Difference between revisions of "Abortion"

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[[Image:Baby.jpg|right|thumb|250px|A human fetus in the womb]]
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<!--Note to Editors: This article has a long and intense history of 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 induced termination of a [[pregnancy]],<ref>American Heritage Dictionary definition, [http://www.bartleby.com/61/7/A0020700.html abortion]</ref> often causing [[fetal pain]]. Abortion is a billion-dollar industry<ref>http://archives.cnn.com/2000/HEALTH/03/09/fetal.tissue/index.html</ref><ref>http://www.healthy.net/scr/news.asp?Id=8247</ref><ref>For example, Dr. George Tiller "estimated that he performed 250 to 300 late-term abortions in 2003, each costing an average of $6,000."[http://apnews.myway.com/article/20090327/D976JVSG4.html]</ref> in the [[United States]]<ref>Over 52,000,000 babies have been aborted in the United States since 1973.[http://www.christianliferesources.com/?/library/view.php&articleid=1042]</ref> and Western Europe except for [[Ireland]], [[Malta]] and [[Poland]], where it has been abolished.<ref>http://www.cwnews.com/news/viewstory.cfm?recnum=50451</ref><ref>On April 10, 2007, Portugal legalized abortion up until the 10th week of pregnancy, with some conditions placed on the obtaining of consent for the abortion.</ref><ref>God warns in His word that a nation that sheds innocent blood will not prosper. (Deuteronomy 19:11-13)</ref>  [[Abortion in Poland]] declined by 99% after [[communism]] was overthrown, and women's health has dramatically improved there due to fewer abortions.
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{{Infobox_Disease
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  | Name          = Induced abortion
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| Image          = AngkorWatAbortionAD1150.JPG
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| Caption        = [[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>{{cite book |author=Potts M ''et al.'' |title=Thousand-year-old depictions of massage abortion |journal=Journal of Family Planning and Reproductive Health Care |volume=33 |pages=234 |year=2007 |quote=at Angkor, the operator is a demon.}} Also see {{cite book |author=Mould R |title=Mould's Medical Anecdotes |pages=406 |publisher=[[CRC Press]] |year=1996}}</ref>
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| ICD10          = {{ICD10|O|04||o|00}}
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  | ICD9          = {{ICD9|779.6}}
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| DiseasesDB    = 4153
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| ICDO          =
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  | OMIM          =
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| MedlinePlus    = 002912
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| eMedicineSubj  = article
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| eMedicineTopic = 252560
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| MeshID        =
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}}
  
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'''About 80% of women who see an ultrasound of their fetus (unborn child) decide not to abort'''.<ref>http://www.redorbit.com/news/health/145703/abortion_foes_use_ultrasound__focus_on_the_family_budgets/</ref>  Millions of women who had an abortion later suffer psychologically or physically from it, and support groups exist to help.<ref>http://www.post-gazette.com/regionstate/20020120abortion0120p3.asp</ref> Many victims of abortion find healing by speaking out against, and discouraging, similar harm to other mothers and their children.<ref>"I've noticed that everyone who is for abortion has already been born," observed [[Ronald Reagan]].</ref>
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'''Abortion''' is the termination of a [[pregnancy (mammals)|pregnancy]] by the removal or expulsion from the [[uterus]] of a [[fetus]] or [[embryo]], resulting in or caused by its death.<ref>{{cite book |url=http://books.google.com/?id=KiRHpRl7TjsC&pg=PA173 |title=Gynaecology for Lawyers |author=Dutt T, Matthews MP |volume=14 |series-title=Medico-legal practitioner series |publisher=Routledge |year=1998 |isbn=9781859412152}}</ref> An abortion can occur spontaneously due to [[complication (medicine)|complications]] during pregnancy or can be induced, in humans and other species. In the context of human pregnancies, an abortion induced to preserve the health of the [[gravidity|gravida]] (pregnant female) is termed a ''therapeutic abortion'', while an abortion induced for any other reason is termed an ''elective abortion''. The term ''abortion'' most commonly refers to the induced abortion of a [[pregnancy|human pregnancy]], while spontaneous abortions are usually termed [[miscarriage]]s. <!--Annotation: This paragraph serves to disambiguate abortion terminology and and types-->
  
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"Abortion doesn't solve your problems, it only creates different ones," warned a full-page ad by many women who had abortions.<ref>http://www.silentnomoreawareness.org/signaturead/ad.pdf</ref> '''Many women begin regretting their abortion before they even leave the abortion clinic'''. In some cases, women begin regretting their abortion just before it is performed,<ref>In one case where a woman changed her mind from inside the abortion clinic, she "called her friend from inside the abortion clinic and arranged for her to come 'rescue' her." [http://www.40daysforlife.com/southfield/index.cfm?load=page&page=30]</ref> but are told by abortionists that it is too late to change their mind because they already signed a consent form (which is a lie - it is never too late to withdraw consent for an abortion).
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Worldwide 42 million abortions are estimated to take place annually with 22 million of these occurring safely and 20 million unsafely.<ref name=OBGY09>{{cite journal |author=Shah I, Ahman E |title=Unsafe abortion: global and regional incidence, trends, consequences, and challenges |journal=[[J Obstet Gynaecol Can]] |volume=31 |issue=12 |pages=1149–58 |year=2009 |month=December |pmid=20085681 |doi= |url=}}</ref>  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/> One of the main determinants of the availability of safe abortions is the legality of the procedure. Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits.<ref name=IJGO10>{{cite journal |author=Culwell KR, Vekemans M, de Silva U, Hurwitz M|title=Critical gaps in universal access to reproductive health: Contraception and prevention of unsafe abortion |journal=[[International Journal of Gynecology & Obstetrics]] |volume=110 |pages=S13–16 |year=2010 |month=July |pmid=20451196 |doi=10.1016/j.ijgo.2010.04.003 }}</ref> The frequency of abortions is, however, similar whether or not access is restricted.<ref name=IJGO10/><!--Annotation: This paragraph discusses epidemiology and health risk related to the procedure.-->
  
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==Health risks from abortion==
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Abortion has a long [[history of abortion|history]] and has been induced by various methods including herbal [[abortifacient]]s, the use of sharpened tools, [[physical trauma]], and other [[traditional medicine|traditional methods]]. Contemporary medicine utilizes medications and surgical procedures to induce abortion. The [[abortion law|legality]], prevalence, and cultural views on abortion vary substantially around the world. In many parts of the world there is prominent and divisive [[Abortion debate|public controversy]] over the [[ethical aspects of abortion|ethical]] and legal issues of abortion. Abortion and abortion-related issues feature prominently in the national politics in many nations, often involving the opposing [[pro-life]] and [[pro-choice]] worldwide social movements ([[Pro-choice#Term_controversy|both self-named]]). Incidence of abortion has declined worldwide, as access to [[family planning]] education and contraceptive services has increased.<ref name="worldtrends">{{cite journal |author=Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J |title=Legal abortion worldwide: incidence and recent trends |journal=Int Fam Plan Perspect |volume=33 |issue=3 |pages=106–16 |year=2007 |month=September |pmid=17938093 |doi=10.1363/ifpp.33.106.07 |url=http://www.guttmacher.org/pubs/journals/3310607.html }}</ref> <!--Annotation: This paragraph covers related issues and current events.-->
  
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Abortion always ends the life of the unborn child, typically by stopping his or her beating heart.  Abortion increases the risk of breast cancer, future premature birth, and other long-term health problems for the mother, as detailed below. Sometimes women die from abortion.<ref>See "Documented Incidents of 365 Women Who Have Been Killed by "Safe" and Legal Abortion." [http://abortionviolence.com/DEATHS.HTM 365 women who have been killed by 'Legal' abortion]</ref>
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==Types==
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[[File:Human fetus 10 weeks - therapeutic abortion.jpg|thumb|A 10-week-old fetus removed from a 44-year-old female diagnosed with early-stage [[uterine cancer]] via a therapeutic abortion. The uterus (womb), included the fetus.]]
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===Spontaneous===
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{{Main|Miscarriage}}
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Spontaneous abortion (also known as miscarriage) is the expulsion of an embryo or fetus due to accidental trauma or natural causes before approximately the 22nd [[gestational age|week of gestation]]; the definition by gestational age varies by country.<ref name="WHOmiscarriage">{{cite web |url=http://www.who.int/reproductive-health/impac/Symptoms/Vaginal_bleeding_early_S7_S16.html |title=Managing Complications in Pregnancy and Childbirth – A guide for midwives and doctors |last=Department of Reproductive Health and Research |publisher=World Health Organization |year=2003 |accessdate=2009-04-07}} NB: This definition is subject to regional differences, see [[Miscarriage#Terminology|miscarriage]].</ref> Most miscarriages are due to incorrect replication of chromosomes; they can also be caused by environmental factors. A pregnancy that ends before 37 weeks of gestation resulting in a [[live birth|live-born]] infant is known as a "[[premature birth]]". When a fetus dies [[in utero]] after about 22 weeks, or during [[childbirth|delivery]], it is usually termed "[[stillbirth|stillborn]]". Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.
  
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=== Abortion and Breast Cancer ===
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Between 10% and 50% of pregnancies end in clinically apparent miscarriage, depending upon the age and health of the pregnant woman.<ref name=BBCmiscarriage>{{cite news |url=http://news.bbc.co.uk/2/hi/health/2176898.stm |title=Q&A: Miscarriage |date=2002-08-06 |publisher=BBC |accessdate=2009-04-07}}</ref> Most miscarriages occur very early in pregnancy, in most cases, they occur so early in the pregnancy that the woman is not even aware that she was pregnant. One study testing hormones for ovulation and pregnancy found that 61.9% of conceptuses were lost prior to 12 weeks, and 91.7% of these losses occurred subclinically, without the knowledge of the once pregnant woman.<ref name="pmid7117572">{{cite journal |author=Edmonds DK, Lindsay KS, Miller JF, Williamson E, Wood PJ |title=Early embryonic mortality in women |journal=Fertil. Steril. |volume=38 |issue=4 |pages=447–453 |year=1982 |pmid=7117572 |doi=}}</ref>
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The vast majority of scientific studies have shown that abortion causes an increase in breast cancer, including 16 out of 17 statistically significant studies.<ref>http://www.jpands.org/vol8no2/malec.pdf</ref> "A new study coming from researchers in [[Sri Lanka]] finds women who had abortions ... [had a] 3.42 [increased risk] ... compared with those who kept their baby. ... The Sri Lankan study is the fourth epidemiological study in fourteen months to report an abortion-breast cancer link, including studies from the U.S., China and Turkey."<ref>http://www.lifenews.com/nat6451.html</ref>  LifeNews also reported in 2010 that a [[National Cancer Institute]] researcher admitted there was a link between abortion and breast cancer.<ref>http://www.lifenews.com/nat5850.html</ref>  Studies showing that abortion increases breast cancer predate the political controversy.<ref>http://www.bcpinstitute.org/brochure.htm</ref> A study at the Fred Hutchinson Cancer Research Center published in 2009 confirmed a 40% increase in risk in breast cancer from abortion.<ref>http://www.chicagonow.com/blogs/dennis-byrne-barbershop/2010/01/breast-cancer-oral-contraceptives-abortion-and-lies.html</ref><ref>It is undisputed that childbirth protects against breast cancer, and thus early termination of pregnancy must increase the risk of cancer for the mother compared to carrying that same pregnancy to birth.</ref> Yet the abortion industry conceals this increased risk, just as the tobacco industry concealed its cancer risk for decades.<ref>http://www.mindfully.org/Industry/Tobacco-ChronologyJul98.htm</ref>
 
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[[Image:Abortion Hurts Women.jpg|thumb|250px|right|Walk for Life rally]]
 
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A new study on breast cancer in Turkey published in April 2009 in the peer-reviewed World Journal of Surgical Oncology found, through a surveying process, that induced abortion was a statistically significant cause of breast cancer risk. The study concludes, “Our findings suggest that age and induced abortion were found to be significantly associated with increased breast cancer risk….”<ref>http://wjso.com/content/7/1/37</ref>
 
  
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Specifically, the study found that Turkish women who received one or more induced abortions had a 66% higher risk of breast cancer than women who never had an abortion.<ref>http://www.lifesitenews.com/ldn/2009/jul/09072903.html</ref> <ref>http://www.abortionbreastcancer.com/press_releases/090728/index.htm</ref>
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The risk of spontaneous abortion decreases sharply after the 10th week from the [[gestational age|last menstrual period]] (LMP).<ref name=BBCmiscarriage /><ref>{{cite book |first=Lennart |last=Nilsson |authorlink=Lennart Nilsson |coauthors=Lars Hamberger | page=91 |title=[[A Child Is Born (book)|A child is born]] |publisher=[[Doubleday (publisher)|Doubleday]] |location=[[Garden City, New York]] |year=1990 |pages= |isbn=0-385-40085-3 |oclc=21412111 |origyear=1965}}</ref> One study of 232 pregnant women showed "virtually complete <nowiki>[pregnancy loss]</nowiki> by the end of the embryonic period" (10 weeks LMP) with a pregnancy loss rate of only 2 percent after 8.5 weeks LMP.<ref name="fetal med 836">{{cite book |chapter=Early pregnancy loss |editor=Martin J. Whittle and C. H. Rodeck |title=Fetal medicine: basic science and clinical practice |publisher=Churchill Livingstone |location=Edinburgh |year=1999 |url=http://books.google.com/?id=0BY0hx2l5uoC |isbn=0-443-05357-X |oclc=42792567 |page=836 |author8=Jauniaux E, Kaminopetros P, El-Rafaey H }}</ref>
  
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Dr. Janet Daling, who considers herself supportive of a right to perform abortions, brought the abortion-breast cancer link into the mainstream with her federally funded research on the topic.  Her report, released in 1994, found a 50% increase in breast cancer risk due to induced abortion.<ref>Janet R. Daling et al., "Risk of Breast Cancer Among Young Women: Relationship to Induced Abortion," 86 Journal of the National Cancer Institute; (1994);1584</ref><ref>http://www.abortionbreastcancer.com/032801.htm</ref> She said, "I have three sisters with breast cancer and I resent people messing with the scientific data to further their own agenda, be they pro-choice or pro-life.  I would have loved to have found no association between breast cancer and abortion, but our research is rock solid and our data is accurate."<ref>L.A. Daily News, Sept. 1997.</ref> Similarly, an early study published in Japan in 1957 showed that women who have abortions have a much higher risk of breast cancer than those who decide to keep their baby.<ref>Segi M, et al. An epidemiological study on cancer in Japan. GANN. 1957; 48:1-63.</ref>
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The most common cause of spontaneous abortion during the first trimester is chromosomal abnormalities of the embryo/fetus,<ref name="mednet">{{cite web |url=http://www.medicinenet.com/miscarriage/page1.htm |title=Miscarriage (Spontaneous Abortion) |accessdate=2009-04-07 |last=Stöppler |author=Conrad M |editor=Shiel WC Jr |work=MedicineNet.com }}</ref> accounting for at least 50% of sampled early pregnancy losses.<ref name="fetal med 837">{{cite book |author=Jauniaux E, Kaminopetros P, El-Rafaey H |chapter=Early pregnancy loss |editor=Whittle MJ,Rodeck CH |title=Fetal medicine: basic science and clinical practice |publisher=Churchill Livingstone |location=Edinburgh |year=1999 |url=http://books.google.com/?id=0BY0hx2l5uoC |isbn=0-443-05357-X |oclc=42792567 |page=837 }}</ref> Other causes include [[vascular disease]] (such as [[Systemic lupus erythematosus|lupus]]), [[diabetes]], other hormonal problems, infection, and abnormalities of the uterus.<ref name="mednet" /> Advancing maternal age and a patient 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 |accessdate=2009-04-07 |publisher=[[National Conference of State Legislatures]]}}</ref>
  
