |url-status=live |archive-url=https://web.archive.org/web/20200819111414/https://www.oed.com/start;jsessionid=5BD236F54839DEEFCB6B4A7FEBB47BF4?authRejection=true&url=%2Fview%2FEntry%2F503%3Frskey%3DTpobDi%26result%3D1#eid |archive-date=19 August 2020 |access-date=5 April 2019 |website=Oxford English Dictionary}}</ref><ref name="OED">{{cite web |title=Abortion (noun) |url=https://en.oxforddictionaries.com/definition/abortion |url-status=dead |archive-url=https://web.archive.org/web/20180528131142/https://en.oxforddictionaries.com/definition/abortion |archive-date=28 May 2018 |access-date=8 June 2018 |publisher=Oxford Living Dictionaries |quote=''[mass noun]'' The deliberate termination of a human pregnancy, most often performed during the first 28 weeks of pregnancy}}</ref> or deliberate actions to end a pregnancy.{{refn|Induced abortion is less frequently called "induced miscarriage".|group=nb}} Abortion occurring without intervention is known as [[spontaneous abortion]] or "miscarriage", and occurs in roughly 30–40% of all pregnancies.<ref name="John2012">{{cite book| title=The Johns Hopkins Manual of Gynecology and Obstetrics| date=2012| publisher=Lippincott Williams & Wilkins| isbn=978-1-4511-4801-5| pages=438–439| edition=4| url=https://books.google.com/books?id=4Sg5sXyiBvkC&pg=PA438| url-status=live|archive-url=https://web.archive.org/web/20170910181311/https://books.google.com/books?id=4Sg5sXyiBvkC&pg=PA438|archive-date=September 10, 2017}}</ref><ref name="NIH2013Epi">{{cite web| title=How many people are affected by or at risk for pregnancy loss or miscarriage?|url=http://www.nichd.nih.gov/health/topics/pregnancyloss/conditioninfo/Pages/risk.aspx| website=NICHD |access-date=14 March 2015| date=2013-07-15|url-status=dead |archive-url=https://web.archive.org/web/20150402093633/http://www.nichd.nih.gov/health/topics/pregnancyloss/conditioninfo/Pages/risk.aspx| archive-date=April 2, 2015}}</ref> Common reasons for inducing an abortion are birth-timing and limiting family size.<ref name="bankole98" /><ref name="Chae_2017" /><ref name="guttmacher" /> Other reasons include [[maternal health]], [[Poverty|an inability to afford a child]], [[domestic violence]], lack of support, feelings of being too young, wishing to complete an education or advance a career, and not being able, or willing, to raise a child conceived as a result of [[rape]] or [[incest]].<ref name="bankole98" /><ref name="guttmacher" /><ref name=":5" />
<!-- Methods and safety -->
When done legally in industrialized societies, induced abortion is [[#Safety|one of the safest procedures in medicine]].{{r|lancet-grimes|p=1|q=Unsafe abortion is a persistent, preventable pandemic.{{nbsp}}[...] By contrast, legal abortion in industrialised nations has emerged as one of the safest procedures in contemporary medical practice, with minimum morbidity and a negligible risk of death.}}{{r|Ray2014}} Modern methods use [[medical abortion|medication]] or [[#surgical|surgery]] for abortions.<ref name=":0">{{cite journal | vauthors = Zhang J, Zhou K, Shan D, Luo X | title = Medical methods for first trimester abortion | journal = The Cochrane Database of Systematic Reviews | volume = 2022 | pages = CD002855 | date = May 2022 | issue = 5 | pmid = 35608608 | pmc = 9128719 | doi = 10.1002/14651858.CD002855.pub5 }}</ref> The drug [[mifepristone]] (aka RU-486) in combination with [[prostaglandin]] appears to be as safe and effective as surgery during the [[first trimester|first]] and [[second trimester]]s of pregnancy.<ref name=":0" /><ref name="Kapp2013" /> [[Self-managed abortion|Self-managed]] [[medication abortion]] is highly effective and safe throughout the [[Trimester (pregnancy)|first trimester]].<ref name="WHO-SHR">{{cite web |date=2021-11-19 |title=Self-management Recommendation 50: Self-management of medical abortion in whole or in part at gestational ages < 12 weeks (3.6.2) - Abortion care guideline |url=https://srhr.org/abortioncare/chapter-3/service-delivery-options-and-self-management-approaches-3-6/self-management-recommendation-50-self-management-of-medical-abortion-in-whole-or-in-part-at-gestational-ages-12-weeks-3-6-2/ |access-date=2023-09-21 |website=WHO Department of Sexual and Reproductive Health and Research |language=en-US |archive-date=29 June 2022 |archive-url=https://web.archive.org/web/20220629195513/https://srhr.org/abortioncare/chapter-3/service-delivery-options-and-self-management-approaches-3-6/self-management-recommendation-50-self-management-of-medical-abortion-in-whole-or-in-part-at-gestational-ages-12-weeks-3-6-2/ |url-status=live }}</ref><ref>{{cite journal | vauthors = Moseson H, Jayaweera R, Raifman S, Keefe-Oates B, Filippa S, Motana R, Egwuatu I, Grosso B, Kristianingrum I, Nmezi S, Zurbriggen R, Gerdts C | display-authors = 6 | title = Self-managed medication abortion outcomes: results from a prospective pilot study | journal = Reproductive Health | volume = 17 | issue = 1 | article-number = 164 | date = October 2020 | pmid = 33109230 | pmc = 7588945 | doi = 10.1186/s12978-020-01016-4 |doi-access=free |issn=1742-4755 }}</ref><ref>{{cite journal | vauthors = Moseson H, Jayaweera R, Egwuatu I, Grosso B, Kristianingrum IA, Nmezi S, Zurbriggen R, Motana R, Bercu C, Carbone S, Gerdts C | display-authors = 6 | title = Effectiveness of self-managed medication abortion with accompaniment support in Argentina and Nigeria (SAFE): a prospective, observational cohort study and non-inferiority analysis with historical controls | journal = The Lancet. Global Health | volume = 10 | issue = 1 | pages = e105–e113 | date = January 2022 | pmid = 34801131 | doi = 10.1016/S2214-109X(21)00461-7 | pmc = 9359894 }}</ref> The most common surgical technique involves [[Dilation and evacuation|dilating]] the [[cervix]] and using a [[vacuum aspiration|suction device]].<ref>{{cite news |title=Abortion – Women's Health Issues |url=https://www.merckmanuals.com/home/women-s-health-issues/family-planning/abortion |website=Merck Manuals Consumer Version |access-date=12 July 2018 |archive-url=https://web.archive.org/web/20180713183550/https://www.merckmanuals.com/home/women-s-health-issues/family-planning/abortion |archive-date=13 July 2018 |url-status=live }}</ref> [[Birth control]], such as [[combined oral contraceptive pill|the pill]] or [[intrauterine device]]s, can be used immediately following an abortion.<ref name="Kapp2013">{{cite journal | vauthors = Kapp N, Whyte P, Tang J, Jackson E, Brahmi D | title = A review of evidence for safe abortion care | journal = Contraception | volume = 88 | issue = 3 | pages = 350–363 | date = September 2013 | pmid = 23261233 | doi = 10.1016/j.contraception.2012.10.027 }}</ref> When performed legally and safely on a woman who desires it, an induced abortion does not increase the risk of long-term [[mental health|mental]] or physical problems.<ref name="BMJ2014">{{cite journal |vauthors=Lohr PA, Fjerstad M, Desilva U, Lyus R |year=2014 |title=Abortion |journal=BMJ |volume=348 |page=f7553 |doi=10.1136/bmj.f7553 |s2cid=220108457}}</ref> In contrast, [[unsafe abortion]]s performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities cause between 22,000 and 44,000 deaths and 6.9 million hospital admissions each year<ref>{{cite web |date=2018-03-01 |title=Induced Abortion Worldwide {{!}} Guttmacher Institute |url=https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide |archive-url=https://web.archive.org/web/20180301060904/https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide |archive-date=2018-03-01 |access-date=2023-06-23 |website=Guttmacher.org}}</ref>—responsible for between 5% and 13% of [[maternal death]]s, especially in [[low income countries]].<ref name="WHO-preventing-unsafe">{{cite web |url=https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion |title=Preventing unsafe abortion |publisher=World Health Organization|access-date=6 August 2019 |archive-date=23 August 2019 |archive-url=https://web.archive.org/web/20190823190843/https://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion |url-status=live }}</ref> The [[World Health Organization]] states that "access to legal, safe and comprehensive abortion care, including [[post-abortion care]], is essential for the attainment of the highest possible level of sexual and reproductive health".<ref>{{cite web|title=Abortion| url=https://www.who.int/health-topics/abortion#tab=tab_1| access-date=2021-04-14| website=www.who.int| language=en| archive-date=6 May 2021| archive-url=https://web.archive.org/web/20210506092947/https://www.who.int/health-topics/abortion#tab=tab_1}}</ref> Public health data show that making safe abortion legal and accessible reduces maternal deaths.<ref>{{cite journal | vauthors = Faúndes A, Shah IH | title = Evidence supporting broader access to safe legal abortion | journal = International Journal of Gynaecology and Obstetrics | volume = 131 | issue = Suppl 1 | pages = S56–S59 | date = October 2015 | pmid = 26433508 | doi = 10.1016/j.ijgo.2015.03.018 | series = World Report on Women's Health 2015: The unfinished agenda of women's reproductive health | doi-access = free | quote = A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible.{{nbsp}}[...] [C]riminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates. }}</ref><ref>{{cite journal | first1= Su Mon |last1= Latt |first2=Allison |last2= Milner|author-link2= Allison Milner| last3= Kavanagh |first3= Anne | title = Abortion laws reform may reduce maternal mortality: an ecological study in 162 countries | journal = BMC Women's Health | volume = 19 | issue = 1 | article-number = 1 | date = January 2019 | pmid = 30611257 | pmc = 6321671 | doi = 10.1186/s12905-018-0705-y |doi-access=free }}</ref>
<!-- Epidemiology -->
Around 73 million abortions are performed each year in the world,<ref>{{cite web |title=Abortion |url=https://www.who.int/news-room/fact-sheets/detail/abortion |access-date=2022-09-21 |website=www.who.int |language=en |archive-date=21 September 2022 |archive-url=https://web.archive.org/web/20220921025025/https://www.who.int/news-room/fact-sheets/detail/abortion |url-status=live }}</ref> with about 45% done unsafely.<ref>{{cite web| title=Worldwide, an estimated 25 million unsafe abortions occur each year| url=https://www.who.int/mediacentre/news/releases/2017/unsafe-abortions-worldwide/en/|publisher=World Health Organization| access-date=29 September 2017|date=28 September 2017|archive-url=https://web.archive.org/web/20170929131145/http://who.int/mediacentre/news/releases/2017/unsafe-abortions-worldwide/en/| archive-date=29 September 2017|url-status=live}}</ref> Abortion rates changed little between 2003 and 2008,<ref name="Sedgh 2012">{{cite journal | vauthors = Sedgh G, Singh S, Shah IH, Ahman E, Henshaw SK, Bankole A | title = Induced abortion: incidence and trends worldwide from 1995 to 2008 | journal = Lancet | volume = 379 | issue = 9816 | pages = 625–632 | date = February 2012 | pmid = 22264435 | doi = 10.1016/S0140-6736(11)61786-8 | url = http://www.guttmacher.org/pubs/journals/Sedgh-Lancet-2012-01.pdf | url-status = live | quote = Because few of the abortion estimates were based on studies of random samples of women, and because we did not use a model-based approach to estimate abortion incidence, it was not possible to compute confidence intervals based on standard errors around the estimates. Drawing on the information available on the accuracy and precision of abortion estimates that were used to develop the subregional, regional, and worldwide rates, we computed intervals of certainty around these rates (webappendix). We computed wider intervals for unsafe abortion rates than for safe abortion rates. The basis for these intervals included published and unpublished assessments of abortion reporting in countries with liberal laws, recently published studies of national unsafe abortion, and high and low estimates of the numbers of unsafe abortion developed by WHO. | s2cid = 27378192 | archive-url = https://web.archive.org/web/20120206043854/http://www.guttmacher.org/pubs/journals/Sedgh-Lancet-2012-01.pdf | archive-date = 6 February 2012 }}</ref> before which they decreased for at least two decades as access to [[family planning]] and birth control increased.<ref name="worldtrends2007">{{cite journal | vauthors = Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J | title = Legal abortion worldwide: incidence and recent trends | journal = International Family Planning Perspectives | volume = 33 | issue = 3 | pages = 106–116 | date = September 2007 | pmid = 17938093 | doi = 10.1363/3310607 | url = http://www.guttmacher.org/pubs/journals/3310607.html | url-status = live | doi-access = free | archive-url = https://web.archive.org/web/20090819122933/http://www.guttmacher.org/pubs/journals/3310607.html | archive-date = 19 August 2009 }}</ref> {{as of|2018}}, 37% of the world's women had access to legal abortions without limits as to reason.<ref name=Gutt_2018_fact >{{cite web | url=https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide | title=Induced Abortion Worldwide | work=[[Guttmacher Institute]] | date=2018-03-01 | access-date=2020-02-21 | quote=Of the world's 1.64 billion women of reproductive age, 6% live where abortion is banned outright, and 37% live where it is allowed without restriction as to reason. Most women live in countries with laws that fall between these two extremes. | archive-date=23 February 2020 | archive-url=https://web.archive.org/web/20200223022612/https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide | url-status=live }}</ref> Countries that permit abortions have different limits on how late in pregnancy abortion is allowed.<ref name=IJGO10>{{cite journal | vauthors = Culwell KR, Vekemans M, de Silva U, Hurwitz M, Crane BB | title = Critical gaps in universal access to reproductive health: contraception and prevention of unsafe abortion | journal = International Journal of Gynaecology and Obstetrics | volume = 110 | issue = Suppl | pages = S13–S16 | date = July 2010 | pmid = 20451196 | doi = 10.1016/j.ijgo.2010.04.003 | s2cid = 40586023 }}</ref> Abortion rates are similar between countries that restrict abortion and countries that broadly allow it, though this is partly because countries which restrict abortion tend to have higher [[unintended pregnancy]] rates.<ref>{{cite web|date=2020-05-28| title=Unintended Pregnancy and Abortion Worldwide| url=https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide|access-date=2021-03-09|website=Guttmacher Institute| language=en| archive-date=23 February 2020|archive-url=https://web.archive.org/web/20200223022612/https://www.guttmacher.org/fact-sheet/induced-abortion-worldwide|url-status=live | quote=Abortion is sought and needed even in settings where it is restricted—that is, in countries where it is prohibited altogether or is allowed only to save the women’s life or to preserve her physical or mental health. Unintended pregnancy rates are highest in countries that restrict abortion access and lowest in countries where abortion is broadly legal. As a result, abortion rates are similar in countries where abortion is restricted and those where the procedure is broadly legal (i.e., where it is available on request or on socioeconomic grounds).}}</ref>
<!-- society, and culture -->Since 1973, there has been a global trend towards greater legal access to abortion,<ref>{{cite web |last=Staff |first=F. P. |date=2022-06-24 |title=Roe Abolition Makes U.S. a Global Outlier |url=https://foreignpolicy.com/2022/06/24/roe-v-wade-overturned-global-abortion-laws/ |access-date=2023-10-20 |website=Foreign Policy |language=en-US |archive-date=24 June 2022 |archive-url=https://web.archive.org/web/20220624181307/https://foreignpolicy.com/2022/06/24/roe-v-wade-overturned-global-abortion-laws/ |url-status=live }}</ref> but [[Abortion debate|there remains debate]] with regard to moral, religious, ethical, and legal issues.<ref>{{cite book| veditors = Nixon F | vauthors = Paola A, Walker R, LaCivita L |title=Medical ethics and humanities|date=2010|publisher=Jones and Bartlett Publishers|___location=Sudbury, MA| isbn=978-0-7637-6063-2|page=249|url=https://books.google.com/books?id=9pM2pw-2wl4C&pg=PA249|url-status=live|archive-url=https://web.archive.org/web/20170906191717/https://books.google.com/books?id=9pM2pw-2wl4C&pg=PA249|archive-date=6 September 2017| ol=13764930W}}</ref><ref>{{cite journal| vauthors = Johnstone MJ |title=Bioethics a nursing perspective| journal=Confederation of Australian Critical Care Nurses Journal| volume=3|issue=4|pages=24–30|date=2009| publisher=Churchill Livingstone/Elsevier|___location=Sydney, NSW| isbn=978-0-7295-7873-8|edition=5th| url=https://books.google.com/books?id=EG-Yg1xDYakC&pg=PA228| quote=Although abortion has been legal in many countries for several decades now, its moral permissibilities continues to be the subject of heated public debate.| url-status=live| archive-url=https://web.archive.org/web/20170906191717/https://books.google.com/books?id=EG-Yg1xDYakC&pg=PA228|archive-date=6 September 2017| pmid=2129925}}</ref> Those who [[Anti-abortion movements|oppose abortion]] often argue that an embryo or fetus is a person with a [[right to life]], and thus equate abortion with [[murder]].<ref>{{cite news | vauthors = Driscoll M |author-link= Mark Driscoll| title=What do 55 million people have in common? |publisher=Fox News |date=18 October 2013 |access-date=2 July 2014 |url=https://www.foxnews.com/opinion/what-do-55-million-people-have-in-common/ |url-status=live |archive-url=https://web.archive.org/web/20140831022138/http://www.foxnews.com/opinion/2013/10/18/what-do-55-million-people-have-in-common/ |archive-date=31 August 2014 }}</ref><ref>{{cite news | vauthors = Hansen D |title=Abortion: Murder, or Medical Procedure? |work=The Huffington Post |date=18 March 2014 |access-date=2 July 2014 |url=https://www.huffingtonpost.com/dale-hansen/abortion-murder-or-medica_b_4986637.html |url-status=live |archive-url=https://web.archive.org/web/20140714230359/http://www.huffingtonpost.com/dale-hansen/abortion-murder-or-medica_b_4986637.html |archive-date=14 July 2014 }}</ref> Those who [[Abortion-rights movements|support abortion's legality]] often argue that it is a woman's [[reproductive rights|reproductive right]].<ref>{{cite book| vauthors = Sifris RN |title=Reproductive freedom, torture and international human rights: challenging the masculinisation of torture|date=2013|publisher=Taylor & Francis |___location=Hoboken, NJ|isbn=978-1-135-11522-7|oclc=869373168|page=3|url=https://books.google.com/books?id=9pVWAgAAQBAJ&pg=PA3|url-status=live|archive-url=https://web.archive.org/web/20151015195038/https://books.google.com/books?id=9pVWAgAAQBAJ&pg=PA3|archive-date=15 October 2015}}</ref> Others favor legal and accessible abortion as a public health measure.<ref>{{cite book| first= Elisabeth |last=Åhman |title=Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2003| date=2007| publisher=World Health Organization| isbn=978-92-4-159612-1| edition=5th| url=https://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241596121/en/|access-date=24 March 2018| archive-url=https://web.archive.org/web/20180407131435/http://www.who.int/reproductivehealth/publications/unsafe_abortion/9789241596121/en/| archive-date=7 April 2018| url-status=dead}}</ref> [[Abortion law]]s 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.<ref>Fabiola Sanchez, Megan Janetsky, ''[https://apnews.com/article/mexico-abortion-decriminalize-d87f6edbdf68c2e6c8f5700b3afd15de Mexico decriminalizes abortion, extending Latin American trend of widening access to procedure] {{Webarchive|url=https://web.archive.org/web/20230906235527/https://apnews.com/article/mexico-abortion-decriminalize-d87f6edbdf68c2e6c8f5700b3afd15de |date=6 September 2023 }}'', Associated Press (AP), September 6, 2023</ref> In some areas, abortion is legal only in specific cases such as rape, incest, [[fetal defects]], poverty, and risk to a woman's health.<ref name="Dev98-07">{{cite journal |vauthors=Boland R, Katzive L |date=September 2008 |title=Developments in laws on induced abortion: 1998-2007 |url=http://www.guttmacher.org/pubs/journals/3411008.html |url-status=live |journal=International Family Planning Perspectives |volume=34 |issue=3 |pages=110–120 |doi=10.1363/3411008 |pmid=18957353 |archive-url=https://web.archive.org/web/20111007221828/http://www.guttmacher.org/pubs/journals/3411008.html |archive-date=7 October 2011 |doi-access=free}}</ref> [[history of abortion|Historically]], abortions have been attempted using [[abortifacient|herbal medicines]], sharp tools, [[fundal massage|forceful massage]], or other [[traditional medicine|traditional methods]].<ref name="Management of Abortion, Chp 1">{{cite book |title=Management of Unintended and Abnormal Pregnancy |vauthors=Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD, Joffe C |publisher=John Wiley & Sons |year=2009 |isbn=978-1-4443-1293-5 |edition=1st |___location=Oxford |chapter=1. Abortion and medicine: A sociopolitical history |ol=15895486W |chapter-url=http://media.wiley.com/product_data/excerpt/62/14051769/1405176962.pdf |archive-url=https://web.archive.org/web/20120119025652/http://media.wiley.com/product_data/excerpt/62/14051769/1405176962.pdf |archive-date=19 January 2012 |url-status=live}}</ref>
== Types ==
===Induced===
{{Infobox medical intervention
| name = Induced abortion
| synonyms = Induced miscarriage, termination of pregnancy
| image =
| caption =
| field = [[Obstetrics]] and [[gynecology]]
| ICD10 = {{ICD10PCS|10A0|1/0/A/0}}
| ICD9 = {{ICD9|779.6}}
| ICDO =
| OMIM =
| MedlinePlus = 007382
| eMedicine = 252560
| MeshID = D000028
<!-- Infobox medical intervention does not support the following parameters:
| DiseasesDB = 4153
-->
}}
An induced abortion is a medical procedure to end a pregnancy.<ref>{{cite web |vauthors=Cheng L |date=1 November 2008 |title=Surgical versus medical methods for second-trimester induced abortion |url=http://apps.who.int/rhl/fertility/abortion/CD006714_chengl_com/en/index.html |work=The WHO Reproductive Health Library |publisher=World Health Organization |access-date=17 June 2011 |archive-url=https://web.archive.org/web/20100801023058/http://apps.who.int/rhl/fertility/abortion/CD006714_chengl_com/en/index.html |archive-date=1 August 2010 |url-status=dead}}</ref> In present-day English, the term ''abortion'', when used without further qualification, generally refers to induced abortion.<ref name=OED/>
A pregnancy can be intentionally aborted in several ways. The abortion method depends upon the [[Embryonic age|gestational age]] of the embryo or fetus, which gains mass as the pregnancy progresses.<ref>{{cite book| vauthors = Stubblefield PG |chapter=10. Family Planning |title=Novak's Gynecology| veditors=Berek JS |editor1-link=Jonathan Berek| publisher=Lippincott Williams & Wilkins| year=2002| edition=13| isbn=978-0-7817-3262-8}}</ref><ref>{{cite journal| title=Risk factors for legal induced abortion-related mortality in the United States |pmid=15051566| journal=Obstetrics & Gynecology |year=2004 | vauthors = Bartlett LA, Berg CJ, [[Holly Shulman|Shulman HB]], Zane SB, Green CA, Whitehead S, Atrash HK |volume=103 |issue=4 |pages=729–737 |doi=10.1097/01.AOG.0000116260.81570.60| s2cid=42597014| doi-access=free }}</ref> [[Abortion law|Abortion laws]], regional availability, and the personal preference of the women and her doctor may inform the women's choice of a specific abortion procedure.
