Wikipedia

Abortion

This is an old revision of this page, as edited by Fenice (talk | contribs) at 09:40, 25 May 2005 (rm minor pro-life-org, weeks of discussion -> not a single reason has been given as to why they should be e, other minor org to balance were also not added, let al). The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

Abortion generally refers to the use of surgical procedures or drugs to end a pregnancy, associated with the death of the human embryo or fetus.

Medically, the term also refers to the early expulsion of a embryo or fetus by natural causes ("spontaneous abortion" or miscarriage, which ends approximately ten percent of all pregnancies, usually within the first thirteen weeks), or to the cessation of normal growth of a body part or organ. What follows is a discussion of the issues related to deliberately induced abortion.

Methods of abortion

Depending on the gestational age of the developing embryo or fetus, abortion can describe a number of different ways to destroy and remove a living fetus or embryo from the womb. Chemical abortion (or Medical Abortion as opposed to Surgical Abortion) is a method that is used when it is induced during the first nine weeks. The procedure consists of administering either methotrexate or mifepristone (RU-486) followed by administration of misoprostol. Approximately eight percent of these abortions require surgical followup, usually by vacuum aspiration (See below). Methotrexate may also treat undiagnosed or concomittant tubal pregnancies, which occur in about two percent of all patients who desire to terminate their fetus or embryo. About ten percent of abortions in the United States and Europe are induced medically.

In the first fifteen weeks, suction-aspiration or vacuum abortion are the most common methods, replacing the more risky dilation and curettage (D & C). Manual vacuum aspiration, or MVA abortion, consists of removing the embryo by suction using a manual syringe, while theElectric vacuum aspiration or EVA abortion method uses suction produced by an electric pump to remove the embryo. From the fifteenth week up until around the eighteenth week, a surgical dilation and evacuation (D & E) is used. D & E consists of opening the cervix of the uterus and emptying it using surgical instruments and suction.

Dilation and suction curettage consists of emptying the uterus by suction using a different apparatus. Curettage refers to the cleaning of the walls of the uterus with a curette. Dilation and curettage (D & C) is a standard gynaecological procedure performed for a variety of reasons, such as examination.

As the fetus grows, other techniques must be used to induce abortion in the third trimester. Premature delivery of the human fetus can be induced with prostaglandin; this can be coupled with injecting the amniotic fluid with caustic solutions containing saline or urea. Very late abortions can be brought about by the intact dilation and extraction (D & X) or a hysterotomy abortion, similar to a caesarian section, and requiring the surgical decompression of the fetus's head before evacuation. This procedure is controversially termed "partial-birth abortion".

Ingestion of drugs, such as RU-486 and the morning-after pill, is dealt with in detail in other entries.

Health risks

Complications

  • Even in regulated legal clinics, there is a small risk of serious complications, including death, from the most common surgical abortion procedures. These risks include perforated uterus, septic shock and sterility.
  • The exact risk and type of complications depend on the abortion method as well as the clinical and hygienic conditions. Studies have found that in developed countries where abortion is legal, the risk of serious physical complications of an abortion is less than one percent. In countries where abortion is illegal, this percentage is much higher, although the exact figure is unknown. This is likely due to the inherently dangerous nature of unregulated illegal surgery by doctors of dubious skill. Use of "traditional medicine" methods (overdoses of various drugs, inserting various objects into uterus) for abortions is also dangerous. Serious complications from abortions done outside of professional clinics may include infections, bleeding, and in many cases lead to death.

Physical health

  • Premature Birth: A study appearing in the British Journal of Obstetrics and Gynaecology by Dr. Caroline Moreau of the Hôpital de Bicêtre in Paris recently revealed a substantially greater chance of premature birth for the next baby after an aborted pregnancy. Overall, women who had had an abortion were 40 percent more likely to have a very pre-term delivery (less than 33 weeks) than those without such a history. The risk of an extremely premature baby - one born at less than 28 weeks - was raised even more sharply, by 70 percent. Abortion appeared to increase the risk of most major causes of premature birth, including premature rupture of membranes, incorrect position of the fetus on the placenta, and spontaneous early labor. The only common cause of premature birth not linked to abortion was high blood pressure. Earlier studies had shown an increased risk of preterm birth associated with abortion, but had failed to establish a conclusive link. [1]
The Abortion-Breast Cancer (ABC) hypothesis posits an association between having an abortion and a higher risk of developing breast cancer. The proposed mechanism is based on the increased estrogen levels found during early pregnancy, which initiate cellular differentiation (growth) in the breast in preparation for lactation. The ABC hypothesis states that if the pregnancy is aborted before full differentiation in the third trimester, then more "vulnerable" undifferentiated cells would be left than prior to the pregnancy, resulting in an elevated risk of breast cancer. The majority of interview-based studies have indicated a link, and some are statistically significant, but there is a debate as to their reliability.
The most recent meta-analysis of of 53 epidemiological studies published by Dr. Beral et al. in The Lancet in March 2004 found no ABC link; those findings have been disputed by Dr. Brind, a leading scientific advocate of the ABC hypothesis. Nevertheless, gaps remain in the research as the "ABC link" remains an issue in anti-abortion circles.