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[[Image:Hitler.jpg‎|thumb|275px|right|In 1942, [[Adolf Hitler]] declared: "In view of the large families of the [[Slavic|Slav]] native population, it could only suit us if girls and women there had as many abortions as possible."<ref>http://www.lifesitenews.com/ldn/2007/sep/07090708.html</ref> After [[World War II]], the War Crimes Tribunal indicted ten [[Nazi]] leaders for "encouraging and compelling abortion," which the tribunal considered a "crime against humanity."<ref>http://www.abortionfacts.com/online_books/love_them_both/why_cant_we_love_them_both_25.asp#But%20didn%E2%80%99t%20Hitler%20oppose%20abortion?</ref> ]]
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===Induced===
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A pregnancy can be intentionally aborted in many ways. The manner selected depends chiefly upon the [[gestational age]] of the embryo or fetus, which increases in size as it ages.<ref>Menikoff, Jerry. [http://books.google.com/books?id=2jXOYv3X8zsC&pg=PA78&dq=size+fetus+abortion+technique&lr=&as_brr=3&ei=MymmSayEFJaQyATt6JiUDg Law and Bioethics], p. 78 (Georgetown University Press 2001): "As the fetus grows in size, however, the vacuum aspiration method becomes increasingly difficult to use."</ref> Specific procedures may also be selected due to legality, regional availability, and doctor-patient preference. Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. An abortion is medically referred to as ''therapeutic'' when it is performed to:
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*save the life of the pregnant woman;<ref name="roche1">Roche, Natalie E. (2004). [http://www.emedicine.com/med/topic3311.htm Therapeutic Abortion]. Retrieved 2006-03-08.</ref>
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*preserve the woman's physical or mental health;<ref name="roche1"/>
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*terminate pregnancy that would result in a child born with a [[congenital disorder]] that would be fatal or associated with significant [[morbidity]];<ref name="roche1"/> or
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*[[selective reduction|selectively reduce]] the number of fetuses to lessen health risks associated with [[multiple birth|multiple pregnancy]].<ref name="roche1"/>
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An abortion is referred to as ''elective'' when it is performed at the request of the woman "for reasons other than maternal health or fetal disease."<ref>''Encyclopedia Britannica'', (2007), Vol 26, p. 674.</ref>
  
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In a peer-reviewed medical journal, Karen Malec observed that:<ref>http://www.jpands.org/vol8no2/malec.pdf</ref>
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==Methods==
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[[Image:Abortionmethods.png|thumb|350px|right|[[Gestational age]] may determine which abortion methods are practiced.]]
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===Medical===
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{{Main|Medical abortion}}
  
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:Thirty-eight epidemiological studies exploring an independent link [between abortion and] breast cancer have been published. Twenty-nine report risk elevations. Thirteen out of 15 American studies found risk elevations. Seventeen studies are statistically significant, 16 of which report increased risk.
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"Medical abortions" are non-surgical abortions that use pharmaceutical drugs, and are only effective in the first trimester of pregnancy. {{Citation needed|date=February 2009}} Medical abortions comprise 10% of all abortions in the United States<ref>{{cite journal |author=Strauss LT, Gamble SB, Parker WY, Cook DA, Zane SB, Hamdan S |title=Abortion surveillance—United States, 2004 |journal=MMWR Surveill Summ |volume=56 |issue=9 |pages=1–33 |year=2007 |month=November |pmid=18030283 |doi= |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm}}</ref> and Europe.{{Citation needed|date=February 2009}} Combined regimens include [[methotrexate]] or [[mifepristone]], followed by a [[prostaglandin]] (either [[misoprostol]] or [[gemeprost]]: misoprostol is used in the U.S.; gemeprost is used in the UK and Sweden.) When used within 49 days gestation, approximately 92% of women undergoing medical abortion with a combined regimen completed it without surgical intervention.<ref>{{cite journal|author=Spitz, I.M|title=Early pregnancy termination with mifepristone and misoprostol in the United States|journal=New England Journal of Medicine|year=1998|volume=338|issue=18|pmid=9562577|doi=10.1056/NEJM199804303381801|page=1241|last2=Bardin|first2=CW|last3=Benton|first3=L|last4=Robbins|first4=A}}</ref> Misoprostol can be used alone, but has a lower efficacy rate than combined regimens. In cases of failure of medical abortion, vacuum or manual aspiration is used to complete the abortion surgically.
  
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Dr. Angela Lanfranchi, M.D., F.A.C.S., a specialist in breast cancer an a clinical assistant professor of surgery at the Robert Wood Johnson Medical School, has explained the physiology and epidemiology of the abortion-breast cancer link. She made the following observation:<ref>Angela Lanfranchi, M.D., F.A.C.S, "The breast physiology and the epidemiology of the abortion breast cancer link," 12 Imago Hominis, No. 3, 228 (2005) (emphasis added).</ref>
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===Surgical===
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[[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:''' Uterine lining<br />'''4:''' Speculum<br />'''5:''' Vacurette<br />'''6:''' Attached to a suction pump]]
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In the first 12 weeks, [[suction-aspiration abortion|suction-aspiration]] or vacuum abortion is the most common method.<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 |publisher=[[WebMD]] |accessdate=2008-12-05}}</ref> ''Manual [[Vacuum aspiration]]'' (MVA) abortion consists of removing the [[fetus]] or [[embryo]], [[placenta]] and membranes by suction using a manual syringe, while ''electric [[vacuum aspiration]]'' (EVA) abortion uses an electric pump. These techniques are comparable, and differ in the mechanism used to apply suction, how early in pregnancy they can be used, and whether cervical dilation is necessary. MVA, also known as "mini-suction" and "[[menstrual extraction]]", can be used in very early pregnancy, and does not require cervical dilation. Surgical techniques are sometimes referred to as 'Suction (or surgical) Termination Of Pregnancy' (STOP). From the 15th week until approximately the 26th, [[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.
  
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:This past August in Minneapolis, Patrick Carroll, director of the Pension and Population Research Institute of London, presented a paper to the largest gathering of statisticians in North America. '''He showed that abortion was the best predictor of breast cancer in Britain.''' Breast cancer is the only cancer in Britain which has its highest incidence and mortality rate among the upper rather than lower social classes. Abortion before a full term pregnancy and late pregnancy were the best explanations for this incidence. He also found that there had been a 70% increase risk of breast cancer between 1971 and 2002 and that for women between 50 and 54 years of age incidence was highly correlated with abortion.
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''[[Dilation and curettage]]'' (D&C), the second most common method of abortion, 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. ''[[Curettage]]'' refers to cleaning the walls of the [[uterus]] with a [[curette]]. The [[World Health Organization]] recommends this procedure, also called ''sharp curettage,'' only when MVA is unavailable.<ref>{{cite book |author=[[World Health Organization]] |chapter=Dilatation and curettage |chapterurl=http://www.who.int/reproductive-health/impac/Procedures/Dilatetion_P61_P63.html |title=Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors |publisher=[[World Health Organization]] |location=Geneva |year=2003 |pages= |isbn=92-4-154587-9 |oclc=181845530 |accessdate=2008-12-05}}</ref>
  
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Demographic evidence of abortion causing breast cancer includes the following. Breast cancer rates are far lower in Western countries that prohibited abortion than in those that promoted it.  Ireland, which virtually bans abortion, reportedly has a lifetime rate of breast cancer of only 1 in 13, nearly half the rate of 1 in 7.5 in the United States.<ref>"Probability of breast cancer in American Women," National Cancer Institute (Apr. 15, 2005);  K. O'Flaherty, R. Oakley, "Self-checks 'useless' in breast cancer fight," Sunday Tribune (Ireland), at 8 (Oct. 6, 2002).</ref>  The rate of breast cancer increases steadily as one travels from Ireland, where abortion is illegal, to Northern Ireland, where abortion is legal but rare, to England, where abortion is common. <ref> R. O'Reilly, "New weapon in war against breast cancer," The Press Association Limited (Dec. 17, 1998); "Portugal-abortion referendum," Associated Press Worldstream (June 27, 1998).</ref>  
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Other techniques must be used to induce abortion in the second [[wiktionary:trimester|trimester]]. Premature delivery can be induced with [[prostaglandin]]; this can be coupled with injecting the [[amniotic sac|amniotic fluid]] with hypertonic solutions containing [[saline (medicine)|saline]] or [[urea]]. After the 16th week of gestation, abortions can be induced by [[intact dilation and extraction]] (IDX) (also called intrauterine cranial decompression), which requires surgical decompression of the fetus's head before evacuation. IDX is sometimes called "partial-birth abortion," which has been [[Partial-Birth Abortion Ban Act|federally banned]] in the United States. A [[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 is used during later stages of pregnancy.<ref name="encarta">{{cite encyclopedia |last=McGee |first=Glenn |authorlink=Glenn McGee |coauthors=[[Jon F. Merz]] |encyclopedia=[[Encarta]] |title=Abortion |url=http://encarta.msn.com/encyclopedia_761553899/Abortion.html |accessdate=2008-12-05 |publisher=[[Microsoft]]|archiveurl=http://www.webcitation.org/5kvWYG63q|archivedate=2009-10-31|deadurl=yes}}</ref>
  
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In Romania, abortion was illegal under two decades of rule by the dictator Nicolae Ceausescu, and the country enjoyed one of the lowest breast cancer rates in the entire world during that time, far lower than comparable Western countries. Romania's breast cancer rate was an astounding one-sixth the rate of the United States.<ref>A. Khan, "The role of fat in breast cancer," The Independent (May 18, 1998).</ref> But after the execution of Ceausescu on Christmas Day, 1989, Romania has taken the opposite approach, embracing abortion to the point that Romania now has one of the highest abortion rates in the world.<ref>N. Abdullaev, "Russians are quickest to marry and divorce," Moscow Times (Dec 8, 2004).</ref> One Romanian observer decried, "The liberalization of abortions in Romania in 1990, the significant increase of the number of abortions at relatively short intervals, determined a rise in the incidence of breast and uterine cervix cancer in my country."<ref>Information packet, Women’s Environment and Development Organization (WEDO) World Conference on Breast Cancer (July 1997).</ref>
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From the 20th to 23rd week of gestation, an injection to stop the fetal heart can be used as the first phase of the surgical abortion procedure<ref>{{cite journal |author=Vause S, Sands J, Johnston TA, Russell S, Rimmer S |title=Could some fetocides be avoided by more prompt referral after diagnosis of fetal abnormality? |journal=J Obstet Gynaecol |volume=22 |issue=3 |pages=243–245 |year=2002 |month=May |pmid=12521492 |doi=10.1080/01443610220130490 |url=http://www.informaworld.com/openurl?genre=article&doi=10.1080/01443610220130490&magic=pubmed&#124;&#124;1B69BA326FFE69C3F0A8F227DF8201D0 |accessdate=2008-12-03}}</ref><ref>{{cite journal |author=Dommergues M, Cahen F, Garel M, Mahieu-Caputo D, Dumez Y |title=Feticide during second- and third-trimester termination of pregnancy: opinions of health care professionals |journal=Fetal. Diagn. Ther. |volume=18 |issue=2 |pages=91–97 |year=2003 |pmid=12576743 |doi=10.1159/000068068 |url=http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=fdt18091 |accessdate=2008-12-03}}</ref><ref>{{cite journal |author=Bhide A, Sairam S, Hollis B, Thilaganathan B |title=Comparison of feticide carried out by cordocentesis versus cardiac puncture |journal=Ultrasound Obstet Gynecol |volume=20 |issue=3 |pages=230–232 |year=2002 |month=September |pmid=12230443 |doi=10.1046/j.1469-0705.2002.00797.x |accessdate=2008-12-03}}</ref><ref>{{cite journal |author=Senat MV, Fischer C, Bernard JP, Ville Y |title=The use of lidocaine for fetocide in late termination of pregnancy |journal=BJOG |volume=110 |issue=3 |pages=296–300 |year=2003 |month=March |pmid=12628271 |doi= 10.1046/j.1471-0528.2003.02217.x|url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=1470-0328&date=2003&volume=110&issue=3&spage=296 |accessdate=2008-12-03}}</ref><ref>{{cite journal |author=Senat MV, Fischer C, Ville Y |title=Funipuncture for fetocide in late termination of pregnancy |journal=Prenat. Diagn. |volume=22 |issue=5 |pages=354–356 |year=2002 |month=May |pmid=12001185 |doi=10.1002/pd.290 |accessdate=2008-12-03}}</ref> to ensure that the fetus is not born alive.<ref>{{cite book |author=Nuffield Council on Bioethics |chapter=Clinical perspectives (Continued) |chapterurl=http://www.nuffieldbioethics.org/go/browseablepublications/criticalCareDecisionFetalNeonatalMedicine/report_542.html |accessdate=2008-12-03 |title=Critical Case Decisions in Fetal and Neonatal Medicine: Ethical Issues |publisher=Nuffield Council on Bioethics |location= |year=2006 |isbn=1-904384-14-5 |oclc=85782378}}</ref>
  
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Studies on rats, which are an accepted method for identifying causes of cancer in humans, further confirm that abortion does indeed increase the risk of breast cancer.  As Dr. [[Joel Brind]] observed, "Researchers also widely admit to the biological plausibility of abortion as an independent cause of breast cancer, through the estrogen-mediated stimulation of breast growth in the absence of differentiation. This was demonstrated experimentally in rats in the landmark experiments of Russo and Russo."<ref>[[Joel Brind]], "Induced Abortion as an Independent Risk Factor for Breast Cancer: A Critical Review of Recent Studies Based on Prospective Data," J. of Am. Physicians & Surgeons 105 (Winter 2005) [http://www.jpands.org/vol10no4/brind.pdf] (citing Russo J, Russo IH. Susceptibility of the mammary gland to
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===Other methods===
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carcinogenesis. 1980;100:497-512).</ref> Additional scientific information on the abortion-breast cancer link is available [http://www.bcpinstitute.org here].
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Historically, a number of herbs reputed to possess [[abortifacient]] properties have been used in [[folk medicine]]: [[tansy]], [[pennyroyal]], [[black cohosh]], and the now-extinct [[silphium]] (see [[Abortion#History of abortion|history of abortion]]).<ref name="riddle2">{{cite book |first=John M. |last=Riddle |title=Eve's herbs: a history of contraception and abortion in the West |publisher=[[Harvard University Press]] |location=[[Cambridge, Massachusetts]] |year=1997 |pages= |isbn=0-674-27024-X |oclc=36126503}}{{pn}}</ref> The use of herbs in such a manner can cause serious—even lethal—side effects, such as [[multiple organ dysfunction syndrome|multiple organ failure]], and is not recommended by [[physician]]s.<ref>{{cite journal |author=Ciganda C, Laborde A |title=Herbal infusions used for induced abortion |journal=J. Toxicol. Clin. Toxicol. |volume=41 |issue=3 |pages=235–239 |year=2003 |pmid=12807304 |doi=10.1081/CLT-120021104 |url= |accessdate=2008-12-04}}</ref>
  
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An expert (Dr. Lynn Rosenberg) hired to defend abortion felt compelled to admit, under cross-examination, that a woman increases her risk for breast cancer by having an abortion compared to carrying her pregnancy to childbirth:<ref>http://www.abortionbreastcancer.com/rosenbergs_testimony.htm</ref>
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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>Education for Choice. (2005-05-06). http://www.efc.org.uk/Foryoungpeople/Factsaboutabortion/Unsafeabortion Unsafe abortion. Retrieved 2006-01-11.</ref> Both accidental and deliberate abortions of this kind can be subject to criminal liability in many countries. In Southeast Asia, there is an ancient tradition of attempting abortion through forceful abdominal massage.<ref name="potts">{{cite journal |first=Malcolm |last=Potts |authorlink=Malcolm Potts |year=2002 |title=History of Contraception |journal=Gynecology and Obstetrics |volume=6 |issue=8 |accessdate=2008-12-04}}</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 has been sent to the [[underworld]].<ref name="potts" />
  
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:Question by the attorney: 'So in other words, a woman who finds herself pregnant at age 15 will have a higher breast cancer risk if she chooses to abort that pregnancy, than if she carries the pregnancy to term, [is that] correct?'
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Reported methods of unsafe, [[self-induced abortion]] include misuse of [[misoprostol]], and insertion of non-surgical implements such as knitting needles and clothes hangers into the uterus. These methods are rarely seen in developed countries where surgical abortion is legal and available.<ref>{{cite journal |author=Thapa SR, Rimal D, Preston J |title=Self induction of abortion with instrumentation |journal=Aust Fam Physician |volume=35 |issue=9 |pages=697–698 |year=2006 |month=September |pmid=16969439 |doi= |url=http://www.racgp.org.au/afp/200609/11015 |accessdate=2008-12-04}}</ref>
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{{clr}}<!-- The clr tag prevents the picture from running into the next section. Please keep it at the bottom of this section. -->
  