Abortions can be characterized as either therapeutic or elective. When an abortion is performed for medical reasons, the procedure is referred to as a therapeutic abortion. Medical reasons for therapeutic abortion include saving the life of the pregnant woman, preventing harm to the woman's [[Health|physical]] or [[mental health]], preventing the birth of a child who will have a significantly increased chance of mortality or morbidity, and [[selective reduction|reducing]] the number of fetuses to lessen health risks associated with [[multiple pregnancy]].<ref name="roche1">{{cite web| vauthors = Roche NE |date=28 September 2004 |title=Therapeutic Abortion |publisher=eMedicine |archive-url=https://web.archive.org/web/20041214092044/http://www.emedicine.com/MED/topic3311.htm |url=http://emedicine.medscape.com/article/252560-overview |archive-date=14 December 2004 |access-date=19 June 2011}}</ref><ref name="Williams Gyn, Chp 6" /> An abortion is referred to as elective or voluntary when it is performed at the request of the woman for non-medical reasons.<ref name="Williams Gyn, Chp 6" /> Confusion sometimes arises over the term ''elective'' because "[[elective surgery]]" generally refers to all scheduled surgery, whether medically necessary or not.<ref>{{cite journal |last1=Janiak |first1=Elizabeth |last2=Goldberg |first2=Alisa B. |date=2016-02-01 |title=Eliminating the phrase 'elective abortion': why language matters |url=https://www.contraceptionjournal.org/article/S0010-7824(15)00624-1/abstract |journal=Contraception |language=English |volume=93 |issue=2 |pages=89–92 |doi=10.1016/j.contraception.2015.10.008 |pmid=26480889 |issn=0010-7824 |access-date=27 November 2022 |archive-date=24 January 2023 |archive-url=https://web.archive.org/web/20230124173416/https://www.contraceptionjournal.org/article/S0010-7824%2815%2900624-1/fulltext |url-status=live |url-access=subscription }}</ref>
About one in five pregnancies worldwide ends with an induced abortion.<ref name="Sedgh 2012" /> Most abortions result from unintended pregnancies.<ref name=bankole98/><ref>{{cite journal |vauthors=Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM |title=Reasons U.S. women have abortions: quantitative and qualitative perspectives |journal=Perspectives on Sexual and Reproductive Health |volume=37 |issue=3 |pages=110–118 |date=September 2005 |pmid=16150658 |doi=10.1111/j.1931-2393.2005.tb00045.x |url=http://www.guttmacher.org/pubs/journals/3711005.pdf |url-status=live |archive-url=https://web.archive.org/web/20060117143856/https://www.guttmacher.org/pubs/journals/3711005.pdf |archive-date=17 January 2006}}</ref> In the United Kingdom, 1 to 2% of abortions are done because of genetic problems in the fetus.<ref name=BMJ2014/>
===Spontaneous===
{{Main|Miscarriage}}
Miscarriage, also known as spontaneous abortion, is the unintentional expulsion of an embryo or fetus before the 24th [[Gestational age (obstetrics)|week of gestation]].<ref>{{cite book | title = Churchill Livingstone medical dictionary | publisher = Churchill Livingstone Elsevier | ___location = Edinburgh New York | year = 2008 | isbn = 978-0-443-10412-1 | quote = The preferred term for unintentional loss of the product of conception prior to 24 weeks' gestation is miscarriage.}}</ref> A pregnancy that ends before 37 weeks of gestation resulting in a [[live birth (human)|live-born]] infant is a "[[premature birth]]" or a "preterm birth".<ref>{{cite book|quote=A preterm birth is defined as one that occurs before the completion of 37 menstrual weeks of gestation, regardless of birth weight.|page=669| veditors = Gabbe SG, Niebyl JR, Simpson JL |editor1-link=Steven Gabbe|year=2007|title=Obstetrics: Normal and Problem Pregnancies|edition=5th |publisher=Churchill Livingstone|chapter=51. Legal and Ethical Issues in Obstetric Practice|isbn=978-0-443-06930-7|vauthors = AnnasGJ, Elias S |author-link1=George Annas }}</ref> When a fetus dies [[Uterus|in utero]] after [[Fetal viability|viability]], or during [[childbirth|delivery]], it is usually termed "[[stillbirth|stillborn]]".<ref>{{cite encyclopedia|quote=birth of a fetus that shows no evidence of life (heartbeat, respiration, or independent movement) at any time later than 24 weeks after conception|title=Stillbirth|series=Concise Medical Dictionary|publisher=Oxford University Press|year=2010|url=https://books.google.com/books?id=Zs8ZM4OUurcC&pg=PA698|url-status=live|archive-url=https://web.archive.org/web/20151015195038/https://books.google.com/books?id=Zs8ZM4OUurcC&pg=PA698|archive-date=15 October 2015|isbn=978-0-19-955714-1}}</ref> [[Premature births]] and [[stillbirth]]s are generally not considered to be miscarriages, although usage of these terms can sometimes overlap.<ref>{{cite web|url=https://fam.state.gov/FAM/07FAM/07FAM1470.html|title=7 FAM 1470 Documenting Stillbirth (Fetal Death)|publisher=United States Department of State|date=18 February 2011|access-date=12 January 2016|archive-url=https://web.archive.org/web/20160205060246/https://fam.state.gov/FAM/07FAM/07FAM1470.html|archive-date=5 February 2016|url-status=live}}</ref>
Studies of pregnant women in the US and China have shown that between 40% and 60% of embryos do not progress to birth.<ref name="Gabbe, Chp 24">{{cite book | veditors = Gabbe SG, Niebyl JR, Simpson JL |editor1-link=Steven Gabbe |year=2007|title=Obstetrics: Normal and Problem Pregnancies|edition=5th |publisher=Churchill Livingstone |chapter=24. Pregnancy loss|isbn=978-0-443-06930-7| vauthors = Annas GJ, Elias S |author-link1=George Annas }}</ref><ref>{{cite journal |title=Early embryo mortality in natural human reproduction: What the data say [version 2; peer review: 2 approved, 1 approved with reservations] |journal=F1000Research |date=7 June 2017 | vauthors = Jarvis GE |volume=5 |page=2765 |doi=10.12688/f1000research.8937.2 |doi-access=free |pmid=28580126 |pmc=5443340 }}</ref><ref>{{cite journal |title=Estimating limits for natural human embryo mortality [version 1; peer review: 2 approved] |journal=F1000Research |date=26 August 2016 |vauthors=Jarvis GE |volume=5 |page=2083 |doi=10.12688/f1000research.9479.1 |doi-access=free |pmid=28003878 |pmc=5142718 }}</ref> The vast majority of miscarriages occur before the woman is [[clinically silent|aware that she is pregnant]],<ref name="Williams Gyn, Chp 6" /> and many pregnancies spontaneously abort before medical practitioners can detect an embryo.<ref>{{cite book| vauthors = Katz VL |publisher=Mosby|year=2007|edition=5 th|title=Katz: Comprehensive Gynecology| veditors = Katz VL, Lentz GM, Lobo RA, Gershenson DM |chapter=16. Spontaneous and Recurrent Abortion – Etiology, Diagnosis, Treatment|isbn=978-0-323-02951-3}}</ref> Between 15% and 30% of known pregnancies end in clinically apparent miscarriage, depending upon the age and health of the pregnant woman.<ref>{{cite book| vauthors = Stovall TG |chapter=17. Early Pregnancy Loss and Ectopic Pregnancy|title=Novak's Gynecology| veditors = Berek JS |editor1-link=Jonathan Berek|publisher=Lippincott Williams & Wilkins|year=2002|edition=13|isbn=978-0-7817-3262-8}}</ref> 80% of these spontaneous abortions happen in the first trimester.<ref name=Williams18>{{cite book | veditors = Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, Casey BM, Sheffield JS |editor-link4=Catherine Y. Spong |title = Williams Obstetrics |edition = 24th |year = 2014 |publisher = McGraw Hill Education |isbn = 978-0-07-179893-8}}</ref>
The most common cause of spontaneous abortion during the first trimester is [[chromosomal abnormalities]] of the embryo or fetus,<ref name="Williams Gyn, Chp 6">{{cite book| veditors = Schorge JO, Schaffer JI, Halvorson LM, Hoffman BL, Bradshaw KD, Cunningham FG |year=2008|title=Williams Gynecology|edition=1|publisher=McGraw-Hill Medical|isbn=978-0-07-147257-9|chapter=6. First-Trimester Abortion}}</ref><ref name="mednet">{{cite web|url=http://www.medicinenet.com/miscarriage/page1.htm |title=Miscarriage (Spontaneous Abortion) |access-date=7 April 2009 | vauthors = Stöppler MS | veditors = Shiel Jr WC |work=MedicineNet.com |publisher=WebMD |url-status=dead |archive-url=https://web.archive.org/web/20040829013142/http://www.medicinenet.com/Miscarriage/page1.htm |archive-date=29 August 2004 }}</ref> accounting for at least 50% of sampled early pregnancy losses.<ref name="fetal med 837">{{cite book |vauthors=Jauniaux E, Kaminopetros P, El-Rafaey H |chapter=Early pregnancy loss |veditors=Whittle MJ, Rodeck CH |title=Fetal medicine: basic science and clinical practice |publisher=Churchill Livingstone |___location=Edinburgh |year=1999 |chapter-url=https://archive.org/details/fetalmedicinebas0000unse/page/836/mode/2up |isbn=978-0-443-05357-3 |oclc=42792567 |page=837 }}</ref> Other causes include [[vascular disease]] (such as [[Systemic lupus erythematosus|lupus]]), [[diabetes mellitus|diabetes]], other [[Endocrine disease|hormonal problems]], infection, and abnormalities of the uterus.<ref name="mednet" /> Advancing maternal age and a woman's history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion.<ref name="fetal med 837" /> A spontaneous abortion can also be caused by accidental [[Physical trauma|trauma]]; intentional trauma or stress to cause miscarriage is considered induced abortion or [[feticide]].<ref name="Fetal Homicide Laws">{{cite web |url=http://www.ncsl.org/programs/health/fethom.htm |title=Fetal Homicide Laws |access-date=7 April 2009 |publisher=National Conference of State Legislatures |archive-url=https://archive.today/20120911171355/http://www.ncsl.org/issues-research/health/fetal-homicide-state-laws.aspx |archive-date=11 September 2012}}{{cbignore|bot=medic}}</ref>
==Methods==
===Medical===
{{Distinguish|text= [[emergency contraception]]}}
{{Image frame|width=300|innerstyle=font-size:88%;|link=:File:Abortionmethods.png|caption=[[Gestational age (obstetrics)|Gestational age]] may determine which abortion methods are practiced.|content={{#invoke:Block diagram|main|width=300|height=190|<border-color #cccccc><border-width 0px 0px 0px 1px><left 30><right 30> <vcentertext><left 70><right 70> <border-width 0px><top 0><bottom 12><left 0><right 100><background-color #ffbcd8>Practice of Induced Abortion Methods<background-color #bdc9df><top 19><bottom 29><left 7.5><right 20>[[manual vacuum aspiration|MVA]]<left 40><right 65>[[dilation and evacuation|D&E]]<top 38><bottom 48><left 15><right 30>[[electric vacuum aspiration|EVA]]<left 50><right 75>[[Hysterotomy abortion|Hyst.]]<left 15><right 37.5><top 56><bottom 66>[[Dilation and curettage|D&C]]<left 50><right 75>[[Intact dilation and extraction|Intact D&X]]<left 7.5><right 30><top 74><bottom 84>[[Mifepristone|Mifepr.]]<left 40><right 75>Induced Miscarr.<left 0><right 30><background-color #b7e690><top 90><bottom 100>[[First trimester|0–12 wks]]<left 30><right 70><background-color #dfe988>[[Second trimester|12–28 weeks]]<left 70><right 100><background-color #e9c788>[[Third trimester|28–40 wks]]}}}}
Medical abortions are those induced by [[abortifacient]] pharmaceuticals. Medical abortion became an alternative method of abortion with the availability of [[prostaglandin]] [[prostaglandin analogue|analogs]] in the 1970s and the [[antiprogestin|antiprogestogen]] [[mifepristone]] (also known as RU-486) in the 1980s.<ref name=Kapp2013/><ref name=":0" /><ref name="Creinin 2009">{{cite book|vauthors=Creinin MD, Gemzell-Danielsson K |year=2009| chapter=Medical abortion in early pregnancy|veditors=Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD |title=Management of unintended and abnormal pregnancy: comprehensive abortion care| ___location=Oxford|publisher=Wiley-Blackwell|pages=111–134| isbn=978-1-4051-7696-5}}</ref><ref name="Kapp 2009">{{cite book| vauthors=Kapp N, von Hertzen H |year=2009| chapter=Medical methods to induce abortion in the second trimester| veditors=Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD |title=Management of unintended and abnormal pregnancy: comprehensive abortion care| ___location=Oxford|publisher=Wiley-Blackwell| pages=178–192| isbn=978-1-4051-7696-5}}</ref>
The most common early first trimester medical abortion regimens use mifepristone in combination with [[misoprostol]] (or sometimes another prostaglandin analog, [[gemeprost]]) up to 10 weeks (70 days) gestational age,<ref name=":2"/><ref name=":1">{{cite web |author=Center for Drug Evaluation and Research |title=Mifeprex (mifepristone) Information |url=https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information |website=FDA |access-date=2 July 2019 |date=8 February 2019 |archive-date=23 April 2019 |archive-url=https://web.archive.org/web/20190423032409/https://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm111323.htm |url-status=dead }}</ref> [[methotrexate]] in combination with a prostaglandin analog up to 7 weeks gestation, or a prostaglandin analog alone.<ref name=":0" /> Mifepristone–misoprostol combination regimens work faster and are more effective at later gestational ages than methotrexate–misoprostol combination regimens, and combination regimens are more effective than misoprostol alone, particularly in the second trimester.<ref name="Creinin 2009"/><ref>{{cite journal | vauthors = Wildschut H, Both MI, Medema S, Thomee E, Wildhagen MF, Kapp N | title = Medical methods for mid-trimester termination of pregnancy | journal = The Cochrane Database of Systematic Reviews | volume = 2011 | issue = 1 | pages = CD005216 | date = January 2011 | pmid = 21249669 | pmc = 8557267 | doi = 10.1002/14651858.CD005216.pub2 }}</ref> Medical abortion regimens involving mifepristone followed by misoprostol in the cheek between 24 and 48 hours later are effective when performed before 70 days' gestation.<ref name=":1" /><ref name=":2">{{cite journal | vauthors = Chen MJ, Creinin MD | title = Mifepristone With Buccal Misoprostol for Medical Abortion: A Systematic Review | journal = Obstetrics and Gynecology | volume = 126 | issue = 1 | pages = 12–21 | date = July 2015 | pmid = 26241251 | doi = 10.1097/AOG.0000000000000897 | url = http://www.escholarship.org/uc/item/2pw521h5 | access-date = 30 July 2019 | url-status = live | s2cid = 20800109 | archive-url = https://web.archive.org/web/20200726105924/https://escholarship.org/uc/item/2pw521h5 | archive-date = 26 July 2020 }}</ref>
[[File:Abortion pill.jpg|thumb|right|Shown here is the typical regimen for early medical abortions (200 mg [[mifepristone]] and 800 μg [[misoprostol]]).]]
In very early abortions, up to 7 weeks [[gestation]], medical abortion using a mifepristone–misoprostol combination regimen is considered to be more effective than surgical abortion ([[vacuum aspiration]]), especially when clinical practice does not include detailed inspection of aspirated tissue.<ref name="WHO FAQs 2006">{{cite book |author=WHO Department of Reproductive Health and Research |url=http://whqlibdoc.who.int/publications/2006/9241594845_eng.pdf |title=Frequently asked clinical questions about medical abortion |publisher=World Health Organization |year=2006 |isbn=92-4-159484-5 |___location=Geneva |access-date=22 November 2011 |url-access=subscription |archive-url=https://web.archive.org/web/20111226115043/http://whqlibdoc.who.int/publications/2006/9241594845_eng.pdf |archive-date=26 December 2011 |url-status=dead}}</ref> Early medical abortion regimens using mifepristone, followed 24–48 hours later by [[Buccal administration|buccal]] or vaginal misoprostol are 98% effective up to 9 weeks gestational age; from 9 to 10 weeks efficacy decreases modestly to 94%.<ref name=":2" /><ref name="Fjerstad 2009b">{{cite journal | vauthors = Fjerstad M, Sivin I, Lichtenberg ES, Trussell J, Cleland K, Cullins V | title = Effectiveness of medical abortion with mifepristone and buccal misoprostol through 59 gestational days | journal = Contraception | volume = 80 | issue = 3 | pages = 282–286 | date = September 2009 | pmid = 19698822 | pmc = 3766037 | doi = 10.1016/j.contraception.2009.03.010 }} The regimen (200 mg of mifepristone, followed 24–48 hours later by 800 mcg of ''vaginal'' misoprostol) ''previously'' used by [[Planned Parenthood]] clinics in the United States from 2001 to March 2006 was 98.5% effective through 63 days gestation—with an ongoing pregnancy rate of about 0.5%, and an additional 1% of women having uterine evacuation for various reasons, including problematic bleeding, persistent gestational sac, clinician judgment or a woman's request. The regimen (200 mg of mifepristone, followed 24–48 hours later by 800 mcg of ''[[wikt:buccal|buccal]]'' misoprostol) ''currently'' used by Planned Parenthood clinics in the United States since April 2006 is 98% effective through 59 days gestation.</ref> If medical abortion fails, surgical abortion must be used to complete the procedure.<ref>{{cite book| vauthors=Holmquist S, Gilliam M |year=2008| chapter=Induced abortion| veditors=Gibbs RS, Karlan BY, Haney AF, Nygaard I |title=Danforth's obstetrics and gynecology| edition=10th| ___location=Philadelphia|publisher=Lippincott Williams & Wilkins| pages=586–603| isbn=978-0-7817-6937-2}}</ref>
Early medical abortions account for the majority of abortions before 9 weeks gestation in [[Abortion in Great Britain|Britain]],<ref>{{Cite report |title=Abortion statistics, England and Wales: 2022 |url=https://www.gov.uk/government/statistics/abortion-statistics-for-england-and-wales-2022 |publisher= [[Office for Health Improvement and Disparities]] |date=2023| access-date=2024-07-23 |language=en|section = Table 5: Legal abortions: gestation weeks by purchaser and method of abortion, residents of England and Wales, numbers, percentages, 2022 |section-url = https://assets.publishing.service.gov.uk/media/664dcb9d4f29e1d07fadcc7b/Abortion-statistics-2022-data-tables.ods}}</ref> [[Abortion in France|France]],<ref>{{cite web| vauthors=Vilain A, Mouquet MC |date=22 June 2011 |title=Voluntary terminations of pregnancies in 2008 and 2009 |___location=Paris |publisher=DREES, Ministry of Health, France |url=http://www.sante.gouv.fr/IMG/pdf/er765.pdf |access-date=22 November 2011 |url-status=dead |archive-url=https://web.archive.org/web/20110926235733/http://www.sante.gouv.fr/IMG/pdf/er765.pdf |archive-date=26 September 2011 }}</ref> [[Abortion in Switzerland|Switzerland]],<ref>{{cite web| date=5 July 2011|title=Abortions in Switzerland 2010| ___location=Neuchâtel| publisher=Office of Federal Statistics, Switzerland| url=http://www.bfs.admin.ch/bfs/portal/fr/index/themen/14/02/03/key/03.html|access-date=22 November 2011| url-status=dead| archive-url=https://web.archive.org/web/20111003203103/http://www.bfs.admin.ch/bfs/portal/fr/index/themen/14/02/03/key/03.html|archive-date=3 October 2011}}</ref> [[Abortion in the United States|United States]],<ref>{{cite report | vauthors = Jones RK, Witwer E, Jerman J |title=Abortion Incidence and Service Availability in the United States, 2017 |year=2019 |publisher=Guttmacher Institute |doi=10.1363/2019.30760 |doi-access=free |pmc=5487028 }}</ref> and the [[Nordic countries]].<ref>{{cite web| vauthors=Gissler M, Heino A|date=21 February 2011| title=Induced abortions in the Nordic countries 2009| ___location=Helsinki| publisher=National Institute for Health and Welfare, Finland| url=http://www.stakes.fi/tilastot/tilastotiedotteet/2011/Tr09_11.pdf| access-date=22 November 2011| url-status=dead|archive-url=https://web.archive.org/web/20120118094034/http://www.stakes.fi/tilastot/tilastotiedotteet/2011/Tr09_11.pdf|archive-date=18 January 2012}}</ref>
Medical abortion regimens using mifepristone in combination with a prostaglandin analog are the most common methods used for second trimester abortions in [[Abortion in Canada|Canada]], most of Europe, [[Abortion in China|China]] and [[Abortion in India|India]],<ref name="Kapp 2009"/> in contrast to the United States where 96% of second trimester abortions are performed surgically by [[dilation and evacuation]].<ref name=":3">{{cite book|title=Management of unintended and abnormal pregnancy: comprehensive abortion care| vauthors=Meckstroth K, Paul M|publisher=Wiley-Blackwell| year=2009|isbn=978-1-4051-7696-5|veditors=Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD| ___location=Oxford|pages=135–156|chapter=First-trimester aspiration abortion}}</ref>
A 2020 [[Cochrane review|Cochrane Systematic Review]] concluded that providing women with medications to take home to complete the second stage of the procedure for an early medical abortion results in an effective abortion.<ref name=":4">{{cite journal | vauthors = Gambir K, Kim C, Necastro KA, Ganatra B, Ngo TD | title = Self-administered versus provider-administered medical abortion | journal = The Cochrane Database of Systematic Reviews | volume = 2020 | pages = CD013181 | date = March 2020 | issue = 3 | pmid = 32150279 | pmc = 7062143 | doi = 10.1002/14651858.CD013181.pub2 }}</ref> Further research is required to determine if self-administered medical abortion is as safe as provider-administered medical abortion, where a health care professional is present to help manage the medical abortion.<ref name=":4" /> Safely permitting women to self-administer abortion medication has the potential to improve access to abortion.<ref name=":4" /> The review also noted a research gap concerning methods to support women who take medication at home for a self-administered abortion.<ref name=":4" />
===Surgical===
[[File:Vacuum-aspiration (single).svg|thumb|A vacuum aspiration abortion at eight weeks gestational age (six weeks after fertilization).<br />'''1:''' [[Amniotic sac]]<br />'''2:''' [[Embryo]]<br />'''3:''' [[Endometrium|Uterine lining]]<br />'''4:''' [[Speculum (medical)|Speculum]]<br />'''5:''' Vacurette<br />'''6:''' Attached to a [[Vacuum pump|suction pump]]]]
Up to 15 weeks' gestation, [[suction-aspiration abortion|suction-aspiration]] or vacuum aspiration are the most common surgical methods of induced abortion.<ref>{{cite web| author=Healthwise |url=http://www.webmd.com/hw/womens_conditions/tw1078.asp#tw1112 |title=Manual and vacuum aspiration for abortion |year=2004 |website=WebMD |access-date=5 December 2008| archive-url= https://web.archive.org/web/20070211155626/http://www.webmd.com/hw/womens_conditions/tw1078.asp| archive-date=11 February 2007| url-status= live}}</ref> ''Manual vacuum aspiration'' (MVA) consists of removing the [[fetus]] or [[embryo]], [[placenta]], and membranes by suction using a manual syringe, while ''electric vacuum aspiration'' (EVA) uses an electric pump. Both techniques can be used very early in pregnancy. MVA can be used up to 14 weeks but is more often used earlier in the U.S. EVA can be used later.<ref name=":3" />
MVA, also known as "mini-suction" and "[[menstrual extraction]]", or EVA can be used in very early pregnancy when cervical dilation may not be required. [[Dilation and curettage]] (D&C) refers to opening the cervix (dilation) and removing tissue (curettage) via suction or sharp instruments. D&C is a standard gynecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion. The [[World Health Organization]] recommends ''sharp curettage'' only when suction aspiration is unavailable.<ref>{{cite book|title=Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors| author=World Health Organization| publisher=World Health Organization| year=2017| isbn=978-92-4-154587-7| ___location=Geneva| chapter=Dilatation and curettage| oclc=181845530| access-date=30 July 2019|chapter-url=https://www.who.int/reproductive-health/impac/Procedures/Dilatetion_P61_P63.html|archive-date=19 May 2009|archive-url=https://web.archive.org/web/20090519162903/http://www.who.int/reproductive-health/impac/Procedures/Dilatetion_P61_P63.html| url-status=live}}</ref>
[[Dilation and evacuation]] (D&E), used after 12 to 16 weeks, consists of opening the [[cervix]] and emptying the uterus using surgical instruments and suction. D&E is performed vaginally and does not require an incision. [[Intact dilation and extraction]] (D&X) refers to a variant of D&E sometimes used after 18 to 20 weeks when removal of an intact fetus improves surgical safety or for other reasons.<ref>{{cite book| title=Dilation and evacuation. In Paul M, Lichtenberg ES Borgatta L Grimes DA Stubblefield P Creinin (eds)Management of unintended and abnormal pregnancy: comprehensive abortion care.| vauthors = Hammond C, Chasen S |publisher=Oxford: Wiley-Blackwell|year=2009|isbn=978-1-4051-7696-5|pages=178–192}}</ref>
Abortion may also be performed surgically by hysterotomy or gravid hysterectomy. [[Hysterotomy abortion]] is a procedure similar to a [[caesarean section]] and is performed under [[general anesthesia]]. It requires a smaller incision than a caesarean section and can be used during later stages of pregnancy. Gravid hysterectomy refers to removal of the whole uterus while still containing the pregnancy. Hysterotomy and hysterectomy are associated with much higher rates of maternal morbidity and mortality than D&E or induction abortion.<ref>{{cite journal | vauthors = | title = ACOG Practice Bulletin No. 135: Second-trimester abortion | journal = Obstetrics and Gynecology | volume = 121 | issue = 6 | pages = 1394–1406 | date = June 2013 | pmid = 23812485 | doi = 10.1097/01.AOG.0000431056.79334.cc | s2cid = 205384119 }}</ref>
First trimester procedures can generally be performed using [[local anesthesia]], while second trimester methods may require [[Sedation#Levels of sedation|deep sedation]] or [[general anesthesia]].<ref name="NEJMDec2011">{{cite journal | vauthors = Templeton A, Grimes DA | title = Clinical practice. A request for abortion | journal = The New England Journal of Medicine | volume = 365 | issue = 23 | pages = 2198–2204 | date = December 2011 | pmid = 22150038 | doi = 10.1056/NEJMcp1103639 | doi-access = }}</ref><ref>{{cite journal | vauthors = Allen RH, Singh R | title = Society of Family Planning clinical guidelines pain control in surgical abortion part 1 - local anesthesia and minimal sedation | language = English | journal = Contraception | volume = 97 | issue = 6 | pages = 471–477 | date = June 2018 | pmid = 29407363 | doi = 10.1016/j.contraception.2018.01.014 | url = https://www.contraceptionjournal.org/article/S0010-7824(18)30036-2/abstract | access-date = 20 January 2022 | url-status = live | s2cid = 3777869 | archive-url = https://web.archive.org/web/20220303075142/https://www.contraceptionjournal.org/article/S0010-7824%2818%2930036-2/fulltext | archive-date = 3 March 2022 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Cansino C, Denny C, Carlisle AS, Stubblefield P | title = Society of Family Planning clinical recommendations: Pain control in surgical abortion part 2 - Moderate sedation, deep sedation, and general anesthesia | language = English | journal = Contraception | volume = 104 | issue = 6 | pages = 583–592 | date = December 2021 | pmid = 34425082 | doi = 10.1016/j.contraception.2021.08.007 | url = https://www.contraceptionjournal.org/article/S0010-7824(21)00351-6/abstract | access-date = 20 January 2022 | url-status = live | s2cid = 237279946 | archive-url = https://web.archive.org/web/20220303075141/https://www.contraceptionjournal.org/article/S0010-7824%2821%2900351-6/fulltext | archive-date = 3 March 2022 | doi-access = free }}</ref>
===Labor induction abortion===
In places lacking the necessary medical skill for dilation and extraction, or when preferred by practitioners, an abortion can be induced by first [[Labor induction|inducing labor]] and then [[Late termination of pregnancy#Methods|inducing fetal demise]] if necessary.<ref name=GLOWM_Late>{{cite journal| last = Borgatta | first= Lynn |journal=Global Library of Women's Medicine| date=December 2014 |volume=GLOWM.10444| doi=10.3843/GLOWM.10444| url=http://www.glowm.com/section_view/heading/Labor%20Induction%20Termination%20of%20Pregnancy/item/443| access-date=25 September 2015| title=Labor Induction Termination of Pregnancy| url-status=live| archive-url=https://web.archive.org/web/20150924082507/http://www.glowm.com/section_view/heading/Labor%20Induction%20Termination%20of%20Pregnancy/item/443| archive-date=24 September 2015| url-access=subscription}}</ref> This is sometimes called "induced miscarriage". This procedure may be performed from 13 weeks gestation to the third trimester. Although it is very uncommon in the United States, more than 80% of induced abortions throughout the second trimester are labor-induced abortions in Sweden and other nearby countries.<ref name=Labor_Induced_Abortion>{{cite journal | last1 = Borgatta | first1= Lynn |first2 =Nathalie |last2 =Kapp| title = Clinical guidelines. Labor induction abortion in the second trimester | journal = Contraception | volume = 84 | issue = 1 | pages = 4–18 | date = July 2011 | pmid = 21664506 | doi = 10.1016/j.contraception.2011.02.005 | url = http://www.contraceptionjournal.org/article/S0010-7824(11)00057-6/pdf | access-date = 25 September 2015 | url-status = live | quote = 10. What is the effect of feticide on labor induction abortion outcome? Deliberately causing demise of the fetus before labor induction abortion is performed primarily to avoid transient fetal survival after expulsion; this approach may be for the comfort of both the woman and the staff, to avoid futile resuscitation efforts. Some providers allege that feticide also facilitates delivery, although little data support this claim. Transient fetal survival is very unlikely after intraamniotic installation of saline or urea, which are directly feticidal. Transient survival with misoprostol for labor induction abortion at greater than 18 weeks ranges from 0% to 50% and has been observed in up to 13% of abortions performed with high-dose oxytocin. Factors associated with a higher likelihood of transient fetal survival with labor induction abortion include increasing gestational age, decreasing abortion interval and the use of nonfeticidal inductive agents such as the PGE1 analogues. | archive-url = https://web.archive.org/web/20200606205318/https://www.contraceptionjournal.org/article/S0010-7824(11)00057-6/pdf | archive-date = 6 June 2020 | doi-access = free }}</ref>
Only limited data are available comparing labor-induced abortion with the dilation and extraction method.<ref name=Labor_Induced_Abortion/> Unlike D&E, labor-induced abortions after 18 weeks may be complicated by the occurrence of brief fetal survival, which may be legally characterized as live birth. For this reason, labor-induced abortion is legally risky in the United States.<ref name=Labor_Induced_Abortion/><ref name=NAF_2015_Policy>{{cite book| title=2015 Clinical Policy Guidelines| publisher=National Abortion Federation| date=2015| url=http://prochoice.org/wp-content/uploads/2015_NAF_CPGs.pdf| access-date=30 October 2015| quote=Policy Statement: Medical induction abortion is a safe and effective method for termination of pregnancies beyond the first trimester when performed by trained clinicians in medical offices, freestanding clinics, ambulatory surgery centers, and hospitals. Feticidal agents may be particularly important when issues of viability arise.| url-status=live| archive-url=https://web.archive.org/web/20150812220053/http://prochoice.org/wp-content/uploads/2015_NAF_CPGs.pdf| archive-date=12 August 2015}}</ref>
===Other methods===
Historically, a number of herbs reputed to possess abortifacient properties have been used in [[folk medicine]]. Such herbs include [[tansy]], [[Mentha pulegium|pennyroyal]], [[black cohosh]], and the now-extinct [[Silphium (antiquity)|silphium]].<ref name="riddle2">{{cite book |last=Riddle |first=John M |url=https://archive.org/details/evesherbshistory0000ridd |title=Eve's herbs: a history of contraception and abortion in the West |publisher=Harvard University Press |year=1997 |isbn=978-0-674-27024-4 |___location=Cambridge, MA |oclc=36126503 |author-link=John M. Riddle |url-access=registration}}</ref>{{rp|44–47, 62–63, 154–155, 230–231}}
In 1978, one woman in Colorado died and another developed organ damage when they attempted to terminate their pregnancies by taking pennyroyal oil.<ref>{{cite journal | vauthors = Sullivan JB, Rumack BH, Thomas H, Peterson RG, Bryson P | title = Pennyroyal oil poisoning and hepatotoxicity | journal = JAMA | volume = 242 | issue = 26 | pages = 2873–2874 | date = December 1979 | pmid = 513258 | doi = 10.1001/jama.1979.03300260043027 | s2cid = 26198529 }}</ref>
Because the indiscriminant use of herbs as abortifacients can cause serious—even lethal—side effects, such as [[multiple organ dysfunction syndrome|multiple organ failure]],<ref>{{cite journal | vauthors = Ciganda C, Laborde A | title = Herbal infusions used for induced abortion | journal = Journal of Toxicology. Clinical Toxicology | volume = 41 | issue = 3 | pages = 235–239 | year = 2003 | pmid = 12807304 | doi = 10.1081/CLT-120021104 | s2cid = 44851492 }}</ref> such use is not recommended by physicians.
