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Abortion
Specialty	Obstetrics

Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo before it is viable. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced. The term abortion most commonly refers to the induced abortion of a human pregnancy.

Abortion, when induced in the developed world in accordance with local law, is among the safest procedures in medicine. However, unsafe abortions (those performed by persons without proper training or outside of a medical environment) result in approximately 70 thousand maternal deaths and 5 million disabilities per year globally. An estimated 42 million abortions are performed globally each year, with 20 million of those performed unsafely. The incidence of abortion has declined worldwide as access to family planning education and contraceptive services has increased. Forty percent of the world's women have access to induced abortions (within gestational limits).

Induced abortion has a long history and has been facilitated 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, cultural and religious status of 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 movements (both self-named).

Types

Induced

Approximately 205 million pregnancies occur each year worldwide. Over a third are unintended and about a fifth end in induced abortion. Most abortions result from unintended pregnancies. A pregnancy can be intentionally aborted in several ways. The manner selected often depends upon the gestational age of the embryo or fetus, which increases in size as the pregnancy progresses. Specific procedures may also be selected due to legality, regional availability, and doctor or patient preference.

Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. An abortion is medically referred to as a therapeutic abortion when it is performed to save the life of the pregnant woman; prevent harm to the woman's physical or mental health; terminate a pregnancy where indications are that the child will have a significantly increased chance of premature morbidity or mortality or be otherwise disabled; or to selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy. An abortion is referred to as an elective or voluntary abortion when it is performed at the request of the woman for non-medical reasons.

Spontaneous

Spontaneous abortion, also known as miscarriage, is the unintentional expulsion of an embryo or fetus before the 20th to 22nd week of gestation. A pregnancy that ends before 37 weeks of gestation resulting in a live-born infant is known as a "premature birth" or a "preterm birth". When a fetus dies in utero after viability, 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.

Only 30 to 50% of conceptions progress past the first trimester. The vast majority of those that do not progress are lost before the woman is aware of the conception, and many pregnancies are lost before medical practitioners have the ability to detect the presence of an embryo. Between 15% and 30% of known pregnancies end in clinically apparent miscarriage, depending upon the age and health of the pregnant woman.

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

Induction methods

Medical

Medical abortions are those induced with pharmaceuticals, categorically called abortifacients. In 2005, medical abortions constituted 13% of all abortions in the United States; in 2010 the figure increased to 17%. 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. Misoprostol can be used alone, but has a lower efficacy rate than combined regimens. In cases of failure of medical abortion, surgical abortion must be used to complete the procedure.

Surgical

In the first 15 weeks, suction-aspiration or vacuum abortion is the most common method. 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. Dilation and curettage (D&C), the second most common method of surgical 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.

From the 15th week until approximately the 26th, other techniques must be used. Dilation and evacuation (D&E) consists of opening the cervix of the uterus and emptying it using surgical instruments and suction. Premature labor and 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 also 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.

In the third trimester of pregnancy, abortion may be performed by IDX as described above, induction of labor, or by hysterotomy. 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.

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). 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.

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. In Southeast Asia, there is an ancient tradition of attempting abortion through forceful abdominal massage. 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.

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.

Safety

The health risks of abortion depend on whether the procedure is performed safely or unsafely. The World Health Organization defines unsafe abortions as those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities. Abortion, when performed in the developed world in accordance with local law, is among the safest procedures in medicine. In the US, a study by David A. Grimes of maternal mortality from 1990 - 1999 estimated risk of maternal death following an abortion over the period was 0.567 per 100,000 procedures, suggesting abortion approximately 12.5 times safer than childbirth (7.06 maternal deaths per 100,000 live births). A Scandavian study reported a disparate finding which indicated childbirth was safer than abortion. The risk of abortion-related mortality increases with increasing gestational age, but remains lower than that of childbirth through at least 21 weeks' gestation.

Vacuum aspiration in the first trimester is the safest method of surgical abortion, and can be performed in a primary care office, abortion clinic, or hospital. Complications are rare and can include uterine perforation, pelvic infection, and retained products of conception requiring a second procedure to evacuate. Preventive antibiotics (such as doxycycline or metronidazole) are typically given before elective abortion, as they are believed to substantially reduce the risk of postoperative uterine infection. Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen. A 2008 Cochrane Library review found that dilation and evacuation was safer than other means of second-trimester abortion.

Medical abortion with mifepristone and misoprostol is effective through 49 days of gestational age. It has been used in women up to 63 days of gestational age, albeit with an increased risk of failure (requiring surgical abortion). Medical abortion is generally considered as safe as surgical abortion in the first trimester, but is associated with more pain and a lower success rate (requiring surgical abortion). Overall, the risk of uterine infection is lower with medical than with surgical abortion.

Unsafe abortion

In contrast, unsafe abortion is a major cause of injury and death among women worldwide. Although data are imprecise, it is estimated that approximately 20 million unsafe abortions are performed annually, with 97% taking place in developing countries. Unsafe abortion is believed to result in approximately 68,000 deaths and millions of injuries annually. Groups such as the World Health Organization have advocated a public-health approach to addressing unsafe abortion, emphasizing the legalization of abortion, the training of medical personnel, and ensuring access to reproductive-health services.

Women seeking to terminate their pregnancies sometimes resort to unsafe methods, particularly when access to legal abortion is restricted. They may attempt to self-abort or rely on another person who does not have proper medical training or access to proper facilities. This has a tendency to lead to severe complications, such as incomplete abortion, sepsis, hemorrhage, and damage to internal organs.

The legality of abortion is one of the main determinants of its safety. Restrictive abortion laws are associated with a high rate of unsafe abortions. For example, the 1996 legalization of abortion in South Africa had an immediate positive impact on the frequency of abortion-related complications, with abortion-related deaths dropping by more than 90%. In addition, a lack of access to effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by as much as 73% without any change in abortion laws if modern family planning and maternal health services were readily available globally.

Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits, while an additional 35 percent have access to legal abortion if they meet certain physical, mental, or socioeconomic criteria. While maternal mortality seldom results from safe abortions, unsafe abortions result in 70,000 deaths and 5 million disabilities per year. Complications of unsafe abortion account for approximately an eighth of maternal mortalities worldwide, though this varies by region. Secondary infertility caused by an unsafe abortion affects an estimated 24 million women. 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. Health education, access to family planning, and improvements in health care during and after abortion have been proposed to address this phenomenon.

Breast cancer hypothesis

Some studies have suggested an association between abortion and breast cancer. Proponents of a causal link between the two suggest that the interruption of normal breast development during pregnancy leaves immature cells that are more cancer-prone in the breasts. However, major medical bodies, including the World Health Organization, the US National Cancer Institute, the American Cancer Society, the Royal College of Obstetricians and Gynaecologists, and the American Congress of Obstetricians and Gynecologists, have all concluded on the basis of existing evidence that abortion does not cause breast cancer. The concept of a causal link between induced abortion and breast cancer is currently promoted primarily by pro-life groups.

Mental health

The current scientific consensus holds that there is no causal relationship between abortion and mental-health problems. Some factors in a woman's life, such as emotional attachment to the pregnancy, lack of social support, or pre-existing psychiatric illness increase the likelihood of experiencing negative feelings after an abortion. The American Psychological Association has concluded that a single abortion is not a threat to women's mental health, and that women are no more likely to have mental-health problems after a first-trimester abortion than after carrying an unwanted pregnancy to term. Similarly, abortions performed after the first trimester because of fetal abnormalities are not thought to cause mental-health problems.

Some studies have disagreed with above conclusions; other researchers and professional organizations have noted that such studies typically fail to use appropriate comparison groups, do not adequately account for confounding variables, improperly account for pre-existing mental health complications or and their degree of severity. Some proposed negative psychological effects of abortion have been referred to by pro-life advocates as a separate condition called "post-abortion syndrome", which is not recognized by any medical or psychological organization.

Incidence

There are two commonly used methods of measuring the incidence of abortion:

• Abortion rate – number of abortions per 1000 women between 15 and 44 years of age
• Abortion ratio – number of abortions out of 100 known pregnancies (excluding miscarriages and stillbirths)

The number of abortions performed worldwide has decreased between 1995 and 2003 from 45.6 million to 41.6 million, which means a decrease in abortion rate per annum from 35 to 29 per 1000 women. The greatest decrease has occurred in the developed world with a drop from 39 to 26 per 1000 women in comparison to the developing world, which had a decrease from 34 to 29 per 1000 women. In 2003, the estimated global abortion ratio was 31.

On average, the incidence of abortion is similar in countries with restrictive abortion laws and those with more liberal access to abortion. However, restrictive abortion laws are associated with increases in the percentage of abortions which are performed unsafely. The unsafe abortion rate in developing countries is partly attributable to lack of access to modern contraceptives; according to the Guttmacher Institute, providing access to contraceptives would result in about 14.5 million fewer unsafe abortions and 38,000 fewer deaths from unsafe abortion annually worldwide.

The incidence of induced abortion varies extensively worldwide. The ratio of induced abortion ranges from ten to thirty percent; figures in the developing world vary widely and are often incomplete.

By gestational age and method

Abortion rates also vary depending on the stage of pregnancy and the method practiced. In 2003, the Centers for Disease Control and Prevention (CDC) reported that 26% of abortions in the United States were known to have been obtained at less than 6 weeks' gestation, 18% at 7 weeks, 15% at 8 weeks, 4.1% at 16 through 20 weeks and 1.4% at more than 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). According to the CDC, due to data collection difficulties the data must be viewed as tentative and some fetal deaths reported beyond 20 weeks may be natural deaths erroneously classified as abortions if the removal of the fetus is accomplished by the same procedure as an induced abortion.

The Guttmacher Institute estimated there were 2,200 intact dilation and extraction procedures in the US during 2000; this accounts for 0.17% of the total number of abortions performed that year. 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. Later abortions are more common in China, India, and other developing countries than in developed countries.

Personal and social factors

A 1998 study from 27 countries on the reasons women seek to terminate their pregnancies concluded that the most common reason women cited for having an abortion was to postpone childbearing to a more suitable time or to focus energies and resources on existing children. The most commonly reported reasons were socioeconomic factors such as being unable to afford a child either in terms of the direct costs of raising a child or the loss of income while she is caring for the child, lack of support from the father, inability to afford additional children, desire to provide schooling for existing children, disruption of education, relationship problems with a husband or partner, the perception that she is too young, and unemployment. A 2004 study in which American women at clinics answered a questionnaire yielded similar results. A 1998 survey found risk to maternal health cited as the main reason by 5-10% in seven countries and by 20-38% in three (Kenya, Bangladesh and India). A 1997 U.S. report cited maternal health the "most important reason" for their decision by 3% of women and another 3% cited concern that the fetus had a health problem. In a 2004 survey-based U.S. study, 1% of women having abortions became pregnant as a result of rape and 0.5% as a result of incest. 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. 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."

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.

History

Induced abortion has long history, and can be traced back to civilizations as varied as China under Shennong (c. 2700 BCE), Ancient Egypt with its Ebers Papyrus (c. 1550 BCE), and the Roman Empire in the time of Juvenal (c. 200 CE). There is evidence to suggest that 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.

Some medical scholars and abortion opponents have suggested that the Hippocratic Oath forbade Ancient Greek physicians from performing abortions; other scholars disagree with this interpretation, and note the medical texts of Hippocratic Corpus contain descriptions of abortive techniques and notes on the risks they posed to a woman's health. In Christianity, Pope Sixtus V (1585–90) is noted as the first Pope to declare that abortion is homicide regardless of the stage of pregnancy; the Church had previously been divided on whether if believed that abortion was murder, and did not begin vigorously opposing abortion until the 19th century. Islamic tradition has traditionally permitted abortion up until a point in time when Muslims believe the soul enters the fetus, considered by various theologians to be at conception, 40 days after conception, 120 days after conception, or quickening. However, abortion is largely heavily restricted or forbidden in areas of high Islamic faith such as the Middle East and North Africa.