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:Dr. Lynn Rosenberg: 'Probably, yes.'
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==Health risks==
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{{See also|Unsafe abortion#Health risks|l1=Health risks of unsafe abortion}}
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Abortion, when legally performed in developed countries, is among the safest procedures in medicine.<ref name="lancet-grimes">{{cite journal |author=Grimes DA, Benson J, Singh S, ''et al.'' |title=Unsafe abortion: the preventable pandemic |journal=Lancet |volume=368 |issue=9550 |pages=1908–19 |year=2006 |month=November |pmid=17126724 |doi=10.1016/S0140-6736(06)69481-6 |url=http://www.who.int/reproductivehealth/publications/general/lancet_4.pdf}}</ref><ref name="grimes-overview">{{cite journal |author=Grimes DA, Creinin MD |title=Induced abortion: an overview for internists |journal=Ann. Intern. Med. |volume=140 |issue=8 |pages=620–6 |year=2004 |month=April |pmid=15096333 |doi= |url=http://www.annals.org/content/140/8/620.full}}</ref>  In such settings, risk of [[maternal death]] is between 0.2–1.2 per 100,000 procedures.<ref name=IOB2003>{{cite journal |author=Yanda K. et al |title=Reproductive health and human rights |journal=International journal of gynecology and obstetrics |volume=82 |issue=3 |pages=275–283 |year=2003 |month=Sept |pmid= 14499974|doi= 10.1016/S0020-7292(03)00226-1|url=http://www.ijgo.org/article/PIIS0020729203002261/fulltext}}</ref><ref>{{cite journal |author=Vekemans M |title=Making induced abortion safe and legal, worldwide |journal=Eur J Contracept Reprod Health Care |volume=14 |issue=3 |pages=165–8 |year=2009 |month=June |pmid=19565413 |doi=10.1080/13625180902886371 |url=}}</ref><ref name="grimes-mortality">{{cite journal |author=Grimes DA |title=Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999 |journal=Am. J. Obstet. Gynecol. |volume=194 |issue=1 |pages=92–4 |year=2006 |month=January |pmid=16389015 |doi=10.1016/j.ajog.2005.06.070 |url=}}</ref><ref>{{cite book |author=Douglas W. Laube; Barzansky, Barbara M.; Beckmann, Charles R. B.; Herbert, William G. |title=Obstetrics and Gynecology |publisher=Lippincott Williams & Wilkins |location=Hagerstown, Maryland |year=2009 |pages=150 |isbn=0-7817-8807-2 |oclc= |doi= |accessdate=}}</ref> In comparison, by 1996, mortality from childbirth in developed countries was 11 times greater.<ref>{{cite journal |author=Kulczycki A, Potts M, Rosenfield A |title=Abortion and fertility regulation |journal=Lancet |volume=347 |issue=9016 |pages=1663–8 |year=1996 |month=June |pmid=8642962 |doi= 10.1016/S0140-6736(96)91491-9|url=}}</ref><ref>{{cite journal |author=Yanda K. et al |title=Reproductive health and human rights |journal=International journal of gynecology and obstetrics |volume=82 |issue=3 |pages=275–283 |year=2003 |month=Sept |pmid= 14499974|doi= 10.1016/S0020-7292(03)00226-1|url=http://www.ijgo.org/article/PIIS0020729203002261/fulltext}}</ref><ref>{{cite book |author=Danielle Mazza |title=Women's health in general practice |publisher=Butterworth-Heinemann |location=Oxford |year=2004 |pages=93 |isbn=0-7506-8773-8 |oclc= |doi= |accessdate=}}</ref><ref>{{cite book |author=Eric Sokol; Andrew Sokol |title=General gynecology |publisher=Mosby |location=St. Louis |year=2007 |pages=238 |isbn=0-323-03247-8 |oclc= |doi= |accessdate=}}</ref><ref>{{cite book |author=Lloyd, Cynthia B. |title=Growing up global: the changing transitions to adulthood in developing countries |publisher=National Academies Press |location=Washington, D.C |year=2005 |pages=215 |isbn=0-309-09528-X |oclc= |doi= |accessdate=}}</ref><ref>{{cite book |author=Douglas W. Laube; Barzansky, Barbara M.; Beckmann, Charles R. B.; Herbert, William G. |title=Obstetrics and Gynecology |publisher=Lippincott Williams & Wilkins |location=Hagerstwon, MD |year=2009 |pages=150 |isbn=0-7817-8807-2 |oclc= |doi= |accessdate=}}</ref>  [[Unsafe abortion]]s (defined by the [[World Health Organization]] as those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities) carry a high risk of maternal death and other complications.<ref name="who-unsafe-1995">{{cite web| publisher = [[World Health Organization]] | title = The Prevention and Management of Unsafe Abortion | date = April 1995 | accessdate = June 1, 2010 | url = http://whqlibdoc.who.int/hq/1992/WHO_MSM_92.5.pdf |format = PDF}}</ref>  For unsafe procedures, the mortality rate has been estimated at 367 per 100,000.<ref>{{cite journal |author=Fawcus SR |title=Maternal mortality and unsafe abortion |journal=Best Pract Res Clin Obstet Gynaecol |volume=22 |issue=3 |pages=533–48 |year=2008 |month=June |pmid=18249585 |doi=10.1016/j.bpobgyn.2007.10.006 |url=}}</ref>
  
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:Question: 'Looking at that another way, let's compare two women. Let's say both got pregnant at age 15-- one terminates the pregnancy, but the other carries the pregnancy to term. And both women go on to get married and have two kids, say, at age 30 and age 35. Is the risk of breast cancer higher for the woman who had an abortion at age 15 or the woman who had a baby at age 15, all other things being equal?'
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====Physical health====
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Surgical abortion methods, like most [[minimally invasive procedure]]s, carry a small potential for serious complications.<ref>{{cite book |author=[[World Health Organization]] |title=Medical Methods for Termination of Pregnancy: Report of a Who Scientific Group |series=Who Technical Report Series No. 871 |publisher=[[World Health Organization]] |location=[[Geneva]] |year=1997 |pages= |isbn=92-4-120871-6 |oclc=38276325}}{{pn}}</ref>
  
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:Dr. Lynn Rosenberg: 'It's probably higher for the one who had an abortion at age 15.'
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Surgical abortion is generally safe and the rate of major complications is low<ref>{{cite book |last1=Botha|first1=Rosanne L.|last2=Bednarek|first2=Paula H.|last3=Kaunitz|first3=Andrew M.|coauthors=Alison B. Edelman|editor=Guy I Benrubi |title=Handbook of Obstetric and Gynecologic Emergencies |edition=4|year=2010|publisher=Lippincott Williams & Wilkins|isbn=978-1605476667|page=256|chapter=Complications of Medical and Surgical Abortion|quote=Although first trimester medical and surgical abortion are safe with low rates of major complications, these are common procedures, and therefore it is not unusual for women with abortion complications to present for emergent care.}}</ref> but varies depending on how far pregnancy has progressed and the surgical method used.<ref name="Pregler"/> Concerning gestational age, incidence of major complications is highest after 20 weeks of gestation and lowest before the 8th week.<ref name="Pregler"/> With more advanced gestation there is a higher risk of [[uterine perforation]] and retained products of conception,<ref name="Rello">{{cite book|editor=Jordi Rello|title=Infectious diseases in critical care|edition=2|publisher=Springer|isbn=978-3540344056|page=490}}</ref> and specific procedures like [[dilation and evacuation]] may be required.<ref name="cochrane-2nd-tri">{{cite journal |author=Lohr PA, Hayes JL, Gemzell-Danielsson K |title=Surgical versus medical methods for second trimester induced abortion |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD006714 |year=2008 |pmid=18254113 |doi=10.1002/14651858.CD006714.pub2 }}</ref>
  
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Despite the overwhelming evidence -- and inescapable logic -- for abortion increasing breast cancer, promoters of abortion cite flawed articles in an attempt to deny the link.<ref>The flaws in these articles are exposed in [[Harvard abortion study]] and [http://www.jpands.org/vol10no1/aschlafly.pdf].</ref>
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Concerning the methods used, general incidence of major complications for surgical abortion varies from lower for suction curettage, to higher for saline instillation.<ref name="Pregler">{{cite book|last1=Pregler|first1=Janet P. |last2=DeCherney|first2=Alan H. |title=Women's health: principles and clinical practice |year=2002 |publisher=pmph usa |isbn=978-1550091700 |page=232}}</ref>  Possible complications include [[hemorrhage]], incomplete abortion, uterine or pelvic infection, ongoing intrauterine pregnancy, misdiagnosed/unrecognized [[ectopic pregnancy]], [[hematometra]] (in the uterus), [[uterine perforation]] and cervical laceration.<ref>{{cite book |last1=Botha|first1=Rosanne L. |last2=Bednarek|first2=Paula H. |last3=Kaunitz|first3=Andrew M. |coauthors=Alison B. Edelman |editor=Guy I Benrubi |title=Handbook of Obstetric and Gynecologic Emergencies |edition=4 |year=2010 |publisher=Lippincott Williams & Wilkins |isbn=978-1605476667 |page=258 |chapter=Complications of Medical and Surgical Abortion}}</ref> Use of [[general anesthesia]] increases the risk of complications because it relaxes uterine musculature making it easier to perforate.<ref>{{cite book |last1=Morgan|first1=Mark |last2=Siddighi|first2=Sam |title=NMS Obstetrics and Gynecology |edition=5 |series=National Medical Series for Independent Study |year=2004 |publisher=Lippincott Williams & Wilkins |isbn=978-0781726795 |page=140}}</ref>
  
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As Dr. Lanfranchi has explained:<ref>http://www.jpands.org/vol13no1/lanfranchi.pdf</ref>
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Women who have uterine anomalies, [[leiomyomas]] or had previous difficult first-trimester abortion are contraindicated to undertake surgical abortion unless [[Medical ultrasonography|ultrasonography]] is immediately available and the surgeon is experienced in its intraoperative use.<ref>{{cite book|last1=Speroff|first1=Leon|last2=Fritz|first2=Marc A.|title=Clinical gynecologic endocrinology and infertility|edition=7|year=2004|publisher=Lippincott Williams & Wilkins|isbn=978-0781747950|page=851|chapter=Family Planning, Sterilization, and Abortion}}</ref> Abortion does not impair subsequent pregnancies, nor does it increase the risk of future [[premature birth]]s, infertility, [[ectopic pregnancy]], or miscarriage.<ref name="grimes-overview"/>
  
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:Well-documented breast physiology accounts for the fact that oral contraceptives and abortion are risk factors for breast cancer. There is an effort to suppress this information by federal agencies and those in academic medicine.  Without this information, women cannot make a fully informed choice about their method of fertility control or about whether to maintain an unplanned pregnancy. Medical ethics demands that they be informed.
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<!-- pain should be better defined to avoid ignoring a possible complication
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Women typically experience minor pain during first-trimester abortion procedures. In a 1979 study of 2,299 patients, 97% reported experiencing some degree of pain. Patients rated the pain as being less than earache or toothache, but more than headache or backache.<ref name="pmid443287">{{cite journal |author=Smith GM, Stubblefield PG, Chirchirillo L, McCarthy MJ |title=Pain of first-trimester abortion: its quantification and relations with other variables |journal=[[Am J Obstet Gynecol]] |volume=133 |issue=5 |pages=489–498 |year=1979 |pmid=443287 |doi= |url=}}</ref>{{better source}}-->
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In the first trimester, [[Medical abortion#Health risks|health risks associated with medical abortion]] are generally considered no greater than for surgical abortion.<ref name="who-medical-abortion">{{cite web | publisher = [[World Health Organization]] | title = Medical versus surgical methods for first trimester termination of pregnancy | url = http://apps.who.int/rhl/fertility/abortion/pccom/en/index.html | date = December 15, 2006 | accessdate = June 1, 2010}}</ref>
  
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Pro-choice should include ''informed'' choice.<ref>The Archdiocese of St. Louis, for example, remarked about abortions and increased risk for breast cancer: "To dismiss that link is irresponsible." [http://www.chron.com/disp/story.mpl/ap/tx/5620863.html]</ref>  Yet efforts continue to suppress awareness that abortion increases breast cancer.  Pro-life scientists were almost entirely barred from the National Cancer Institute's "study" of the link, and its resulting statements were fatally flawed as explained in  [[National Cancer Institute on Abortion]].
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===Mental health===
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{{Main|Abortion and mental health}}
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No scientific research has demonstrated that abortion is a cause of poor mental health in the general population. However there are groups of women who may be at higher risk of coping with problems and distress following abortion.<ref name="Cockburn">{{cite book |last1=Cockburn|first1=Jayne |last2=Pawson|first2=Michael E. |title=Psychological Challenges to Obstetrics and Gynecology: The Clinical Management |year=2007 |publisher=Springer |isbn=978-1846288074 |page=243}}</ref> Some factors in a woman's life, such as emotional attachment to the pregnancy, lack of social support, pre-existing psychiatric illness, and conservative views on abortion increase the likelihood of experiencing negative feelings after an abortion.<ref name="APA89">{{cite journal |author=Adler NE, David HP, Major BN, Roth SH, Russo NF, Wyatt GE |title=Psychological responses after abortion |journal=[[Science (journal)|Science]] |volume=248 |issue=4951 |pages=41–4 |year=1990 |pmid=2181664 |doi=10.1126/science.2181664}}</ref> The [[American Psychological Association]] (APA) concluded that abortion does not lead to increased mental health problems.<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=August 13, 2008}}</ref>
  
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[[File:Smelliesdoublecrochet.jpg|right|thumb|250px| The Smellie's double crochet abortion tool was used to grab and rip the baby out.]]
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Some proposed negative psychological effects of abortion have been referred to by anti-abortion advocates as a separate condition called "post-abortion syndrome." However, the existence of "post-abortion syndrome" is not recognized by any medical or psychological organization.<ref name="Grimes">{{cite journal |author=Grimes DA, Creinin MD |title=Induced abortion: an overview for internists |journal=[[Ann Intern Med]] |volume=140 |issue=8 |pages=620–6 |year=2004 |pmid=15096333 |doi=10.1001/archinte.140.5.620 |quote=Abortion does not lead to an increased risk for breast cancer or other late psychiatric or medical sequelae. ... The alleged 'postabortion trauma syndrome' does not exist.}}</ref><ref name="stotlandreview">{{cite journal |author=Stotland NL |title=Abortion and psychiatric practice |journal=[[J Psychiatr Pract]] |volume=9 |issue=2 |pages=139–149 |year=2003 |pmid=15985924 |doi=10.1097/00131746-200303000-00005 |quote=Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae.}}</ref><ref name="stotland_1404747">{{cite journal |author=Stotland NL |title=The myth of the abortion trauma syndrome |journal=[[J Am Med Assoc]] |volume=268 |issue=15 |pages=2078–9 |year=1992 |month=October |pmid=1404747 |doi=10.1001/jama.268.15.2078 |doi_brokendate=2009-11-14}}</ref>
  
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=== Abortion Causes Future Harm with Premature Births ===
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==Incidence==
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The number of abortions performed worldwide has deceased between 1995 and 2003 from 45.6&nbsp;million to 41.6&nbsp;million (a decrease from 35 to 29 per 1000 women between 15 and 44 years of age).<ref name=OBGY09/>  The greatest decrease has occurred in the developed world with a decrease from 39 to 26 per 1000 women in comparison to the developing world which had a decrease from 34 to 29 per 1000 women.<ref name=OBGY09/>  Of these approximately 42 million abortions 22 million occurred safely and 20 million unsafely.<ref name=OBGY09/>
  
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"At least 49 studies have demonstrated a statistically significant increase in premature births (PB) or low birth weight (LBW) risk in women with prior induced abortions (IAs)."<ref>Brent Rooney and Byron C. Calhoun, "Induced Abortion and Risk of Later Premature Births," 8 J. Am. Physicians & Surgeons 46 (Summer 2003). [http://www.jpands.org/vol8no2/rooney.pdf]</ref> Premature birth tragically causes brain damage, and an array of other severe, lifelong injuries ranging from Cerebral Palsy to blindness, or even death, and few mothers would knowingly increase the risk of that happening.  "There are at least seventeen (17) studies that have found that previous induced abortions increase preterm birth risk” and thereby increase debilitating Cerebral Palsy in children."<ref>Brent Rooney, Letter, 96 European Journal of Obstetrics & Gynecology and Reproductive Biology, 239 (2001) (citations omitted).</ref>
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The incidence and reasons for induced abortion vary regionally.  Some countries, such as Belgium (11.2 per 100 known pregnancies) and the Netherlands (10.6 per 100), had a comparatively low rate of induced abortion, while others like Russia (62.6 per 100) and Vietnam (43.7 per 100) had a high rate. The world ratio was 26 induced abortions per 100 known pregnancies (excluding miscarriages and stillbirths).<ref>Henshaw, Stanley K., Singh, Susheela, and Haas, Taylor. (1999). [http://www.guttmacher.org/pubs/journals/25s3099.html The Incidence of Abortion Worldwide]. ''International Family Planning Perspectives, 25 (Supplement)'', 30–38. Retrieved 2006-01-18.</ref>
  