Abortion is sometimes attempted by causing trauma to the abdomen. The degree of force, if severe, can cause serious internal injuries without necessarily succeeding in inducing [[miscarriage]].<ref>{{cite journal | vauthors = Smith JP | title = Risky choices: the dangers of teens using self-induced abortion attempts | journal = Journal of Pediatric Health Care | volume = 12 | issue = 3 | pages = 147–151 | year = 1998 | pmid = 9652283 | doi = 10.1016/S0891-5245(98)90245-0 }}</ref> In Southeast Asia, there is an ancient tradition of attempting abortion through forceful abdominal massage.<ref name="potts">{{cite journal | vauthors = Potts M, Graff M, Taing J | title = Thousand-year-old depictions of massage abortion | journal = The Journal of Family Planning and Reproductive Health Care | volume = 33 | issue = 4 | pages = 233–234 | date = October 2007 | pmid = 17925100 | doi = 10.1783/147118907782101904 | doi-access = free | author-link1 = Malcolm Potts }}</ref> One of the [[bas relief]]s decorating the temple of [[Angkor Wat]] in Cambodia depicts a demon performing such an abortion upon a woman who had been sent to the [[underworld]].<ref name="potts" />
Reported methods of unsafe, [[self-induced abortion]] include misuse of [[misoprostol]] and insertion of non-surgical implements such as knitting needles and [[clothes hanger]]s into the uterus. These and other methods to terminate pregnancy may be called "induced miscarriage". Such methods are rarely used in countries where surgical abortion is legal and available.<ref>{{cite journal | vauthors = Thapa SR, Rimal D, Preston J | title = Self induction of abortion with instrumentation | journal = Australian Family Physician | volume = 35 | issue = 9 | pages = 697–698 | date = September 2006 | pmid = 16969439 | url = http://www.racgp.org.au/afp/200609/11015 | url-status = live | archive-url = https://web.archive.org/web/20090108181951/http://www.racgp.org.au/afp/200609/11015 | archive-date = 8 January 2009 }}</ref>
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==Safety==
[[File:Abortion Quick & Pain Free sign, Joe Slovo Park, Cape Town, South Africa-3869.jpg|thumb|right|A likely illegal abortion flyer in South Africa]]
The health risks of abortion depend principally on how, and under what conditions, the procedure is performed. The [[World Health Organization]] (WHO) defines [[unsafe abortion]]s as a procedure for terminating an unintended pregnancy carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both.<ref name="m194">{{cite web | title=Abortion | website=World Health Organization (WHO) | date=2024-05-17 | url=https://www.who.int/news-room/fact-sheets/detail/abortion | ref={{sfnref|World Health Organization (WHO)|2024}} | access-date=2025-05-21}}</ref> Legal abortions performed in the [[developed country|developed world]] are among the safest procedures in medicine.<ref name="lancet-grimes" >{{cite journal | vauthors = Grimes DA, Benson J, Singh S, Romero M, Ganatra B, Okonofua FE, Shah IH | title = Unsafe abortion: the preventable pandemic | journal = Lancet | volume = 368 | issue = 9550 | pages = 1908–1919 | date = November 25, 2006 | pmid = 17126724 | doi = 10.1016/S0140-6736(06)69481-6 | url = https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69481-6/fulltext | s2cid = 6188636 | url-access = subscription | access-date = 8 June 2023 | archive-date = 3 April 2023 | archive-url = https://web.archive.org/web/20230403232414/https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69481-6/fulltext | url-status = live }}</ref><ref name="grimes-overview">{{cite journal | vauthors = Grimes DA, Creinin MD | title = Induced abortion: an overview for internists | journal = Annals of Internal Medicine | volume = 140 | issue = 8 | pages = 620–626 | date = April 2004 | pmid = 15096333 | doi = 10.7326/0003-4819-140-8-200404200-00009 | doi-access = free | citeseerx = 10.1.1.694.3531 }}</ref> According to a 2012 study in ''Obstetrics & Gynecology'', in the United States the risk of maternal mortality is 14 times lower after induced abortion than after childbirth.<ref name=Grimes2012>{{cite journal | first1 = Elizabeth G| last1 = Raymond| last2= Grimes |first2= David A | author-link2=David Grimes (physician)| title = The comparative safety of legal induced abortion and childbirth in the United States | journal = [[Obstetrics & Gynecology (journal)|Obstetrics & Gynecology]] | volume = 119 | issue = 2 Pt 1 | pages = 215–219 | date = February 2012 | pmid = 22270271 | doi = 10.1097/AOG.0b013e31823fe923 | quote = Conclusion: Legal induced abortion is markedly safer than childbirth. The risk of death associated with childbirth is approximately 14 times higher than that with abortion. Similarly, the overall morbidity associated with childbirth exceeds that with abortion. | s2cid = 25534071 }}</ref> The CDC estimated in 2019 that US pregnancy-related mortality was 17.2 maternal deaths per 100,000 live births,<ref>{{cite journal | vauthors = Petersen EE, Davis NL, Goodman D, Cox S, Mayes N, Johnston E, Syverson C, Seed K, Shapiro-Mendoza CK, Callaghan WM, Barfield W | display-authors = 6 | title = Vital Signs: Pregnancy-Related Deaths, United States, 2011–2015, and Strategies for Prevention, 13 States, 2013-2017 | journal = MMWR. Morbidity and Mortality Weekly Report | volume = 68 | issue = 18 | pages = 423–429 | date = May 2019 | pmid = 31071074 | pmc = 6542194 | doi = 10.15585/mmwr.mm6818e1 }}</ref> while the US abortion mortality rate was 0.43 maternal deaths per 100,000 procedures.<ref name="Ray2014">{{cite journal | vauthors = Raymond EG, Grossman D, Weaver MA, Toti S, Winikoff B | title = Mortality of induced abortion, other outpatient surgical procedures and common activities in the United States | journal = Contraception | volume = 90 | issue = 5 | pages = 476–479 | date = November 2014 | pmid = 25152259 | doi = 10.1016/j.contraception.2014.07.012 | quote = Results: The abortion-related mortality rate in 2000–2009 in the United States was 0.7 per 100,000 abortions. Studies in approximately the same years found mortality rates of 0.8-1.7 deaths per 100,000 plastic surgery procedures, 0-1.7 deaths per 100,000 dental procedures, 0.6-1.2 deaths per 100,000 marathons run and at least 4 deaths among 100,000 cyclists in a large annual bicycling event. The traffic fatality rate per 758 vehicle miles traveled by passenger cars in the United States in 2007-2011 was about equal to the abortion-related mortality rate. Conclusions: The safety of induced abortion as practiced in the United States for the past decade met or exceeded expectations for outpatient surgical procedures and compared favorably to that of two common nonmedical voluntary activities. }}</ref><ref>{{cite book|url=https://www.nap.edu/read/24950/chapter/4|title=Read "The Safety and Quality of Abortion Care in the United States" at NAP.edu|doi=10.17226/24950|pmid=29897702|year=2018|isbn=978-0-309-46818-3 | author2 = Health Medicine Division| author1 = National Academies of Sciences Engineering |author3=Board on Health Care Services|author4=Board on Population Health Public Health Practice|author5=Committee on Reproductive Health Services: Assessing the Safety Quality of Abortion Care in the U.S|access-date=26 May 2019|archive-date=24 July 2020|archive-url=https://web.archive.org/web/20200724204509/https://www.nap.edu/read/24950/chapter/4|url-status=live}}</ref><ref name=CDC_2022_AS>{{cite journal |last=Kortsmit |first=Katherine |date=2022 |title=Abortion Surveillance — United States, 2020 |url=https://www.cdc.gov/mmwr/volumes/71/ss/ss7110a1.htm |journal=MMWR. Surveillance Summaries |language=en-us |volume=71 |issue=10 |pages=1–27 |doi=10.15585/mmwr.ss7110a1 |issn=1546-0738 |pmc=9707346 |pmid=36417304 |quote=The national case-fatality rate for legal induced abortion for 2013–2019 was 0.43 deaths related to legal induced abortions per 100,000 reported legal abortions. This case-fatality rate was lower than the rates for the previous 5-year periods. |access-date=14 November 2023 |archive-date=15 November 2023 |archive-url=https://web.archive.org/web/20231115033902/https://www.cdc.gov/mmwr/volumes/71/ss/ss7110a1.htm |url-status=live }}</ref> In the UK, guidelines of the Royal College of Obstetricians and Gynaecologists state that "Women should be advised that abortion is generally safer than continuing a pregnancy to term."<ref>{{cite journal| vauthors = Donnelly L |title=Abortion is Safer than Having a Baby, Doctors Say|journal=The Telegraph|date=26 February 2011}}</ref> Worldwide, on average, abortion is safer than carrying a pregnancy to term. A 2007 study reported that "26% of all pregnancies worldwide are terminated by induced abortion," whereas "deaths from improperly performed [abortion] procedures constitute 13% of maternal mortality globally."<ref>{{cite journal | vauthors = Dixon-Mueller R, Germain A | title = Fertility regulation and reproductive health in the Millennium Development Goals: the search for a perfect indicator | journal = American Journal of Public Health | volume = 97 | issue = 1 | pages = 45–51 | date = January 2007 | pmid = 16571693 | pmc = 1716248 | doi = 10.2105/AJPH.2005.068056 }}</ref> In Indonesia in 2000 it was estimated that 2 million pregnancies ended in abortion, 4.5 million pregnancies were carried to term, and 14–16 percent of maternal deaths resulted from abortion.<ref>{{cite web |url=https://www.guttmacher.org/sites/default/files/report_pdf/ib_abortion_indonesia_0.pdf |title=Abortion in Indonesia |publisher=Guttmacher Institute |year=2008 |access-date=13 October 2019 |archive-date=7 June 2020 |archive-url=https://web.archive.org/web/20200607212421/https://www.guttmacher.org/sites/default/files/report_pdf/ib_abortion_indonesia_0.pdf |url-status=live }}</ref>
In the US from 2000 to 2009, abortion had a mortality rate lower than [[plastic surgery]], lower or similar to running a marathon, and about equivalent to traveling {{convert|760|miles}} in a passenger car.{{ r | Ray2014 }} Five years after seeking abortion services, women who gave birth after being denied an abortion reported worse health than women who had either first or second trimester abortions.<ref>{{cite journal | vauthors = Ralph LJ, Schwarz EB, Grossman D, Foster DG | title = Self-reported Physical Health of Women Who Did and Did Not Terminate Pregnancy After Seeking Abortion Services: A Cohort Study | journal = Annals of Internal Medicine | volume = 171 | issue = 4 | pages = 238–247 | date = August 2019 | pmid = 31181576 | doi = 10.7326/M18-1666 | s2cid = 184482546 }}</ref> The risk of abortion-related mortality increases with gestational age, but remains lower than that of childbirth.<ref>{{cite journal | vauthors = Raymond EG, Grimes DA | title = The comparative safety of legal induced abortion and childbirth in the United States | journal = Obstetrics and Gynecology | volume = 119 | issue = 2 Pt 1 | pages = 215–219 | date = February 2012 | pmid = 22270271 | doi = 10.1097/AOG.0b013e31823fe923 | s2cid = 25534071 }}</ref> Outpatient abortion is as safe from 64 to 70 days' gestation as it before 63 days.<ref>{{cite journal | vauthors = Abbas D, Chong E, Raymond EG | title = Outpatient medical abortion is safe and effective through 70 days gestation | journal = Contraception | volume = 92 | issue = 3 | pages = 197–199 | date = September 2015 | pmid = 26118638 | doi = 10.1016/j.contraception.2015.06.018 }}</ref>
=== Safety of abortion methods ===
There is little difference in terms of safety and efficacy between medical abortion using a combined regimen of mifepristone and misoprostol and surgical abortion (vacuum aspiration) in early first trimester abortions up to 10 weeks gestation.<ref name="WHO FAQs 2006"/> Medical abortion using the prostaglandin analog misoprostol alone is less effective and more painful than medical abortion using a combined regimen of mifepristone and misoprostol or surgical abortion.<ref>{{cite web| vauthors = Grossman D|date=3 September 2004|title=Medical methods for first trimester abortion: RHL commentary|work=Reproductive Health Library|___location=Geneva|publisher=World Health Organization|url=http://apps.who.int/rhl/fertility/abortion/dgcom/en/index.html|access-date=22 November 2011|url-status=dead|archive-url=https://web.archive.org/web/20111028054620/http://apps.who.int/rhl/fertility/abortion/dgcom/en/index.html|archive-date=28 October 2011}}</ref><ref>{{cite web|vauthors=Chien P, Thomson M |date=15 December 2006|title=Medical versus surgical methods for first trimester termination of pregnancy: RHL commentary|work=Reproductive Health Library|___location=Geneva|publisher=World Health Organization|url=http://apps.who.int/rhl/fertility/abortion/pccom/en/index.html |access-date=1 June 2010| archive-url= https://web.archive.org/web/20100517201143/http://apps.who.int/rhl/fertility/abortion/pccom/en/index.html| archive-date= 17 May 2010 | url-status= dead}}</ref>
=== Safety and gestational age===
[[Vacuum aspiration]] in the first trimester is the safest method of surgical abortion, and can be performed in a [[primary care|primary care office]], [[abortion clinic]], or hospital. Complications, which are rare, can include [[uterine perforation]], [[endometritis|pelvic infection]], and retained products of conception requiring a second procedure to evacuate.<ref name="arch-fam-practice">{{cite journal | vauthors = Westfall JM, Sophocles A, Burggraf H, Ellis S | title = Manual vacuum aspiration for first-trimester abortion | journal = Archives of Family Medicine | volume = 7 | issue = 6 | pages = 559–562 | year = 1998 | pmid = 9821831 | doi = 10.1001/archfami.7.6.559 | url = http://archfami.ama-assn.org/cgi/content/full/7/6/559 | url-status = dead | archive-url = https://web.archive.org/web/20050405202853/http://archfami.ama-assn.org/cgi/content/full/7/6/559 | archive-date = 5 April 2005 | url-access = subscription }}</ref> Infections account for one-third of abortion-related deaths in the United States.<ref>{{cite journal | vauthors = Dempsey A | title = Serious infection associated with induced abortion in the United States | journal = Clinical Obstetrics and Gynecology | volume = 55 | issue = 4 | pages = 888–892 | date = December 2012 | pmid = 23090457 | doi = 10.1097/GRF.0b013e31826fd8f8 }}</ref> The rate of complications of vacuum aspiration abortion in the first trimester is similar regardless of whether the procedure is performed in a hospital, surgical center, or office.<ref>{{cite journal | vauthors = White K, Carroll E, Grossman D | title = Complications from first-trimester aspiration abortion: a systematic review of the literature | journal = Contraception | volume = 92 | issue = 5 | pages = 422–438 | date = November 2015 | pmid = 26238336 | doi = 10.1016/j.contraception.2015.07.013 }}</ref> Preventive antibiotics (such as [[doxycycline]] or [[metronidazole]]) are typically given before abortion procedures,<ref>{{cite journal | vauthors = | title = ACOG practice bulletin No. 104: antibiotic prophylaxis for gynecologic procedures | journal = Obstetrics and Gynecology | volume = 113 | issue = 5 | pages = 1180–1189 | date = May 2009 | pmid = 19384149 | doi = 10.1097/AOG.0b013e3181a6d011 | doi-access = }}</ref> as they are believed to substantially reduce the risk of postoperative uterine infection;<ref name="NEJMDec2011" /><ref>{{cite journal | vauthors = Sawaya GF, Grady D, Kerlikowske K, Grimes DA | title = Antibiotics at the time of induced abortion: the case for universal prophylaxis based on a meta-analysis | journal = Obstetrics and Gynecology | volume = 87 | issue = 5 Pt 2 | pages = 884–890 | date = May 1996 | pmid = 8677129 }}</ref> however, antibiotics are not routinely given with abortion pills.<ref>{{cite journal | vauthors = Achilles SL, Reeves MF | title = Prevention of infection after induced abortion: release date October 2010: SFP guideline 20102 | journal = Contraception | volume = 83 | issue = 4 | pages = 295–309 | date = April 2011 | pmid = 21397086 | doi = 10.1016/j.contraception.2010.11.006 | doi-access = free }}</ref> The rate of failed procedures does not appear to vary significantly depending on whether the abortion is performed by a doctor or a [[mid-level practitioner]].<ref>{{cite journal | vauthors = Barnard S, Kim C, Park MH, Ngo TD | title = Doctors or mid-level providers for abortion | journal = The Cochrane Database of Systematic Reviews | volume = 2015 | issue = 7 | pages = CD011242 | date = July 2015 | pmid = 26214844 | doi = 10.1002/14651858.CD011242.pub2 | pmc = 9188302 | url = https://researchonline.lshtm.ac.uk/2274695/1/Doctors%20or%20mid-level%20providers%20for%20abortion_GREEN%20VoR.pdf | access-date = 24 November 2019 | archive-date = 27 August 2021 | archive-url = https://web.archive.org/web/20210827202229/https://researchonline.lshtm.ac.uk/id/eprint/2274695/1/Doctors | url-status = live }}</ref>
Complications after second trimester abortion are similar to those after first trimester abortion, and depend somewhat on the method chosen.<ref>{{cite journal | vauthors = Lerma K, Shaw KA | title = Update on second trimester medical abortion | journal = Current Opinion in Obstetrics & Gynecology | volume = 29 | issue = 6 | pages = 413–418 | date = December 2017 | pmid = 28922193 | doi = 10.1097/GCO.0000000000000409 | quote = Second trimester surgical abortion is well tolerated and increasingly expeditious | s2cid = 12459747 }}</ref> The risk of death from abortion approaches roughly half the risk of death from childbirth the farther along a woman is in pregnancy; from one in a million before 9 weeks gestation to nearly one in ten thousand at 21 weeks or more (as measured from the last menstrual period).<ref>{{cite journal | collaboration = Committee on Practice Bulletins-Gynecology | vauthors = Steinauer J, Jackson A, Grossman D |title=Second-trimester abortion. Practice Bulletin No. 135. |journal=American College of Obstetrics & Gynecology - Practice Bulletins |date=June 2013 |url=https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Second-Trimester-Abortion |access-date=4 December 2019 |quote=The mortality rate associated with abortion is low (0.6 per 100,000 legal, induced abortions), and the risk of death associated with childbirth is approximately 14 times higher than that with abortion. Abortion-related mortality increases with each week of gestation, with a rate of 0.1 per 100,000 procedures at 8 weeks of gestation or less, and 8.9 per 100,000 procedures at 21 weeks of gestation or greater. |archive-date=24 December 2019 |archive-url=https://web.archive.org/web/20191224111109/https://www.acog.org/Clinical-Guidance-and-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Second-Trimester-Abortion |url-status=live }}</ref><ref name=Bartlett2004>{{cite journal | vauthors = Bartlett LA, Berg CJ, Shulman HB, Zane SB, Green CA, Whitehead S, Atrash HK | title = Risk factors for legal induced abortion-related mortality in the United States | journal = Obstetrics and Gynecology | volume = 103 | issue = 4 | pages = 729–737 | date = April 2004 | pmid = 15051566 | doi = 10.1097/01.AOG.0000116260.81570.60 | quote = The risk factor that continues to be most strongly associated with mortality from legal abortion is gestational age at the time of the abortion | s2cid = 42597014 | doi-access = free }}</ref> It appears that having had a prior surgical uterine evacuation (whether because of induced abortion or treatment of miscarriage) correlates with a small increase in the risk of preterm birth in future pregnancies. The studies supporting this did not control for factors not related to abortion or miscarriage, and hence the causes of this correlation have not been determined, although multiple possibilities have been suggested.<ref name=Saccone2016>{{cite journal | vauthors = Saccone G, Perriera L, Berghella V | title = Prior uterine evacuation of pregnancy as independent risk factor for preterm birth: a systematic review and metaanalysis | journal = American Journal of Obstetrics and Gynecology | volume = 214 | issue = 5 | pages = 572–591 | date = May 2016 | pmid = 26743506 | doi = 10.1016/j.ajog.2015.12.044 | url = https://www.iris.unina.it/retrieve/handle/11588/697884/158333/25%20Abortion%20PTB%20-%20AJOG%20-%20SACCONE.pdf | access-date = 27 June 2020 | url-status = live | quote = Prior surgical uterine evacuation for either I-TOP[induced termination of pregnancy] or SAB[spontaneous abortion, - also known as miscarriage] is an independent risk factor for PTB[pre-term birth]. These data warrant caution in the use of surgical uterine evacuation and should encourage safer surgical techniques as well as medical methods. | archive-url = https://web.archive.org/web/20210827202228/https://www.iris.unina.it/retrieve/handle/11588/697884/158333/25%20Abortion%20PTB%20-%20AJOG%20-%20SACCONE.pdf | archive-date = 27 August 2021 }}</ref><ref>{{cite journal | vauthors = Averbach SH, Seidman D, Steinauer J, Darney P | title = Re: Prior uterine evacuation of pregnancy as independent risk factor for preterm birth: a systematic review and metaanalysis | journal = American Journal of Obstetrics and Gynecology | volume = 216 | issue = 1 | page = 87 | date = January 2017 | pmid = 27596618 | doi = 10.1016/j.ajog.2016.08.038 | url = https://www.ajog.org/article/S0002-9378(16)30650-0/fulltext | access-date = 28 June 2020 | url-status = live | archive-url = https://web.archive.org/web/20210827202230/https://www.ajog.org/article/S0002-9378%2816%2930650-0/fulltext | archive-date = 27 August 2021 | doi-access = | url-access = subscription }}</ref>
===
{{Main|Abortion and mental health}}
Current evidence finds no relationship between most induced abortions and [[abortion and mental health|mental health problems]]<ref name=BMJ2014/><ref name=Hor2017>{{cite journal | vauthors = Horvath S, Schreiber CA | title = Unintended Pregnancy, Induced Abortion, and Mental Health | journal = Current Psychiatry Reports | volume = 19 | issue = 11 | article-number = 77 | date = September 2017 | pmid = 28905259 | doi = 10.1007/s11920-017-0832-4 | s2cid = 4769393 }}</ref> other than those expected for any unwanted pregnancy.<ref name="apa-press"/> A report by the [[American Psychological Association]] concluded that a woman's first abortion is not a threat to mental health when carried out in the first trimester, with such women no more likely to have mental-health problems than those carrying an unwanted pregnancy to term; the mental-health outcome of a woman's second or greater abortion is less certain.<ref name="apa-press">{{cite press release |publisher=American Psychological Association |title=APA Task Force Finds Single Abortion Not a Threat to Women's Mental Health |date=12 August 2008 |access-date=7 September 2011 |url=http://www.apa.org/news/press/releases/2008/08/single-abortion.aspx |url-status=live |archive-url=https://web.archive.org/web/20110906022824/http://www.apa.org/news/press/releases/2008/08/single-abortion.aspx |archive-date=6 September 2011 }}</ref><ref>{{cite web |url=http://www.apa.org/pi/women/programs/abortion/mental-health.pdf |title=Report of the APA Task Force on Mental Health and Abortion |publisher=American Psychological Association|___location=Washington, DC |date=13 August 2008 |url-status=live |archive-url=https://web.archive.org/web/20100615020211/http://apa.org/pi/women/programs/abortion/mental-health.pdf |archive-date=15 June 2010 }}</ref> Some older reviews concluded that abortion was associated with an increased risk of psychological problems;<ref>{{cite journal | vauthors = Coleman PK | title = Abortion and mental health: quantitative synthesis and analysis of research published 1995-2009 | journal = The British Journal of Psychiatry | volume = 199 | issue = 3 | pages = 180–186 | date = September 2011 | pmid = 21881096 | doi = 10.1192/bjp.bp.110.077230 | doi-access = free }}</ref> however, later reviews of the medical literature found that previous reviews did not use an appropriate control group.<ref name=Hor2017/> When a control group is utilized, receiving abortion is not associated with adverse psychological outcomes.<ref name=Hor2017/> However, women seeking abortion who are denied access to abortion have an increase in anxiety after the denial.<ref name=Hor2017/>