In Europe and North America, abortion techniques advanced starting in the 17th century. However, conservatism by most physicians with regards to sexual matters prevented the wide expansion of safe abortion techniques. Other medical practitioners in addition to some physicians advertised their services, and they were not widely regulated until the 19th century, when the practice was banned in both the United States and the United Kingdom. Church groups as well as physicians were highly influential in anti-abortion movements. In the US, abortion was more dangerous than childbirth until about 1930 when incremental improvements in abortion procedures relative to childbirth made abortion safer. The Soviet Union (1919), Iceland (1935) and Sweden (1938) were among the first countries to legalize certain or all forms of abortion. 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. Beginning in the second half of the twentieth century, abortion was legalized in a greater number of countries.

Society and culture

Abortion debate

Induced abortion has long 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. Opinions of abortion may be described as being a combination of beliefs on its morality; beliefs on the responsibility, ethical scope, and proper extent of governmental authorities in public policy; and on the rights and responsibilities of the woman seeking to have an abortion. Religious ethics also has an influence upon both personal opinion and the greater debate over abortion.

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. Abortion debates, especially pertaining to abortion laws, are often spearheaded by groups advocating one of these two positions. Those in favor of greater legal restrictions on abortion, including complete prohibition, 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 morally the same as murder. The latter position argues that a woman has certain reproductive rights, especially the choice whether or not to carry a pregnancy to term.

Modern abortion law

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.

In jurisdictions where abortion is legal, certain requirements must often be met before a woman may obtain an abortion (an abortion performed without the woman's consent is considered feticide). These requirements are usually dependent on the age of the fetus, often using a trimester-based system to regulate the window of legality. Many restrictions are waived in emergency situations. Some jurisdictions require a 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. Other jurisdictions may require that a woman obtain the consent of the fetus' father before aborting the fetus, that abortion providers inform patients of health risks of the procedure—sometimes including those not supported by the medical literature—and that multiple medical authorities certify that the abortion is either medically or socially necessary.

Other jurisdictions ban abortion almost entirely. However, many, but not all, of these will allow them to be performed in a variety of circumstances. These circumstances vary based on jurisdiction, but may include whether the pregnancy is a result of rape or incest, whether the fetus' development is impaired, whether the mother's physical or mental well-being is endangered, or whether there are socioeconomic considerations that could be taken into consideration. In countries where abortion is banned entirely, such as Nicaragua, rises in maternal death directly and indirectly due to pregnancy have been noted. Some countries, such as Bangledesh, that nominally ban abortion, may also support clinics that perform abortions under the guise of menstrual hygiene. 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 attempt to perform an abortion by themselves.

Emergency contraception is generally available in countries that have not restricted abortion, and is also sometimes available in countries that have otherwise banned abortion, such as Chile. This has caused controversy, as some pro-life groups have advocated that certain forms of emergency contraception are not contraceptives but abortifacients.

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 termination of a fetus based on sex. The selective termination of a female fetus is most common.

Sex-selective abortion is partially responsible for the noticeable disparities between the birth rates of male and female children in some countries. The preference for male children is reported in many areas of Asia, and abortion used to limit female births has been reported in Taiwan, South Korea, India, and China. In China, a historical preference for a male child has been exacerbated by the one-child policy, which was enacted in 1979. This deviation from the standard birth rates of males and females occurs despite the fact that the country in question may have officially banned sex-selective abortion or even sex-screening.

Anti-abortion violence

In a number of cases, abortion providers and these facilities have been subjected to various forms of violence, including murder, attempted murder, kidnapping, stalking, assault, arson, and bombing. Anti-abortion violence has been classified by governmental and scholarly sources as terrorism. Only a small fraction of those opposed to abortion commit violence, often rationalizing their actions as justifiable homicide or defense of others, committed in order to protect the lives of fetuses.

In the United States, four physicians who performed abortions—David Gunn, John Britton, Barnett Slepian, and George Tiller—have been assassinated. Attempted assassinations have also taken place in the United States and Canada, and other personnel at abortion clinics, including receptionists and security guards, have been killed in the United States and Australia. Hundreds of bombings, arsons, acid attacks, invasions, and incidents of vandalism against abortion providers have also occurred. Notable perpetrators of anti-abortion violence include Eric Robert Rudolph, Scott Roeder, Shelley Shannon, and Paul Jennings Hill, the first person to be executed in the United States for murdering an abortion provider.

Art, literature and film

Art serves to humanize the abortion issue and illustrates the myriad of decisions and consequences it has. One of the earliest known representations of abortion is in a bas relief at Angkor Wat (c. 1150). Pro-life activist Børre Knudsen was linked to a 1994 art theft as part of a pro-life drive in Norway surrounding the 1994 Winter Olympics. A Swiss gallery removed a piece from a Chinese art collection in 2005, that had the head of a fetus attached to the body of a bird. In 2008, a Yale student proposed using aborted excretions and the induced abortion itself as a performance art project.

The Cider House Rules (novel 1985, film 1999) follows the story of Dr. Larch an orphanage director who is a reluctant abortionist after seeing the consequences of back-alley abortions, and his orphan medical assistant Homer who is against abortion. Feminist novels such as Braided Lives (1997) by Marge Piercy emphasize the struggles women had in dealing with unsafe abortion in various circumstances prior to legalization. Physician Susan Wicklund wrote This Common Secret (2007) about how a personal traumatic abortion experience hardened her resolve to provide compassionate care to women who decide to have an abortion. As Wicklund crisscrosses the West to provide abortion services to remote clinics, she tells the stories of women she's treated and the sacrifices she and her loved ones made. In 2009, Irene Vilar revealed her past abuse and addiction to abortion in Impossible Motherhood, where she aborted 15 pregnancies in 17 years. According to Vilar it was the result of a dark psychological cycle of power, rebellion and societal expectations. In Annie Finch's mythic epic poem and opera libretto Among the Goddesses (2010), the heroine's abortion is contextualized spiritually by the goddesses Demeter, Kali, and Inanna.