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In 2008, the generally pro-abortion British medical journal, ''The Lancet'', admitted that a procedure often used in abortion increase the risk of premature birth:<ref>Dr, Jay D. Iams, Dr. Robert Romero, Jennifer F. Culhane (PhD), Dr. Robert L. Goldenberg.  Primary, secondary, and tertiary interventions to reduce the morbidity and mortality of preterm birth. Lancet  2008;371:164-175.  While the text of this article conceals the connection with abortion, it cites as support for its claims two studies showing how abortion increases risk of premature birth: the 2004 'Ancel' study of ten (10) European countries and the 2005 'Moreau' study that used French subjects.  Ancel P-Y,  Lelong  N,  Papiernik  E, Saurel-Cubizoilles M-J, Kaminski M.  History of induced abortion as a risk factor for preterm birth in European countries: results of the EUROPOP survey. Human Reproduction. 2004;112:734-740.  Moreau C, Kaminski M, Ancel PY et al.  Previous I induced abortions and the risk of very preterm delivery; Results of the EPIPAGE study.  British J Obstetrics Gynaecology 2005; 112:430-437.</ref>
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===By gestational age and method===
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{{Double image|right|UK abortion by gestational age 2004 histogram.svg|200|US abortion by gestational age 2004 histogram.svg|200|[[Histogram]] of abortions by [[gestational age]] in England and Wales during 2004. Average is 9.5 weeks. (left) Abortion in the United States by gestational age, 2004. (Data source: Centers for Disease Control and Prevention) (right) ||}}
  
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:"For example, greater public and professional awareness of evidence that repeated uterine instrumentation--eg, uterine curettage or endometrial biopsy--is associated with increased risk of subsequent preterm birth might over time influence decision-making about the procedure."
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Abortion rates also vary depending on the stage of pregnancy and the method practiced. In 2003, from data collected in those areas of the United States that sufficiently reported gestational age, it was found that 88.2% of abortions were conducted at or prior to 12 weeks, 10.4% from 13 to 20 weeks, and 1.4% at or after 21 weeks. 90.9% of these were classified as having been done by "[[curettage]]" ([[Suction-aspiration abortion|suction-aspiration]], [[Dilation and curettage]], [[Dilation and evacuation]]), 7.7% by "[[medical abortion|medical]]" means ([[mifepristone]]), 0.4% by "[[instillation abortion|intrauterine instillation]]" (saline or [[prostaglandin]]), and 1.0% by "other" (including [[hysterotomy abortion|hysterotomy]] and [[hysterectomy]]).<ref name="cdc2003">Strauss, L.T., Gamble, S.B., Parker, W.Y, Cook, D.A., Zane, S.B., and Hamdan, S. (November 24, 2006). [http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5511a1.htm Abortion Surveillance – United States, 2003]. ''Morbidity and Mortality Weekly Report, 55 (11),'' 1–32. Retrieved May 10, 2007.</ref> The [[Guttmacher Institute]] estimated there were 2,200 [[intact dilation and extraction]] procedures in the U.S. during 2000; this accounts for 0.17% of the total number of abortions performed that year.<ref>Finer, Lawrence B. and Henshaw, Stanley K. (2003). [http://www.guttmacher.org/pubs/journals/3500603.html Abortion Incidence and Services in the United States in 2000]. ''Perspectives on Sexual and Reproductive Health, 35 (1).'.' Retrieved 2006-05-10.</ref> Similarly, in England and Wales in 2006, 89% of terminations occurred at or under 12 weeks, 9% between 13 to 19 weeks, and 1.5% 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 |url=http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_075697 |accessdate=2007-10-12}}</ref> Later abortions are more common in China, India, and other developing countries than in developed countries.<ref>Cheng L. [http://www.who.int/rhl/fertility/abortion/CD006714_chengl_com/en/index.html “Surgical versus medical methods for second-trimester induced abortion : RHL commentary”] (last revised: 1 November 2008). The WHO Reproductive Health Library; Geneva: World Health Organization.</ref>
  
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Researchers Rooney and Calhoun observed:<ref>''Id.''</ref>
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===By personal and social factors===
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[[Image:AGIAbortionReasonsBarChart.png|thumb|A bar chart depicting selected data from the 1998 [[Alan Guttmacher Institute|AGI]] [[meta-study]] on the reasons women stated for having an abortion.]]
  
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:Large studies have reported a doubling of [early premature birth] EPB risk from two prior IAs. Women who had four or more IAs experienced, on average, nine times the risk of [extremely early premature births] XPB, an increase of 800 percent. These results suggest that women contemplating IA should be informed of this potential risk to subsequent pregnancies, and that physicians should be aware of the potential liability and possible need for intensified prenatal care.
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A 1998 aggregated study, from 27 countries, on the reasons women seek to terminate their pregnancies concluded that common factors cited to have influenced the abortion decision were: desire to delay or end childbearing, concern over the interruption of work or education, issues of financial or relationship stability, and perceived immaturity.<ref name="bankole98">Bankole, Akinrinola, Singh, Susheela, and Haas, Taylor. (1998). [http://www.guttmacher.org/pubs/journals/2411798.html Reasons Why Women Have Induced Abortions: Evidence from 27 Countries]. ''International Family Planning Perspectives, 24 (3)'', 117–127 and 152. Retrieved 2006-01-18.</ref> A 2004 study in which American women at [[abortion clinic|clinics]] answered a questionnaire yielded similar results.<ref name="finer2005">Finer, Lawrence B., Frohwirth, Lori F., Dauphinee, Lindsay A., Singh, Shusheela, and Moore, Ann M. (2005). [http://www.guttmacher.org/pubs/journals/3711005.pdf Reasons U.S. women have abortions: quantative and qualitative perspectives]. ''Perspectives on Sexual and Reproductive Health, 37 (3),'' 110–118. Retrieved 2006-01-18.</ref> In Finland and the United States, concern for the health risks posed by pregnancy in individual cases was not a factor commonly given; however, in [[Bangladesh]], India, and [[Kenya]] health concerns were cited by women more frequently as reasons for having an abortion.<ref name="bankole98"/> 1% of women in the 2004 survey-based U.S. study became pregnant as a result of [[rape]] and 0.5% as a result of [[incest]].<ref name="finer2005"/> Another American study in 2002 concluded that 54% of women who had an abortion were using a form of [[birth control|contraception]] at the time of becoming pregnant while 46% were not. Inconsistent use was reported by 49% of those using [[condom]]s and 76% of those using the [[combined oral contraceptive pill]]; 42% of those using condoms reported failure through slipping or breakage.<ref>Jones, Rachel K., Darroch, Jacqueline E., Henshaw, Stanley K. (2002). [http://www.guttmacher.org/pubs/journals/3429402.pdf Contraceptive Use Among U.S. Women Having Abortions in 2000–2001]. ''Perspectives on Sexual and Reproductive Health, 34 (6).'.' Retrieved June 15, 2006.</ref> The Guttmacher Institute estimated that "most abortions in the United States are obtained by minority women" because minority women "have much higher rates of unintended pregnancy."<ref>Susan A. Cohen: [http://www.guttmacher.org/pubs/gpr/11/3/gpr110302.html ''Abortion and Women of Color: The Bigger Picture''], Guttmacher Policy Review, Summer 2008, Volume 11, Number 3.</ref>
  
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Demographic evidence of how abortion increases premature birth includes the following:
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Some abortions are undergone as the result of societal pressures. These might include the stigmatization of disabled people, preference for children of a specific sex, disapproval of single motherhood, 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]].
  
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:The Centers for Disease Control and Prevention (CDC): "[T]he abortion rate for black women has been approximately '''three times''' as high as that for white women (range: 2.6--3.1) since 1991"<ref>http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5407a1.htm (emphasis added)</ref>
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===Unsafe abortion===
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[[Image:RussianAbortionPoster.jpg|thumb|Soviet poster circa 1925, promoting hospital abortions. Title translation: "Abortions performed by either trained or self-taught midwives not only maim the woman, they also often lead to death."]]
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{{Main|Unsafe abortion}}
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Women seeking to terminate their pregnancies sometimes resort to unsafe methods, particularly where and when access to legal abortion is restricted.  The [[World Health Organization]] (WHO) defines an unsafe abortion as being "a procedure ... carried out by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both."<ref name="whounsafe">World Health Organization. (2004). [http://www.who.int/reproductive-health/publications/unsafeabortion_2000/estimates.pdf "Unsafe abortion: global and regional estimates of unsafe abortion and associated mortality in 2000"]. Retrieved 2009-03-22.</ref> Unsafe abortions are sometimes known colloquially as "back-alley" abortions. They may be performed by [[self-induced abortion|the woman herself]], another person without medical training, or a professional health provider operating in sub-standard conditions. Unsafe abortion remains a public health concern due to the higher incidence and severity of its associated complications, such as incomplete abortion, [[sepsis]], hemorrhage, and damage to internal organs. It is estimated that 20 million unsafe abortions occur around the world annually and that 70,000 of these result in the woman's death.<ref name=OBGY09/>  Complications of unsafe abortion are said to account, globally, for approximately 13% of all [[maternal death|maternal mortalities]], with regional estimates including 12% in Asia, 25% in Latin America, and 13% in [[sub-Saharan Africa]].<ref>Salter, C., Johnson, H.B., and Hengen, N. (1997). [http://www.infoforhealth.org/pr/l10edsum.shtml Care for post abortion complications: saving women's lives]. ''Population Reports, 25 (1).'.' Retrieved 2006-02-22.</ref>  Although the global rate of abortion declined from 45.6 million in 1995 to 41.6 million in 2003, unsafe procedures still accounted for 48% of all abortions performed in 2003.<ref name="Worldwide">{{cite journal |first=Gilda |last=Sedgh |year=2007 |month=October |title=Induced abortion: estimated rates and trends worldwide |journal=[[The Lancet]] |volume=370 |issue=9595 |pages=1338–1345 |doi=10.1016/S0140-6736(07)61575-X |pmid=17933648 |url=http://media.mcclatchydc.com/smedia/2007/10/17/13/Chang-Guttmacher_Institute_abortion_report.source.prod_affiliate.91.pdf |format=PDF|accessdate=2008-12-02 |last2=Henshaw |first2=S |last3=Singh |first3=S |last4=Ahman |first4=E |last5=Shah |first5=IH}}</ref>
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Health education, access to family planning, and improvements in health care during and after abortion have been proposed to address this phenomenon.<ref>World Health Organization. (1998). [http://www.who.int/docstore/world-health-day/en/pages1998/whd98_10.html Address Unsafe Abortion]. Retrieved 2006-03-01.</ref>
  
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:''Science Daily'''s report on a study by the Washington University School of Medicine: "African-American women are '''three times''' more likely to deliver babies three to 17 weeks prematurely than Caucasian women"<ref>http://www.sciencedaily.com/releases/2007/02/070209074144.htm (emphasis added)</ref>
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==History==
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[[Image:FrenchPeriodicalPills-January61845,BostonDailyTimes.jpg|thumb|right|"French Periodical Pills." An example of a clandestine advertisement published in an 1845 edition of the ''Boston Daily Times''.]]
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{{Main|History of abortion}}
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Induced abortion can be traced to ancient times.<ref name="devereux">{{cite book |last=Devereux |first=G. |chapter=A typological study of abortion in 350 primitive, ancient, and pre-industrial societies |chapterurl=http://www.popline.org/docs/671051 |accessdate=2008-12-02 |editor=Harold Rosen |title=Abortion in America; medical, psychiatric, legal, anthropological, and religious considerations |year=1967 |location=[[Boston]] |publisher=[[Beacon Press]] |oclc=187445}}</ref> There is evidence to suggest that, historically, pregnancies were terminated through a number of methods, including the administration of [[abortifacient]] herbs, the use of sharpened implements, the application of abdominal pressure, and other techniques.
  
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In 2002 an article entitled "Preterm Birth: A Continuing Challenge" noted that premature births are abnormally high in the United States, citing a study that observed that a previous abortion is a "risk factor[] for both infertility and preterm birth."<ref>http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595132/</ref>
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The [[Hippocratic Oath]], the chief statement of [[medical ethics]] for Hippocratic physicians in [[Ancient Greece]], forbade doctors from helping to procure an abortion by [[pessary]]. [[Soranus (Greek Physician)|Soranus]], a second-century Greek [[physician]], suggested in his work ''[[Gynaecology]]'' that women wishing to abort their pregnancies should engage in energetic exercise, energetic jumping, carrying heavy objects, and riding animals. He also prescribed a number of recipes for herbal baths, pessaries, and [[bloodletting]], but advised against the use of sharp instruments to induce miscarriage due to the risk of organ perforation.<ref>{{cite book |first=Mary R. |last=Lefkowitz |authorlink=Mary Lefkowitz |coauthors=Maureen B. Fant |title=Women's life in Greece & Rome: a source book in translation |publisher=[[Johns Hopkins University Press]] |location=[[Baltimore]] |year=1992 |pages= |isbn=0-8018-4474-6 |oclc=25373320 |url=http://www.stoa.org/diotima/anthology/wlgr/ |accessdate=2008-12-02}}</ref> It is also believed that, in addition to using it as a [[contraceptive]], the ancient Greeks relied upon [[silphium]] as an [[abortifacient]]. Such folk remedies, however, varied in effectiveness and were not without risk. [[Tansy]] and [[pennyroyal]], for example, are two poisonous herbs with serious [[Adverse effect (medicine)|side effects]] that have at times been used to terminate pregnancy.
  
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The rate of premature birth is elevated by the same amount as the abortion rate, as expected if abortion increases the risk of premature birth.
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During the [[Islamic Golden Age|medieval period]], [[Medicine in medieval Islam|physicians in the Islamic world]] documented detailed and extensive lists of birth control practices, including the use of abortifacients, commenting on their effectiveness and prevalence.<ref>{{Cite book|last=Sheikh|first=Sa'diyya|contribution=Family Planning, Contraception, and Abortion in Islam|editor-first=Daniel C.|editor-last=Maguire|title=Sacred Rights: The Case for Contraception and Abortion in World Religions|publisher=[[Oxford University Press]] US|year=2003|isbn=0195160010|pages=105–128 [105–106]}}</ref> They listed many different birth control substances in their medical encyclopedias, such as [[Avicenna]] listing 20 in ''[[The Canon of Medicine]]'' (1025) and [[Muhammad ibn Zakariya ar-Razi]] listing 176 in his ''Hawi'' (10th century). This was unparalleled in European medicine until the 19th century.<ref>{{Cite book|last=Sheikh|first=Sa'diyya|contribution=Family Planning, Contraception, and Abortion in Islam|editor-first=Daniel C.|editor-last=Maguire|title=Sacred Rights: The Case for Contraception and Abortion in World Religions|publisher=[[Oxford University Press]] US|year=2003|isbn=0195160010|pages=105–128 [115]}}</ref>{{Request quotation|date=January 2010}}
  
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=== Other Health Risks from Abortion ===
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During the [[Middle Ages]], abortion was tolerated and there were no laws against it.<ref>"[http://facts.randomhistory.com/2008/12/14_abortion.html 50 Random Facts About ...... Abortion]". Random Facts.</ref> A medieval female physician, [[Trotula]] of Salerno,<ref>"[[s:1911 Encyclopædia Britannica/Medicine|1911 Encyclopædia Britannica/Medicine]]"</ref> administered a number of remedies for the “retention of menstrua,” which was sometimes a code for early abortifacients.<ref>Riddle, John M. 1992. Contraception and Abortion from the Ancient World to the Renaissance. London, England: Harvard University Press.</ref> [[Pope Sixtus V]] (1585–90) is noted as the first Pope to declare that abortion is homicide regardless of the stage of pregnancy.<ref>"[http://civilliberty.about.com/od/gendersexuality/tp/History-of-Prostitution.htm History of Prostitution]". About.com: Civil Liberties.</ref> Abortion in the 19th century continued, despite bans in both the United Kingdom and the United States, as the disguised, but nonetheless open, advertisement of services in the [[Victorian era]] suggests.<ref>{{cite web |first=James |last=DeHullu |url=http://mysite.verizon.net/jdehullu/abortion/abhist.htm |accessdate=2008-12-02 |title=Histories of Abortion}}</ref>
  
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The [[U.S. Supreme Court]] ruled in 2007 that:<ref>''Gonzales v. Carhart'', 127 S. Ct. 1610, 1634 (2007).</ref>
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In the 20th century the Soviet Union (1919), Iceland (1935) and Sweden (1938) were among the first countries to legalize certain or all forms of abortion.<ref name="cbctrust">{{cite web |url=http://www.cbctrust.com/history_law_religion.php |archiveurl=http://web.archive.org/web/20080208053146/http://www.cbctrust.com/history_law_religion.php |archivedate=2008-02-08 |title=Abortion Law, History & Religion |accessdate=2008-03-23 |work=Childbirth By Choice Trust}}</ref> In 1935 Nazi Germany, a law was passed permitting abortions for those deemed "hereditarily ill," while women considered of German stock were specifically prohibited from having abortions.<ref>{{cite book |last=Friedlander |first=Henry |authorlink=Henry Friedlander |title=The origins of Nazi genocide: from euthanasia to the final solution |publisher=University of North Carolina Press |location=Chapel Hill |year=1995 |page=[http://books.google.com/books?id=gqLDEKVk2nMC&printsec=frontcover&source=gbs_summary_r&cad=0#PPA30,M1 30] |isbn=0-8078-4675-9 |oclc=60191622}}</ref><ref>{{cite book |first=Robert |last=Proctor |authorlink=Robert N. Proctor |title=Racial Hygiene: Medicine Under the Nazis |publisher=[[Harvard University Press]] |location=[[Cambridge, Massachusetts]] |year=1988 |pages=122, 123 and 366 |isbn=0-674-74578-7 |oclc=20760638}}</ref><ref>{{cite book |first=Margaret L. |last=Arnot |authorlink= |coauthors=Cornelie Usborne |title=Gender and Crime in Modern Europe |publisher=Routledge |location=New York |year=1999 |page=231 |isbn=1-85728-745-2 |oclc=186748539}}</ref><ref>{{cite encyclopedia |last=DiMeglio |first=Peter M. |editor=Helen Tierney |encyclopedia=Women's studies encyclopedia |title=Germany 1933–1945 (National Socialism) |year=1999 |publisher=Greenwood Press |location=[[Westport, Connecticut]] |isbn=0-313-31072-6 |oclc=38504469 |pages=[http://books.google.com/books?id=gQLqRd7hJq0C&printsec=frontcover&source=gbs_summary_r&cad=0#PPA589,M1 589]}}</ref>
  