Mental health

  • Research has been carried on the question of whether abortion is associated with increased risk of clinical depression, but the results are mixed.
  • According to one study of 1,884 women conducted by the National Longitudinal Survey of Youth, women whose first pregnany ended in abortion are 65 percent more likely to be diagnosed with clinical depression around eight years later.
  • Another study of 2,525 women revealed that women who had an abortion were more likely to report depression or lower satisfaction with their lives. However, they also often reported rape, childhood physical and sexual abuse, and violent partners. After controlling for the history of abuse, partner characteristics, and background variables, abortion was not related to poorer mental health (Denious, J. & Russo, N. F. (2000). The Socio-Political Context of Abortion and its Relationship to Women's Mental Health. In J. Ussher (Ed.). Women's Health: Contemporary International Perspectives (pp. 431-439). London: British Psychological Society.).
  • A study in the Medical Science Monitor stated that, "Consistent with previous research, the data here suggest abortion can increase stress and decrease coping abilities, particularly for those women who have a history of adverse childhood events and prior traumata." In the study, 65 percent of post-abortive American women and 13.1 percent of Russian women experienced multiple symptoms of increased arousal, re-experiencing, and avoidance associated with posttraumatic stress disorder (PTSD). According to the study, 14.3 percent of American and 0.9 percent of Russian women met the full diagnostic criteria for PTSD. (Vincent Rue, Priscilla Coleman, James Rue, David Reardon (2004). Induced abortion and traumatic stress: A preliminary comparison of American and Russian women. Med Sci Monit, 2004; 10(10): SR5-16).

Abortion law

Main Article: abortion law

Abortion has been a controversial subject throughout history due to the moral and ethical issues that surround it. Limitations of the constitutional right to self-determination of women are one of the core issues of the philosophy of law. Abortion has been regularly banned and otherwise limited. Almost two thirds of the world's women currently reside in countries where abortion may be obtained on request or for a broad range of social, economic or personal reasons. Abortion laws vary widely by country, with some countries allowing nearly total liberalization, and others banning abortion under any circumstances. There are also countries that do not have any laws restricting abortion, such as Canada (see Abortion in Canada).

Paternal rights

Some have argued that abortion also involves rights for prospective fathers. For a discussion of this topic, please see the Oklahoma Law Review, "Abortions of the Paternal Prerogatives Of Unwed Natural Fathers," 2000.

Abortion as a Political Issue

Abortion has at times been a bitterly-fought political issue, particularly in the United States. The controversy in the U.S. started in 1973 with the case of Roe vs. Wade, when the Supreme Court ruled abortion to be a constitutionally protected right. Specifically, it ruled that states could not forbid a woman to terminate her pregnancy in the first three months (the first trimester) of her pregnancy.

Opponents of abortion are usually termed Pro-Life, while proponents of abortion rights are usually termed Pro-Choice. The United States Supreme Court is largely considered the gatekeeper of abortion rights in the United States, and as a result, the possibility of the balance of the Court shifting towards a more conservative body became an issue in the 2004 US Presidential Election.

The United States' current position regarding abortion under President George W. Bush, who cites his belief in a culture of life as the basis for his viewpoint, is geared toward restricting access to abortion, including abortions taking place outside the sovereign borders of the United States.

Even so, abortion access in the US has routinely been upheld in court decisions due to the concept of undue burden, in which a woman forced to bear an unwanted child is thought to suffer undue hardship, including health and financial concerns. A key case would be the US Supreme Court's decision in Planned Parenthood v. Casey, which established that the government cannot place an "undue burden" on a women's right to terminate a non-viable fetus.