Various options and realities of abortion have been dramatized in film. In Riding in Cars with Boys (2001) an underage woman carries her pregnancy to term as abortion is not an affordable option, moves in with the father and finds herself involved with drugs, has no opportunities, and questioning if she loves her child. While in Juno (2007) a 16-year-old initially goes to have an abortion but decides to bear the child and allow a wealthy couple to adopt it. Other films Dirty Dancing (1987) and If These Walls Could Talk (1996) explore the availability, affordability and dangers of illegal abortions. The emotional impact of dealing with an unwanted pregnancy alone is the focus of Things You Can Tell Just By Looking At Her (2000) and Circle of Friends (1995). As a marriage was in trouble in the The Godfather Part II (1974) Kay knew the relationship was over when she aborted "a son" in secret. On the abortion debate, an irresponsible drug addict is used as a pawn in a power struggle between pro-choice and pro-life groups in Citizen Ruth (1996). The Law & Order television episode "Dignity" deals with the trial of a man who killed a late-term abortion doctor; the storyline was inspired by the assassination of abortion provider George Tiller.

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. In cows, abortion may be caused by contagious disease, such as Brucellosis or Campylobacter, but can often be controlled by vaccination.

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.

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

References

Citations

1. ^ Grimes DA; Benson J; Singh S; et al. (2006). "Unsafe abortion: the preventable pandemic" (PDF). Lancet. 368 (9550): 1908–19. doi:10.1016/S0140-6736(06)69481-6. PMID 17126724. {{cite journal}}: Unknown parameter |author-separator= ignored (help)
2. ^ Shah, I.; Ahman, E. (2009). "Unsafe abortion: global and regional incidence, trends, consequences, and challenges" (PDF). Journal of Obstetrics and Gynaecology Canada. 31 (12): 1149–58. PMID 20085681. {{cite journal}}: Unknown parameter |month= ignored (help)
3. Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J (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. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
4. ^ Culwell KR, Vekemans M, de Silva U, Hurwitz M (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. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
5. Cheng L. (November 1, 2008). "Surgical versus medical methods for second-trimester induced abortion". The WHO Reproductive Health Library. World Health Organization. Archived from the original on June 17, 2011. Retrieved June 17, 2011. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
6. Bankole et al., "Reasons Why Women Have Induced Abortions: Evidence from 27 Countries", International Family Planning Perspectives (1998). Also see Lawrence B. Finer, Lori F. Frohwirth, Lindsay A. Dauphinee, Susheela Singh, and Ann M. Moore, "Reasons U.S. Women Have Abortions: Quantitative and Qualitative Perspectives", Perspectives on Sexual and Reproductive Health, 37(3):110-118 (September 2005).
7. Stubblefield, Phillip G. (2002). "10. Family Planning". In Berek, Jonathan S. (ed.). Novak's Gynecology (13 ed.). Lippincott Williams & Wilkins. ISBN 978-0781732628.
8. Bartlett, LA; Berg, CJ; Shulman, HB; Zane, SB; Green, CA; Whitehead, S; Atrash, HK (2004). "Risk factors for legal induced abortion-related mortality in the United States" (PDF). Obstetrics & Gynecology. 103 (4): 729–37. doi:10.1097/01.AOG.0000116260.81570.60. PMID 15051566.
9. Roche, Natalie E. (September 28, 2004). "Therapeutic Abortion". eMedicine. Archived from the original on December 14, 2004. Retrieved June 19, 2011.
10. ^ Schorge, John O.; Schaffer, Joseph I.; Halvorson, Lisa M.; Hoffman, Barbara L.; Bradshaw, Karen D.; Cunningham, F. Gary, eds. (2008). "6. First-Trimester Abortion". Williams Gynecology (1 ed.). McGraw-Hill Medical. ISBN 978-0-07-147257-9.
11. Annas, George J.; Elias, Sherman (2007). "51. Legal and Ethical Issues in Obstetric Practice". In Gabbe, Steven G.; Niebyl, Jennifer R.; Simpson, Joe Leigh (eds.). Obstetrics: Normal and Problem Pregnancies (5 ed.). Churchill Livingstone. p. 669. ISBN 978-0-443-06930-7. A preterm birth is defined as one that occurs before the completion of 37 menstrual weeks of gestation, regardless of birth weight.
12. "Stillbirth". Concise Medical Dictionary. Oxford University Press. 2010. birth of a fetus that shows no evidence of life (heartbeat, respiration, or independent movement) at any time later than 24 weeks after conception {{cite web}}: Missing or empty |url= (help)
13. Annas, George J.; Elias, Sherman (2007). "24. Pregnancy loss". In Gabbe, Steven G.; Niebyl, Jennifer R.; Simpson, Joe Leigh (eds.). Obstetrics: Normal and Problem Pregnancies (5 ed.). Churchill Livingstone. ISBN 978-0-443-06930-7.
14. Katz, Vern L. (2007). "16. Spontaneous and Recurrent Abortion - Etiology, Diagnosis, Treatment". In Katz, Vern L.; Lentz, Gretchen M.; Lobo, Rogerio A.; Gershenson, David M. (eds.). Katz: Comprehensive Gynecology (5 ed.). Mosby. ISBN 9780323029513.
15. Stovall, Thomas G. (2002). "17. Early Pregnancy Loss and Ectopic Pregnancy". In Berek, Jonathan S. (ed.). Novak's Gynecology (13 ed.). Lippincott Williams & Wilkins. ISBN 978-0781732628.