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:While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained. See Brief for Sandra Cano ''et al.'' as Amici Curiae in No. 05-380, pp 22-24. Severe depression and loss of esteem can follow. See ''ibid.''
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==Society and culture==
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===Abortion debate===
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{{Refimprovesect|date=November 2008}}
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{{Double image|right|March for Women's Lives detail.jpg|200|March for life 2009.JPG|200|Pro-choice activists near the [[Washington Monument]] at the [[March for Women's Lives]] in 2004. (left) Pro-life activists near the Washington Monument at the annual 2009 [[March for Life]] in [[Washington, DC]]. (right) ||}}
  
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A study published in the Southern Medical Journal observed that there are higher death rates association with women who have abortion, and that these higher death rates persist over time and across socioeconomic boundaries.<ref>D.C. Reardon, P.G. Ney, F.J. Scheuren, J.R. Cougle, P.K. Coleman, T. Strahan, "Deaths associated with pregnancy outcome: a record linkage study of low income women," 95 Southern Medical Journal 8, at 834-41 (August 2002).</ref>
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{{Main|Abortion debate}}
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In the [[history of abortion]], induced abortion has been the source of considerable debate, controversy, and activism. An individual's position on the complex ethical, moral, philosophical, biological, and legal issues is often related to his or her [[value system]]. The main positions are one that argues in favor of access to abortion and one argues against access to abortion. Opinions of abortion may be described as being a combination of beliefs on its morality, and beliefs on the responsibility, ethical scope, and proper extent of governmental authorities in public policy. [[religion|Religious ethics]] also has an influence upon both personal opinion and the greater debate over abortion (see [[religion and abortion]]).
  
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In [[England]], the "Royal College of Psychiatrists says women should not be allowed to have an abortion until they are counselled on the possible risk to their mental health."  The medical royal college warned that women who have abortions may be at risk of mental health problems.<ref>http://www.timesonline.co.uk/tol/life_and_style/health/article3559486.ece</ref>  A New Zealand study found that abortion in young women may be associated with increased risks of mental health problems.<ref>http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16405636</ref>  The researcher in this study, who was not pro-life, was shaken by the study and had to go to four journals before he could find one who would publish it. <ref>http://www.thinkingchristian.net/C1148465919/E20060224082323/index.html</ref> 
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Abortion debates, especially pertaining to [[abortion law]]s, are often spearheaded by groups advocating one of these two positions. In the United States, those in favor of greater legal restrictions on, or even complete prohibition of abortion, most often describe themselves as pro-life while those against legal restrictions on abortion describe themselves as pro-choice. Generally, the former position argues that a human fetus is a human being with a [[right to life|right to live]] making abortion tantamount to murder. The latter position argues that a woman has certain [[reproductive rights]], especially the choice whether or not to carry a pregnancy to term.
  
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The study concludes with the following statement:
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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 justification of laws permitting or restricting abortion.
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{{cquote|These findings are inconsistent with the current consensus on the psychological effects of abortion. In particular, in its 2005 statement on abortion, the [[American Psychological Association]] concluded that “well-designed studies of psychological responses following abortion have consistently shown that risk of psychological harm is low...the percentage of women who experience clinically relevant distress is small and appears to be no greater than in general samples of women of reproductive age” (American Psychological Association, 2005). This relatively strong conclusion about the absence of harm from abortion was based on a relatively small number of studies which had one or more of the following limitations: a) absence of comprehensive assessment of mental disorders; b) lack of comparison groups; and c) limited statistical controls. Furthermore, the statement appears to disregard the findings of a number of studies that had claimed to show negative effects for abortion (Cougle et al., 2003; Gissler et al., 1996; Reardon & Cougle, 2002). <ref>http://www.thinkingchristian.net/C1148465919/E20060224082323/index.html</ref>}}
 
  
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Professor David Fergusson, lead author of the New Zealand study stated:  
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Debate also focuses on whether the pregnant woman should have to notify and/or have the consent of others in distinct cases: a [[minor (law)|minor]], her parents; a legally married or [[common-law marriage|common-law]] wife, her husband; or a pregnant woman, the biological father. In a 2003 Gallup poll in the United States, 79% of male and 67% of female respondents were in favor of legalized mandatory spousal notification; overall support was 72% with 26% opposed.<ref>The Pew Research Center for the People and the Press. (2005-11-02). "[http://people-press.org/commentary/display.php3?AnalysisID=122 Public Opinion Supports Alito on Spousal Notification Even as It Favors Roe v. Wade]." ''Pew Research Center Pollwatch.'.' Retrieved 2006-03-01.</ref>
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{{cquote|It borders on scandalous that one of the most common surgical procedures performed on young women is so poorly researched and evaluated. If this were Prozac or Vioxx, reports of associated harm would be taken much more seriously with more careful research and monitoring procedures." <ref>http://www.washtimes.com/commentary/20060120-091648-6456r.htm</ref>}}
 
  
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Another study published in the OB/GYN Survey detailed long-term physical and psychological health consequences of induced abortions.<ref>J.M. Thorp, Jr., K.E. Hartmann, and E.M. Shadigian, "Long-Term Physical & Psychological Health Consequences of Induced Abortion: Review of the Evidence," 58 OB/GYN Survey 1, at 67-79 (2003)</ref>
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===Abortion law===
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{{Main|Abortion law}}
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{{See also|Reproductive rights}}
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[[File:AbortionLawsMap-NoLegend.png|thumb|right|250px|International status of abortion law: {{legend|#3f9bbb|Legal on request}} {{legend|#d4df5a|Legal for maternal life, health, mental health, rape, fetal defects, and/or socioeconomic factors}} {{legend|#64513B|Legal for or illegal with exception for maternal life, health, mental health, rape, and/or fetal defects}} {{legend|#FA7014|Illegal with exception for maternal life, health, mental health and/or rape}} {{legend|#cc7662|Illegal with exception for maternal life, health, and/or mental health}} {{legend|#3236D3|Illegal with no exceptions}} {{legend|#B3B3B3|No information}} Vertical stripes (various colours): Illegal but unenforced]]
  
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Suicide rates among women who had abortions are six times higher than women who gave birth in the prior year.<ref>http://www.abortionrecoverycounseling.com/Page8.html</ref> Overall, deaths from suicide, homicide and accidents were 248% higher after an abortion, as found by a 13-year study in Finland of its entire population.<ref>''Id.''</ref>
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Before the scientific discovery in the nineteenth century that human development begins at [[human fertilization|fertilization]],<ref>{{cite book |author=Garrison, Fielding |url=http://books.google.com/?id=JvoIAAAAIAAJ&pg=PA567&dq=fetilization+was+discovered+hertwig |title=An Introduction to the History of Medicine |pages=566–7 |publisher=Saunders |year=1921 |oclc=}}</ref> [[English common law]] forbade abortions after "[[quickening]]", that is, after "an infant is able to stir in the mother's womb."<ref>{{cite book |first=William |last=Blackstone |authorlink=William Blackstone |chapter=Amendment IX, Document 1 |chapterurl=http://press-pubs.uchicago.edu/founders/documents/amendIXs1.html |title=[[Commentaries on the Laws of England]] |origyear=1765 |year=1979 |publisher=University of Chicago Press |location=Chicago |volume=5 |page=388 |isbn=3511090288}}</ref> There was also an earlier period in England when abortion was prohibited "if the foetus is already formed" but not yet quickened.<ref>{{cite book |author=[[Henry de Bracton]] |chapter=The crime of homicide and the divisions into which it falls |editor=George E. Woodbine ed.; Samuel Edmund Thorne trans. |title=On the Laws and Customs of England |origyear={{circa|1250}} |year=1968 |accessdate=2008-12-11 |volume=2 |page=341 |url=http://hlsl5.law.harvard.edu/bracton/Unframed/English/v2/341.htm |oclc=1872}}</ref> Both pre- and post-quickening abortions were criminalized by ''[[Lord Ellenborough's Act]]'' in 1803.<ref>{{cite web |url=http://web.archive.org/web/20070918233015/http://members.aol.com/abtrbng/lea.htm |title=Lord Ellenborough’s Act |year=1998 |work=The Abortion Law Homepage |accessdate=2007-02-20}} (via Archive.org)</ref> In 1861, the [[Parliament of the United Kingdom]] passed the ''[[Offences against the Person Act 1861]]'', which continued to outlaw abortion and served as a model for similar prohibitions in some other nations.<ref>{{cite web |author=United Nations Population Division |year=2002 |url=http://www.un.org/esa/population/publications/abortion |title=Abortion Policies: A Global Review |accessdate=February 22, 2007}}</ref>
  
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In the United States, only one state (Missouri) requires that the abortionist have admitting privileges at a hospital within 30 miles of the abortion.<ref>Mo. Rev. Stat. § 188.080 prohibits an abortion by a physician "who does not have clinical privileges at a hospital which offers obstetrical or gynecological care located within thirty miles of the location at which the abortion is performed or induced."</ref>  In the other 49 states, an abortion patient can and often is left without prompt medical care by the treating physician.
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The Soviet Union, with legislation in 1920, and [[Iceland]], with legislation in 1935, were two of the first countries to generally allow abortion. The second half of the 20th century saw the liberalization of abortion laws in other countries. The ''[[Abortion Act 1967]]'' allowed abortion for limited reasons in the United Kingdom (except Northern Ireland). In the 1973 case, ''[[Roe v. Wade]]'', the [[Supreme Court of the United States|United States Supreme Court]] struck down state laws banning abortion, ruling that such laws violated an implied [[right to privacy]] in the [[United States Constitution]]. The [[Supreme Court of Canada]], similarly, in the case of ''[[R. v. Morgentaler]]'', discarded its criminal code regarding abortion in 1988, after ruling that such restrictions violated the security of person guaranteed to women under the ''[[Canadian Charter of Rights and Freedoms]]''. Canada later struck down provincial regulations of abortion in the case of ''[[R. v. Morgentaler (1993)]].'' By contrast, [[Abortion in the Republic of Ireland|abortion in Ireland]] was affected by the addition of an [[Eighth Amendment of the Constitution of Ireland|amendment]] to the Irish [[Constitution of Ireland|Constitution]] in 1983 by popular referendum, recognizing "the right to life of the unborn".
  
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One of the largest abortion providers in the United States, the Metropolitan Medical Associates of New Jersey, was shut down in 2007 by state health officials after one of its botched abortions left a 20-year-old woman in a coma for more than four weeks.  She "became severely ill following the abortion and was transferred to Newark Beth Israel Medical Center where she needed blood transfusions and had her uterus removed. She also suffered a stroke due to the serious blood loss and had one of her lungs collapse."<ref>http://www.lifenews.com/state2137.html</ref> The State of New Jersey had shut down the same facility in 1993 also.<ref>''Id.''</ref>
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Current laws pertaining to abortion are diverse. Religious, moral, and cultural sensibilities 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 rights|reproductive health]] are major issues of human rights that are sometimes used as justification for the existence or absence of laws controlling abortion. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained, often, but not always, using a trimester-based system to regulate the window of legality:
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*In the United States, some states impose a 24-hour 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>[http://www.lawserver.com/abortion Interactive maps comparing U.S. abortion restrictions by state] LawServer.</ref>
 +
*In the United Kingdom, as in some other countries, two doctors must first certify that an abortion is medically or socially necessary before it can be performed.
 +
*In Canada, a similar requirement was rejected as unconstitutional in 1988.
  
−
==Abortion Alternatives==
+
Other countries, in which abortion is normally illegal, will allow one to be performed in the case of rape, incest, or danger to the pregnant woman's life or health.
−
[[Optionline]] provides consultants that connects individuals to nearby pregnancy centers that offer the following services: free pregnancy tests and pregnancy information; Information about the risks of abortion and the morning after pill; medical services, including [[STD]] tests; early ultrasounds and pregnancy confirmation. <ref>http://www.pregnancycenters.org/</ref> In addition, some of these centers provide information regarding free housing to women who are facing housing concerns.<ref>http://www.pregnancycenters.org/</ref>
+
*A few nations ban abortion entirely: [[Abortion in Chile|Chile]], [[Abortion in El Salvador|El Salvador]], [[Abortion in Malta|Malta]], and [[Abortion in Nicaragua|Nicaragua]], with consequent rises in maternal death directly and indirectly due to pregnancy.<ref>{{cite web |title=European delegation visits Nicaragua to examine effects of abortion ban |date=November 26, 2007 |publisher=Ipas |accessdate=2009-06-15| url=http://www.ipas.org/Library/News/News_Items/European_delegation_visits_Nicaragua_to_examine_effects_of_abortion_ban.aspx }} "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 |place=Montevideo |agency=IPS |publisher=Inside Costa Rica}}</ref> However, in 2006, the [[Politics of Chile|Chilean government]] began the free distribution of [[emergency contraception]].<ref>{{cite news |author=Ross, Jen |date=September 12, 2006 |url=http://www.csmonitor.com/2006/0912/p01s04-woam.html |title=In Chile, free morning-after pills to teens |work=The Christian Science Monitor |accessdate=2006-12-07}}</ref><ref>{{cite news |author=Gallardoi, Eduardo |date=September 26, 2006 |url=http://www.washingtonpost.com/wp-dyn/content/article/2006/09/26/AR2006092600770.html |title=Morning-After Pill Causes Furor in Chile |work=[[The Washington Post]] |accessdate=2006-12-07}}</ref>
 +
* In [[Bangladesh]], abortion is illegal, but the government has long supported a network of "menstrual regulation clinics", where [[menstrual extraction]] ([[manual vacuum aspiration]]) can be performed as menstrual hygiene.<ref>{{cite web |title=Surgical Abortion: History and Overview |publisher=National Abortion Federation |accessdate=2006-09-04 |url=http://www.prochoice.org/education/resources/surg_history_overview.html }}</ref>
  
−
The primary alternative to abortion is adoption. [[Liberty Godparent Foundation]] is a [[Christian]] organization focused on improving the lives of unwed pregnant teens, babies and adoptive families by providing two alternatives, The Liberty Godparent Maternity Home and Family Life Services Adoption Agency.<ref>http://www.godparent.org/index.php?option=com_content&task=view&id=20&Itemid=59</ref>. [[Catholic Social Services]] provides adoption assistance to people of all beliefs in addition to supporting families in need.
+
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. Women without the means to travel can resort to providers of illegal abortions or try to do it themselves.
 +
<ref>{{cite web |title=Need Abortion, Will Travel |author=Marcy Bloom |date=February 25, 2008 |publisher=RH Reality Check |accessdate=2009-06-15| url=http://www.rhrealitycheck.org/blog/2008/02/25/need-abortion-will-travel}}</ref>
  
−
== Abortion Industry and How It Targets Minority Communities ==
+
In the US, about 8% of abortions are performed on women who travel from another state.<ref>{{cite web |title=United States: Percentage of Legal Abortions Obtained by Out-of-State Residents, 2005 |publisher=The Kaiser Family Foundation |accessdate=2009-06-14| url=http://www.statehealthfacts.kff.org/profileind.jsp?rgn=1&cat=10&ind=467}}</ref> However, that is driven at least partly by differing limits on abortion according to gestational age or the scarcity of doctors trained and willing to do later abortions.
−
[[File:4287336112 d3f9126c99.jpg|right|thumb|325px|According to [[Cybercast News Service]]: "An analysis by the Cybercast News Service compared the location of [[Planned Parenthood]] abortion clinics with population data from the U.S. Census in 2000. The results appear to bolster the charge that the organization targets black communities."<ref>http://www.cnsnews.com/ViewSpecialReports.asp?Page=%5CSpecialReports%5Carchive%5C200502%5CSPE20050207a.html</ref>(photo obtained from [http://www.flickr.com/photos/muriel215/4287336112/ Flickr, see Creative commons license agreement)] ]]
 
−
"Each day '''1,786''' African American children are aborted." According to the [[U.S.]] Census of 2006, African Americans are at 1.96 birth rate which is <u>beneath</u> the replacement level of 2.1. <ref>[http://www.christiannewswire.com/news/1685410938.html African American Pro-Life Group Holds Protest at NAACP] Christian News Network, July 13, 2009</ref> At the continued rate, [[racism]] by abortion will decimate the black population of the U.S.
 
