Abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus.[nb 1] An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of all pregnancies.[2][3] When deliberate steps are taken to end a pregnancy, it is called an induced abortion, or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion.[4][5] The most common reason women give for having an abortion is for birth-timing and limiting family size.[6][7][8] Other reasons reported include maternal health, an inability to afford a child, domestic violence, lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest.[6][8][9]
For other uses, see Abortion (disambiguation).Abortion
Induced miscarriage, termination of pregnancy
Obstetrics and gynecology
When done legally in industrialized societies, induced abortion is one of the safest procedures in medicine.[10]: 1 [11] Unsafe abortions—those performed by people lacking the necessary skills, or in inadequately resourced settings—are responsible for between 5–13% of maternal deaths, especially in the developing world.[12] However, medication abortions that are self-managed are highly effective and safe throughout the first trimester.[13][14][15] Public health data shows that making safe abortion legal and accessible reduces maternal deaths.[16][17]
Modern methods use medication or surgery for abortions.[18] The drug mifepristone in combination with prostaglandin appears to be as safe and effective as surgery during the first and second trimesters of pregnancy.[18][19] The most common surgical technique involves dilating the cervix and using a suction device.[20] Birth control, such as the pill or intrauterine devices, can be used immediately following abortion.[19] When performed legally and safely on a woman who desires it, induced abortions do not increase the risk of long-term mental or physical problems.[21] In contrast, unsafe abortions 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.[22] 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".[23] Historically, abortions have been attempted using herbal medicines, sharp tools, forceful massage, or other traditional methods.[24]
Around 73 million abortions are performed each year in the world,[25] with about 45% done unsafely.[26] Abortion rates changed little between 2003 and 2008,[27] before which they decreased for at least two decades as access to family planning and birth control increased.[28] As of 2018, 37% of the world's women had access to legal abortions without limits as to reason.[29] Countries that permit abortions have different limits on how late in pregnancy abortion is allowed.[30] 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.[31]
Globally, there has been a widespread trend towards greater legal access to abortion since 1973,[32] but there remains debate with regard to moral, religious, ethical, and legal issues.[33][34] Those who oppose abortion often argue that an embryo or fetus is a person with a right to life, and thus equate abortion with murder.[35][36] Those who support abortion's legality often argue that it is a woman's reproductive right.[37] Others favor legal and accessible abortion as a public health measure.[38] Abortion laws and views of the procedure are different around the world. In some countries abortion is legal and women have the right to make the choice about abortion.[39] In some areas, abortion is legal only in specific cases such as rape, incest, fetal defects, poverty, and risk to a woman's health.[40]
Types
Induced
Approximately 205 million pregnancies occur each year worldwide. Over a third are unintended and about a fifth end in induced abortion.[27][41] Most abortions result from unintended pregnancies.[42][43] In the United Kingdom, 1 to 2% of abortions are done because of genetic problems in the fetus.[21] A pregnancy can be intentionally aborted in several ways. The manner selected often depends upon the gestational age of the embryo or fetus, which increases in size as the pregnancy progresses.[44][45]
Legality, regional availability, and a woman's or her doctor's personal preference may inform her choice of a specific procedure. Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. An abortion is medically referred to as a therapeutic abortion when it is performed to save the life of the pregnant woman; to prevent harm to the woman's physical or mental health; to terminate a pregnancy where indications are that the child will have a significantly increased chance of mortality or morbidity; or to selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy.[46][47] An abortion is referred to as elective or voluntary when it is performed at the request of the woman for non-medical reasons.[47] Confusion sometimes arises over the term elective because "elective surgery" generally refers to all scheduled surgery, whether medically necessary or not.[48]