Although some studies show negative mental-health outcomes in women who choose abortions after the first trimester because of fetal abnormalities,<ref name="apa-2008">{{cite web |title=Mental Health and Abortion |url=http://www.apa.org/pi/women/programs/abortion/index.aspx |publisher=[[American Psychological Association]] |year=2008 |access-date=18 April 2012 |url-status=live |archive-url=https://web.archive.org/web/20120419174044/http://www.apa.org/pi/women/programs/abortion/index.aspx |archive-date=19 April 2012}}</ref> more rigorous research would be needed to show this conclusively.<ref name="Steinberg2011">{{cite journal |vauthors=Steinberg JR |title=Later abortions and mental health: psychological experiences of women having later abortions--a critical review of research | journal = Women's Health Issues |volume=21 |issue=3 Suppl |pages=S44–S48 |year=2011 |pmid=21530839 |doi=10.1016/j.whi.2011.02.002}}</ref> Some proposed negative psychological effects of abortion have been referred to by anti-abortion advocates as a separate condition called "[[post-abortion syndrome]]", but this is not recognized by medical or psychological professionals in the United States.<ref>{{cite journal |vauthors=Kelly K |title=The spread of 'Post Abortion Syndrome' as social diagnosis |journal=Social Science & Medicine |volume=102 |pages=18–25 |date=February 2014 |pmid=24565137 |doi=10.1016/j.socscimed.2013.11.030}}</ref>
A 2020 long term-study among US women found that about 99% of women felt that they made the right decision five years after they had an abortion. Relief was the primary emotion with few women feeling sadness or guilt. Social stigma was a main factor predicting negative emotions and regret years later. The researchers also stated: "These results add to the scientific evidence that emotions about an abortion are associated with personal and social context, and are not a product of the abortion procedure itself."<ref>{{cite journal | vauthors = Rocca CH, Samari G, Foster DG, Gould H, Kimport K | title = Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion stigma | journal = Social Science & Medicine | volume = 248 | article-number = 112704 | date = March 2020 | pmid = 31941577 | doi = 10.1016/j.socscimed.2019.112704 | doi-access = free | quote=We found no evidence of emerging negative emotions or abortion decision regret; both positive and negative emotions declined over the first two years and plateaued thereafter, and decision rightness remained high and steady (predicted percent: 97.5% at baseline, 99.0% at five years). At five years postabortion, relief remained the most commonly felt emotion among all women (predicted mean on 0-4 scale: 1.0; 0.6 for sadness and guilt; 0.4 for regret, anger and happiness). Despite converging levels of emotions by decision difficulty and stigma level over time, these two factors remained most important for predicting negative emotions and decision non-rightness years later. }}</ref>
=== Safety in the abortion debate ===
Some purported risks of abortion are promoted primarily by anti-abortion groups,<ref name="JASEN"/><ref name=Cancer_Linacre>{{cite journal | vauthors = Schneider AP, Zainer CM, Kubat CK, Mullen NK, Windisch AK | title = The breast cancer epidemic: 10 facts | journal = The Linacre Quarterly | volume = 81 | issue = 3 | pages = 244–277 | date = August 2014 | pmid = 25249706 | pmc = 4135458 | doi = 10.1179/2050854914Y.0000000027 | publisher = Catholic Medical Association | quote = an association between [induced abortion] and breast cancer has been found by numerous Western and non-Western researchers from around the world. This is especially true in more recent reports that allow for a sufficient breast cancer latency period since an adoption of a Western life style in sexual and reproductive behavior. | doi-access = free }}</ref> but lack scientific support.<ref name="JASEN">{{cite journal | vauthors = Jasen P | title = Breast cancer and the politics of abortion in the United States | journal = Medical History | volume = 49 | issue = 4 | pages = 423–444 | date = October 2005 | pmid = 16562329 | pmc = 1251638 | doi = 10.1017/S0025727300009145 }}</ref> For example, the question of a link between [[abortion-breast cancer hypothesis|induced abortion and breast cancer]] has been investigated extensively. Major medical and scientific bodies (including the WHO, [[National Cancer Institute]], [[American Cancer Society]], [[Royal College of Obstetricians and Gynaecologists|Royal College of OBGYN]] and [[American Congress of Obstetricians and Gynecologists|American Congress of OBGYN]]) have concluded that abortion does not cause breast cancer.<ref>Position statements of major medical bodies on abortion and breast cancer include:
* World Health Organization: {{cite web|url=https://www.who.int/mediacentre/factsheets/fs240/en/ |title=Induced abortion does not increase breast cancer risk (Fact sheet N°240) |publisher=World Health Organization |access-date=6 January 2011 |archive-url=https://web.archive.org/web/20110213141046/http://www.who.int/mediacentre/factsheets/fs240/en/ |archive-date=13 February 2011 }}
* National Cancer Institute: {{cite web|url=http://www.cancer.gov/cancertopics/factsheet/risk/abortion-miscarriage |title=Abortion, Miscarriage, and Breast Cancer Risk |publisher=National Cancer Institute |access-date=11 January 2011 |archive-url=https://web.archive.org/web/20101221084337/http://www.cancer.gov/cancertopics/factsheet/Risk/abortion-miscarriage |archive-date=21 December 2010 |url-status=live |date=20 February 2003 }}
* American Cancer Society: {{cite web|url=http://www.cancer.org/Cancer/BreastCancer/MoreInformation/is-abortion-linked-to-breast-cancer |publisher=American Cancer Society|date=23 September 2010 |access-date=20 June 2011 |title=Is Abortion Linked to Breast Cancer? |quote=At this time, the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer. |archive-url=https://web.archive.org/web/20110605204701/http://www.cancer.org/Cancer/BreastCancer/MoreInformation/is-abortion-linked-to-breast-cancer |archive-date=5 June 2011 |url-status=live }}
* Royal College of Obstetricians and Gynaecologists: {{cite web|url=http://www.rcog.org.uk/files/rcog-corp/uploaded-files/NEBAbortionSummary.pdf |title=The Care of Women Requesting Induced Abortion |page=9 |publisher=Royal College of Obstetricians and Gynaecologists |access-date=29 June 2008 |quote=Induced abortion is not associated with an increase in breast cancer risk. |url-status=dead |archive-url=https://web.archive.org/web/20130727105037/http://www.rcog.org.uk/files/rcog-corp/uploaded-files/NEBAbortionSummary.pdf |archive-date=27 July 2013 }}
* American Congress of Obstetricians and Gynecologists: {{cite web|url=http://www.acog.org/from_home/publications/press_releases/nr07-31-03-2.cfm |title=ACOG Finds No Link Between Abortion and Breast Cancer Risk |date=31 July 2003 |publisher=American Congress of Obstetricians and Gynecologists |access-date=11 January 2011 |archive-url=https://web.archive.org/web/20110102030744/http://www.acog.org/from_home/publications/press_releases/nr07-31-03-2.cfm |archive-date=2 January 2011 |url-status=dead }}</ref>
In the past even illegality has not automatically meant that the abortions were unsafe. Referring to the U.S., historian [[Linda Gordon]] states: "In fact, illegal abortions in this country have an impressive safety record."<ref>{{cite book | vauthors = Gordon L | title = The Moral Property of Women | publisher = University of Illinois Press | year = 2002 | isbn = 0-252-02764-7 }}</ref>{{rp|25|}}
According to [[Rickie Solinger]],
{{Blockquote|
A related myth, promulgated by a broad spectrum of people concerned about abortion and public policy, is that before legalization abortionists were dirty and dangerous back-alley butchers.... [T]he historical evidence does not support such claims.<ref>{{cite book | vauthors = Solinger R | chapter = Introduction | veditors = Solinger R | title = Abortion Wars: A Half Century of Struggle, 1950–2000 | pages = [https://archive.org/details/abortionwarshalf0000soli/page/1 1–9] | publisher = University of California Press | year = 1998 | isbn = 978-0-520-20952-7 | url = https://archive.org/details/abortionwarshalf0000soli/page/1 }}</ref>{{rp|4}}
}}
A 1940s American physician spoke of his pride in having performed 13,844 illegal abortions without any fatalities.<ref>{{cite book | last1 = Bates | first1 = Jerome E | last2 = Zawadzki | first2 = Edward S | title = Criminal Abortion: A Study in Medical Sociology | publisher = Charles C. Thomas | year = 1964 | isbn = 978-0-398-00109-4 |oclc =299149| page = 59| quote = In my practice I average three operations a day. By working a six day week, I complete approximately eighteen operations in this time. This amounts to seventy-two operations a month. In my sixteen years of specializing, I have successfully performed about 13,844 abortions.<br/> This was without the loss of the life of a single one of my patients. I feel those figures are something of which to be proud. I feel—I’m sure—that the work I have been engaged in these past years has been a contribution to Society and has helped to straighten out the messed up lives of many people.}}</ref>
In 1870s New York City, the abortionist/midwife [[Madame Restell]] (Anna Trow Lohman) is said to have lost very few women among her more than 100,000 patients<ref>{{cite book | vauthors = Keller A | title = Scandalous Lady: The Life and Times of Madame Restell | publisher = Atheneum | year = 1981 | isbn = 978-0-689-11213-3 }}</ref>—a lower mortality rate than the childbirth mortality rate at the time. In 1936, obstetrics and gynecology professor [[Frederick J. Taussig]] wrote that a cause of increasing mortality during the years of illegality in the U.S. was that
{{Blockquote|With each decade of the past fifty years the actual and proportionate frequency of this accident [perforation of the uterus] has increased, due, first, to the increase in the number of instrumentally induced abortions; second, to the proportionate increase in abortions handled by doctors as against those handled by midwives; and, third, to the prevailing tendency to use instruments instead of the finger in emptying the uterus.<ref>{{cite book | last = Taussig | first= Frederick J. | author-link = Frederick J. Taussig | title = Abortion Spontaneous and Induced: Medical and Social Aspects | publisher = C.V. Mosby | year = 1936 |___location = St. Louis | page = 223 |url = https://archive.org/details/b29818394/page/223/mode/1up | oclc = 1041029321 }}</ref>
}}
===Unsafe abortion===
{{Main|Unsafe abortion}}
[[File:RussianAbortionPoster.jpg|thumb|Soviet poster {{Circa|1925}} (after Russia legalized abortion in 1920) warning against abortions performed by folk practitioners]]
Women seeking an abortion may use unsafe methods, especially when abortion is legally restricted. They may attempt [[self-induced abortion]] or seek the help of a person without proper medical training or facilities. This can lead to severe complications, such as incomplete abortion, [[sepsis]], hemorrhage, and damage to internal organs.<ref>{{cite journal | vauthors = Okonofua F | title = Abortion and maternal mortality in the developing world | journal = Journal of Obstetrics and Gynaecology Canada | volume = 28 | issue = 11 | pages = 974–979 | date = November 2006 | pmid = 17169222 | doi = 10.1016/S1701-2163(16)32307-6 | url = http://www.jogc.org/abstracts/full/200611_WomensHealth_1.pdf | url-status = dead | archive-url = https://web.archive.org/web/20120111121431/http://www.jogc.org/abstracts/full/200611_WomensHealth_1.pdf | archive-date = 11 January 2012 }}</ref>
Unsafe abortions are a major cause of injury and death among women worldwide. Although data are imprecise, it is estimated that approximately 20 million unsafe abortions are performed annually, with 97% taking place in [[developing country|developing countries]].<ref name="lancet-grimes"/> Unsafe abortions are believed to result in millions of injuries.<ref name="lancet-grimes"/><ref name="Haddad-2009">{{cite journal | vauthors = Haddad LB, Nour NM | title = Unsafe abortion: unnecessary maternal mortality | journal = Reviews in Obstetrics & Gynecology | volume = 2 | issue = 2 | pages = 122–126 | year = 2009 | pmid = 19609407 | pmc = 2709326 }}</ref> Estimates of deaths vary according to methodology, and have ranged from 37,000 to 70,000 in the past decade;<ref name="lancet-grimes"/><ref name="OBGY09">{{cite journal |vauthors=Shah I, Ahman E |date=December 2009 |title=Unsafe abortion: global and regional incidence, trends, consequences, and challenges |url=http://www.sogc.org/jogc/abstracts/full/200912_WomensHealth_1.pdf |url-status=dead |journal=Journal of Obstetrics and Gynaecology Canada |volume=31 |issue=12 |pages=1149–1158 |doi=10.1016/s1701-2163(16)34376-6 |pmid=20085681 |s2cid=35742951 |archive-url=https://web.archive.org/web/20110716212405/http://www.sogc.org/jogc/abstracts/full/200912_WomensHealth_1.pdf |archive-date=16 July 2011}}</ref><ref name=Loz2012>{{cite journal | vauthors = Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, Abraham J, Adair T, Aggarwal R, Ahn SY, Alvarado M, Anderson HR, Anderson LM, Andrews KG, Atkinson C, Baddour LM, Barker-Collo S, Bartels DH, Bell ML, Benjamin EJ, Bennett D, Bhalla K, Bikbov B, Bin Abdulhak A, Birbeck G, Blyth F, Bolliger I, Boufous S, Bucello C, Burch M, Burney P, Carapetis J, Chen H, Chou D, Chugh SS, Coffeng LE, Colan SD, Colquhoun S, Colson KE, Condon J, Connor MD, Cooper LT, Corriere M, Cortinovis M, de Vaccaro KC, Couser W, Cowie BC, Criqui MH, Cross M, Dabhadkar KC, Dahodwala N, De Leo D, Degenhardt L, Delossantos A, Denenberg J, Des Jarlais DC, Dharmaratne SD, Dorsey ER, Driscoll T, Duber H, Ebel B, Erwin PJ, Espindola P, Ezzati M, Feigin V, Flaxman AD, Forouzanfar MH, Fowkes FG, Franklin R, Fransen M, Freeman MK, Gabriel SE, Gakidou E, Gaspari F, Gillum RF, Gonzalez-Medina D, Halasa YA, Haring D, Harrison JE, Havmoeller R, Hay RJ, Hoen B, Hotez PJ, Hoy D, Jacobsen KH, James SL, Jasrasaria R, Jayaraman S, Johns N, Karthikeyan G, Kassebaum N, Keren A, Khoo JP, Knowlton LM, Kobusingye O, Koranteng A, Krishnamurthi R, Lipnick M, Lipshultz SE, Ohno SL, Mabweijano J, MacIntyre MF, Mallinger L, March L, Marks GB, Marks R, Matsumori A, Matzopoulos R, Mayosi BM, McAnulty JH, McDermott MM, McGrath J, Mensah GA, Merriman TR, Michaud C, Miller M, Miller TR, Mock C, Mocumbi AO, Mokdad AA, Moran A, Mulholland K, Nair MN, Naldi L, Narayan KM, Nasseri K, Norman P, O'Donnell M, Omer SB, Ortblad K, Osborne R, Ozgediz D, Pahari B, Pandian JD, Rivero AP, Padilla RP, Perez-Ruiz F, Perico N, Phillips D, Pierce K, Pope CA, Porrini E, Pourmalek F, Raju M, Ranganathan D, Rehm JT, Rein DB, Remuzzi G, Rivara FP, Roberts T, De León FR, Rosenfeld LC, Rushton L, Sacco RL, Salomon JA, Sampson U, Sanman E, Schwebel DC, Segui-Gomez M, Shepard DS, Singh D, Singleton J, Sliwa K, Smith E, Steer A, Taylor JA, Thomas B, Tleyjeh IM, Towbin JA, Truelsen T, Undurraga EA, Venketasubramanian N, Vijayakumar L, Vos T, Wagner GR, Wang M, Wang W, Watt K, Weinstock MA, Weintraub R, Wilkinson JD, Woolf AD, Wulf S, Yeh PH, Yip P, Zabetian A, Zheng ZJ, Lopez AD, Murray CJ, AlMazroa MA, Memish ZA | display-authors = 6 | title = Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010 | journal = Lancet | volume = 380 | issue = 9859 | pages = 2095–2128 | date = December 2012 | pmid = 23245604 | doi = 10.1016/S0140-6736(12)61728-0 | pmc = 10790329 | url = https://zenodo.org/record/2557786 | access-date = 14 March 2020 | url-status = live | hdl-access = free | s2cid = 1541253 | archive-date = 19 May 2020 | archive-url = https://web.archive.org/web/20200519152712/https://zenodo.org/record/2557786 | hdl = 10536/DRO/DU:30050819 }}</ref> deaths from unsafe abortion account for around 13% of all [[maternal deaths]].<ref>{{cite book| vauthors = Speroff L, Darney PD |title=A clinical guide for contraception|year=2010|publisher=Lippincott Williams & Wilkins|___location=Philadelphia|isbn=978-1-60831-610-6|page=406|edition=5th }}</ref> The [[World Health Organization]] believes that mortality has fallen since the 1990s.<ref name="WHO2011">{{cite book |last=World Health Organization |title=Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008 |publisher=World Health Organization |year=2011 |edition=6th |page=27 |isbn=978-92-4-150111-8 |url=http://whqlibdoc.who.int/publications/2011/9789241501118_eng.pdf |url-status=live |archive-url=https://web.archive.org/web/20140328093307/http://whqlibdoc.who.int/publications/2011/9789241501118_eng.pdf |archive-date=28 March 2014}}</ref> To reduce the number of unsafe abortions, public health organizations have generally advocated emphasizing the legalization of abortion, training of medical personnel, and ensuring access to reproductive-health services.<ref name="berer-who">{{cite journal |vauthors=Berer M | title=Making abortions safe: a matter of good public health policy and practice |journal=Bulletin of the World Health Organization |volume=78 |issue=5 |pages=580–592 |year=2000 |pmid=10859852 |pmc=2560758}}</ref>
A major factor in whether abortions are performed safely or not is the legal standing of abortion. Countries with restrictive abortion laws have higher rates of unsafe abortion and similar overall abortion rates compared to countries where abortion is legal and available.<ref name="OBGY09"/><ref name="Sedgh 2012"/> For example, the [[Choice on Termination of Pregnancy Act, 1996|1996 legalization of abortion in South Africa]] led to an immediate reduction in abortion-related complications,<ref name="jewkes">{{cite journal |vauthors=Jewkes R, Rees H, Dickson K, Brown H, Levin J |title=The impact of age on the epidemiology of incomplete abortions in South Africa after legislative change |journal=BJOG |volume=112 |issue=3 |pages=355–359 |date=March 2005 |pmid=15713153 |doi=10.1111/j.1471-0528.2004.00422.x |s2cid=41663939 |doi-access=}}</ref> with abortion-related deaths dropping by more than 90%.<ref name="bateman-samj">{{cite journal |vauthors=Bateman C |title=Maternal mortalities 90% down as legal TOPs more than triple |journal=South African Medical Journal = Suid-Afrikaanse Tydskrif vir Geneeskunde |volume=97 |issue=12 |pages=1238–1242 |date=December 2007 |pmid=18264602 |url=http://samj.org.za/index.php/samj/article/view/642 |url-status=live |archive-url=https://web.archive.org/web/20170830200316/http://samj.org.za/index.php/samj/article/view/642 |archive-date=30 August 2017}}</ref> Similar reductions in maternal mortality have been observed after other countries have liberalized their abortion laws, such as [[Romania]] and [[Nepal]].<ref>{{cite journal |vauthors=Conti JA, Brant AR, Shumaker HD, Reeves MF |title=Update on abortion policy |journal=Current Opinion in Obstetrics & Gynecology |volume=28 |issue=6 |pages=517–521 |date=December 2016 |pmid=27805969 |doi=10.1097/GCO.0000000000000324 |s2cid=26052790}}</ref> A 2011 study concluded that in the United States, some state-level anti-abortion laws are correlated with lower rates of abortion in that state.<ref>{{cite journal| vauthors=New MJ |s2cid=53314166|title=Analyzing the Effect of Anti-Abortion U.S. State Legislation in the Post-Casey Era |journal=State Politics & Policy Quarterly|date=15 February 2011|volume=11|issue=1|pages=28–47|doi=10.1177/1532440010387397}}</ref> The analysis, however, did not take into account travel to other states without such laws to obtain an abortion.<ref>{{cite journal| vauthors = Medoff MH, Dennis C |title=Another Critical Review of New's Reanalysis of the Impact of Antiabortion Legislation|journal=State Politics & Policy Quarterly|date=21 July 2014 |volume=14|issue=3|pages=269–76|doi=10.1177/1532440014535476|s2cid=155464018}}</ref> In addition, a lack of access to effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by up to 75% (from 20 million to 5 million annually) if modern family planning and maternal health services were readily available globally.<ref name="Singh">{{cite web |url=http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |title=Facts on Investing in Family Planning and Maternal and Newborn Health |publisher=Guttmacher Institute|year=2010 |access-date=24 May 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120324101905/http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |archive-date=24 March 2012 }}</ref> Rates of such abortions may be difficult to measure because they can be reported variously as miscarriage, "induced miscarriage", "menstrual regulation", "mini-abortion", and "regulation of a delayed/suspended menstruation".<ref name="lancet-grimes"/><ref name=Brazil_Unsafe>{{cite journal |vauthors=Nations MK, Misago C, Fonseca W, Correia LL, Campbell OM |title=Women's hidden transcripts about abortion in Brazil |journal=Social Science & Medicine |volume=44 |issue=12 |pages=1833–1845 |date=June 1997 |pmid=9194245 |doi=10.1016/s0277-9536(96)00293-6}}</ref>
Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits,<ref name="IJGO10"/> while an additional 35 percent have access to legal abortion if they meet certain physical, mental, or socioeconomic criteria.<ref name="Dev98-07"/> While [[maternal death|maternal mortality]] seldom results from safe abortions, unsafe abortions result in 70,000 deaths and 5 million disabilities per year.<ref name=OBGY09/> Complications of unsafe abortion account for approximately an eighth of maternal mortalities worldwide,<ref name="Maclean">{{cite book| vauthors=Maclean G |chapter-url=https://books.google.com/books?id=u4Aeiu2eDMAC&pg=PA299|chapter=XI. Dimension, Dynamics and Diversity: A 3D Approach to Appraising Global Maternal and Neonatal Health Initiatives |pages=299–300|title=Trends in Midwifery Research| veditors=Balin RE |publisher=Nova Publishers|year=2005|isbn=978-1-59454-477-4|url-status=live|archive-date=15 March 2015|archive-url=https://web.archive.org/web/20150315113348/http://books.google.com/books?id=u4Aeiu2eDMAC&pg=PA299}}</ref> though this varies by region.<ref>{{cite journal| vauthors=Salter C, Johnson HB, Hengen N |year=1997 |url=http://info.k4health.org/pr/l10edsum.shtml |title=Care for Postabortion Complications: Saving Women's Lives |journal=Population Reports |volume=25 |issue=1 |publisher=Johns Hopkins School of Public Health |url-status=dead |archive-url=https://web.archive.org/web/20091207070103/http://info.k4health.org/pr/l10edsum.shtml |archive-date=7 December 2009}}</ref> Secondary infertility caused by an unsafe abortion affects an estimated 24 million women.<ref name="WHO-unsafe-2007">{{cite web |year=2007 |title=Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2003 |url=http://whqlibdoc.who.int/publications/2007/9789241596121_eng.pdf |url-status=live |archive-url=https://web.archive.org/web/20110216141018/http://whqlibdoc.who.int/publications/2007/9789241596121_eng.pdf |archive-date=16 February 2011 |access-date=7 March 2011 |publisher=World Health Organization}}</ref> The rate of unsafe abortions has increased from 44% to 49% between 1995 and 2008.<ref name="Sedgh 2012" /> Health education, access to family planning, and improvements in health care during and after abortion have been proposed to address consequences of unsafe abortion.<ref>{{cite web|title=Packages of interventions: Family planning, safe abortion care, maternal, newborn and child health|author1=UNICEF |author2=UNFPA |author3=WHO |author4=World Bank|year=2010|access-date=31 December 2010|url-status=dead|url= https://www.who.int/reproductivehealth/publications/maternal_perinatal_health/fch_10_06/en/index.html |archive-url=https://web.archive.org/web/20101109224916/http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/fch_10_06/en/index.html|archive-date=9 November 2010}}</ref>
==Incidence==
There are two commonly used methods of measuring the incidence of abortion:
* Abortion rate – number of abortions annually per 1,000 women between 15 and 44 years of age;<ref>{{cite web| title = Facts on Induced Abortion Worldwide| date = January 2012| publisher = World Health Organization| url = https://www.who.int/reproductivehealth/publications/unsafe_abortion/induced_abortion_2012.pdf| access-date = 9 May 2021| archive-url = https://web.archive.org/web/20210309200507/http://www.who.int/reproductivehealth/publications/unsafe_abortion/induced_abortion_2012.pdf| archive-date = 9 March 2021| url-status = live}}</ref> some sources use a range of 15–49.