16. ^ Stöppler, Melissa Conrad. Shiel, William C., Jr. (ed.). "Miscarriage (Spontaneous Abortion)". MedicineNet.com. WebMD. Retrieved 2009-04-07.{{cite web}}: CS1 maint: multiple names: editors list (link)
17. ^ Jauniaux E, Kaminopetros P, El-Rafaey H (1999). "Early pregnancy loss". In Whittle MJ, Rodeck CH (ed.). Fetal medicine: basic science and clinical practice. Edinburgh: Churchill Livingstone. p. 837. ISBN 978-0-443-05357-3. OCLC 42792567.{{cite book}}: CS1 maint: multiple names: authors list (link)
18. "Fetal Homicide Laws". National Conference of State Legislatures. Retrieved 2009-04-07.
19. Jones R. K.; et al. (2008). "Abortion in the United States: incidence and access to services, 2005" (PDF). Perspectives on Sexual and Reproductive Health. 40 (1): 6–16. doi:10.1363/4000608. PMID 18318867. {{cite journal}}: Unknown parameter |author-separator= ignored (help)
20. Stein, Rob (2011-01-11). "Decline in U.S. abortion rate stalls". The Washington Post.
21. 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. {{cite journal}}: More than one of |pages= and |page= specified (help)
22. Trupin, Suzanne R. (2003). "31. Induced Abortion". In Scott, James R.; Gibbs, Ronald S.; Karlan, Beth y.; Haney, Arthur F. (eds.). Danforth's Obstetrics and Gynecology (9 ed.). Lippincott Williams & Wilkins. ISBN 978-0781737302.
23. Healthwise (2004). "Manual and vacuum aspiration for abortion". WebMD. Retrieved 2008-12-05.
24. World Health Organization (2003). "Dilatation and curettage". Managing Complications in Pregnancy and Childbirth: A Guide for Midwives and Doctors. Geneva: World Health Organization. ISBN 978-92-4-154587-7. OCLC 181845530. {{cite book}}: |access-date= requires |url= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
25. McGee, Glenn. "Abortion". Encarta. Microsoft. Archived from the original on 2009-10-31. Retrieved 2008-12-05. {{cite encyclopedia}}: Unknown parameter |coauthors= ignored (|author= suggested) (help); Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
26. ^ Potts, M.; Graff, M.; Taing, J. (2007). "Thousand-year-old depictions of massage abortion". Journal of Family Planning and Reproductive Health Care. 33 (4): 233–234. doi:10.1783/147118907782101904. PMID 17925100.
27. Mould R (1996). Mould's Medical Anecdotes. CRC Press. p. 406. ISBN 978-0-85274-119-1.
28. Riddle, John M. (1997). Eve's herbs: a history of contraception and abortion in the West. Cambridge, Massachusetts: Harvard University Press. ISBN 978-0-674-27024-4. OCLC 36126503.
29. Ciganda C, Laborde A (2003). "Herbal infusions used for induced abortion". J. Toxicol. Clin. Toxicol. 41 (3): 235–239. doi:10.1081/CLT-120021104. PMID 12807304.
30. Attention: This template ({{cite doi}}) is deprecated. To cite the publication identified by doi:10.1016/S0891-5245(98)90245-0, please use {{cite journal}} (if it was published in a bona fide academic journal, otherwise {{cite report}} with |doi=10.1016/S0891-5245(98)90245-0 instead.
31. Thapa, S. R.; Rimal, D.; Preston, J. (2006). "Self induction of abortion with instrumentation". Australian Family Physician. 35 (9): 697–698. PMID 16969439.
32. "The Prevention and Management of Unsafe Abortion" (PDF). World Health Organization. April 1995. Retrieved June 1, 2010.
33. Grimes, DA; Creinin, MD (2004). "Induced abortion: an overview for internists". Ann. Intern. Med. 140 (8): 620–6. doi:10.1001/archinte.140.5.620. PMID 15096333.
34. Grimes DA (2006). "Estimation of pregnancy-related mortality risk by pregnancy outcome, United States, 1991 to 1999". Am. J. Obstet. Gynecol. 194 (1): 92–4. doi:10.1016/j.ajog.2005.06.070. PMID 16389015. {{cite journal}}: Unknown parameter |month= ignored (help)
35. Bartlett LA; Berg CJ; Shulman HB; et al. (2004). "Risk factors for legal induced abortion-related mortality in the United States". Obstet Gynecol. 103 (4): 729–37. doi:10.1097/01.AOG.0000116260.81570.60. PMID 15051566. {{cite journal}}: Unknown parameter |author-separator= ignored (help); Unknown parameter |month= ignored (help)
36. Trupin, Suzanne (May 27, 2010). "Elective Abortion". eMedicine. Retrieved June 1, 2010. At every gestational age, elective abortion is safer for the mother than carrying a pregnancy to term.
37. Westfall JM, Sophocles A, Burggraf H, Ellis S (1998). "Manual vacuum aspiration for first-trimester abortion". Arch Fam Med. 7 (6): 559–62. doi:10.1001/archfami.7.6.559. PMID 9821831.{{cite journal}}: CS1 maint: multiple names: authors list (link)
38. ACOG Committee on Practice Bulletins--Gynecology (2009). "ACOG practice bulletin No. 104: antibiotic prophylaxis for gynecologic procedures". Obstet Gynecol. 113 (5): 1180–9. doi:10.1097/AOG.0b013e3181a6d011. PMID 19384149. {{cite journal}}: Unknown parameter |month= ignored (help)
39. Sawaya GF, Grady D, Kerlikowske K, Grimes DA (1996). "Antibiotics at the time of induced abortion: the case for universal prophylaxis based on a meta-analysis". Obstet Gynecol. 87 (5 Pt 2): 884–90. PMID 8677129. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
40. Lohr PA, Hayes JL, Gemzell-Danielsson K (2008). Lohr, Patricia A. (ed.). "Surgical versus medical methods for second trimester induced abortion". Cochrane Database Syst Rev (1): CD006714. doi:10.1002/14651858.CD006714.pub2. PMID 18254113.{{cite journal}}: CS1 maint: multiple names: authors list (link)