  
−
According to writer George Grant, the author of ''Killing Angel'':
+
===Sex-selective===
 +
{{Main|Sex-selective abortion}}
  
−
"During the 1980s when [[Planned Parenthood]] shifted its focus from community-based clinics to school-based clinics, it again targeted inner-city minority neighborhoods...Of the more than 100 school-based clinics that have opened nationwide in the last decade [1980s], none has been at substantially all-white schools....None has been at suburban middle-class schools. All have been at black, minority or ethnic schools.” <ref>http://www.citizenreviewonline.org/special_issues/population/the_negro_project.htm</ref>
+
[[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 targeted termination of female fetuses.
  
−
Planned Parenthood itself reported that its abortions on minorities in 1991 was 42.7% of its total abortions. <ref>http://www.ewtn.com/library/PROLIFE/PPRACISM.TXT</ref>.  However, during that time period, minorities comprised only 19.7% of the U.S. population.<ref>http://www.ewtn.com/library/PROLIFE/PPRACISM.TXT</ref>
+
It is suggested that sex-selective abortion might be partially responsible for the noticeable disparities between the birth rates of male and female children in some places. The preference for male children is reported in many areas of Asia, and abortion used to limit female births has been reported in China, Taiwan, South Korea, and India.<ref>Banister, Judith. (1999-03-16). [http://www.census.gov/ipc/www/ebspr96a.html Son Preference in Asia – Report of a Symposium]. Retrieved 2006-01-12.</ref>
  
−
According to [[Cybercast News Service]]: "An analysis by the Cybercast News Service compared the location of Planned Parenthood abortion clinics with population data from the U.S. Census in 2000. The results appear to bolster the charge that the organization targets black communities."<ref>http://www.cnsnews.com/ViewSpecialReports.asp?Page=%5CSpecialReports%5Carchive%5C200502%5CSPE20050207a.html</ref>
+
In India, the economic role of men, the costs associated with [[dowry|dowries]], and a common Indian tradition which dictates that [[funeral|funeral rites]] must be performed by a male relative have led to a cultural preference for sons.<ref>Mutharayappa, Rangamuthia, Kim Choe, Minja, Arnold, Fred, and Roy, T.K. (1997). [http://www2.eastwestcenter.org/pop/misc/subj-3.pdf Son Preferences and Its Effect on Fertility in India]. ''National Family Health Survey Subject Reports, Number 3.'.' Retrieved 2006-01-12.</ref> The widespread availability of diagnostic testing, during the 1970s and '80s, led to advertisements for services which read, "Invest 500 [[rupee]]s &#91;for a sex test&#93; now, save 50,000 rupees &#91;for a dowry&#93; later."<ref>{{cite journal |first=Rita |last=Patel |year=1996 |month=Fall |title=The practice of sex selective abortion in India: May you be the mother of a hundred sons |journal=Carolina Papers in International Health and Development |volume=7 |url=http://cgi.unc.edu/research/pdf/abortion.pdf |format=PDF|accessdate=2008-12-03}}</ref> In 1991, the male-to-female [[human sex ratio|sex ratio]] in India was skewed from its biological norm of 105 to 100, to an average of 108 to 100.<ref>{{cite journal |last=Sudha |first=S. |year=1999 |month=July |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 |doi=10.1111/1467-7660.00130 |url=http://www.hsph.harvard.edu/organizations/healthnet/gender/docs/sudha.html |archiveurl=http://web.archive.org/web/20030101210623/http://www.hsph.harvard.edu/organizations/healthnet/gender/docs/sudha.html |archivedate=2003-01-01 |accessdate=2008-12-03 |last2=Rajan |first2=S. Irudaya |pmid=20162850}}</ref> Researchers have asserted that between 1985 and 2005 as many as 10 million female fetuses may have been selectively aborted.<ref>{{cite news |first=Patricia |last=Reaney |publisher=Reuters |url=http://www.alertnet.org/thenews/newsdesk/L06779563.htm |archiveurl=http://web.archive.org/web/20060220072756/http://www.alertnet.org/thenews/newsdesk/L06779563.htm |archivedate=2006-02-20 |title=Selective abortion blamed for India's missing girls |accessdate=2008-12-03}}</ref> The Indian government passed an official ban of pre-natal sex screening in 1994 and moved to pass a complete ban of sex-selective abortion in 2002.<ref>{{cite journal |last=Mudur |first=Ganapati |year=2002 |title=India plans new legislation to prevent sex selection |journal=[[BMJ]] |volume=324 |issue=7334 |page=385b |doi=10.1136/bmj.324.7334.385/b}}</ref>
−
== Political Support of Abortion ==
 
−
The most powerful political action committee (PAC) is EMILY’s List.<ref>http://www.emilyslist.org/newsroom/releases/20070201.html</ref> EMILY's List contributes money to Democratic candidates who support abortion-on-demand, including forced taxpayer funding of abortion. EMILY's List candidates also oppose regulations such as:
 
  
−
:providing health information to abortion patients;
+
In the People's Republic of China, there is also a historic son preference. The implementation of the one-child policy in 1979, in response to population concerns, led to an increased disparity in the sex ratio as parents attempted to circumvent the law through sex-selective abortion or the abandonment of unwanted daughters.<ref>{{cite journal |first=Maureen J. |last=Graham |year=1998 |month=June |title=Son Preference in Anhui Province, China |journal=International Family Planning Perspectives |volume=24 |issue=2 |url=http://www.agi-usa.org/pubs/journals/2407298.html |accessdate=2008-12-03 |doi=10.2307/2991929 |page=72 |author2=Larsen |author3=Xu}}</ref> Sex-selective abortion might be an influence on the shift from the baseline male-to-female birth rate to an elevated national rate of 117:100 reported in 2002. The trend was more pronounced in rural regions: as high as 130:100 in [[Guangdong]] and 135:100 in [[Hainan]].<ref>{{cite journal |last=Plafker |first=Ted |year=2002 |month=May |title=Sex selection in China sees 117 boys born for every 100 girls |journal=[[BMJ]] |volume=324 |issue=7348 |page=1233a |doi=10.1136/bmj.324.7348.1233/a |pmid=12028966 |pmc=1123206}}</ref> A ban upon the practice of sex-selective abortion was enacted in 2003.<ref>"[http://www.china.org.cn/english/2003/Mar/59194.htm China Bans Sex-selection Abortion]." (2002-03-22). ''Xinhua News Agency.'.' Retrieved 2006-01-12.</ref>
  
−
:requiring that the abortionist have admitting privileges at a nearby hospital in case there is a complication; and
+
==In other animals==
 +
{{See|Miscarriage#In other animals}}
 +
Spontaneous abortion occurs in various animals. For example, in sheep, it may be caused by crowding through doors, or being chased by dogs.<ref>Spencer, James. ''[http://books.google.com/books?id=RXMuAAAAYAAJ&pg=PA124&lpg=PA124&dq=abortion+and+husbandry&source=bl&ots=WjmvGj-fB2&sig=8qH_WrPR08YEwPKr_c6PHDUOMmQ&hl=en&ei=erDbSeSVBoz4MY-F7M4I&sa=X&oi=book_result&ct=result&resnum=2#PPA124,M1 Sheep Husbandry in Canada]'', p. 124 (1911).</ref> In cows, abortion may be caused by contagious disease, such as [[Brucellosis]] or [[Campylobacter]], but can often be controlled by vaccination.<ref>[http://www.teara.govt.nz/1966/B/BeefCattleAndBeefProduction/ManagementAndHusbandryOfBeefCattle/en "Beef cattle and Beef production: Management and Husbandry of Beef Cattle”], ''Encyclopaedia of New Zealand'' (1966).</ref> Additionally, many other diseases are known to increase the risk of miscarriage in humans and other animals.{{Citation needed|date=April 2009}}
  
−
:providing parental notification if the patient is a teenager.
+
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>McKinnon, Angus et al. ''[http://books.google.com/books?id=jlZAT-9VwUIC&pg=PA563&lpg=PA563&dq=%22induce+abortion%22+and+husbandry&source=bl&ots=6T9w3LtpsI&sig=aEYDFpnMIbLaKlstxK1MGK2rxwQ&hl=en&ei=eLTbSY7EO5muMrXUkMkI&sa=X&oi=book_result&ct=result&resnum=7 Equine Reproduction]'', p. 563 (Wiley-Blackwell 1993).</ref>
  
−
Due to the influence of the abortion industry and EMILY's List, nearly every Democratic presidential candidate and senatorial candidate supports abortion-on-demand. "EMILY's List, the nation's largest political action committee, continues to be the dominant financial resource for Democratic candidates," its above-referenced website declares.
+
[[Feticide]] can occur in horses and zebras due to male harassment of pregnant mares or forced copulation,<ref>{{cite journal|last=Berger|first=Joel W|date=5 May 1983|title=Induced abortion and social factors in wild horses|journal=Nature|location=London|volume=303|pages=59–61|url=http://www.nature.com/nature/journal/v303/n5912/abs/303059a0.html|doi=10.1038/303059a0|pmid=6682487|issue=5912}}</ref><ref>{{cite journal|last=Pluháček|first=Jan|year=2000|title=Male infanticide in captive plains zebra, Equus burchelli|journal=Animal Behaviour|volume=59|pages=689–694|url=http://af.czu.cz/~bartos/publications/pdf/Pluhacek_Bartos_2000_AB.pdf|doi=10.1006/anbe.1999.1371|pmid=10792924|last2=Bartos|first2=L|issue=4}}</ref><ref>{{cite journal|last=Pluháček|first=Jan|year=2005|title=Further evidence for male infanticide and feticide in captive plains zebra, Equus burchelli|journal=Folia Zool.|volume=54|issue=3|pages= 258–262|url=http://www.ivb.cz/folia/54/3/258-262.pdf}}</ref> although the frequency in the wild has been questioned.<ref>{{cite journal|last=JW|first=Fitzpatrick|date=October 1991|title=Changes in herd stallions among feral horse bands and the absence of forced copulation and induced abortion |journal=Behavioral Ecology and Sociobiology|publisher=Springer|location=Berlin/Heidelberg|volume=29|issue=3|pages=217–219|issn=0340-5443 (Print) 1432-0762 (Online)|url=http://www.springerlink.com/content/k1543n1548987255/}}</ref> Male [[Gray langur]] monkeys may attack females following male takeover, causing miscarriage.<ref>{{cite journal|last=Agoramoorthy |first=G.|date=August 1988|title=Abortions in free ranging Hanuman langurs (Presbytis entellus)—a male induced strategy?|journal=Human Evolution|publisher=Springer|location=Netherlands|volume=3|issue=4|pages=297–308|issn=0393-9375 (Print) 1824-310X (Online)|url=http://www.springerlink.com/content/324g107410293474/}}</ref>
  
−
There is no comparably funded organization opposing abortion, because there are no monetary rewards to defending human life. Instead, candidates and supporters who oppose abortion are motivated by religious and ethical principles.
+
==See also==
 +
*[[Abortion fund]]
 +
*[[Anti-abortion violence]]
 +
*[[Connolly v. DPP]]
 +
*[[Fetal rights]]
 +
*[[Late-term abortion]]
 +
*[[Minors and abortion]]
 +
*[[Paternal rights and abortion]]
 +
*[[Population control]]
 +
*[[Self-induced abortion]]
 +
*[[Stem cell controversy]]
  
−
== History of Abortion ==
+
==References==
−
 
+
{{Reflist|colwidth=30em}}
−
''Please also see:'' [[History of abortion]]
 
−
 
 
−
The father of [[medicine]], [[Hippocrates]], expressly prohibited abortion in his ethical [[Oath]] long before [[Christianity]].
 
−
 
 
−
Prior to 1973 abortion was illegal in most of the United States, though a few states (such as Hawaii and New York) allowed it with restrictions.<ref>''A Timeline of Reproductive Rights'' [http://ecampus.bentley.edu/org/wc/reproductiverights.html The Women's Center]</ref> The U.S. Supreme Court's 1973 [[Roe v. Wade]]<ref>Online text of [http://caselaw.lp.findlaw.com/scripts/getcase.pl?navby=CASE&court=US&vol=410&page=113 Roe v. Wade, 410 U.S. 113 (1973)]</ref> decision ruled that abortions are lawful under the [[U.S. Constitution]] up to the point at which the fetus becomes able to survive outside the womb, and an accompanying decision issued the same day captioned [[Doe v. Bolton]] essentially legalized abortion in the unlimited discretion of the abortionist at any time during pregnancy, up to and including birth.  Conservatives immediately criticized these decisions as examples of [[Judicial Activism]].
 
−
 
 
−
In 2008, worldwide there were approximately 115,000 abortions done per day.<ref>http://www.abortionno.org/Resources/fastfacts.html</ref> In 2008, approximately 83% of all abortions were performed in developing countries and 17% occurred in developed countries.<ref>http://www.abortionno.org/Resources/fastfacts.html</ref>
 
−
 
 
−
States may regulate abortion, such as requiring a 24-hour waiting period and parental consent for minors.  Abortion clinics often fail to comply with the health standards of surgical facilities, and States can require compliance (but often do not, resulting in discomfort and harm to the victims of abortion).  Many abortionists lack hospital admitting privileges at nearby facilities, so women having complications must go on their own to emergency rooms to see physicians unfamiliar with what actually happened.  For any other operation the cost of treating complications is included in the cost of the operation, but for abortions the abortion clinics take their money and typically do not pay for the care of complications.
 
−
 
 
−
The more pro-abortion the State regulations are, the larger the number of abortion clinics it will have.  [[Arizona]], though a pro-life State, has a regulatory system that results in twelve abortion clinics operating within its borders.  In contrast, [[Mississippi]] has only one abortion clinic, and [[Missouri]] has only two. 
 
−
 
 
−
=== Adolf Hitler and Abortion ===
 
−
''For more information see:'' [[Abortion and Adolf Hitler]]
 
−
[[Image:Hitlerspeech.jpg|thumb|290px|right|[[Adolf Hitler]]]]‎In 1942 [[Adolf Hitler]] declared:
 
−
{{cquote|In view of the large families of the Slav native population, it could only suit us if girls and women there had as many abortions as possible. We are not interested in seeing the non-[[German]] population multiply…We must use every means to instill in the population the idea that it is harmful to have several children, the expenses that they cause and the dangerous effect on woman's health… It will be necessary to open special institutions for abortions and doctors must be able to help out there in case there is any question of this being a breach of their professional ethics. <ref>http://www.lifesitenews.com/ldn/2007/sep/07090708.html</ref>}}
 
−
 
 
−
After [[World War II]], the War Crimes Tribunal indicted ten [[Nazi]] leaders for "encouraging and compelling abortion," which the tribunal considered a "crime against humanity."<ref>http://www.abortionfacts.com/online_books/love_them_both/why_cant_we_love_them_both_25.asp#But%20didn%E2%80%99t%20Hitler%20oppose%20abortion?</ref>
 
−
 
 
−
==American Liberals and Abortion==
 
−
According to the Pew Research Center, American [[liberal]]s are more likely to support pro-abortion views. <ref>http://people-press.org/report/283/pragmatic-americans-liberal-and-conservative-on-social-issues</ref>
 
  
−
==Evolutionary Thought and Abortion==
+
==External links==
−
[[Theory of evolution and liberalism|Liberals are more likely to advocate the evolutionary paradigm than conservatives]].  [[Creation Ministries International]] has written that [[evolution|evolutionary]] thinking has contributed to the [[eugenics|eugenic]] idea of aborting babies with defects and has also contributed to erroneous and immoral justifications for abortion.<ref>http://creation.com/abortion-an-indispensable-right-or-violence-against-women-sex-selection-aborting-girls</ref><ref>http://creation.com/human-life-questions-and-answers-abortion-and-euthanasia</ref>
+
{{sisterlinks|abortion}}
−
 
+
*{{dmoz|Health/Reproductive_Health/Abortion}}
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==Ultrasound images==
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*[http://www.un.org/esa/population/publications/abortion Abortion Policies: A Global Review]
−
 
+
*[http://www.nlm.nih.gov/medlineplus/ency/article/002912.htm#Definition MedlinePlus Medical Encyclopedia: Abortion]
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*http://www.ob-ultrasound.net/frames.htm
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*http://www.flickr.com/photos/drakelelane/388759116/
 
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*http://www.parentingweekly.com/pregnancy/pregnancy_information/ultrasound/13_weeks.htm
 
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*http://www.parentingweekly.com/pregnancy/pregnancy_information/ultrasound/ultrasound_3d.htm
 
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*http://www.parentingweekly.com/pregnancy/pregnancy_information/ultrasound/triple_jump.htm
 
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[[File:2 61 ultrasound.jpg|right|thumb|350px| When an Ohio woman looked at an ultrasound she expected to see a developing baby.
 