* Abortion percentage – number of abortions out of 100 known pregnancies; pregnancies include live births, abortions, and miscarriages.
In many places, where abortion is illegal or carries a heavy social stigma, medical reporting of abortion is not reliable.<ref name="Sedgh 2007">{{cite journal |vauthors=Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH |date=October 2007 |title=Induced abortion: estimated rates and trends worldwide |journal=Lancet |volume=370 |issue=9595 |pages=1338–1345 |citeseerx=10.1.1.454.4197 |doi=10.1016/S0140-6736(07)61575-X |pmid=17933648 |s2cid=28458527}}</ref> For this reason, estimates of the incidence of abortion must be made without determining certainty related to [[standard error]].<ref name="Sedgh 2012" /> The number of abortions performed worldwide was characterized as stable in the early 2000s, with 41.6 million having been performed in 2003 and 43.8 million having been performed in 2008.<ref name="Sedgh 2012" /> The abortion rate worldwide was 28 per 1000 women per year, though it was 24 per 1000 women per year for developed countries and 29 per 1000 women per year for developing countries.<ref name="Sedgh 2012" /> The same 2012 study indicated that in 2008, the estimated abortion percentage of known pregnancies was at 21% worldwide, with 26% in developed countries and 20% in developing countries.<ref name="Sedgh 2012" />
On average, the incidence of abortion is similar in countries with restrictive abortion laws and those with more liberal access to abortion.<ref name="nytimes-abortion-rates"/> Restrictive abortion laws are associated with increases in the percentage of abortions performed unsafely.<ref name=IJGO10/><ref>{{cite journal | vauthors = Shah I, Ahman E | title = Unsafe abortion: global and regional incidence, trends, consequences, and challenges | journal = Journal of Obstetrics and Gynaecology Canada | volume = 31 | issue = 12 | pages = 1149–1158 | date = December 2009 | pmid = 20085681 | doi = 10.1016/s1701-2163(16)34376-6 | s2cid = 35742951 | quote = However, a woman's chance of having an abortion is similar whether she lives in a developed or a developing region: in 2003 the rates were 26 abortions per 1,000 women aged 15 to 44 in developed areas and 29 per 1,000 in developing areas. The main difference is in safety, with abortion being safe and easily accessible in developed countries and generally restricted and unsafe in most developing countries. }}</ref><ref name="nytimes-abortion-rates">{{cite news| vauthors = Rosenthal E |url= https://www.nytimes.com/2007/10/12/world/12abortion.html |title=Legal or Not, Abortion Rates Compare|newspaper=The New York Times|date=12 October 2007|access-date=18 July 2011|url-status=live|archive-url=https://web.archive.org/web/20110828173628/http://www.nytimes.com/2007/10/12/world/12abortion.html|archive-date=28 August 2011}}</ref> The unsafe abortion rate in developing countries is partly attributable to lack of access to modern contraceptives; 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 abortion annually worldwide.<ref>{{cite web|url=http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |title=Facts on Investing in Family Planning and Maternal and Newborn Health |publisher=Guttmacher Institute |date=November 2010 |access-date=24 October 2011 |url-status=dead |archive-url=https://web.archive.org/web/20111020135329/http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |archive-date=20 October 2011 }}</ref>
The rate of legal, induced abortion varies extensively worldwide. According to the report of employees of Guttmacher Institute it ranged from 7 per 1000 women per year (Germany and Switzerland) to 30 per 1000 women per year (Estonia) in countries with complete statistics in 2008. The proportion of pregnancies that ended in induced abortion ranged from about 10% (Israel, the Netherlands and Switzerland) to 30% (Estonia) in the same group, though it might be as high as 36% in Hungary and Romania, whose statistics were deemed incomplete.<ref>{{cite journal | vauthors = Sedgh G, Singh S, Henshaw SK, Bankole A | title = Legal abortion worldwide in 2008: levels and recent trends | journal = Perspectives on Sexual and Reproductive Health | volume = 43 | issue = 3 | pages = 188–198 | date = September 2011 | pmid = 21884387 | doi = 10.1363/4318811 | url = http://www.guttmacher.org/pubs/journals/3708411.html | url-status = live | archive-url = https://web.archive.org/web/20120107111306/http://www.guttmacher.org/pubs/journals/3708411.html | archive-date = 7 January 2012 }}</ref><ref>{{cite book|date=2011-05-15|chapter=Populație|url=http://www.insse.ro/cms/files/Anuar%2520statistic/02/02%2520Populatie_ro.pdf|access-date=2023-02-16|archive-url=https://web.archive.org/web/20110515195102/http://www.insse.ro/cms/files/Anuar%2520statistic/02/02%2520Populatie_ro.pdf |archive-date=15 May 2011 |title=Romanian Statistical Yearbook |page=62 |publisher=[[National Institute of Statistics (Romania)|National Institute of Statistics]]}}</ref>
An American study in 2002 concluded that about half of women having abortions were using a form of [[birth control|contraception]] at the time of becoming pregnant. Inconsistent use was reported by half of those using [[condom]]s and three-quarters of those using the [[combined oral contraceptive pill|birth control pill]]; 42% of those using condoms reported failure through slipping or breakage.<ref name=":8">{{cite journal | vauthors = Jones RK, Darroch JE, Henshaw SK | title = Contraceptive use among U.S. women having abortions in 2000-2001 | journal = Perspectives on Sexual and Reproductive Health | volume = 34 | issue = 6 | pages = 294–303 | year = 2002 | pmid = 12558092 | doi = 10.2307/3097748 | url = http://www.guttmacher.org/pubs/journals/3429402.pdf | url-status = live | archive-url = https://web.archive.org/web/20060615011127/http://www.guttmacher.org/pubs/journals/3429402.pdf | archive-date = 15 June 2006 | jstor = 3097748 }}</ref> Of the other half of women, who were not using contraception at the time of becoming pregnant, the vast majority had used contraception at some point in the past, indicating some level of dissatisfaction with the contraceptive options available to them. Indeed, 32% of these contraceptive nonusers cited concerns about contraceptive methods as their reason for nonuse,<ref name=":8" /> and a more recent study found similar results.<ref>{{Cite journal |last1=Mosher |first1=William |last2=Jones |first2=Jo |last3=Abma |first3=Joyce |date=2015 |title=Nonuse of contraception among women at risk of unintended pregnancy in the United States |journal=Contraception |volume=92 |issue=2 |pages=170–176 |doi=10.1016/j.contraception.2015.05.004 |issn=0010-7824 |pmc=6413311 |pmid=25998937}}</ref> Taken together, these statistics suggest that new contraceptive methods, such as non-hormonal contraceptives or [[male contraceptive]]s, could reduce unintended pregnancy and abortion rates.<ref>{{Cite journal |last1=Dorman |first1=Emily |last2=Perry |first2=Brian |last3=Polis |first3=Chelsea B. |last4=Campo-Engelstein |first4=Lisa |last5=Shattuck |first5=Dominick |last6=Hamlin |first6=Aaron |last7=Aiken |first7=Abigail |last8=Trussell |first8=James |last9=Sokal |first9=David |date=2018 |title=Modeling the impact of novel male contraceptive methods on reductions in unintended pregnancies in Nigeria, South Africa, and the United States |url=|journal=Contraception |volume=97 |issue=1 |pages=62–69 |doi=10.1016/j.contraception.2017.08.015 |issn=0010-7824 |pmc=5732079 |pmid=28887053}}</ref>
The Guttmacher Institute has found that "most abortions in the United States are obtained by minority women" because minority women "have much higher rates of unintended pregnancy".<ref>{{cite journal | vauthors = Cohen SA |url= http://www.guttmacher.org/pubs/gpr/11/3/gpr110302.html |title=Abortion and Women of Color: The Bigger Picture |journal=Guttmacher Policy Review |year=2008 |volume=11 |issue=3 |url-status=live |archive-url=https://web.archive.org/web/20080915094346/http://www.guttmacher.org/pubs/gpr/11/3/gpr110302.html |archive-date=15 September 2008 }}</ref> In a 2022 analysis by the [[Kaiser Family Foundation]], while people of color comprise 44% of the population in Mississippi, 59% of the population in Texas, 42% of the population in Louisiana, and 35% of the population in Alabama, they comprise 80%, 74%, 72%, and 70%, respectively, of those receiving abortions.<ref>{{cite news | vauthors = Pettus EW, Willingham L |title=Minority women most affected if abortion is banned, limited |url=https://apnews.com/article/abortion-us-supreme-court-business-health-race-and-ethnicity-3fff455cce7ef0d8694f5371f805ea18 |access-date=1 February 2022 |work=Associated Press |date=1 February 2022 |archive-date=1 February 2022 |archive-url=https://web.archive.org/web/20220201144918/https://apnews.com/article/abortion-us-supreme-court-business-health-race-and-ethnicity-3fff455cce7ef0d8694f5371f805ea18 |url-status=live }}</ref>
===Gestational age and method===
{{multiple image
| align = right
| image1 = UK abortion by gestational age 2019 histogram.svg
| width1 = 200
| alt1 =
| caption1 =
| image2 = US abortion by gestational age 2016 histogram.svg
| width2 = 200
| alt2 =
| caption2 =
| footer = [[Histogram]] of abortions by [[Gestational age (obstetrics)|gestational age]] in England and Wales during 2019 (left). Abortion in the United States by gestational age, 2016 (right).
}}
Abortion rates vary depending on the stage of pregnancy and the method practiced. In 2003, the [[Centers for Disease Control and Prevention]] (CDC) reported that 26% of reported legal induced abortions in the United States were known to have been obtained at the end of 6 weeks of gestation or less, 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% of these were classified as having been done by "[[curettage]]" ([[Suction-aspiration abortion|suction-aspiration]], [[dilation and curettage]], [[dilation and evacuation]]), 8% by "[[medical abortion|medical]]" means ([[mifepristone]]), >1% by "[[instillation abortion|intrauterine instillation]]" (saline or [[prostaglandin]]), and 1% by "other" (including [[hysterotomy abortion|hysterotomy]] and [[hysterectomy]]).<ref name="cdc2003">{{cite journal | vauthors = Strauss LT, Gamble SB, Parker WY, Cook DA, Zane SB, Hamdan S | title = Abortion surveillance--United States, 2003 | journal = Morbidity and Mortality Weekly Report. Surveillance Summaries | volume = 55 | issue = 11 | pages = 1–32 | date = November 2006 | pmid = 17119534 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5511a1.htm | url-status = live | author7 = Centers for Disease Control Prevention | archive-url = https://web.archive.org/web/20170602171423/https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5511a1.htm | archive-date = 2 June 2017 }}</ref> According to the CDC, due to data collection difficulties the data must be viewed as tentative and some fetal deaths reported beyond 20 weeks may be natural deaths erroneously classified as abortions if the removal of the dead fetus is accomplished by the same procedure as an induced abortion.<ref name="guttmacher">{{cite web |publisher=The Guttmacher Institute |title=The limitations of U.S. statistics on abortion |work=Issues in Brief |___location=New York |year=1997 |url=http://www.guttmacher.org/pubs/ib14.html |archive-url=https://web.archive.org/web/20120404080239/http://www.guttmacher.org/pubs/ib14.html |archive-date=4 April 2012 |url-status=dead}}</ref>
The Guttmacher Institute estimated there were 2,200 [[intact dilation and extraction]] procedures in the US during 2000; this accounts for <0.2% of the total number of abortions performed that year.<ref>{{cite journal | vauthors = Finer LB, Henshaw SK | title = Abortion incidence and services in the United States in 2000 | journal = Perspectives on Sexual and Reproductive Health | volume = 35 | issue = 1 | pages = 6–15 | year = 2003 | pmid = 12602752 | doi = 10.1363/3500603 | url = http://www.guttmacher.org/pubs/journals/3500603.html | url-status = live | archive-url = https://web.archive.org/web/20160122204324/http://www.guttmacher.org/pubs/journals/3500603.html | archive-date = 22 January 2016 | url-access = subscription }}</ref> Similarly, in England and Wales in 2006, 89% of terminations occurred at or under 12 weeks, 9% between 13 and 19 weeks, and 2% at or over 20 weeks. 64% of those reported were by vacuum aspiration, 6% by D&E, and 30% were medical.<ref>{{cite web|author=Department of Health |year=2007 |title=Abortion statistics, England and Wales: 2006 |access-date=12 October 2007 |url=http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_075697 |url-status=dead |archive-url=https://web.archive.org/web/20101206002417/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_075697 |archive-date=6 December 2010 }}</ref> There are more second trimester abortions in developing countries such as China, India and Vietnam than in developed countries.<ref>{{cite web| vauthors = Cheng L |date=1 November 2008|title=Surgical versus medical methods for second-trimester induced abortion: RHL commentary|work=The WHO Reproductive Health Library|___location=Geneva|publisher=World Health Organization|url=https://www.who.int/rhl/fertility/abortion/CD006714_chengl_com/en/index.html|access-date=10 February 2009|url-status=dead|archive-url= https://web.archive.org/web/20090215134007/http://www.who.int/rhl/fertility/abortion/CD006714_chengl_com/en/index.html|archive-date=15 February 2009}} commentary on:<br />{{cite journal | vauthors = Lohr PA, Hayes JL, Gemzell-Danielsson K | title = Surgical versus medical methods for second trimester induced abortion | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD006714 | date = January 2008 | pmid = 18254113 | doi = 10.1002/14651858.CD006714.pub2 | s2cid = 205184764 }}</ref>{{Update inline|reason=Updated version https://www.ncbi.nlm.nih.gov/pubmed/40626417|date = August 2025}}
There are both medical and non-medical reasons to have an abortion later in pregnancy (after 20 weeks). A study was conducted from 2008 to 2010 at the University of California San Francisco where more than 440 women were asked about why they experienced delays in obtaining abortion care, if there were any. This study found that almost half of individuals who obtained an abortion after 20 weeks did not suspect that they were pregnant until later in their pregnancy.<ref name=":7">{{cite web |date=December 5, 2019 |title=Abortions Later in Pregnancy |url=https://www.kff.org/womens-health-policy/fact-sheet/abortions-later-in-pregnancy/ |website=KFF (Kaiser Family Foundation) |access-date=10 November 2023 |archive-date=10 November 2023 |archive-url=https://web.archive.org/web/20231110191733/https://www.kff.org/womens-health-policy/fact-sheet/abortions-later-in-pregnancy/ |url-status=live }}</ref> Other barriers to abortion care found in the study included lack of information about where to access an abortion, difficulties with transportation, lack of insurance coverage, and inability to pay for the abortion procedure.<ref name=":7" />
Medical reasons for seeking an abortion later in pregnancy include [[Birth defect|fetal anomalies]] and health risk to the pregnant person.<ref name=":6">{{cite book |last=Vaughn |first=Lewis |title=Bioethics: Principles, Issues, and Cases |publisher=Oxford University Press |year=2023 |isbn=978-0-19-760902-6 |edition=5th |pages=328}}</ref> There are prenatal tests that can diagnose [[Down syndrome|Down Syndrome]] or [[cystic fibrosis]] as early as 10 weeks into gestation, but structural fetal anomalies are often detected much later in pregnancy.<ref name=":7" /> A proportion of structural fetal anomalies are lethal, which means that the fetus will almost certainly die before or shortly after birth.<ref name=":7" /> Life-threatening conditions may also develop later in pregnancy, such as [[Pre-eclampsia|early severe preeclampsia]], newly diagnosed cancer in need of urgent treatment, and [[Chorioamnionitis|intrauterine infection (chorioamnionitis)]], which often occurs along with [[Prelabor rupture of membranes|premature rupture of the amniotic sac (PPROM)]].<ref name=":7" /> If serious medical conditions such as these arise before the fetus is viable, the person carrying the pregnancy may pursue an abortion to preserve their own health.<ref name=":7" />
==Motivation==
===Personal===
[[File:AGIAbortionReasonsBarChart.png|thumb|upright=1.8|A bar chart depicting selected data from a 1998 [[Alan Guttmacher Institute|AGI]] [[meta-study]] on the reasons women stated for having an abortion]]
The reasons why women have abortions are diverse and vary across the world.<ref name="guttmacher" /><ref name="bankole98"/><ref name=Chae_2017>{{ cite journal | last1=Chae | first1=Sophia | last2=Desai | first2=Sheila | last3=Crowell | first3=Marjorie | last4=Sedgh | first4=Gilda | date=2017-10-01 | title=Reasons why women have induced abortions: a synthesis of findings from 14 countries | journal=[[Contraception (journal)|Contraception]] | volume=96 | issue=4 | pages=233–241 | doi=10.1016/j.contraception.2017.06.014 | pmid=28694165 | pmc=5957082 | quote=In most countries, the most frequently cited reasons for having an abortion were socioeconomic concerns or limiting childbearing. With some exceptions, little variation existed in the reasons given by women's sociodemographic characteristics. Data from three countries where multiple reasons could be reported in the survey showed that women often have more than one reason for having an abortion. | doi-access=free }}</ref> Some of the reasons may include an inability to afford a child, domestic violence, lack of support, feeling they are too young, and the wish to complete education or advance a career.<ref name=":5">{{cite journal | last = Stotland | first = Nada L |author-link = Nada Stotland| title = Update on Reproductive Rights and Women's Mental Health | journal = The Medical Clinics of North America | volume = 103 | issue = 4 | pages = 751–766 | date = July 2019 | pmid = 31078205 | doi = 10.1016/j.mcna.2019.02.006 | s2cid = 153307516 }}</ref> Additional reasons include not being able or willing to raise a child conceived as a result of rape or incest.<ref name="bankole98">{{cite journal | vauthors = Bankole A, Singh S, Haas T |date = September 1998 |url=http://www.guttmacher.org/pubs/journals/2411798.html |title=Reasons Why Women Have Induced Abortions: Evidence from 27 Countries |journal=International Family Planning Perspectives |volume=24 |issue=3 |pages=117–127, 152 |doi=10.2307/3038208 |url-status=live |archive-url=https://web.archive.org/web/20060117191716/http://www.guttmacher.org/pubs/journals/2411798.html |archive-date=17 January 2006 |jstor=3038208 | quote= Worldwide, the most commonly reported reason women cite for having an abortion is to postpone or stop childbearing. The second most common reason—socioeconomic concerns—includes disruption of education or employment; lack of support from the father; desire to provide schooling for existing children; and poverty, unemployment or inability to afford additional children. In addition, relationship problems with a husband or partner and a woman's perception that she is too young constitute other important categories of reasons. Women's characteristics are associated with their reasons for having an abortion: With few exceptions, older women and married women are the most likely to identify limiting childbearing as their main reason for abortion. - Conclusions - Reasons women give for why they seek abortion are often far more complex than simply not intending to become pregnant; the decision to have an abortion is usually motivated by more than one factor. }}</ref><ref name="finer2005">{{cite journal |vauthors=Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM |title=Reasons U.S. women have abortions: quantitative and qualitative perspectives |journal=Perspectives on Sexual and Reproductive Health |volume=37 |issue=3 |pages=110–118 |date=September 2005 |pmid=16150658 |doi=10.1111/j.1931-2393.2005.tb00045.x |url=http://www.guttmacher.org/pubs/journals/3711005.html |url-status=live |archive-url=https://web.archive.org/web/20120107092446/http://www.guttmacher.org/pubs/journals/3711005.html |archive-date=7 January 2012|url-access=subscription }}</ref>
===Societal===
Some abortions are undergone as the result of societal pressures.<ref>{{cite encyclopedia | veditors = Fried MG |title=From Privacy to Autonomy: The Conditions for Reproductive and Sexual Freedom | vauthors = Copelon R |author-link=Rhonda Copelon |encyclopedia=From Abortion to Reproductive Freedom: Transforming a Movement |date=1990 |publisher=South End Press |isbn=978-0-89608-387-5 |url=https://books.google.com/books?id=keE5EmSKYr0C&q=abortion%20poverty%20autonomy&pg=PA38 |pages=27–43 |quote=The prevalence of economically influenced abortions and the sterilization campaigns against poor, minority, and disabled women show us that autonomy is impossible without eradication of discrimination and poverty. Racism, sexism, and poverty can make the difference between abortions that reflect choice and those reflecting bitter necessity. |access-date=29 October 2020 |archive-date=26 January 2021 |archive-url=https://web.archive.org/web/20210126082936/https://books.google.com/books?id=keE5EmSKYr0C&q=abortion%20poverty%20autonomy&pg=PA38 |url-status=live }}</ref> These might include the preference for children of a specific sex or race, disapproval of single or early motherhood, stigmatization of people with disabilities, insufficient economic support for families, lack of access to or rejection of contraceptive methods, or efforts toward [[population control]] (such as China's [[one-child policy]]). These factors can sometimes result in compulsory abortion or [[sex-selective abortion]].<ref name="MissingWomen">{{cite journal | vauthors = Oster E |author-link=Emily Oster |title=Explaining Asia's "Missing Women": A New Look at the Data |journal=Population and Development Review |date=September 2005 |volume=31 |issue=3 |pages=529–535 |url=https://www.researchgate.net/publication/4994961 |access-date=5 February 2019 |doi=10.1111/j.1728-4457.2005.00082.x |quote=Households have variously resorted to female infanticide and postnatal withholding of health care; and since the mid-1980s, when technology permitting fairly low-cost determination of the sex of fetuses became available, there has been a shift toward prenatal sex selection by means of induced abortion. |archive-url=https://web.archive.org/web/20190207131815/https://www.researchgate.net/publication/4994961_Explaining_Asia%27s_Missing_Women_A_New_Look_at_the_Data |archive-date=7 February 2019 |url-status=live }}</ref> In cultures where there is a preference for male children, some women have sex selective abortions, which have partially replaced the earlier practice of female [[infanticide]].<ref name="MissingWomen" />