41. ^ Spitz IM, Bardin CW, Benton L, Robbins A (1998). "Early pregnancy termination with mifepristone and misoprostol in the United States". N. Engl. J. Med. 338 (18): 1241–7. doi:10.1056/NEJM199804303381801. PMID 9562577. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
42. Aubény E; Peyron R; Turpin CL; et al. (1995). "Termination of early pregnancy (up to 63 days of amenorrhea) with mifepristone and increasing doses of misoprostol ". Int J Fertil Menopausal Stud. 40 Suppl 2: 85–91. PMID 8574255. {{cite journal}}: Unknown parameter |author-separator= ignored (help)
43. "Medical versus surgical methods for first trimester termination of pregnancy". World Health Organization. December 15, 2006. Retrieved June 1, 2010.
44. Haddad, LB.; Nour, NM. (2009). "Unsafe abortion: unnecessary maternal mortality". Rev Obstet Gynecol. 2 (2): 122–6. PMC 2709326. PMID 19609407.
45. ^ Berer M (2000). "Making abortions safe: a matter of good public health policy and practice". Bull. World Health Organ. 78 (5): 580–92. PMC 2560758. PMID 10859852.
46. Okonofua, F. (2006). "Abortion and maternal mortality in the developing world" (PDF). Journal of Obstetrics and Gynaecology Canada. 28 (11): 974–979. PMID 17169222.
47. ^ Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH (2007). "Induced abortion: estimated rates and trends worldwide". Lancet. 370 (9595): 1338–45. doi:10.1016/S0140-6736(07)61575-X. PMID 17933648.{{cite journal}}: CS1 maint: multiple names: authors list (link)
48. ^ "Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2003" (PDF). World Health Organization. 2007. Retrieved March 7, 2011.
49. Berer M (2004). "National laws and unsafe abortion: the parameters of change". Reprod Health Matters. 12 (24 Suppl): 1–8. doi:10.1016/S0968-8080(04)24024-1. PMID 15938152. {{cite journal}}: Unknown parameter |month= ignored (help)
50. Jewkes R, Rees H, Dickson K, Brown H, Levin J (2005). "The impact of age on the epidemiology of incomplete abortions in South Africa after legislative change". BJOG. 112 (3): 355–9. doi:10.1111/j.1471-0528.2004.00422.x. PMID 15713153. {{cite journal}}: Unknown parameter |month= ignored (help)CS1 maint: multiple names: authors list (link)
51. Bateman C (2007). "Maternal mortalities 90% down as legal TOPs more than triple". S. Afr. Med. J. 97 (12): 1238–42. PMID 18264602. {{cite journal}}: Unknown parameter |month= ignored (help)
52. Singh, Susheela et al. Adding it Up: The Costs and Benefits of Investing in Family Planning and Newborn Health (New York: Guttmacher Institute and United Nations Population Fund 2009): "If women’s contraceptive needs were addressed (and assuming no changes in abortion laws)...the number of unsafe abortions would decline by 73% from 20 million to 5.5 million." A few of the findings in that report were subsequently changed, and are available at: "Facts on Investing in Family Planning and Maternal and Newborn Health" (Guttmacher Institute 2010).
53. ^ Boland, R.; Katzive, L. (2008). "Developments in Laws on Induced Abortion: 1998–2007". International Family Planning Perspectives. 34 (3): 110–120. doi:10.1363/ifpp.34.110.08. PMID 18957353.
54. Maclean, Gaynor (2005). "XI. Dimension, Dynamics and Diversity: A 3D Approach to Appraising Global Maternal and Neonatal Health Initiatives". In Balin, Randell E. (ed.). Trends in Midwifery Research. Nova Publishers. pp. 299–300. ISBN 9781594544774.
55. Salter, C., Johnson, H.B., and Hengen, N. (1997). "Care for Postabortion Complications: Saving Women's Lives". Population Reports. 25 (1). Johns Hopkins School of Public Health. Archived from the original on September 1, 2011.{{cite journal}}: CS1 maint: multiple names: authors list (link)
56. UNICEF, United Nations Population Fund, WHO, World Bank (2010). "Packages of interventions: Family planning, safe abortion care, maternal, newborn and child health". Retrieved December 31, 2010.{{cite web}}: CS1 maint: multiple names: authors list (link)
57. ^ Jasen P (2005). "Breast cancer and the politics of abortion in the United States". Medical History. 49 (4): 423–44. PMC 1251638. PMID 16562329.
58. • World Health Organization: "Induced abortion does not increase breast cancer risk (Fact sheet N°240)". World Health Organization. Archived from the original on February 13, 2011. Retrieved January 6, 2011.
    • National Cancer Institute: "Abortion, Miscarriage, and Breast Cancer Risk". National Cancer Institute. Retrieved January 11, 2011.
    • American Cancer Society: "Is Abortion Linked to Breast Cancer?". American Cancer Society. September 23, 2010. Retrieved June 20, 2011. At this time, the scientific evidence does not support the notion that abortion of any kind raises the risk of breast cancer.
    • Royal College of Obstetricians and Gynaecologists: "The Care of Women Requesting Induced Abortion" (PDF). Royal College of Obstetricians and Gynaecologists. p. 9. Retrieved June 29, 2008. Induced abortion is not associated with an increase in breast cancer risk.
    • American Congress of Obstetricians and Gynecologists: "ACOG Finds No Link Between Abortion and Breast Cancer Risk". American Congress of Obstetricians and Gynecologists. July 31, 2003. Retrieved January 11, 2011.
59. Cockburn, Jayne; Pawson, Michael E. (2007). Psychological Challenges to Obstetrics and Gynecology: The Clinical Management. Springer. p. 243. ISBN 978-1-84628-807-4.