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Instead, she saw what she believes to be an image of Jesus Christ]]
 
−
 
 
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== See Also ==
 
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*[[Conservapedia:Anti-abortion Project|Conservapedia Anti-abortion Project]]
 
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*[http://www.conservapedia.com/Category:Abortion Directory of abortion related articles]
 
−
*[http://www.investigatemagazine.com/mar3abrt.htm Abortion and breast cancer in New Zealand]
 
−
*[[Abortion and the Bible]]
 
−
*[[Abortion and eugenics]]
 
−
*[[Abortion Facts]]
 
−
*[[Abortion funding]]
 
−
*[[Abortion genocide]]
 
−
*[[Abortion procedures]]
 
−
*[[Abortion rates by US state]]
 
−
*[[Abortionist]]
 
−
*[[Anti Abortion activism: a personal essay]]
 
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*[[More News/Abortion|Articles about '''Abortion''' from "More News"]]
 
−
*[[Culture of life]]
 
−
*[[Separate Life|Essay on abortion]]
 
−
*[[Eugenics]]
 
−
*[[Fetus]]
 
−
*[[Harvard abortion study]]
 
−
*[[Abortion breast cancer studies]]
 
−
*[[Homosexual activists and abortion]]
 
−
*[[Margaret Sanger]]
 
−
*[http://www.health.state.mn.us/divs/chs/abrpt/2006abrpt.pdf Minnesota official abortion statistics]
 
−
*[[National Right to Life Committee]]
 
−
*[[Partial birth abortion]]
 
−
*[[Planned Parenthood]]
 
−
*[[Right to life]]
 
−
*[[Right to life movement]]
 
−
*[[Sanctity of life]]
 
−
*[[Silent scream]]
 
−
*[[Taxpayer-funded abortion]]
 
−
 
 
−
==External Links==
 
−
*[http://www.abortionfacts.com/ Abortion Facts]
 
−
*[http://www.carm.org/abortion.htm Abortion] by [[Christian Apologetics and Research Ministry]]
 
−
*[http://www.lifesitenews.com/ LifeSiteNews.com]
 
−
*[http://www.ProLifeOnCampus.com/ Pro Life on Campus]
 
−
*[http://www.aim.org/wls/category/abortion/ What Liberals Say - Category: Abortion], [[Accuracy In Media]]
 
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{{Abortion}}
 
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{{Liberalism}}
 
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==References==
 
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{{reflist|2}}
 
  
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[[Category:Abortion]]
+
'''The following information resources may be created by those with a non-neutral position in the abortion debate:'''
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[[Category:Sexuality]]
+
*[http://www.guttmacher.org/ The Guttmacher Institute]
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[[Category:Religion and Politics]]
+
*[http://www.johnstonsarchive.net/policy/abortion Johnston's Archive: Abortion Statistics and Other Data]
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[[Category:Liberals]]
 
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[[Category:Featured articles]]
 

Revision as of 19:59, July 15, 2010

Template:Infobox Disease

Abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus or embryo, resulting in or caused by its death.[1] An abortion can occur spontaneously due to complications during pregnancy or can be induced, in humans and other species. In the context of human pregnancies, an abortion induced to preserve the health of the gravida (pregnant female) is termed a therapeutic abortion, while an abortion induced for any other reason is termed an elective abortion. The term abortion most commonly refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed miscarriages.

Worldwide 42 million abortions are estimated to take place annually with 22 million of these occurring safely and 20 million unsafely.[2] While maternal mortality seldom results from safe abortions, unsafe abortions result in 70,000 deaths and 5 million disabilities per year.[2] One of the main determinants of the availability of safe abortions is the legality of the procedure. Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits.[3] The frequency of abortions is, however, similar whether or not access is restricted.[3]

Abortion has a long history and has been induced by various methods including herbal abortifacients, the use of sharpened tools, physical trauma, and other traditional methods. Contemporary medicine utilizes medications and surgical procedures to induce abortion. The legality, prevalence, and cultural views on abortion vary substantially around the world. In many parts of the world there is prominent and divisive public controversy over the ethical and legal issues of abortion. Abortion and abortion-related issues feature prominently in the national politics in many nations, often involving the opposing pro-life and pro-choice worldwide social movements (both self-named). Incidence of abortion has declined worldwide, as access to family planning education and contraceptive services has increased.[4]

Types

File:Human fetus 10 weeks - therapeutic abortion.jpg
A 10-week-old fetus removed from a 44-year-old female diagnosed with early-stage uterine cancer via a therapeutic abortion. The uterus (womb), included the fetus.

Spontaneous

For a more detailed treatment, see Miscarriage.
Spontaneous abortion (also known as miscarriage) is the expulsion of an embryo or fetus due to accidental trauma or natural causes before approximately the 22nd week of gestation; the definition by gestational age varies by country.[5] Most miscarriages are due to incorrect replication of chromosomes; they can also be caused by environmental factors. A pregnancy that ends before 37 weeks of gestation resulting in a live-born infant is known as a "premature birth". When a fetus dies in utero after about 22 weeks, or during delivery, it is usually termed "stillborn". Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.

Between 10% and 50% of pregnancies end in clinically apparent miscarriage, depending upon the age and health of the pregnant woman.[6] Most miscarriages occur very early in pregnancy, in most cases, they occur so early in the pregnancy that the woman is not even aware that she was pregnant. One study testing hormones for ovulation and pregnancy found that 61.9% of conceptuses were lost prior to 12 weeks, and 91.7% of these losses occurred subclinically, without the knowledge of the once pregnant woman.[7]

The risk of spontaneous abortion decreases sharply after the 10th week from the last menstrual period (LMP).[6][8] One study of 232 pregnant women showed "virtually complete [pregnancy loss] by the end of the embryonic period" (10 weeks LMP) with a pregnancy loss rate of only 2 percent after 8.5 weeks LMP.[9]

The most common cause of spontaneous abortion during the first trimester is chromosomal abnormalities of the embryo/fetus,[10] accounting for at least 50% of sampled early pregnancy losses.[11] Other causes include vascular disease (such as lupus), diabetes, other hormonal problems, infection, and abnormalities of the uterus.[10] Advancing maternal age and a patient history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion.[11] A spontaneous abortion can also be caused by accidental trauma; intentional trauma or stress to cause miscarriage is considered induced abortion or feticide.[12]

Induced

A pregnancy can be intentionally aborted in many ways. The manner selected depends chiefly upon the gestational age of the embryo or fetus, which increases in size as it ages.[13] Specific procedures may also be selected due to legality, regional availability, and doctor-patient preference. Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. An abortion is medically referred to as therapeutic when it is performed to:

An abortion is referred to as elective when it is performed at the request of the woman "for reasons other than maternal health or fetal disease."[15]

Methods

File:Abortionmethods.png
Gestational age may determine which abortion methods are practiced.

Medical

For a more detailed treatment, see Medical abortion.

"Medical abortions" are non-surgical abortions that use pharmaceutical drugs, and are only effective in the first trimester of pregnancy.[Citation Needed] Medical abortions comprise 10% of all abortions in the United States[16] and Europe.[Citation Needed] Combined regimens include methotrexate or mifepristone, followed by a prostaglandin (either misoprostol or gemeprost: misoprostol is used in the U.S.; gemeprost is used in the UK and Sweden.) When used within 49 days gestation, approximately 92% of women undergoing medical abortion with a combined regimen completed it without surgical intervention.[17] Misoprostol can be used alone, but has a lower efficacy rate than combined regimens. In cases of failure of medical abortion, vacuum or manual aspiration is used to complete the abortion surgically.

Surgical

File:Vacuum-aspiration (single).svg
A vacuum aspiration abortion at eight weeks gestational age (six weeks after fertilization).
1: Amniotic sac
2: Embryo
3: Uterine lining
4: Speculum
5: Vacurette
6: Attached to a suction pump

In the first 12 weeks, suction-aspiration or vacuum abortion is the most common method.[18] Manual Vacuum aspiration (MVA) abortion consists of removing the fetus or embryo, placenta and membranes by suction using a manual syringe, while electric vacuum aspiration (EVA) abortion uses an electric pump. These techniques are comparable, and differ in the mechanism used to apply suction, how early in pregnancy they can be used, and whether cervical dilation is necessary. MVA, also known as "mini-suction" and "menstrual extraction", can be used in very early pregnancy, and does not require cervical dilation. Surgical techniques are sometimes referred to as 'Suction (or surgical) Termination Of Pregnancy' (STOP). From the 15th week until approximately the 26th, 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 curettage (D&C), the second most common method of abortion, 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. Curettage refers to cleaning the walls of the uterus with a curette. The World Health Organization recommends this procedure, also called sharp curettage, only when MVA is unavailable.[19]

Other techniques must be used to induce abortion in the second trimester. Premature delivery can be induced with prostaglandin; this can be coupled with injecting the amniotic fluid with hypertonic solutions containing saline or urea. After the 16th week of gestation, abortions can be induced by intact dilation and extraction (IDX) (also called intrauterine cranial decompression), which requires surgical decompression of the fetus's head before evacuation. IDX is sometimes called "partial-birth abortion," which has been federally banned in the United States. A 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 is used during later stages of pregnancy.[20]

From the 20th to 23rd week of gestation, an injection to stop the fetal heart can be used as the first phase of the surgical abortion procedure[21][22][23][24][25] to ensure that the fetus is not born alive.[26]

Other methods

Historically, a number of herbs reputed to possess abortifacient properties have been used in folk medicine: tansy, pennyroyal, black cohosh, and the now-extinct silphium (see history of abortion).[27] The use of herbs in such a manner can cause serious—even lethal—side effects, such as multiple organ failure, and is not recommended by physicians.[28]

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.[29] Both accidental and deliberate abortions of this kind can be subject to criminal liability in many countries. In Southeast Asia, there is an ancient tradition of attempting abortion through forceful abdominal massage.[30] One of the bas reliefs decorating the temple of Angkor Wat in Cambodia depicts a demon performing such an abortion upon a woman who has been sent to the underworld.[30]

Reported methods of unsafe, self-induced abortion include misuse of misoprostol, and insertion of non-surgical implements such as knitting needles and clothes hangers into the uterus. These methods are rarely seen in developed countries where surgical abortion is legal and available.[31] Template:Clr

Health risks

See also: Health risks of unsafe abortion

Abortion, when legally performed in developed countries, is among the safest procedures in medicine.[32][33] In such settings, risk of maternal death is between 0.2–1.2 per 100,000 procedures.[34][35][36][37] In comparison, by 1996, mortality from childbirth in developed countries was 11 times greater.[38][39][40][41][42][43] Unsafe abortions (defined by the World Health Organization as those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities) carry a high risk of maternal death and other complications.[44] For unsafe procedures, the mortality rate has been estimated at 367 per 100,000.[45]

Physical health

Surgical abortion methods, like most minimally invasive procedures, carry a small potential for serious complications.[46]

Surgical abortion is generally safe and the rate of major complications is low[47] but varies depending on how far pregnancy has progressed and the surgical method used.[48] Concerning gestational age, incidence of major complications is highest after 20 weeks of gestation and lowest before the 8th week.[48] With more advanced gestation there is a higher risk of uterine perforation and retained products of conception,[49] and specific procedures like dilation and evacuation may be required.[50]

Concerning the methods used, general incidence of major complications for surgical abortion varies from lower for suction curettage, to higher for saline instillation.[48] Possible complications include hemorrhage, incomplete abortion, uterine or pelvic infection, ongoing intrauterine pregnancy, misdiagnosed/unrecognized ectopic pregnancy, hematometra (in the uterus), uterine perforation and cervical laceration.[51] Use of general anesthesia increases the risk of complications because it relaxes uterine musculature making it easier to perforate.[52]

Women who have uterine anomalies, leiomyomas or had previous difficult first-trimester abortion are contraindicated to undertake surgical abortion unless ultrasonography is immediately available and the surgeon is experienced in its intraoperative use.[53] Abortion does not impair subsequent pregnancies, nor does it increase the risk of future premature births, infertility, ectopic pregnancy, or miscarriage.[33]

In the first trimester, health risks associated with medical abortion are generally considered no greater than for surgical abortion.[54]

Mental health

For a more detailed treatment, see Abortion and mental health.
No scientific research has demonstrated that abortion is a cause of poor mental health in the general population. However there are groups of women who may be at higher risk of coping with problems and distress following abortion.[55] Some factors in a woman's life, such as emotional attachment to the pregnancy, lack of social support, pre-existing psychiatric illness, and conservative views on abortion increase the likelihood of experiencing negative feelings after an abortion.[56] The American Psychological Association (APA) concluded that abortion does not lead to increased mental health problems.[57]

Some proposed negative psychological effects of abortion have been referred to by anti-abortion advocates as a separate condition called "post-abortion syndrome." However, the existence of "post-abortion syndrome" is not recognized by any medical or psychological organization.[58][59][60]

Incidence

The number of abortions performed worldwide has deceased between 1995 and 2003 from 45.6 million to 41.6 million (a decrease from 35 to 29 per 1000 women between 15 and 44 years of age).[2] The greatest decrease has occurred in the developed world with a decrease from 39 to 26 per 1000 women in comparison to the developing world which had a decrease from 34 to 29 per 1000 women.[2] Of these approximately 42 million abortions 22 million occurred safely and 20 million unsafely.[2]

The incidence and reasons for induced abortion vary regionally. Some countries, such as Belgium (11.2 per 100 known pregnancies) and the Netherlands (10.6 per 100), had a comparatively low rate of induced abortion, while others like Russia (62.6 per 100) and Vietnam (43.7 per 100) had a high rate. The world ratio was 26 induced abortions per 100 known pregnancies (excluding miscarriages and stillbirths).[61]

By gestational age and method

Template:Double image

Abortion rates also vary depending on the stage of pregnancy and the method practiced. In 2003, from data collected in those areas of the United States that sufficiently reported gestational age, it was found that 88.2% of abortions were conducted at or prior to 12 weeks, 10.4% from 13 to 20 weeks, and 1.4% at or after 21 weeks. 90.9% of these were classified as having been done by "curettage" (suction-aspiration, Dilation and curettage, Dilation and evacuation), 7.7% by "medical" means (mifepristone), 0.4% by "intrauterine instillation" (saline or prostaglandin), and 1.0% by "other" (including hysterotomy and hysterectomy).[62] The Guttmacher Institute estimated there were 2,200 intact dilation and extraction procedures in the U.S. during 2000; this accounts for 0.17% of the total number of abortions performed that year.[63] Similarly, in England and Wales in 2006, 89% of terminations occurred at or under 12 weeks, 9% between 13 to 19 weeks, and 1.5% at or over 20 weeks. 64% of those reported were by vacuum aspiration, 6% by D&E, and 30% were medical.[64] Later abortions are more common in China, India, and other developing countries than in developed countries.[65]

By personal and social factors

File:AGIAbortionReasonsBarChart.png
A bar chart depicting selected data from the 1998 AGI meta-study on the reasons women stated for having an abortion.

A 1998 aggregated study, from 27 countries, on the reasons women seek to terminate their pregnancies concluded that common factors cited to have influenced the abortion decision were: desire to delay or end childbearing, concern over the interruption of work or education, issues of financial or relationship stability, and perceived immaturity.[66] A 2004 study in which American women at clinics answered a questionnaire yielded similar results.[67] In Finland and the United States, concern for the health risks posed by pregnancy in individual cases was not a factor commonly given; however, in Bangladesh, India, and Kenya health concerns were cited by women more frequently as reasons for having an abortion.[66] 1% of women in the 2004 survey-based U.S. study became pregnant as a result of rape and 0.5% as a result of incest.[67] Another American study in 2002 concluded that 54% of women who had an abortion were using a form of contraception at the time of becoming pregnant while 46% were not. Inconsistent use was reported by 49% of those using condoms and 76% of those using the combined oral contraceptive pill; 42% of those using condoms reported failure through slipping or breakage.[68] The Guttmacher Institute estimated that "most abortions in the United States are obtained by minority women" because minority women "have much higher rates of unintended pregnancy."[69]

Some abortions are undergone as the result of societal pressures. These might include the stigmatization of disabled people, preference for children of a specific sex, disapproval of single motherhood, 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.

Unsafe abortion

File:RussianAbortionPoster.jpg
Soviet poster circa 1925, promoting hospital abortions. Title translation: "Abortions performed by either trained or self-taught midwives not only maim the woman, they also often lead to death."