=== Maternal health ===
Some abortions are performed due to concerns over [[maternal health]]. In 1990s, women cited maternal health as their main motivating factor in about a third of abortions in three of 27 countries analyzed. In seven additional countries, about 7% of abortions were maternal health related.<ref name="guttmacher" /><ref name="bankole98"/><!-- Quote = Risk to maternal health. This reason was somewhat important overall, having been cited as the main reason by 5-10% in seven countries and by 20-38% in three (Kenya, Bangladesh and India). -->
In the U.S., the Supreme Court decisions in ''[[Roe v. Wade]]'' and ''[[Doe v. Bolton]]'': "ruled that the state's interest in the life of the fetus became compelling only at the point of viability, defined as the point at which the fetus can survive independently of its mother. Even after the point of viability, the state cannot favor the life of the fetus over the life or health of the pregnant woman. Under the right of privacy, physicians must be free to use their "medical judgment for the preservation of the life or health of the mother." On the same day that the Court decided Roe, it also decided Doe v. Bolton, in which the Court defined health very broadly: "The medical judgment may be exercised in the light of all factors—physical, emotional, psychological, familial, and the woman's age—relevant to the well-being of the patient. All these factors may relate to health. This allows the attending physician the room he needs to make his best medical judgment."<ref>George J. Annas and Sherman Elias. "Legal and Ethical Issues in Obstetrical Practice". Chapter 54 in ''Obstetrics: Normal and Problem Pregnancies'', 6th edition. Eds. Steven G. Gabbe, et al. 2012 Saunders, an imprint of Elsevier. {{ISBN|978-1-4377-1935-2}}</ref>{{rp|1200–1201}}
====Cancer====
{{Update section|date=September 2022}}<!-- Sources here are >10 years old, and should be updated with new ones -->
The rate of cancer during pregnancy is 0.02–1%, and in many cases, cancer of the mother leads to consideration of abortion to protect the life of the mother, or in response to the potential damage that may occur to the fetus during treatment. This is particularly true for [[cervical cancer]], the most common type of which occurs in 1 of every 2,000–13,000 pregnancies, for which initiation of treatment "cannot co-exist with preservation of fetal life (unless [[neoadjuvant chemotherapy]] is chosen)". Very early stage cervical cancers (I and IIa) may be treated by [[radical hysterectomy]] and pelvic [[lymph node]] dissection, [[radiation therapy]], or both, while later stages are treated by radiotherapy. Chemotherapy may be used simultaneously. Treatment of breast cancer during pregnancy also involves fetal considerations, because [[lumpectomy]] is discouraged in favor of modified [[radical mastectomy]] unless late-term pregnancy allows follow-up radiation therapy to be administered after the birth.<ref name=Weisz>{{cite journal | vauthors = Weisz B, Schiff E, Lishner M | title = Cancer in pregnancy: maternal and fetal implications | journal = Human Reproduction Update | volume = 7 | issue = 4 | pages = 384–393 | year = 2001 | pmid = 11476351 | doi = 10.1093/humupd/7.4.384 | doi-access = free }}</ref>
Exposure to a single chemotherapy drug is estimated to cause a 7.5–17% risk of [[teratogenic]] effects on the fetus, with higher risks for multiple drug treatments. Treatment with more than 40 [[gray (unit)|Gy]] of radiation usually causes spontaneous abortion. Exposure to much lower doses during the first trimester, especially 8 to 15 weeks of development, can cause [[intellectual disability]] or [[microcephaly]], and exposure at this or subsequent stages can cause reduced intrauterine growth and birth weight. Exposures above 0.005–0.025 Gy cause a dose-dependent reduction in [[IQ]].<ref name=Weisz /> It is possible to greatly reduce exposure to radiation with abdominal shielding, depending on how far the area to be irradiated is from the fetus.<ref>{{cite journal | vauthors = Mayr NA, Wen BC, Saw CB | title = Radiation therapy during pregnancy | journal = Obstetrics and Gynecology Clinics of North America | volume = 25 | issue = 2 | pages = 301–321 | date = June 1998 | pmid = 9629572 | doi = 10.1016/s0889-8545(05)70006-1 }}</ref><ref name="pmid11237773">{{cite journal | vauthors = Fenig E, Mishaeli M, Kalish Y, Lishner M | title = Pregnancy and radiation | journal = Cancer Treatment Reviews | volume = 27 | issue = 1 | pages = 1–7 | date = February 2001 | pmid = 11237773 | doi = 10.1053/ctrv.2000.0193 }}</ref>
The process of birth itself may also put the mother at risk. According to Li ''et al.'', "[v]aginal delivery may result in dissemination of neoplastic cells into lymphovascular channels, haemorrhage, cervical laceration and implantation of malignant cells in the episiotomy site, while abdominal delivery may delay the initiation of non-surgical treatment."<ref name="pmid19197101">{{cite journal | vauthors = Li WW, Yau TN, Leung CW, Pong WM, Chan MY | title = Large-cell neuroendocrine carcinoma of the uterine cervix complicating pregnancy | journal = Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi | volume = 15 | issue = 1 | pages = 69–72 | date = February 2009 | pmid = 19197101 }}</ref>
===Fetal health===
[[Congenital disorders]], revealed by [[prenatal screening]], motivate some women to seek abortions.<ref name="bankole98"/> [[Health outcomes for adults born prematurely|Health outcomes of preterm births]] include a significant probability of long-term [[neurodevelopmental impairment]] before gestational age of 29 weeks, with a higher probability with decreasing gestational age.<ref name="z309">{{cite journal | last1=Sarda | first1=Sujata P. | last2=Sarri | first2=Grammati | last3=Siffel | first3=Csaba | title=Global prevalence of long-term neurodevelopmental impairment following extremely preterm birth: a systematic literature review | journal=Journal of International Medical Research | volume=49 | issue=7 | date=2021 | issn=0300-0605 | pmid=34284680 | pmc=8299900 | doi=10.1177/03000605211028026 | page=030006052110280}}</ref>
In the United States, public opinion shifted after television personality [[Sherri Finkbine]]'s was exposed to [[thalidomide]], a [[teratogen]], in her fifth month of pregnancy. Unable to obtain a legal abortion in the United States, Finkbine traveled to Sweden. From 1962 to 1965, an outbreak of [[Rubella|German measles]] left 15,000 babies with severe birth defects. In 1967, the [[American Medical Association]] publicly supported liberalization of abortion laws. A [[National Opinion Research Center]] poll in 1965 showed 73% supported abortion when the mother's life was at risk, 57% when birth defects were present and 59% for pregnancies resulting from rape or incest.{{sfn|Doan|2007|p=57}}
==
{{Main
[[File:AngkorWatAbortionAD1150.JPG|thumb|[[Bas-relief]] at [[Angkor Wat]], [[Cambodia]], c. 1150, depicting a [[demon]] inducing an abortion by pounding the abdomen of a pregnant woman with a [[pestle]]<ref name="potts"/><ref>{{cite book |vauthors=Mould RF |title=Mould's Medical Anecdotes |page=406 |publisher=CRC Press |year=1996 |isbn=978-0-85274-119-1| url=https://archive.org/details/moreofmouldsmedi00moulrich/page/406}}</ref>]]
Since [[ancient times]], abortions have been done using a number of methods, including [[herbal medicine]]s acting as [[abortifacient]]s, sharp tools through the use of force, or through other [[traditional medicine]] methods.<ref name="Management of Abortion, Chp 1"/> Induced abortion has a long history and can be traced back to civilizations as varied as ancient China (abortifacient knowledge is often attributed to the mythological ruler [[Shennong]]),<ref>{{cite book| title=Medical History of Contraception| vauthors = Himes NE |publisher=Gamut Press|year=1963|pages=109–110}}</ref> [[ancient India]] since its [[Vedic age]],<ref name="Misra2006">{{cite book| vauthors = Misra P |title=Domestic Violence Against Women: Legal Control and Judicial Response|url=https://books.google.com/books?id=dp6-_NMfsIsC&pg=PA79| year=2006| publisher=Deep & Deep Publications|isbn=978-81-7629-896-4|pages=79–80|quote=References in Atharva Veda show that abortion was known in the Vedic age.|access-date=5 July 2021|archive-date=9 July 2021|archive-url=https://web.archive.org/web/20210709185150/https://books.google.com/books?id=dp6-_NMfsIsC&pg=PA79|url-status=live}}</ref> [[ancient Egypt]] with its [[Ebers Papyrus]] ({{circa|1550 BCE}}), and the Roman Empire in the time of [[Juvenal]] ({{circa|200 CE}}).<ref name="Management of Abortion, Chp 1"/> One of the earliest known artistic representations of abortion is in a [[bas relief]] at Angkor Wat ({{circa|1150}}). Found in a series of [[frieze]]s that represent judgment after death in [[Hinduism|Hindu]] and [[Buddhist]] culture, it depicts the technique of abdominal abortion.<ref name="potts"/>
Some medical scholars and abortion opponents have suggested that the [[Hippocratic Oath]] forbade physicians in [[Ancient Greece]] from performing abortions;<ref name="Management of Abortion, Chp 1"/> other scholars disagree with this interpretation,<ref name="Management of Abortion, Chp 1"/> and state that the medical texts of [[Hippocratic Corpus]] contain descriptions of abortive techniques right alongside the Oath.<ref>{{cite book| vauthors = Miles SH |title=The Hippocratic Oath and the Ethics of Medicine|year=2005|publisher=Oxford University Press|isbn=978-0-19-518820-2}}</ref> In ''[[Politics (Aristotle)|Politics]]'' (350 BCE), [[Aristotle]] condemned infanticide as a means of population control. He preferred abortion in such cases,<ref>{{cite book| vauthors=Carrick P |title=Medical Ethics in the Ancient World| year=2001 |publisher=Georgetown University Press|isbn=978-0-87840-849-8}}</ref><ref>{{cite journal| vauthors=Meyer HS |date=17 April 2002|title=Ancient Ethics: Medical Ethics in the Ancient World|journal=JAMA |publisher=American Medical Association|volume=287|issue=15|pages=2005–2006|doi=10.1001/jama.287.15.2005-JBK0417-3-1 |s2cid=240484236 }}</ref> with the restriction that it "must be practised on it before it has developed sensation and life; for the line between lawful and unlawful abortion will be marked by the fact of having sensation and being alive."<ref>{{cite book| author=Aristotele| title=Aristotle, Politics|translator=Rackham H|year=1944|url=https://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.01.0058%3Abook%3D7%3Asection%3D1335b |publisher=Harvard University Press |access-date=21 June 2011| via=Perseus|url-status=live|archive-url=https://web.archive.org/web/20110622094459/http://www.perseus.tufts.edu/hopper/text?doc=Perseus%3Atext%3A1999.01.0058%3Abook%3D7%3Asection%3D1335b|archive-date=22 June 2011}}</ref> Abortion has been a fairly common practice,<ref>{{cite book| vauthors = Reagan LJ |year=2022|orig-year=1997|title=When Abortion Was a Crime: Women, Medicine and the Law in the United States, 1867–1973|edition=1st |___location=Berkeley| publisher=University of California Press|isbn=978-0-520-38741-6}}</ref><ref>{{cite web|vauthors=Blakemore E|date=22 May 2022 |url=https://www.nationalgeographic.com/history/article/the-complex-early-history-of-abortion-in-the-united-states |title=The complex early history of abortion in the United States|website=National Geographic|access-date=26 July 2022| quote=But that view of history is the subject of great dispute. Though interpretations differ, most scholars who have investigated the history of abortion argue that terminating a pregnancy wasn't always illegal—or even controversial.| archive-date=26 July 2022|archive-url=https://web.archive.org/web/20220726201522/https://www.nationalgeographic.com/history/article/the-complex-early-history-of-abortion-in-the-united-states|url-status=dead}}</ref> and was not always illegal or controversial until the 19th century.<ref name="Hardin 1978">{{cite journal| vauthors = Hardin G |date=December 1978|title=Abortion in America. The Origins and Evolution of National Policy, 1800–1900. James C. Mohr|journal=The Quarterly Review of Biology| volume=53| issue=4| page=499|doi=10.1086/410954|quote=The long silence had led us to assume that opposition to abortion had existed from time immemorial. Not so: most of the opposition to, and all of the laws against, abortion arose in the 19th century. Historian Mohr amply documents the earlier acceptance of abortion. ... In the 19th century even many of the feminists expressed horror at abortion, urging abstinence instead. Not so in the 20th century. In the 19th century the medical profession was fairly united against abortion; Mohr argues that this arose from the commercial competition between the 'regulars' (men with M.D.'s) and the irregulars (women without M.D.'s). ... A key role in generating prohibition laws was played by the press, ... . By 1900 the abortion-prohibition laws were immune to questioning, as they remained until the 1960's when feminists and a new breed of physicians combined to arouse the public to the injustice of the law. ... the ''Roe v. Wade'' decision of the Supreme Court ... essentially returned the practice of abortion to the permissive state ''ante'' 1820.}}</ref><ref>{{cite journal| vauthors = Acevedo ZP |date=Summer 1979|title=Abortion in early America| journal=Women Health|volume=4|issue=2|pages=159–167|doi=10.1300/J013v04n02_05|pmid=10297561 |quote=This piece describes abortion practices in use from the 1600s to the 19th century among the inhabitants of North America. The abortive techniques of women from different ethnic and racial groups as found in historical literature are revealed. Thus, the point is made that abortion is not simply a 'now issue' that effects select women. Instead, it is demonstrated that it is a widespread practice as solidly rooted in our past as it is in the present.}}</ref> In Europe and North America, abortion techniques advanced starting in the 17th century; the [[conservatism]] of most in the medical profession with regards to [[sexual matters]] prevented the wide expansion of abortion techniques.<ref name="Management of Abortion, Chp 1"/><ref>{{cite book| title=Abortion in America: The Origins and Evolution of National Policy| vauthors = Mohr JC |year=1978|pages=[https://archive.org/details/abortioninameric00mohr/page/35 35–36]|publisher=Oxford University Press|isbn=978-0-19-502616-0| url=https://archive.org/details/abortioninameric00mohr/page/35}}</ref><ref>{{cite book|vauthors=Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD, Joffe C|year=2009|chapter-url=http://media.wiley.com/product_data/excerpt/62/14051769/1405176962.pdf|url-status=live|chapter=Abortion and Medicine: A Sociopolitical History|title=Management of Unintended and Abnormal Pregnancy|edition=1st|___location=Oxford|publisher=John Wiley & Sons| isbn=978-1-4443-1293-5|ol=15895486W|archive-url=https://web.archive.org/web/20120119025652/http://media.wiley.com/product_data/excerpt/62/14051769/1405176962.pdf|archive-date=19 January 2012}}</ref> Other medical practitioners in addition to some physicians advertised their services, and they were not widely regulated until the 19th century when the practice, sometimes called ''[[restellism]]'',<ref>{{cite news| vauthors = Dannenfelser M |title=The Suffragettes Would Not Agree With Feminists Today on Abortion| url=https://time.com/4093214/suffragettes-abortion/|access-date=4 November 2015|magazine=Time|date=4 November 2015|url-status=live| archive-url=https://web.archive.org/web/20151106015742/http://time.com/4093214/suffragettes-abortion/| archive-date=6 November 2015}}</ref> was banned in both the United States and the United Kingdom.<ref name="Management of Abortion, Chp 1"/>{{refn|In the United States, the first laws related to abortion beginning in the 1820s were made to protect women from real or perceived risks, and those more restrictive penalized only the provider. By 1859, abortion was not a crime in 21 out of 33 states, and was prohibited only post-quickening, while penalties for pre-quickening abortions were lower. This changed starting in the 1860s under the influence of [[anti-immigrant]] and [[anti-Catholic]] sentiment.<ref name="Georgian 2022"/>|group=nb}}
[[File:FrenchPeriodicalPills-January61845,BostonDailyTimes.jpg|thumb|"French Periodical Pills" was an example of a clandestine advertisement published in a January 1845 edition of the ''[[Boston Daily Times]]''.<ref>{{cite book |title=The abortion rights controversy in America: a legal reader |date=2004 |publisher=University of North Carolina Press |editor-first=N. E. H. |editor-last=Hull |editor-first2=Williamjames |editor-last2=Hoffer |editor-first3=Peter Charles |editor-last3=Hoffer |isbn=0-8078-2873-4 |___location=Chapel Hill |oclc=53993049 |page=17 }}</ref>]]
Some 19th-century physicians, argued for anti-abortion laws on [[racist]] and [[misogynist]] as well as moral grounds.<ref name="NPR 2022"/><ref>{{cite book |last=Poole |first=W. Scott |url=https://archive.org/details/sataninamericade0000pool |title=Satan in America: The Devil We Know |publisher=[[Rowman & Littlefield]] |year=2009 |isbn=978-0-7425-6171-7 |page=86 |access-date=2023-03-20 |url-access=registration }}</ref><ref>{{cite journal| vauthors = Wilson C |date=2 November 2020|title=Nostalgia, Entitlement and Victimhood: The Synergy of White Genocide and Misogyny|journal=Terrorism and Political Violence|volume=34 |issue=8 |publisher=Routledge|pages=1810–1825|doi=10.1080/09546553.2020.1839428 |s2cid=228837398 }} Storer is cited at p. 4.</ref> Church groups were also highly influential in [[anti-abortion movement]]s,<ref name="Management of Abortion, Chp 1"/><ref name="Hardin 1978"/><ref name="NPR 2022">{{cite news |vauthors=Abdeltath R, Arablouei R, Caine J, Kaplan-Levenson L, Wu L, Yvellez V, Miner C, Sangweni Y, Steinberg A, George D |display-authors=6 |title=Before Roe: The Physicians' Crusade |url=https://www.npr.org/2022/05/18/1099795225/before-roe-the-physicians-crusade |work=Throughline |publisher=NPR |access-date=26 July 2022 |archive-date=26 July 2022 |archive-url=https://web.archive.org/web/20220726150545/https://www.npr.org/2022/05/18/1099795225/before-roe-the-physicians-crusade |url-status=live }}</ref> and religious groups more so since the 20th century.<ref name="Samuels & Potts 2022">{{cite web| vauthors=Samuels A, Potts M|date=25 July 2022|url=https://fivethirtyeight.com/features/how-the-fight-to-ban-abortion-is-rooted-in-the-great-replacement-theory/|title=How The Fight To Ban Abortion Is Rooted In The 'Great Replacement' Theory| website=FiveThirtyEight|access-date=26 July 2022|archive-date=25 July 2022|archive-url=https://web.archive.org/web/20220725234312/https://fivethirtyeight.com/features/how-the-fight-to-ban-abortion-is-rooted-in-the-great-replacement-theory/|url-status=live}}</ref> Some of the early [[anti-abortion laws]] punished only the doctor or abortionist,<ref name="Georgian 2022">{{cite web |date=1 July 2022 |title=The End of Roe in Historical Perspective |url=https://clioandthecontemporary.com/2022/07/01/the-end-of-roe-in-historical-perspective/ |url-status=live |archive-url=https://web.archive.org/web/20220727180424/https://clioandthecontemporary.com/2022/07/01/the-end-of-roe-in-historical-perspective/ |archive-date=27 July 2022 |access-date=27 July 2022 |website=Clio and the Contemporary |vauthors=Georgian E}}</ref> and while women could be criminally tried for a [[self-induced abortion]],<ref name="Alford 2003">{{cite journal| vauthors = Alford S |title=Is Self-Abortion a Fundamental Right?|volume=52|journal=Duke Law Journal|pages=1011–1029| issue=5| year=2003| jstor=1373127|pmid=12964572}}</ref> they were rarely prosecuted in general.<ref name="Hardin 1978"/> Some maintain that in the 19th century early abortions under the hygienic conditions in which [[midwives]] usually worked were relatively safe.<ref>{{cite journal| vauthors = Lee CA |year=1838|title=Report of a Trial for Murder|journal=American Journal of the Medical Sciences|volume=XXII|pages=351–353}}</ref><ref>Benjamin Bailey, "Induction of abortion and premature labor", ''North American Journal of Homeopathy'', vol. XI, no. 3 (1896), pp. 144–150.</ref><ref>Keith Simpson, ''Forensic Medicine'', Edward Arnold Publishers, 1969 [first published 1947], pp. 173–174.</ref> Several scholars argue that, despite improved medical procedures, the period from the 1930s until the 1970s saw more zealous enforcement of anti-abortion laws, alongside an increasing control of abortion providers by organized crime.{{refn|For sources, see:
* James Donner, ''Women in Trouble: The Truth about Abortion in America'', Monarch Books, 1959.
* Ann Oakley, ''The Captured Womb'', Basil Blackwell, 1984, p. 91.
* Rickie Solinger, ''The Abortionist: A Woman Against the Law'', The Free Press, 1994, pp. xi, 5, 16–17, 157–175.
* Leslie J. Reagan, ''When Abortion Was a Crime: Women, Medicine, and Law in the United States, 1867–1973'', University of California Press, 1997.