60. Adler, NE; David, HP; Major, BN; Roth, SH; Russo, NF; Wyatt, GE (1990). "Psychological responses after abortion". Science. 248 (4951): 41–4. doi:10.1126/science.2181664. PMID 2181664.
61. "APA Task Force Finds Single Abortion Not a Threat to Women's Mental Health" (Press release). American Psychological Association. August 12, 2008. Retrieved September 7, 2011.
62. "Report of the APA Task Force on Mental Health and Abortion" (PDF). Washington, DC: American Psychological Association. August 13, 2008.
63. Steinberg, J. R. (2011). "Later Abortions and Mental Health: Psychological Experiences of Women Having Later Abortions—A Critical Review of Research". Women's Health Issues. 21 (3): S44–S48. doi:10.1016/j.whi.2011.02.002. PMID 21530839.
64. • Grimes, DA; Creinin, MD (2004). "Induced abortion: an overview for internists". Ann Intern Med. 140 (8): 620–6. doi:10.1001/archinte.140.5.620. PMID 15096333. 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.
    • Stotland, NL (2003). "Abortion and psychiatric practice". J Psychiatr Pract. 9 (2): 139–149. doi:10.1097/00131746-200303000-00005. PMID 15985924. Currently, there are active attempts to c(onvince 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.
    • Stotland NL (1992). "The myth of the abortion trauma syndrome". J Am Med Assoc. 268 (15): 2078–9. doi:10.1001/jama.268.15.2078. PMID 1404747. {{cite journal}}: Unknown parameter |month= ignored (help)
65. Shah I, Ahman E (2009). "Unsafe abortion: global and regional incidence, trends, consequences, and challenges". J Obstet Gynaecol Can. 31 (12): 1149–58. PMID 20085681. However, a woman's chance of having an abortion is similar whether she lives in a developed or a developing region: in 2003 the rates were 26 abortions per 1000 women aged 15 to 44 in developed areas and 29 per 1000 in developing areas. The main difference is in safety, with abortion being safe and easily accessible in developed countries and generally restricted and unsafe in most developing countries {{cite journal}}: Unknown parameter |month= ignored (help)
66. Rosenthal, Elizabeth (October 12, 2007). "Legal or Not, Abortion Rates Compare". The New York Times. Retrieved July 18, 2011.
67. "Facts on Investing in Family Planning and Maternal and Newborn Health" (PDF). Guttmacher Institute. November 2010. Retrieved October 24, 2011.
68. Sedgh, G.; Singh, S.; Henshaw, S. K.; Bankole, A. (2011). "Legal Abortion Worldwide in 2008: Levels and Recent Trends". Perspectives on Sexual and Reproductive Health. 43 (3): 188–198. doi:10.1363/4318811. PMID 21884387.
69. Strauss, L. T.; Gamble, S. B.; Parker, W. Y.; Cook, D. A.; Zane, S. B.; Hamdan, S.; Centers for Disease Control Prevention (2006). "Abortion surveillance—United States, 2003". Morbidity and Mortality Weekly Report Surveillance Summaries. 55 (SS11): 1–32. PMID 17119534.
70. ^ "The Limitations of U.S. Statistics on Abortion". Issues in Brief. New York: The Guttmacher Institute. 1997.
71. Finer, L. B.; Henshaw, S. K. (2003). "Abortion Incidence and Services in the United States in 2000". Perspectives on Sexual and Reproductive Health. 35 (1): 6–15. doi:10.1363/3500603. PMID 12602752.
72. Department of Health (2007). "Abortion statistics, England and Wales: 2006". Retrieved 2007-10-12.
73. Cheng L. “Surgical versus medical methods for second-trimester induced abortion : RHL commentary” (last revised: November 1, 2008). The WHO Reproductive Health Library; Geneva: World Health Organization.
74. ^ Bankole, Akinrinola, Singh, Susheela, and Haas, Taylor. (1998). Reasons Why Women Have Induced Abortions: Evidence from 27 Countries. International Family Planning Perspectives, 24 (3), 117–127 and 152. Retrieved 2006-01-18.
75. ^ Finer, Lawrence B., Frohwirth, Lori F., Dauphinee, Lindsay A., Singh, Shusheela, and Moore, Ann M. (2005). Reasons U.S. women have abortions: quantative and qualitative perspectives. Perspectives on Sexual and Reproductive Health, 37 (3), 110–118. Retrieved 2006-01-18.
76. Jones, R. K.; Darroch, J. E.; Henshaw, S. K. (2002). "Contraceptive Use Among U.S. Women Having Abortions in 2000-2001" (PDF). Perspectives on Sexual and Reproductive Health. 34 (6): 294–303. doi:10.2307/3097748. PMID 12558092.
77. Susan A. Cohen: Abortion and Women of Color: The Bigger Picture, Guttmacher Policy Review, Summer 2008, Volume 11, Number 3.
78. ^ Joffe, Carole (2009). "1. Abortion and medicine: A sociopolitical history". Management of Unintended and Abnormal Pregnancy (1st ed.). Oxford, United Kingdom: John Wiley & Sons, Ltd. ISBN 9781444312935. Archived from the original (PDF) on October 21, 2011. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help); Unknown parameter |editors= ignored (|editor= suggested) (help)
79. Miles, Steven (2005). The Hippocratic Oath and the Ethics of Medicine. Oxford University Press. ISBN 978-0195188202.
80. Brind'Amour, Katherine (2007). "Effraenatam". Embryo Project Encyclopedia. Arizona State University.
81. http://www.bbc.co.uk/religion/religions/islam/islamethics/abortion_1.shtml
82. Dabash, Rasha; Roudi-Fahimi, Farzaneh (2008). "Abortion in the Middle East and North Africa" (PDF). Population Research Bureau (PDF). {{cite web}}: Check |archiveurl= value (help); Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