In many other countries, abortion is less of a political issue. For a long time, it was not considered a mainstream political issue in Great Britain. However, in the runup to the 2005 General Election, Michael Howard, the leader of the Conservatives, stated that he, personally, might support a reduction in the limit from 24 weeks to 20 weeks, a move supported by both the Anglican and Catholic Churches, and leading figures in other parties. More radical UK Christian groups such as Christian Voice view such reductions as inconsequential and wish to see abortion outlawed completely. Any review would, however, still be subject to a 'free vote' by Members of Parliament - 'free' meaning that Members would not be required to support their party's policy, if any, on the subject.


Debate on abortion

Main article: Morality and legality of abortion

Pro-choice-stance

The cornerstone of the pro-choice movement is the issue of reproductive rights, which its proponents argue encompasses the right of a woman to choose to have an abortion. Most of the arguments are characterized by an appeal to privacy rights and gender equality. Well-known activist organizations like the National Organization for Women are generally pro-choice. Similar views are shared by groups ranging from American Civil Liberties Union to Planned Parenthood.

Pro-life movement

The pro-life movement recognizes the human fetus as a human person with human rights, and conceives of the right to life as the premier right. Some Pro-life supporters connect abortion to war and characterize it as a institution of violence that harms women and children. Well-known organizations like the Catholic Church are pro-life. Similar views are shared by many groups including Carenet (with its 850 pregnancy care centers).

"Rape, Incest and Health" Debate

Abortion rights advocates often argue that abortion needs to be widely available because some women become pregnant due to rape or incest (estimated at 2% of pregnancies) or have dangerous pregnancies such as ectopic pregnancies or conditions such as Eisenmenger's Syndrome that threaten the health of a woman or the unborn child.

Pro-life advocates consider the human embryo or fetus to be an innocent person who should not suffer due to the circumstances of conception.

According to the Alan Guttmacher Institute, there were 1.31 million abortions in the US in 2000, and cases of rape or incest accounted for 1.0% of abortions in 2000. Another study revealed that women reported the following reasons for choosing an abortion: 

25.5% Want to postpone childbearing  
 7.9% Want no (more) children
21.3% Cannot afford a baby  
10.8% Having a child will disrupt education or job  
14.1% Has relationship problem or partner does not want pregnancy
12.2% Too young; parent(s) or other(s) object to pregnancy  
 2.8% Risk to maternal health  
 3.3% Risk to fetal health  
 2.1% Other

Source: Bankole, Akinrinola; Singh, Susheela; Haas, Taylor. "Reasons Why Women Have Induced Abortions: Evidence from 27 Countries." International Family Planning Perspectives, 1998



Feminism and abortion

Historic feminism

Early feminists took the view that abortion was a horrible tragedy, a disastrous crime, and a male-supported instrument to further power over women.

Elizabeth Cady Stanton termed abortion infanticide. Mattie Brinkerhoff characterized abortion as destroying the life of an unborn child, and evidence that a woman "has been greatly wronged." Victoria Woodhull, the first female US presidential candidate, affirmed that "[t]he rights of children as individuals begin while yet they remain the foetus." Caroline Elizabeth Sarah Norton wrote of "infant butcheries" and "ante-natal child murder," describing abortion as interfering with "the right of the unborn to be born." Mary Wollstonecraft suggested outright that abortion violated the laws of nature and Matilda Joslyn Gage suggested it was one of the greatest wrongs against women and that it was committed by men. Alice Paul, author of the first Equal Rights Amendment in 1923, said simply "Abortion is the ultimate exploitation of women." Susan B. Anthony referred to it as "child murder" and said:

"Guilty? Yes. No matter what the motive, love of ease, or a desire to save from suffering the unborn innocent, the woman is awfully guilty who commits the deed. It will burden her conscience in life, it will burden her soul in death; But oh, thrice guilty is he who drove her to the desperation which impelled her to the crime!"

Current Feminism

This historical pro-life stance is no longer shared by most feminist organizations. Feminists oppose limitations of women's rights, and most feminists consider abortion laws as limitations on the right to self determination.

 
Wikiquote has quotations related to Abortion.
  • Just Facts: Abortion - Science of the fetus, history of U.S. abortion law, Gallup poll and other media information.
Retrieved from "https://en.wikipedia.org/w/index.php?title=Abortion&oldid=14204423"