* Max Evans, ''Madam Millie: Bordellos from Silver City to Ketchikan'', University of New Mexico Press, 2002, pp. 209–218, 230, 267–286, 305.|group=nb}} In 1920, [[Soviet Russia]] became the first country to legalize abortion after [[Lenin]] insisted that no woman be forced to give birth.<ref name="Bullough 2001 p. 5">{{cite book | last=Bullough | first=V.L. | title=Encyclopedia of Birth Control | publisher=ABC-CLIO | series=ABC-CLIO E-Books | year=2001 | isbn=978-1-57607-181-6 | url=https://books.google.com/books?id=XuX-MGTZnJoC&pg=PA5 | access-date=2022-10-19 | page=5 | archive-date=24 January 2023 | archive-url=https://web.archive.org/web/20230124173418/https://books.google.com/books?id=XuX-MGTZnJoC&pg=PA5 | url-status=live }}</ref><ref name="Raphael 2011 p. 30">{{cite book | last=Raphael | first=D. | title=Being Female: Reproduction, Power, and Change | publisher=De Gruyter | series=World Anthropology | year=2011 | isbn=978-3-11-081312-8 | url=https://books.google.com/books?id=84hyfRRHeakC&pg=PA30 | access-date=2022-10-19 | page=30 | archive-date=24 January 2023 | archive-url=https://web.archive.org/web/20230124173418/https://books.google.com/books?id=84hyfRRHeakC&pg=PA30 | url-status=live }}</ref> Abortion was then legalized in some form in [[Iceland]] (1935), [[Sweden]] (1938), [[Nazi Germany]] (1935)<ref>For sources describing abortion policy in Nazi Germany, see:
* {{cite book| vauthors = Friedlander H |title=The origins of Nazi genocide: from euthanasia to the final solution|publisher=University of North Carolina Press|___location=Chapel Hill|year=1995|url=https://books.google.com/books?id=gqLDEKVk2nMC|page=30|isbn=978-0-8078-4675-9|oclc=60191622|url-status=live|archive-url=https://web.archive.org/web/20160729051956/https://books.google.com/books?id=gqLDEKVk2nMC|archive-date=29 July 2016}}
* {{cite book| vauthors = Proctor RN |title=Racial Hygiene: Medicine Under the Nazis|publisher=Harvard University Press|year=1988|pages=[https://archive.org/details/racialhygiene00robe/page/122 122–123, 366]|isbn=978-0-674-74578-0|oclc=20760638|url=https://archive.org/details/racialhygiene00robe/page/122}}
* {{cite book | vauthors = Arnot ML, Usborne C|title=Gender and Crime in Modern Europe|publisher=Routledge|___location=New York|year=1999|page=231|isbn=978-1-85728-745-5|oclc=186748539}}
* {{cite encyclopedia|vauthors=DiMeglio PM|veditors=Tierney H|encyclopedia=Women's Studies Encyclopedia|title=Germany 1933–1945 (National Socialism)|year=1999|publisher=Greenwood Press|___location=Westport, Connecticut|isbn=978-0-313-31072-0|oclc=38504469|url=https://books.google.com/books?id=gQLqRd7hJq0C|page=589|url-status=live|archive-url=https://web.archive.org/web/20151015195038/https://books.google.com/books?id=gQLqRd7hJq0C|archive-date=15 October 2015}}</ref> and [[Japan]] (1948)<ref>{{cite news |last1=Ye Hee Lee |first1=Michelle |title=In Japan, Abortion is Legal — But Most Women Need Their Husband's Consent |url=https://www.washingtonpost.com/world/2022/06/14/japan-abortion-pill-women-reproductive-rights/ |access-date=March 16, 2023 |date=June 14, 2022}}</ref><ref name="Wingfield-Hayes_8/31/2022">{{cite web | last=Wingfield-Hayes | first=Rupert | title=Abortion pill: Why Japanese women will need their partner's consent to get a tablet | website=[[BBC News]] | date=August 31, 2022 | url=https://www.bbc.com/news/world-asia-62515356 | access-date=March 15, 2023 | quote=It was actually one of the first countries in the world to pass an abortion law, back in 1948. But it was part of the Eugenics Protection Law – yes, it really was called that. It had nothing to do with giving women more control over their reproductive health. Rather, it was about preventing 'inferior' births. ... So, to this day, women who want an abortion must get written permission from their husband, partner, or in some cases their boyfriend. ... Unlike the US, Japanese views on abortion are not driven by religious belief. Instead, they derive from a long history of patriarchy and deeply traditional views on the role of women and motherhood. | archive-date=5 March 2023 | archive-url=https://web.archive.org/web/20230305214443/https://www.bbc.com/news/world-asia-62515356 | url-status=live }}</ref><ref name="cbctrust">{{cite web|url=http://www.cbctrust.com/history_law_religion.php|title=Abortion Law, History & Religion|access-date=23 March 2008|publisher=Childbirth By Choice Trust|archive-url=https://archive.today/20080208053146/http://www.cbctrust.com/history_law_religion.php|archive-date=8 February 2008}}{{cbignore}}</ref> Beginning in the second half of the 20th century, abortion was legalized in a greater number of countries.<ref name="Management of Abortion, Chp 1"/>
==Religion==
{{Main|Religion and abortion}}
In the [[Catholic Church and abortion|Catholic Church]], opinion was divided on how serious abortion was in comparison with such acts as contraception and oral or anal sex.<ref name="Noonan" />{{rp|155–167}} The [[Catholic Church]] did not begin vigorously opposing abortion until the 19th century.<ref name="Management of Abortion, Chp 1" /><ref name="Georgian 2022" /> As early as ~100 CE, the ''[[Didache]]'' taught that abortion was sinful.<ref>{{cite web|date=9 September 2016|title=Didache|website=Legacy Icons| url=https://legacyicons.com/content/didache.pdf|access-date=16 May 2022|url-status=live|archive-date=8 November 2020 |archive-url=https://web.archive.org/web/20201108201133/https://legacyicons.com/content/didache.pdf}}</ref> Several historians argue that prior to the 19th century most Catholic authors did not regard termination of pregnancy before [[quickening]] or [[ensoulment]] as an abortion.<ref>Joan Cadden, "Western medicine and natural philosophy", in Vern L. Bullough and James A. Brundage, eds., ''Handbook of Medieval Sexuality'', Garland, 1996, pp. 51–80.</ref><ref>Cyril C. Means Jr., "A historian's view", in Robert E. Hall, ed., ''Abortion in a Changing World'', vol. 1, Columbia University Press, 1970, pp. 16–24.</ref><ref>John M. Riddle, "Contraception and early abortion in the Middle Ages", in Vern L. Bullough and James A. Brundage, eds., ''Handbook of Medieval Sexuality'', Garland, 1996, pp. 261–277, {{ISBN|978-0-8153-1287-1}}.</ref> In 1588, [[Pope Sixtus V]] ({{reign}} 1585–1590) was the first Pope to institute a Church policy labeling all abortion as homicide and condemning abortion regardless of the stage of pregnancy.<ref>{{cite web|author=Pope Sixtus V| year=1588| title=Effraenatam| via=The Embryo Project Encyclopedia|url=https://embryo.asu.edu/pages/effraenatam-1588-pope-sixtus-v| url-status=live| archive-url=https://web.archive.org/web/20210526144925/https://embryo.asu.edu/pages/effraenatam-1588-pope-sixtus-v|archive-date=26 May 2021|access-date=26 May 2021}}</ref><ref name="Noonan">{{cite book| vauthors = Noonan JT |title=Contraception: A History of Its Treatment by the Catholic Theologians and Canonists |edition=2nd |publisher= Harvard University Press|year=1986}}</ref>{{rp|362–364}}<ref name="riddle2" />{{rp|157–158}} Sixtus V's pronouncement was reversed in 1591 by [[Pope Gregory XIV]].<ref>{{cite web |vauthors=Gershon L |date=13 February 2018 |title=What a 16th-Century Abortion Ban Revealed |url=https://daily.jstor.org/what-a-16th-century-abortion-ban-revealed/ |url-status=live |archive-url=https://web.archive.org/web/20210526144922/https://daily.jstor.org/what-a-16th-century-abortion-ban-revealed/ |archive-date=26 May 2021 |access-date=26 May 2021 |website=JSTOR Daily}}</ref> In the recodification of [[1917 Code of Canon Law]], ''Apostolicae Sedis'' was strengthened, in part to remove a possible reading that excluded excommunication of the mother.<ref>{{cite web|title=Apostolicae Sedis Moderationi|website=New Advent |url=https://www.newadvent.org/cathen/01645a.htm|access-date=16 May 2022|url-status=live|archive-date=16 May 2022|archive-url=https://web.archive.org/web/20220516174009/https://www.newadvent.org/cathen/01645a.htm}}</ref> Statements made in the ''[[Catechism of the Catholic Church]]'', the codified summary of the Church's teachings, considers abortion from the moment of conception as homicide and called for the end of legal abortion.<ref>{{cite web|date=1992|title=Catechism of the Catholic Church, chapter 2, article 5 |url=https://www.vatican.va/archive/ccc_css/archive/catechism/p3s2c2a5.htm| website=Vatican| access-date=4 December 2019| archive-date=14 May 2011|archive-url=https://web.archive.org/web/20110514012545/https://www.vatican.va/archive/ccc_css/archive/catechism/p3s2c2a5.htm|url-status=live }}</ref>
[[Judaism and abortion|In Judaism]], the fetus is not considered to have a human soul until it is safely outside of the woman, is viable, and has taken its first breath.<ref>{{cite journal |vauthors=Schenker JG |date=June 2008 |title=The beginning of human life: status of embryo. Perspectives in Halakha (Jewish Religious Law) |journal=Journal of Assisted Reproduction and Genetics |volume=25 |issue=6 |pages=271–276 |doi=10.1007/s10815-008-9221-6 |pmc=2582082 |pmid=18551364}}</ref><ref>{{cite book |url=https://books.google.com/books?id=T7w2oAmohpEC |title=Biomedical Ethics and Jewish Law |vauthors=Rosner F |publisher=KTAV Publishing House |year=2001 |isbn=978-0-88125-701-4 |access-date=27 July 2022 |archive-url=https://web.archive.org/web/20230124173418/https://books.google.com/books?id=T7w2oAmohpEC |archive-date=24 January 2023 |url-status=live |via=Google Books}} Reprinted as {{cite web |date=7 June 2015 |title=The Beginning of Life in Judaism |url=https://www.myjewishlearning.com/article/the-beginning-of-life-in-judaism/ |url-status=live |archive-url=https://web.archive.org/web/20150607041405/https://www.myjewishlearning.com/article/the-beginning-of-life-in-judaism/ |archive-date=7 June 2015 |access-date=27 July 2022 |website=My Jewish Learning |vauthors=Rosner F}}</ref><ref>{{cite web |date=23 January 2022 |title=When Does Life Begin? A Jewish View |url=http://www.reclaimingjudaism.org/teachings/when-does-life-begin-jewish-view |url-status=live |archive-url=https://web.archive.org/web/20220803233439/http://www.reclaimingjudaism.org/teachings/when-does-life-begin-jewish-view |archive-date=3 August 2022 |access-date=30 June 2022 |website=Reclaiming Judaism |vauthors=Milgram G}}</ref> The fetus is considered valuable property of the woman and not a human life while in the womb (Exodus 21:22-23). While [[Judaism]] encourages people to [[be fruitful and multiply]] by having children, abortion is allowed and is deemed necessary when a pregnant woman's life is in danger.<ref>{{cite web |date=May 2019 |title=Judaism and Abortion |url=https://www.ncjw.org/wp-content/uploads/2019/05/Judaism-and-Abortion-FINAL.pdf |url-status=live |archive-url=https://ghostarchive.org/archive/20221009/https://www.ncjw.org/wp-content/uploads/2019/05/Judaism-and-Abortion-FINAL.pdf |archive-date=2022-10-09 |access-date=27 July 2022 |publisher=National Council of Jewish Women}}</ref><ref>{{cite news |date=17 June 2022 |title=Religious freedom: The next battleground for US abortion rights? |url=https://www.aljazeera.com/news/2022/6/17/religious-freedom-the-next-battleground-for-us-abortion-rights |url-status=live |archive-url=https://web.archive.org/web/20220801020805/https://www.aljazeera.com/news/2022/6/17/religious-freedom-the-next-battleground-for-us-abortion-rights |archive-date=1 August 2022 |access-date=27 July 2022 |publisher=Al Jazeera |vauthors=Kestler-D'Amours J}}</ref> Several religions, including Judaism, which disagree that [[human life begins at conception]], support the legality of abortion on [[religious freedom]] grounds.<ref name="Georgian 2022" />
In [[Islam and abortion|Islam]], abortion is traditionally permitted until a point in time when Muslims believe the soul enters the fetus,<ref name="Management of Abortion, Chp 1" /> considered by various theologians to be at conception, 40 days after conception, 120 days after conception, or at [[quickening]].<ref name="BBC and Islam / Abortion">{{cite news |date=9 July 2009 |title=Religions – Islam: Abortion |url=http://www.bbc.co.uk/religion/religions/islam/islamethics/abortion_1.shtml |url-status=live |archive-url=https://web.archive.org/web/20111009065222/http://www.bbc.co.uk/religion/religions/islam/islamethics/abortion_1.shtml |archive-date=9 October 2011 |access-date=10 December 2011 |publisher=BBC}}</ref> Abortion is largely heavily restricted or forbidden in areas of high [[Islam]]ic faith such as the [[Middle East and North Africa]].<ref>{{cite web |year=2008 |title=Abortion in the Middle East and North Africa |url=http://www.prb.org/pdf08/MENAabortion.pdf |url-status=live |archive-url=https://web.archive.org/web/20111006171600/http://www.prb.org/pdf08/MENAabortion.pdf |archive-date=6 October 2011 |publisher=Population Research Bureau |vauthors=Dabash R, Farzaneh RF}}</ref>
[[Hinduism|Hindu]] views on abortion are diverse and lack a single authoritative position, shaped by principles like [[ahimsa]] (non-violence), [[karma]], and [[reincarnation]], which typically regard it as morally wrong for interrupting the soul's cycle.<ref>{{Cite journal |last=Aramesh |first=Kiarash |date=2019 |title=Perspectives of Hinduism and Zoroastrianism on abortion: a comparative study between two pro-life ancient sisters |url=https://pmc.ncbi.nlm.nih.gov/articles/PMC7166242/ |journal=Journal of Medical Ethics and History of Medicine |volume=12 |pages=9 |doi=10.18502/jmehm.v12i9.1340 |issn=2008-0387 |pmc=7166242 |pmid=32328222}}</ref> Scriptures often equate abortion to grave sins, with the fetus considered ensouled from conception or early gestation.<ref>{{Cite web |title=What is Hinduism's view on abortion? |url=https://hinduism.stackexchange.com/questions/15904/what-is-hinduisms-view-on-abortion |access-date=2025-07-19 |website=Hinduism Stack Exchange |language=en}}</ref> However, it may be ethically permissible to save the mother's life or in cases of severe fetal abnormalities, prioritizing lesser harm.<ref>{{Cite journal |last=Koley |first=Koyel |date=2 April 2018 |title=HINDUISM AND ABORTION : A TRADITIONAL VIEW |url=https://ijcrt.org/papers/IJCRT1892016.pdf |journal=IJCRT |volume=2 |issue=6 |pages=92-98}}</ref> Modern opinions differ regionally: In India, a majority view abortion as generally illegal, while in the US, most Hindus support legal access in all or most cases.<ref>{{Cite web |last=Corichi |first=Jonathan Evans, Neha Sahgal, Ariana Monique Salazar, Kelsey Jo Starr and Manolo |date=2022-03-02 |title=2. Son preference and abortion |url=https://www.pewresearch.org/religion/2022/03/02/son-preference-and-abortion/ |access-date=2025-07-19 |website=Pew Research Center |language=en-US}}</ref>
Denominations that support abortion rights with some limits include the [[United Methodist Church]], [[Episcopal Church (United States)|Episcopal Church]], [[Evangelical Lutheran Church in America]] and [[Presbyterian Church USA]].<ref name="Masci 2020">{{cite web | last=Masci | first=David | title=Where major religious groups stand on abortion | website=Pew Research Center | date=2020-05-30 | url=https://www.pewresearch.org/fact-tank/2016/06/21/where-major-religious-groups-stand-on-abortion/ | access-date=2023-01-22 | archive-date=22 January 2023 | archive-url=https://web.archive.org/web/20230122160816/https://www.pewresearch.org/fact-tank/2016/06/21/where-major-religious-groups-stand-on-abortion/ | url-status=live }}</ref> A 2014 Guttmacher survey of abortion patients in the United States found that many reported a religious affiliation: 24% were Catholic while 30% were Protestant.<ref>{{cite report| url=https://www.guttmacher.org/report/characteristics-us-abortion-patients-2014|title=Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008| vauthors = Jerman J, Jones RK, Onda T |date=10 May 2016| publisher=Guttmacher| access-date=25 February 2021|archive-date=24 February 2021|archive-url=https://web.archive.org/web/20210224085344/https://www.guttmacher.org/report/characteristics-us-abortion-patients-2014| url-status=live}}</ref> A 1995 survey reported that Catholic women are as likely as the general population to terminate a pregnancy, [[Protestants]] are less likely to do so, and [[evangelical Christians]] are the least likely to do so.<ref name="guttmacher"/><ref name="bankole98"/> A 2019 [[Pew Research Center]] study found that most [[Christian denomination]]s were against overturning ''[[Roe v. Wade]],'' which in the United States legalized abortion, at around 70%, except White Evangelicals at 35%.<ref name="PewReseach2019">{{cite web|url=https://www.pewresearch.org/fact-tank/2020/10/20/8-key-findings-about-catholics-and-abortion/|title=8 key findings about Catholics and abortion|date=20 October 2020 | publisher=Pew Research Center|access-date=15 May 2022|archive-date=15 May 2022|archive-url=https://web.archive.org/web/20220515173202/https://www.pewresearch.org/fact-tank/2020/10/20/8-key-findings-about-catholics-and-abortion/|url-status=live}}</ref>
==Society and culture==
{{Further|Societal attitudes towards abortion}}
===Abortion debate===
{{Main|Abortion debate}}
Induced abortion has long been the source of considerable debate. [[Medical ethics|Ethical]], [[Morality|moral]], [[Philosophical aspects of the abortion debate|philosophical]], [[Therapeutic abortion|biological]], [[Ethics in religion|religious]] and [[Abortion law|legal]] issues surrounding abortion are related to [[value system]]s. Opinions of abortion may be about [[fetal rights]], governmental authority, and [[women's rights]].
In both public and private debate, arguments presented in favor of or against abortion access focus on either the moral permissibility of an induced abortion, or the justification of laws permitting or restricting abortion.<ref>{{cite book | vauthors = Farrell C | title =Abortion Debate| publisher =ABDO Publishing Company| year =2010| pages =6–7| isbn =978-1-61785-264-0}}</ref> The [[World Medical Association]] Declaration on Therapeutic Abortion notes, "circumstances bringing the interests of a mother into conflict with the interests of her unborn child create a dilemma and raise the question as to whether or not the pregnancy should be deliberately terminated."<ref>{{cite web|url=http://www.wma.net/en/30publications/10policies/a1/ |title=WMA Declaration on Therapeutic Abortion |publisher=World Medical Association |access-date=28 October 2015 |url-status=dead |archive-url=https://web.archive.org/web/20151028182953/http://www.wma.net/en/30publications/10policies/a1/ |archive-date=28 October 2015 }}</ref> Abortion debates, especially pertaining to [[abortion law]]s, are often spearheaded by groups advocating one of these two positions. Groups who favor greater legal restrictions on abortion, including complete prohibition, most often describe themselves as "[[anti-abortion movement|pro-life]]" while groups who are against such legal restrictions describe themselves as "[[Abortion-rights movements|pro-choice]]".<ref>Farrell, p. 8</ref>
===Modern abortion law===
{{Main|Abortion law}}
{{See also|History of abortion law debate}}
{{AbortionLawsMap|size=330px}}
Current laws pertaining to abortion are diverse. Religious, moral, and cultural factors continue to influence abortion laws throughout the world. The [[right to life]], the right to liberty, the right to [[security of person]], and the right to [[reproductive health]] are major issues of human rights that sometimes constitute the basis for the existence or absence of abortion laws.
In jurisdictions where abortion is legal, certain requirements must often be met before a woman may obtain a legal abortion (an abortion performed without the woman's consent is considered [[feticide]] and is generally illegal). These requirements usually depend on the age of the fetus, often using a [[Pregnancy#Terminology|trimester]]-based system to regulate the window of legality, or as in the U.S., on a doctor's evaluation of the fetus' [[Fetal viability|viability]]. Some jurisdictions require a waiting period before the procedure, prescribe the distribution of information on [[prenatal development|fetal development]], or require that [[minors and abortion|parents be contacted]] if their minor daughter requests an abortion.<ref>{{cite web|url=http://internationalfamilyplanningperspectives.org/pubs/MandatoryCounseling.pdf |title=The Impact of State Mandatory Counseling and Waiting Period Laws on Abortion: A Literature Review |publisher=Guttmacher Institute| vauthors = Joyce TJ, Henshaw SK, Dennis A, Finer LB, Blanchard K |date=April 2009 |access-date=31 December 2010 |archive-url=https://web.archive.org/web/20120316155239/http://internationalfamilyplanningperspectives.org/pubs/MandatoryCounseling.pdf |archive-date=16 March 2012 |url-status=dead }}</ref> Other jurisdictions may require that a woman obtain the [[Paternal rights and abortion|consent of the fetus' father]] before aborting the fetus, that abortion providers inform women of health risks of the procedure—sometimes including "risks" not supported by the medical literature—and that multiple medical authorities certify that the abortion is either medically or socially necessary. Many restrictions are waived in emergency situations. China, which has ended their<ref>{{cite news|url=https://www.theguardian.com/world/2015/oct/29/china-abandons-one-child-policy|title=China ends one-child policy after 35 years| vauthors = Phillips T |date=29 October 2015|newspaper=The Guardian|issn=0261-3077|access-date=30 November 2016|url-status=live|archive-url=https://web.archive.org/web/20161201021629/https://www.theguardian.com/world/2015/oct/29/china-abandons-one-child-policy|archive-date=1 December 2016}}</ref> [[one-child policy]], and now has a three-child policy,<ref>{{cite news |title=China NPC: Three-child policy formally passed into law |url=https://www.bbc.com/news/world-asia-china-58277473 |access-date=6 April 2024 |date=20 August 2021 |archive-date=29 June 2022 |archive-url=https://web.archive.org/web/20220629190816/https://www.bbc.com/news/world-asia-china-58277473 |url-status=live }}</ref> has at times incorporated mandatory abortions as part of their population control strategy.<ref>{{cite encyclopedia |title=Science, Technology, and Society: An Encyclopedia |page=2 | veditors = Restivo SP |year=2005 |publisher=Oxford University Press |isbn=978-0-19-514193-1 |url=https://books.google.com/books?id=A8C3m8rRba4C |url-status=live |archive-url=https://web.archive.org/web/20150315111926/http://books.google.com/books?id=A8C3m8rRba4C |archive-date=15 March 2015 }}</ref>
Other jurisdictions ban abortion almost entirely. Many, but not all, of these allow legal abortions in a variety of circumstances. These circumstances vary based on jurisdiction, but may include whether the pregnancy is a result of rape or incest, the fetus' development is impaired, the woman's physical or mental well-being is endangered, or socioeconomic considerations make childbirth a hardship.<ref name="Dev98-07" /> In countries where abortion is banned entirely, such as [[Abortion in Nicaragua|Nicaragua]], medical authorities have recorded rises in maternal death directly and indirectly due to pregnancy as well as deaths due to doctors' fears of prosecution if they treat other gynecological emergencies.<ref>{{cite web|title=European delegation visits Nicaragua to examine effects of abortion ban |date=26 November 2007 |publisher=Ipas |access-date=15 June 2009 |url=http://www.ipas.org/Library/News/News_Items/European_delegation_visits_Nicaragua_to_examine_effects_of_abortion_ban.aspx |archive-url=https://web.archive.org/web/20080417033829/http://www.ipas.org/Library/News/News_Items/European_delegation_visits_Nicaragua_to_examine_effects_of_abortion_ban.aspx |archive-date=17 April 2008 |quote=More than 82 maternal deaths had been registered in Nicaragua since the change. During this same period, indirect obstetric deaths, or deaths caused by illnesses aggravated by the normal effects of pregnancy and not due to direct obstetric causes, have doubled.}}</ref><ref>{{cite news |url=http://insidecostarica.com/special_reports/2008-06/nicaragua_womens_movement.htm |title=Nicaragua: 'The Women's Movement Is in Opposition' |date=28 June 2008 |___location=Montevideo |agency=IPS |publisher=Inside Costa Rica |url-status=live |archive-url=https://web.archive.org/web/20110606102151/http://insidecostarica.com/special_reports/2008-06/nicaragua_womens_movement.htm |archive-date=6 June 2011 }}</ref> Some countries, such as Bangladesh, that nominally ban abortion, may also support clinics that perform abortions under the guise of menstrual hygiene.<ref>{{cite web|title=Surgical Abortion: History and Overview |publisher=National Abortion Federation |access-date=4 September 2006 |url=http://www.prochoice.org/education/resources/surg_history_overview.html |archive-url=https://web.archive.org/web/20060922152349/http://www.prochoice.org/education/resources/surg_history_overview.html |archive-date=22 September 2006 |url-status=dead }}</ref> This is also a terminology in traditional medicine.<ref name= nations1977>{{cite journal | vauthors = Nations MK, Misago C, Fonseca W, Correia LL, Campbell OM | title = Women's hidden transcripts about abortion in Brazil | journal = Social Science & Medicine | volume = 44 | issue = 12 | pages = 1833–1845 | date = June 1997 | pmid = 9194245 | doi = 10.1016/s0277-9536(96)00293-6 | quote = Two folk medical conditions, "delayed" (atrasada) and "suspended" (suspendida) menstruation, are described as perceived by poor Brazilian women in Northeast Brazil. Culturally prescribed methods to "regulate" these conditions and provoke menstrual bleeding are also described ... }}</ref> In places where abortion is illegal or carries heavy social stigma, pregnant women may engage in [[medical tourism]] and travel to countries where they can terminate their pregnancies.<ref>{{cite journal | vauthors = Henshaw SK | title = The accessibility of abortion services in the United States | journal = Family Planning Perspectives | volume = 23 | issue = 6 | pages = 246–52, 263 | year = 1991 | pmid = 1786805 | doi = 10.2307/2135775 | url = http://www.guttmacher.org/pubs/journals/3501603.pdf | access-date = 25 October 2017 | url-status = live | citeseerx = 10.1.1.360.6115 | jstor = 2135775 | archive-date = 24 March 2016 | archive-url = https://web.archive.org/web/20160324041912/http://www.guttmacher.org/pubs/journals/3501603.pdf }}</ref> [[Women on Waves]] has provided medication abortion and education on a ship in international waters off the coast of countries with restrictive abortion laws.<ref>{{cite journal | vauthors = Gomperts R | title = Women on waves: where next for the abortion boat? | journal = Reproductive Health Matters | volume = 10 | issue = 19 | pages = 180–183 | date = May 2002 | pmid = 12369324 | doi = 10.1016/S0968-8080(02)00004-6 | doi-access = free }}</ref><ref>{{cite journal| vauthors = Best A |date=2005|title=Abortion Rights along the Irish-English Border and the Liminality of Women's Experiences|journal=Dialectical Anthropology|volume=29|issue=3–4|pages=423–37|doi=10.1007/s10624-005-3863-x|s2cid=145318165|issn=0304-4092}}</ref><ref>{{cite journal| vauthors = Lambert-Beatty C |date=2008|title=Twelve miles: Boundaries of the new art/activism|journal=Signs: Journal of Women in Culture and Society|volume=33|issue=2|pages=309–27|doi=10.1086/521179|s2cid=147307705}}</ref> Women without the means to travel can resort to providers of illegal abortions or attempt to perform an abortion by themselves.<ref>{{cite web |title=Need Abortion, Will Travel | vauthors = Bloom M |date=25 February 2008 |publisher=RH Reality Check |access-date=15 June 2009 |url=http://www.rhrealitycheck.org/blog/2008/02/25/need-abortion-will-travel |url-status=live |archive-url=https://web.archive.org/web/20081130010309/http://www.rhrealitycheck.org/blog/2008/02/25/need-abortion-will-travel |archive-date=30 November 2008 }}</ref>
===Sex-selective abortion===
{{Main|Sex-selective abortion}}
[[Medical ultrasonography|Sonography]] and [[amniocentesis]] allow parents to determine sex before childbirth. The development of this technology has led to [[sex-selective abortion and female infanticide|sex-selective abortion]], or the termination of a fetus based on its sex. The selective termination of a female fetus is most common.