For a more detailed treatment, see Unsafe abortion.
Women seeking to terminate their pregnancies sometimes resort to unsafe methods, particularly where and when access to legal abortion is restricted. The World Health Organization (WHO) defines an unsafe abortion as being "a procedure ... carried out by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both."[70] Unsafe abortions are sometimes known colloquially as "back-alley" abortions. They may be performed by the woman herself, another person without medical training, or a professional health provider operating in sub-standard conditions. Unsafe abortion remains a public health concern due to the higher incidence and severity of its associated complications, such as incomplete abortion, sepsis, hemorrhage, and damage to internal organs. It is estimated that 20 million unsafe abortions occur around the world annually and that 70,000 of these result in the woman's death.[2] Complications of unsafe abortion are said to account, globally, for approximately 13% of all maternal mortalities, with regional estimates including 12% in Asia, 25% in Latin America, and 13% in sub-Saharan Africa.[71] Although the global rate of abortion declined from 45.6 million in 1995 to 41.6 million in 2003, unsafe procedures still accounted for 48% of all abortions performed in 2003.[72] Health education, access to family planning, and improvements in health care during and after abortion have been proposed to address this phenomenon.[73]

History

File:FrenchPeriodicalPills-January61845,BostonDailyTimes.jpg
"French Periodical Pills." An example of a clandestine advertisement published in an 1845 edition of the Boston Daily Times.

For a more detailed treatment, see History of abortion.
Induced abortion can be traced to ancient times.[74] There is evidence to suggest that, historically, pregnancies were terminated through a number of methods, including the administration of abortifacient herbs, the use of sharpened implements, the application of abdominal pressure, and other techniques.

The Hippocratic Oath, the chief statement of medical ethics for Hippocratic physicians in Ancient Greece, forbade doctors from helping to procure an abortion by pessary. Soranus, a second-century Greek physician, suggested in his work Gynaecology that women wishing to abort their pregnancies should engage in energetic exercise, energetic jumping, carrying heavy objects, and riding animals. He also prescribed a number of recipes for herbal baths, pessaries, and bloodletting, but advised against the use of sharp instruments to induce miscarriage due to the risk of organ perforation.[75] It is also believed that, in addition to using it as a contraceptive, the ancient Greeks relied upon silphium as an abortifacient. Such folk remedies, however, varied in effectiveness and were not without risk. Tansy and pennyroyal, for example, are two poisonous herbs with serious side effects that have at times been used to terminate pregnancy.

During the medieval period, physicians in the Islamic world documented detailed and extensive lists of birth control practices, including the use of abortifacients, commenting on their effectiveness and prevalence.[76] They listed many different birth control substances in their medical encyclopedias, such as Avicenna listing 20 in The Canon of Medicine (1025) and Muhammad ibn Zakariya ar-Razi listing 176 in his Hawi (10th century). This was unparalleled in European medicine until the 19th century.[77]Template:Request quotation

During the Middle Ages, abortion was tolerated and there were no laws against it.[78] A medieval female physician, Trotula of Salerno,[79] administered a number of remedies for the “retention of menstrua,” which was sometimes a code for early abortifacients.[80] Pope Sixtus V (1585–90) is noted as the first Pope to declare that abortion is homicide regardless of the stage of pregnancy.[81] Abortion in the 19th century continued, despite bans in both the United Kingdom and the United States, as the disguised, but nonetheless open, advertisement of services in the Victorian era suggests.[82]

In the 20th century the Soviet Union (1919), Iceland (1935) and Sweden (1938) were among the first countries to legalize certain or all forms of abortion.[83] In 1935 Nazi Germany, a law was passed permitting abortions for those deemed "hereditarily ill," while women considered of German stock were specifically prohibited from having abortions.[84][85][86][87]

Society and culture

Abortion debate

Template:Refimprovesect Template:Double image

For a more detailed treatment, see Abortion debate.
In the history of abortion, induced abortion has been the source of considerable debate, controversy, and activism. An individual's position on the complex ethical, moral, philosophical, biological, and legal issues is often related to his or her value system. The main positions are one that argues in favor of access to abortion and one argues against access to abortion. Opinions of abortion may be described as being a combination of beliefs on its morality, and beliefs on the responsibility, ethical scope, and proper extent of governmental authorities in public policy. Religious ethics also has an influence upon both personal opinion and the greater debate over abortion (see religion and abortion).

Abortion debates, especially pertaining to abortion laws, are often spearheaded by groups advocating one of these two positions. In the United States, those in favor of greater legal restrictions on, or even complete prohibition of abortion, most often describe themselves as pro-life while those against legal restrictions on abortion describe themselves as pro-choice. Generally, the former position argues that a human fetus is a human being with a right to live making abortion tantamount to murder. The latter position argues that a woman has certain reproductive rights, especially the choice whether or not to carry a pregnancy to term.

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 justification of laws permitting or restricting abortion.

Debate also focuses on whether the pregnant woman should have to notify and/or have the consent of others in distinct cases: a minor, her parents; a legally married or common-law wife, her husband; or a pregnant woman, the biological father. In a 2003 Gallup poll in the United States, 79% of male and 67% of female respondents were in favor of legalized mandatory spousal notification; overall support was 72% with 26% opposed.[88]

Abortion law

For a more detailed treatment, see Abortion law.

See also: Reproductive rights
File:AbortionLawsMap-NoLegend.png
International status of abortion law:
  Legal on request
  Legal for maternal life, health, mental health, rape, fetal defects, and/or socioeconomic factors
  Legal for or illegal with exception for maternal life, health, mental health, rape, and/or fetal defects
  Illegal with exception for maternal life, health, mental health and/or rape
  Illegal with exception for maternal life, health, and/or mental health
  Illegal with no exceptions
  No information
Vertical stripes (various colours): Illegal but unenforced

Before the scientific discovery in the nineteenth century that human development begins at fertilization,[89] English common law forbade abortions after "quickening", that is, after "an infant is able to stir in the mother's womb."[90] There was also an earlier period in England when abortion was prohibited "if the foetus is already formed" but not yet quickened.[91] Both pre- and post-quickening abortions were criminalized by Lord Ellenborough's Act in 1803.[92] In 1861, the Parliament of the United Kingdom passed the Offences against the Person Act 1861, which continued to outlaw abortion and served as a model for similar prohibitions in some other nations.[93]

The Soviet Union, with legislation in 1920, and Iceland, with legislation in 1935, were two of the first countries to generally allow abortion. The second half of the 20th century saw the liberalization of abortion laws in other countries. The Abortion Act 1967 allowed abortion for limited reasons in the United Kingdom (except Northern Ireland). In the 1973 case, Roe v. Wade, the United States Supreme Court struck down state laws banning abortion, ruling that such laws violated an implied right to privacy in the United States Constitution. The Supreme Court of Canada, similarly, in the case of R. v. Morgentaler, discarded its criminal code regarding abortion in 1988, after ruling that such restrictions violated the security of person guaranteed to women under the Canadian Charter of Rights and Freedoms. Canada later struck down provincial regulations of abortion in the case of R. v. Morgentaler (1993). By contrast, abortion in Ireland was affected by the addition of an amendment to the Irish Constitution in 1983 by popular referendum, recognizing "the right to life of the unborn".

Current laws pertaining to abortion are diverse. Religious, moral, and cultural sensibilities 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 are sometimes used as justification for the existence or absence of laws controlling abortion. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained, often, but not always, using a trimester-based system to regulate the window of legality:

  • In the United States, some states impose a 24-hour waiting period before the procedure, prescribe the distribution of information on fetal development, or require that parents be contacted if their minor daughter requests an abortion.[94]
  • In the United Kingdom, as in some other countries, two doctors must first certify that an abortion is medically or socially necessary before it can be performed.
  • In Canada, a similar requirement was rejected as unconstitutional in 1988.

Other countries, in which abortion is normally illegal, will allow one to be performed in the case of rape, incest, or danger to the pregnant woman's life or health.

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. Women without the means to travel can resort to providers of illegal abortions or try to do it themselves. [100]

In the US, about 8% of abortions are performed on women who travel from another state.[101] However, that is driven at least partly by differing limits on abortion according to gestational age or the scarcity of doctors trained and willing to do later abortions.

Sex-selective

For a more detailed treatment, see Sex-selective abortion.

Sonography and amniocentesis allow parents to determine sex before childbirth. The development of this technology has led to sex-selective abortion, or the targeted termination of female fetuses.

It is suggested that sex-selective abortion might be partially responsible for the noticeable disparities between the birth rates of male and female children in some places. The preference for male children is reported in many areas of Asia, and abortion used to limit female births has been reported in China, Taiwan, South Korea, and India.[102]

In India, the economic role of men, the costs associated with dowries, and a common Indian tradition which dictates that funeral rites must be performed by a male relative have led to a cultural preference for sons.[103] The widespread availability of diagnostic testing, during the 1970s and '80s, led to advertisements for services which read, "Invest 500 rupees [for a sex test] now, save 50,000 rupees [for a dowry] later."[104] In 1991, the male-to-female sex ratio in India was skewed from its biological norm of 105 to 100, to an average of 108 to 100.[105] Researchers have asserted that between 1985 and 2005 as many as 10 million female fetuses may have been selectively aborted.[106] The Indian government passed an official ban of pre-natal sex screening in 1994 and moved to pass a complete ban of sex-selective abortion in 2002.[107]

In the People's Republic of China, there is also a historic son preference. The implementation of the one-child policy in 1979, in response to population concerns, led to an increased disparity in the sex ratio as parents attempted to circumvent the law through sex-selective abortion or the abandonment of unwanted daughters.[108] Sex-selective abortion might be an influence on the shift from the baseline male-to-female birth rate to an elevated national rate of 117:100 reported in 2002. The trend was more pronounced in rural regions: as high as 130:100 in Guangdong and 135:100 in Hainan.[109] A ban upon the practice of sex-selective abortion was enacted in 2003.[110]

In other animals

Template:See Spontaneous abortion occurs in various animals. For example, in sheep, it may be caused by crowding through doors, or being chased by dogs.[111] In cows, abortion may be caused by contagious disease, such as Brucellosis or Campylobacter, but can often be controlled by vaccination.[112] Additionally, many other diseases are known to increase the risk of miscarriage in humans and other animals.[Citation Needed]

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.[113]

Feticide can occur in horses and zebras due to male harassment of pregnant mares or forced copulation,[114][115][116] although the frequency in the wild has been questioned.[117] Male Gray langur monkeys may attack females following male takeover, causing miscarriage.[118]

See also

References

  1. ↑ Dutt T, Matthews MP (1998). Gynaecology for Lawyers. Routledge. ISBN 9781859412152. 
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 Shah I, Ahman E (December 2009). "Unsafe abortion: global and regional incidence, trends, consequences, and challenges". J Obstet Gynaecol Can 31 (12): 1149–58. PMID 20085681. 
  3. ↑ 3.0 3.1 Culwell KR, Vekemans M, de Silva U, Hurwitz M (July 2010). "Critical gaps in universal access to reproductive health: Contraception and prevention of unsafe abortion". International Journal of Gynecology & Obstetrics 110: S13–16. doi:10.1016/j.ijgo.2010.04.003. PMID 20451196. 
  4. ↑ Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J (September 2007). "Legal abortion worldwide: incidence and recent trends". Int Fam Plan Perspect 33 (3): 106–16. doi:10.1363/ifpp.33.106.07. PMID 17938093. http://www.guttmacher.org/pubs/journals/3310607.html. 
  5. ↑ Department of Reproductive Health and Research (2003). Managing Complications in Pregnancy and Childbirth – A guide for midwives and doctors. World Health Organization. Retrieved on 2009-04-07. NB: This definition is subject to regional differences, see miscarriage.
  6. ↑ 6.0 6.1 "Q&A: Miscarriage", BBC, 2002-08-06. Retrieved on 2009-04-07. 
  7. ↑ Edmonds DK, Lindsay KS, Miller JF, Williamson E, Wood PJ (1982). "Early embryonic mortality in women". Fertil. Steril. 38 (4): 447–453. PMID 7117572. 
  8. ↑ Nilsson, Lennart; Lars Hamberger [1965] (1990). A child is born. Garden City, New York: Doubleday. ISBN 0-385-40085-3. OCLC 21412111. 
  9. ↑ (1999) "Early pregnancy loss", in Martin J. Whittle and C. H. Rodeck: Fetal medicine: basic science and clinical practice. Edinburgh: Churchill Livingstone. ISBN 0-443-05357-X. OCLC 42792567. 
  10. ↑ 10.0 10.1 Stöppler. Shiel WC Jr:Miscarriage (Spontaneous Abortion). MedicineNet.com. Retrieved on 2009-04-07.
  11. ↑ 11.0 11.1 Jauniaux E, Kaminopetros P, El-Rafaey H (1999). "Early pregnancy loss", in Whittle MJ,Rodeck CH: Fetal medicine: basic science and clinical practice. Edinburgh: Churchill Livingstone. ISBN 0-443-05357-X. OCLC 42792567. 
  12. ↑ Fetal Homicide Laws. National Conference of State Legislatures. Retrieved on 2009-04-07.
  13. ↑ Menikoff, Jerry. Law and Bioethics, p. 78 (Georgetown University Press 2001): "As the fetus grows in size, however, the vacuum aspiration method becomes increasingly difficult to use."
  14. ↑ 14.0 14.1 14.2 14.3 Roche, Natalie E. (2004). Therapeutic Abortion. Retrieved 2006-03-08.
  15. ↑ Encyclopedia Britannica, (2007), Vol 26, p. 674.
  16. ↑ Strauss LT, Gamble SB, Parker WY, Cook DA, Zane SB, Hamdan S (November 2007). "Abortion surveillance—United States, 2004". MMWR Surveill Summ 56 (9): 1–33. PMID 18030283. http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5609a1.htm. 
  17. ↑ Spitz, I.M; Bardin, CW; Benton, L; Robbins, A (1998). "Early pregnancy termination with mifepristone and misoprostol in the United States". New England Journal of Medicine 338 (18): 1241. doi:10.1056/NEJM199804303381801. PMID 9562577. 
  18. ↑ Healthwise (2004). Manual and vacuum aspiration for abortion. WebMD. Retrieved on 2008-12-05.
  19. ↑ World Health Organization (2003). "Dilatation and curettage", Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors. Geneva: World Health Organization. ISBN 92-4-154587-9. OCLC 181845530. Retrieved on 2008-12-05. 
  20. ↑ Template:Cite encyclopedia
  21. ↑ Vause S, Sands J, Johnston TA, Russell S, Rimmer S (May 2002). "Could some fetocides be avoided by more prompt referral after diagnosis of fetal abnormality?". J Obstet Gynaecol 22 (3): 243–245. doi:10.1080/01443610220130490. PMID 12521492. http://www.informaworld.com/openurl?genre=article&doi=10.1080/01443610220130490&magic=pubmed%7C%7C1B69BA326FFE69C3F0A8F227DF8201D0. Retrieved 2008-12-03. 
  22. ↑ Dommergues M, Cahen F, Garel M, Mahieu-Caputo D, Dumez Y (2003). "Feticide during second- and third-trimester termination of pregnancy: opinions of health care professionals". Fetal. Diagn. Ther. 18 (2): 91–97. doi:10.1159/000068068. PMID 12576743. http://content.karger.com/produktedb/produkte.asp?typ=fulltext&file=fdt18091. Retrieved 2008-12-03. 
  23. ↑ Bhide A, Sairam S, Hollis B, Thilaganathan B (September 2002). "Comparison of feticide carried out by cordocentesis versus cardiac puncture". Ultrasound Obstet Gynecol 20 (3): 230–232. doi:10.1046/j.1469-0705.2002.00797.x. PMID 12230443. 
  24. ↑ Senat MV, Fischer C, Bernard JP, Ville Y (March 2003). "The use of lidocaine for fetocide in late termination of pregnancy". BJOG 110 (3): 296–300. doi:10.1046/j.1471-0528.2003.02217.x. PMID 12628271. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=1470-0328&date=2003&volume=110&issue=3&spage=296. Retrieved 2008-12-03. 
  25. ↑ Senat MV, Fischer C, Ville Y (May 2002). "Funipuncture for fetocide in late termination of pregnancy". Prenat. Diagn. 22 (5): 354–356. doi:10.1002/pd.290. PMID 12001185. 
  26. ↑ Nuffield Council on Bioethics (2006). "Clinical perspectives (Continued)", Critical Case Decisions in Fetal and Neonatal Medicine: Ethical Issues. Nuffield Council on Bioethics. ISBN 1-904384-14-5. OCLC 85782378. Retrieved on 2008-12-03. 
  27. ↑ Riddle, John M. (1997). Eve's herbs: a history of contraception and abortion in the West. Cambridge, Massachusetts: Harvard University Press. ISBN 0-674-27024-X. OCLC 36126503. Template:Pn
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