Sex-selective abortion is partially responsible for the noticeable disparities between the birth rates of male and female children in some countries. The preference for male children is reported in many areas of Asia, and abortion used to limit female births has been reported in Taiwan, South Korea, India, and China.<ref>Banister, Judith. (16 March 1999). [https://www.census.gov/ipc/www/ebspr96a.html Son Preference in Asia – Report of a Symposium] {{webarchive|url=https://web.archive.org/web/20060216134324/http://www.census.gov/ipc/www/ebspr96a.html |date=16 February 2006 }}. Retrieved 12 January 2006.</ref> This deviation from the standard birth rates of males and females occurs despite the fact that the country in question may have officially banned sex-selective abortion or even sex-screening.<ref>{{cite news| vauthors = Reaney P |agency=Reuters |url=http://www.alertnet.org/thenews/newsdesk/L06779563.htm |archive-url=https://web.archive.org/web/20060220072756/http://www.alertnet.org/thenews/newsdesk/L06779563.htm |archive-date=20 February 2006 |title=Selective abortion blamed for India's missing girls |access-date=3 December 2008}}</ref><ref>{{cite journal | vauthors = Sudha S, Irudaya RS | title = Female demographic disadvantage in India 1981-1991: sex selective abortions and female infanticide | journal = Development and Change | volume = 30 | issue = 3 | pages = 585–618 | date = July 1999 | pmid = 20162850 | doi = 10.1111/1467-7660.00130 | s2cid = 33446683 | url = http://www.hsph.harvard.edu/organizations/healthnet/gender/docs/sudha.html | access-date = 3 December 2008 | archive-url = https://web.archive.org/web/20030101210623/http://www.hsph.harvard.edu/organizations/healthnet/gender/docs/sudha.html | archive-date = 1 January 2003 | url-access = subscription }}</ref><ref name="LOC India">{{cite web|url=https://www.loc.gov/law/help/sex-selection/india.php|publisher=Library of Congress|title=Sex Selection & Abortion: India|date=4 April 2011|access-date=18 July 2011|url-status=live|archive-url=https://web.archive.org/web/20110927234151/http://www.loc.gov/law/help/sex-selection/india.php|archive-date=27 September 2011}}</ref><ref>{{cite news|agency=Xinhua News Agency|title=China Bans Sex-selection Abortion|url=http://www.china.org.cn/english/2003/Mar/59194.htm|access-date=2023-02-16|work=www.china.org.cn|date=March 22, 2003|archive-date=12 February 2006|archive-url=https://web.archive.org/web/20060212204114/http://www.china.org.cn/english/2003/Mar/59194.htm|url-status=live}}</ref>
Many countries have taken legislative steps to reduce the incidence of sex-selective abortion. At the [[International Conference on Population and Development]] in 1994 over 180 states agreed to eliminate "all forms of discrimination against the girl child and the root causes of son preference",<ref name="UNFPA">{{cite web|url=http://www.unfpa.org/webdav/site/global/shared/documents/publications/2011/Preventing_gender-biased_sex_selection.pdf|title=Preventing gender-biased sex selection|publisher=UNFPA|access-date=1 November 2011|archive-url=https://web.archive.org/web/20111011095023/https://www.unfpa.org/webdav/site/global/shared/documents/publications/2011/Preventing_gender-biased_sex_selection.pdf|archive-date=11 October 2011|url-status=live}}</ref> conditions also condemned by a [[Parliamentary Assembly of the Council of Europe|PACE]] resolution in 2011.<ref>{{cite web|url=http://assembly.coe.int/Documents/WorkingDocs/Doc11/EDOC12715.pdf |title=Prenatal sex selection |publisher=Parliamentary Assembly of the Council of Europe |url-status=dead |archive-url=https://web.archive.org/web/20111003133834/http://assembly.coe.int/Documents/WorkingDocs/Doc11/EDOC12715.pdf |archive-date=3 October 2011 |access-date=17 November 2015 }}</ref> The [[World Health Organization]] and [[UNICEF]], along with other [[United Nations]] agencies, have found that measures to restrict access to abortion in an effort to reduce sex-selective abortions have unintended negative consequences, largely stemming from the fact that women may seek or be coerced into seeking unsafe, extralegal abortions.<ref name="UNFPA" /> On the other hand, measures to reduce [[gender inequality]] can reduce the prevalence of such abortions without attendant negative consequences.<ref name="UNFPA" /><ref>{{cite journal |last=Das Gupta |first=Monica |date=2019 |title=Is banning sex-selection the best approach for reducing prenatal discrimination? |journal=Asian Population Studies |volume=15 |issue=3 |pages=319–336|doi=10.1080/17441730.2019.1671015 |pmid=34046078 |pmc=8153244 }}</ref>
===Anti-abortion violence===
{{Main|Anti-abortion violence}}
Abortion providers and facilities have been subjected to violence, including murder, assault, arson, and bombing. Some scholars consider anti-abortion violence to be within the [[definition of terrorism]],<ref>{{cite journal | vauthors = Wilson M, Lynxwiler J | title = Abortion clinic violence as terrorism | journal = Terrorism | volume = 11 | issue = 4 | pages = 263–273 | year = 1988 | pmid = 11618209 | doi = 10.1080/10576108808435717 }}</ref> a view shared by some governments.<ref name="csis">{{cite web | vauthors = Smith GD |publisher=Canadian Security Intelligence Service |year=1998 |url=http://www.csis-scrs.gc.ca/en/publications/commentary/com74.asp |title=Single Issue Terrorism Commentary |access-date= 1 September 2011| archive-url=https://web.archive.org/web/20071015065711/http://csis-scrs.gc.ca/en/publications/commentary/com74.asp| archive-date=15 October 2007|url-status=dead}}</ref> In the U.S. and Canada, over 8,000 incidents of violence, trespassing, and death threats have been recorded by providers since 1977, including over 200 bombings/arsons and hundreds of assaults.<ref>{{cite web| url=https://prochoice.org/wp-content/uploads/2017-NAF-Violence-and-Disruption-Statistics.pdf| title=2017 violence and disruption statistics |last=National Abortion Federation| date=2017|access-date=26 May 2019| archive-date=28 July 2020| archive-url=https://web.archive.org/web/20200728204107/https://prochoice.org/wp-content/uploads/2017-NAF-Violence-and-Disruption-Statistics.pdf| url-status=live}}</ref> Abortion clinics have also been targeted by [[Acid attack|acid attacks]], invasions, and vandalism<ref name="naf">{{cite web |publisher=National Abortion Federation| year=2009 |url=http://www.prochoice.org/pubs_research/publications/downloads/about_abortion/violence_stats.pdf |title=Incidence of Violence & Disruption Against Abortion Providers in the U.S. & Canada |access-date=9 February 2010 |url-status=live |archive-url=https://web.archive.org/web/20100613042214/http://prochoice.org/pubs_research/publications/downloads/about_abortion/violence_stats.pdf |archive-date=13 June 2010 }}</ref> The majority of abortion opponents have not been involved in violent acts.
Physicians and other abortion clinic staff have been murdered by abortion opponents. In the United States, at least four physicians have been murdered in connection with their work at abortion clinics, including [[David Gunn (doctor)|David Gunn]] (1993), [[John Britton (doctor)|John Britton]] (1994), [[Barnett Slepian]] (1998), and [[George Tiller]] (2009). In Canada, gynecologist [[Garson Romalis]] survived murder attempts in both 1994 and 2000. Besides physicians, killings have targeted other clinic staff, such as [[John Salvi|John Salvi's]] 1994 murder of two receptionists in Massachusetts clinic and [[Peter James Knight|Peter Knight's]] 2001 murder of a security guard in a [[Melbourne]] clinic. Notable perpetrators of anti-abortion violence include [[Eric Rudolph]], [[Scott Roeder]], [[Shelley Shannon]], and [[Paul Jennings Hill|Paul Hill]], the first person to be executed in the United States for murdering an abortion provider.<ref>{{cite news |url=https://www.theguardian.com/theguardian/1999/feb/03/features11.g26 |newspaper=The Guardian |date=3 February 1999 |title=The bomber under siege | vauthors = Borger J |___location=London |url-status=live |archive-url=https://web.archive.org/web/20170222105914/https://www.theguardian.com/theguardian/1999/feb/03/features11.g26 |archive-date=22 February 2017 }}</ref>
Some countries have [[Legal protection of access to abortion|laws to protecting access to abortion]].
Such laws prevent abortion opponents from interfering with access to legal abortion services. For example, the American [[Freedom of Access to Clinic Entrances Act]] bars the use of threats or violence to interfere with abortion access. Abortion access laws may also establish [[safe access zone]]s around abortion clinics, with limits on protests and enhanced penalties for anti-abortion violence.<ref>{{Cite journal |last1=Pridemore |first1=William Alex |author1-link=William Alex Pridemore |last2=Freilich |first2=Joshua D. |date=2007-12-01 |title=The Impact of State Laws Protecting Abortion Clinics and Reproductive Rights on Crimes Against Abortion Providers: Deterrence, Backlash, or Neither? |url=https://doi.org/10.1007/s10979-006-9078-0 |journal=Law and Human Behavior |language=en |volume=31 |issue=6 |pages=611–627 |doi=10.1007/s10979-006-9078-0 |pmid=17268826 |issn=1573-661X|url-access=subscription }}</ref>
Psychological pressure may also be used to limit abortion access. Some protestors record women entering clinics on camera.{{sfn|Doan|2007|p=2}}
=={{anchor|Other animals}}Non-human examples==
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{{Further|Miscarriage}}
Spontaneous abortion occurs in various animals. For example, in sheep it may be caused by stress or physical exertion, such as crowding through doors or being chased by dogs.<ref>{{cite book | vauthors = Spencer JB |title=Sheep Husbandry in Canada |year=1908 |page=114 |oclc=798508694 }}</ref> In cows, abortion may be caused by contagious disease, such as [[brucellosis]] or ''[[Campylobacter]]'', but can often be controlled by vaccination.<ref>{{cite encyclopedia |url=http://www.teara.govt.nz/1966/B/BeefCattleAndBeefProduction/ManagementAndHusbandryOfBeefCattle/en |title=Beef cattle and Beef production: Management and Husbandry of Beef Cattle |encyclopedia=Encyclopaedia of New Zealand |year=1966 |url-status=live |archive-url=https://web.archive.org/web/20090101142401/http://www.teara.govt.nz/1966/B/BeefCattleAndBeefProduction/ManagementAndHusbandryOfBeefCattle/en |archive-date=1 January 2009 }}</ref> Eating [[pine needle]]s can also induce abortions in cows.<ref>{{cite book | vauthors = Myers B, Beckett J |title=Animal Health Care and Maintenance |chapter=Pine needle abortion |chapter-url=http://ag.arizona.edu/arec/pubs/rmg/4%20animalcare&healthmaintenance/31%20pineneedleabortion01.pdf |access-date=10 April 2013 |year=2001 |publisher=Arizona Cooperative Extension, University of Arizona |___location=Tucson |pages=47–50 |url-status=dead |archive-url=https://web.archive.org/web/20150728003136/http://ag.arizona.edu/AREC/pubs/rmg/4%20animalcare%26healthmaintenance/31%20pineneedleabortion01.pdf |archive-date=28 July 2015 }}</ref><ref>{{cite journal | vauthors = Kim IH, Choi KC, An BS, Choi IG, Kim BK, Oh YK, Jeung EB | title = Effect on abortion of feeding Korean pine needles to pregnant Korean native cows | journal = Canadian Journal of Veterinary Research | volume = 67 | issue = 3 | pages = 194–197 | date = July 2003 | pmid = 12889725 | pmc = 227052 | publisher = Canadian Veterinary Medical Association }}</ref> Several plants, including [[Gutierrezia sarothrae|broomweed]], [[Veratrum californicum|skunk cabbage]], [[Conium maculatum|poison hemlock]], and [[Nicotiana glauca|tree tobacco]], are known to cause fetal deformities and abortion in cattle<ref name="Kirkbride">{{cite book| veditors = Njaa BL |title=Kirkbride's Diagnosis of Abortion and Neonatal Loss in Animals| year=2011| publisher=John Wiley & Sons|isbn=978-0-470-95852-0}}</ref>{{rp|45–46}} and in sheep and goats.<ref name="Kirkbride"/>{{rp|77–80}} In horses, a fetus may be aborted or reabsorbed if it has [[lethal white syndrome]]. Foal embryos that are homozygous for the [[dominant white]] gene (WW) are theorized to also be aborted or [[Embryo resorption|resorbed]] before birth.<ref name=phj>{{cite web| url=http://www.painthorsejournal.com/pastissues/pdfs/byahair-mar04.pdf |title=By a Hair | vauthors = Overton R | work=Paint Horse Journal |date=March 2003 |access-date=19 December 2012 |url-status=dead |archive-url=https://web.archive.org/web/20130218233122/http://www.painthorsejournal.com/pastissues/pdfs/byahair-mar04.pdf |archive-date=18 February 2013}}</ref> In many species of sharks and rays, stress-induced abortions occur frequently on capture.<ref>{{cite journal| vauthors = Adams KR, Fetterplace LC, Davis AR, Taylor MD, Knott NA |title=Sharks, rays and abortion: The prevalence of capture-induced parturition in elasmobranchs| journal=Biological Conservation|date=January 2018|volume=217|pages=11–27| doi=10.1016/j.biocon.2017.10.010|bibcode=2018BCons.217...11A | s2cid=90834034 |url=http://marxiv.org/k2qvy/|access-date=30 July 2019| archive-date=23 February 2019|archive-url=https://web.archive.org/web/20190223020619/https://marxiv.org/k2qvy/|url-status=dead}}</ref>
Viral infection can cause abortion in dogs.<ref name=dogabort1>{{cite web |url = http://www.petmd.com/dog/conditions/infectious-parasitic/c_dg_canine_herpesvirus_infection |title = Herpesvirus in dog pups |publisher = petMD |access-date = 18 December 2012 |url-status = live |archive-url = https://web.archive.org/web/20131109165216/http://www.petmd.com/dog/conditions/infectious-parasitic/c_dg_canine_herpesvirus_infection |archive-date = 9 November 2013}}</ref> Cats can experience spontaneous abortion for many reasons, including hormonal imbalance. A combined abortion and spaying is performed on pregnant cats, especially in [[trap–neuter–return]] programs, to prevent unwanted kittens from being born.<ref name=spay1>{{cite web |url = http://www.carolsferals.org/spaying-pregnant-females/ |title = Spaying Pregnant Females |publisher = Carol's Ferals |access-date = 17 December 2012 |url-status = usurped |archive-url = https://web.archive.org/web/20121118110647/http://www.carolsferals.org/spaying-pregnant-females/ |archive-date = 18 November 2012}}
</ref><ref name=spay2>{{cite web |url = http://www.petmd.com/blogs/fullyvetted/2007/may/feline-abortion-often-unnerving-necessity |title = Feline abortion: often an unnerving necessity | vauthors = Coates J |date = 7 May 2007 |publisher = petMD |access-date = 18 December 2012 |url-status = live |archive-url = https://web.archive.org/web/20120121085850/http://www.petmd.com/blogs/fullyvetted/2007/may/feline-abortion-often-unnerving-necessity |archive-date = 21 January 2012}}</ref><ref name=spay3>{{cite web |url = http://www.carolsferals.org/spaying-pregnant-females/ |title = Feline abortion: often an unnerving necessity (Part 2) | vauthors = Khuly P |date = 1 April 2011 |publisher = petMD |access-date = 18 December 2012 |url-status = usurped |archive-url = https://web.archive.org/web/20121118110647/http://www.carolsferals.org/spaying-pregnant-females/ |archive-date = 18 November 2012}}
</ref> Female rodents may terminate a pregnancy when exposed to the smell of a male not responsible for the pregnancy, known as the [[Bruce effect]].<ref name=Schwagmeyer>{{cite journal |jstor=2460564 |pages=932–938 | vauthors = Schwagmeyer PL |title=The Bruce Effect: An Evaluation of Male/Female Advantages |volume=114 |issue=6 |journal=The American Naturalist |year=1979 |doi=10.1086/283541|bibcode=1979ANat..114..932S |s2cid=85097151 }}</ref>
Abortion may also be induced in animals, in the context of [[animal husbandry]]. For example, abortion may be induced in mares that have been mated improperly, or that have been purchased by owners who did not realize the mares were pregnant, or that are pregnant with twin foals.<ref>{{cite book |url=https://books.google.com/books?id=jlZAT-9VwUIC |title=Equine Reproduction |page=563 | vauthors = McKinnon AO, Voss JL |publisher=Wiley-Blackwell |isbn=0-8121-1427-2 |year=1993 |url-status=live |archive-url=https://web.archive.org/web/20150315091737/http://books.google.com/books?id=jlZAT-9VwUIC |archive-date=15 March 2015 }}</ref> Feticide can occur in horses and zebras due to male harassment of pregnant mares or forced copulation,<ref>{{cite journal | vauthors = Berger J | title = Induced abortion and social factors in wild horses | journal = Nature | volume = 303 | issue = 5912 | pages = 59–61 | date = 5 May 1983 | pmid = 6682487 | doi = 10.1038/303059a0 | s2cid = 4259800 | bibcode = 1983Natur.303...59B }}</ref><ref>{{cite journal | vauthors = Pluhácek J, Bartos L | title = Male infanticide in captive plains zebra, Equus burchelli | journal = Animal Behaviour | volume = 59 | issue = 4 | pages = 689–694 | date = April 2000 | pmid = 10792924 | doi = 10.1006/anbe.1999.1371 | url = http://af.czu.cz/~bartos/publications/pdf/Pluhacek_Bartos_2000_AB.pdf | url-status = dead | s2cid = 10961845 | archive-url = https://web.archive.org/web/20110718170925/http://af.czu.cz/~bartos/publications/pdf/Pluhacek_Bartos_2000_AB.pdf | archive-date = 18 July 2011}}</ref><ref>{{cite journal| first1= Jan |last1 = Pluhacek | first2 = Luděk |last2 = Bartoš |year=2005| title=Further evidence for male infanticide and feticide in captive plains zebra, ''Equus burchelli''| journal=Folia Zoologica|volume=54| issue=3|pages=258–262| url=http://www.ivb.cz/folia/54/3/258-262.pdf| url-status=dead|archive-url=https://web.archive.org/web/20120222174717/http://www.ivb.cz/folia/54/3/258-262.pdf| archive-date=22 February 2012| access-date=12 April 2009}}</ref> although the frequency in the wild has been questioned.<ref>{{cite journal |vauthors = Kirkpatrick JF, Turner JW |title=Changes in Herd Stallions among Feral Horse Bands and the Absence of Forced Copulation and Induced Abortion |journal=Behavioral Ecology and Sociobiology |volume=29 |issue=3 |pages=217–19 |doi=10.1007/BF00166404 |year=1991 |jstor=4600608|bibcode=1991BEcoS..29..217K | s2cid=32756929}}</ref> Male [[gray langur]] monkeys may attack females following male takeover, causing miscarriage.<ref>{{cite journal |vauthors = Agoramoorthy G, Mohnot SM, Sommer V, Srivastava A |title=Abortions in free ranging Hanuman langurs (''Presbytis entellus'') – a male induced strategy? |journal=Human Evolution |volume=3| issue=4| pages=297–308| year=1988 |doi=10.1007/BF02435859| s2cid=84849590}}</ref>
==See also==
*[[Abortion
*[[Forced abortion]]
*[[
*[[Indirect abortion]]
*[[
== Notes ==
{{reflist|group=nb}}
== References ==
{{reflist|colwidth=30em}}
== Bibliography ==
{{Refbegin|30em}}
{{Further|United States anti-abortion movement#Further reading}}
*{{cite Catholic Encyclopedia |wstitle=Abortion |volume=1 | vauthors = Coppens C }}
* {{cite book |vauthors=Devereux G |author-link=George Devereux |title=A Study of Abortion in Primitive Societies |publisher=International Universities Press |year=1976 |isbn=978-0-8236-6245-6 |url=https://archive.org/details/studyofabortioni00deve}}
* {{cite book |vauthors=Doan AE |title=Opposition and Intimidation: The abortion wars and strategies of political harassment |year=2007 |publisher=University of Michigan}}
* {{cite journal |vauthors=Ganatra B, Tunçalp Ö, Johnston HB, Johnson BR, Gülmezoglu AM, Temmerman M |title=From concept to measurement: operationalizing WHO's definition of unsafe abortion |journal=Bulletin of the World Health Organization |volume=92 |issue=3 |page=155 |date=March 2014 |pmid=24700971 |pmc=3949603 |doi=10.2471/BLT.14.136333}}
* {{cite book |vauthors=Hartmann B |title=Reproductive Rights and Wrongs: The Global Politics of Population Control |publisher=South End Press |year=1995 |isbn=978-0-89608-491-9}}
* {{cite book |vauthors=Koblitz AH |author-link=Ann Hibner Koblitz |title=Sex and Herbs and Birth Control: Women and Fertility Regulation Through the Ages |publisher=Kovalevskaia Fund |year=2014 |isbn=978-0-9896655-0-6}}
* {{cite book |vauthors=Riddle JM |author-link=John M. Riddle |title=Eve's Herbs: A History of Contraception and Abortion in the West |year=1997 |publisher=Harvard University Press}}
* {{cite journal |vauthors=Sedgh G, Bearak J, Singh S, Bankole A, Popinchalk A, Ganatra B, Rossier C, Gerdts C, Tunçalp Ö, Johnson BR, Johnston HB, Alkema L |display-authors=6 |title=Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends |journal=Lancet |volume=388 |issue=10041 |pages=258–267 |date=July 2016 |pmid=27179755 |pmc=5498988 |doi=10.1016/S0140-6736(16)30380-4 |ref={{harvid|Sedgh et al|2016}}}}
* {{Cite Q|Q124418995}}
*{{cite book |last=UN |author-link=United Nations |title=Abortion Policies: A Global Review 3 vols. |date=2002 |publisher=Population Division, [[Department of Economic and Social Affairs]], United Nations |url=https://www.un.org/esa/population/publications/abortion/ |access-date=28 June 2017 |archive-date=11 January 2005 |archive-url=https://web.archive.org/web/20050111012745/http://www.un.org/esa/population/publications/abortion/doc/macedonia.doc |url-status=live}}
* {{cite book |last1=WHO |author-link=World Health Organization |title=The World Health Report 2005: Make every mother and child count |url=https://www.who.int/whr/2005/en/ |archive-url=https://web.archive.org/web/20050413194036/http://www.who.int/whr/2005/en/ |url-status=dead |archive-date=13 April 2005 |date=2005 |publisher=World Health Organization |___location=Geneva |isbn=92-4-156290-0}}
* {{cite book |last1=WHO |author-link=World Health Organization |title=Safe abortion: technical and policy guidance for health systems |date=2012 |publisher=World Health Organization |___location=Geneva |isbn=978-92-4-154843-4 |edition=2nd |url=http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf?ua=1 |access-date=2 November 2014 |archive-date=16 January 2015 |archive-url=https://web.archive.org/web/20150116223512/http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf?ua=1 |url-status=live}}
* {{cite web |last1=WHO |author-link=World Health Organization |title=Health worker roles in providing safe abortion care and post-abortion contraception |url=http://srhr.org/safeabortion/ |access-date=8 January 2017 |date=2016 |ref={{harvid|WHO|2016a}} |archive-date=29 March 2019 |archive-url=https://web.archive.org/web/20190329150415/http://srhr.org/safeabortion/ |url-status=live}}
{{Refend}}
== External links ==
{{Library resources box |by=no |onlinebooks=no |others=yes lcheading=Abortion}}
{{Scholia|topic}}
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* [https://www.who.int/news-room/fact-sheets/detail/abortion WHO fact sheet on abortion]
* [https://apps.who.int/iris/bitstream/handle/10665/173586/WHO_RHR_15.04_eng.pdf;jsessionid=A45A2A52E41EF59E9E71A08430BF4DA0?sequence=1 Safe abortion: Technical & policy guidance for health systems], World Health Organization (2015)
* [https://web.archive.org/web/20171018012623/https://www.guideline.gov/summaries/summary/47346/firsttrimester-abortion-in-women-with-medical-conditions?q=Women First-trimester abortion in women with medical conditions.] US Department of Health and Human Services
{{Abortion}}
{{Women's health|state=collapsed}}
{{Pregnancy}}
{{Particular human rights}}
{{Reproductive health}}
{{Birth control methods}}
{{Population}}
{{Subject bar|Medicine |Religion |auto=1|wikt=y|b=y}}
{{Authority control}}
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[[Category:Human reproduction]]
[[Category:Wikipedia medicine articles ready to translate]]
[[Category:Wikipedia emergency medicine articles ready to translate]]
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