83. "Abortion Law, History & Religion". Childbirth By Choice Trust. Archived from the original on 2008-02-08. Retrieved 2008-03-23.
84. • Friedlander, Henry (1995). The origins of Nazi genocide: from euthanasia to the final solution. Chapel Hill: University of North Carolina Press. p. 30. ISBN 978-0-8078-4675-9. OCLC 60191622.
    • Proctor, Robert (1988). Racial Hygiene: Medicine Under the Nazis. Cambridge, Massachusetts: Harvard University Press. pp. 122, 123 and 366. ISBN 978-0-674-74578-0. OCLC 20760638.
    • Arnot, Margaret L. (1999). Gender and Crime in Modern Europe. New York: Routledge. p. 231. ISBN 978-1-85728-745-5. OCLC 186748539. {{cite book}}: Unknown parameter |coauthors= ignored (|author= suggested) (help)
    • DiMeglio, Peter M. (1999). "Germany 1933–1945 (National Socialism)". In Helen Tierney (ed.). Women's studies encyclopedia. Westport, Connecticut: Greenwood Press. p. 589. ISBN 978-0-313-31072-0. OCLC 38504469.
85. Theodore J. Joyce, Stanley K. Henshaw, Amanda Dennis, Lawrence B. Finer and Kelly Blanchard (April 2009). "The Impact of State Mandatory Counseling and Waiting Period Laws on Abortion: A Literature Review". Guttmacher Institute. Archived from the original (PDF) on 2011-01-14. Retrieved December 31, 2010. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)CS1 maint: multiple names: authors list (link)
86. "European delegation visits Nicaragua to examine effects of abortion ban". Ipas. November 26, 2007. Archived from the original on 2008-04-17. Retrieved 2009-06-15. 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.
87. "Nicaragua: "The Women's Movement Is in Opposition"". Montevideo: Inside Costa Rica. IPS. June 28, 2008.
88. "Surgical Abortion: History and Overview". National Abortion Federation. Retrieved 2006-09-04.
89. Attention: This template ({{cite jstor}}) is deprecated. To cite the publication identified by jstor:2135775, please use {{cite journal}} with |jstor=2135775 instead.
90. Marcy Bloom (February 25, 2008). "Need Abortion, Will Travel". RH Reality Check. Retrieved 2009-06-15.
91. Ross, Jen (September 12, 2006). "In Chile, free morning-after pills to teens". The Christian Science Monitor. Retrieved 2006-12-07.
92. Gallardoi, Eduardo (September 26, 2006). "Morning-After Pill Causes Furor in Chile". The Washington Post. Retrieved 2006-12-07.
93. Banister, Judith. (1999-03-16). Son Preference in Asia – Report of a Symposium. Retrieved 2006-01-12.
94. Graham, Maureen J.; Larsen; Xu (1998). "Son Preference in Anhui Province, China". International Family Planning Perspectives. 24 (2): 72–77. doi:10.2307/2991929. Archived from the original on October 21, 2011. {{cite journal}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help); Unknown parameter |month= ignored (help)
95. Reaney, Patricia. "Selective abortion blamed for India's missing girls". Reuters. Archived from the original on 2006-02-20. Retrieved 2008-12-03.
96. Sudha, S.; Rajan, S. Irudaya (1999). "Female Demographic Disadvantage in India 1981–1991: Sex Selective Abortions and Female Infanticide". Development and Change. 30 (3): 585–618. doi:10.1111/1467-7660.00130. PMID 20162850. Archived from the original on 2003-01-01. Retrieved 2008-12-03. {{cite journal}}: Unknown parameter |month= ignored (help)
97. "Sex Selection & Abortion: India". Library of Congress. April 4, 2011. Retrieved July 18, 2011.
98. "China Bans Sex-selection Abortion." (2002-03-22). Xinhua News Agency.'.' Retrieved 2006-01-12.
99. Smith, G. Davidson (Tim) (1998). "Single Issue Terrorism Commentary". Canadian Security Intelligence Service. Archived from the original on October 15, 2007. Retrieved September 1, 2011. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
100. Wilson, M.; Lynxwiler, J. (1988). "Abortion clinic violence as terrorism". Studies in Conflict & Terrorism. 11 (4): 263–273. doi:10.1080/10576108808435717.
101. "The Death of Dr. Gunn". New York Times. March 12, 1993.
102. "Incidence of Violence & Disruption Against Abortion Providers in the U.S. & Canada" (PDF). National Abortion Federation. 2009. Retrieved February 9, 2010.
103. Borger, Julian (February 3, 1999). "The bomber under siege". The Guardian. London.
104. "Art theft linked to pro-life drive Abortion foe hints painting's return hinges on TV film". thestar.com. 1994-02-18. Retrieved 2010-09-25.
105. "Principally relating to Xiao Yu's work Ruan". Other Shore Artfile. Retrieved 2010-06-27.
106. Soupcoff, Marni (2008-04-17). "Marni Soupcoff's Zeitgeist: Photofiddle, Rentbetter.org, Mandie Brady and Aliza Shvarts". Full Comment. National Post. Retrieved 2008-04-30.
107. John Irving (1985). The Cider House Rules. New York: William Morrow. ISBN 978-0-688-03036-0.
108. Marge Piercy (1997). Braided Lives. New York: Ballantine Books. ISBN 978-0-449-00091-5.
109. Susan Wicklund (2007). This Common Secret: My Journey as an Abortion Doctor. New York: PublicAffairs. ISBN 978-1-58648-480-4.
110. Irene Vilar (2009). Impossible Motherhood: Testimony of an Abortion Addict. Other Press. ISBN 978-1-59051-320-0.
111. Finch, Annie (2010). Among the Goddesses. California: Red Hen Press. ISBN 978-1-59709-161-9.
112. "The Godfather: Part II (1974) – Memorable quotes". imdb.com. Retrieved 2010-07-01.
113. "films that discuss Abortion . . . a movie list". movietrain.net. Retrieved 2010-06-13.
114. Wyatt, Edward (October 22, 2009). "NBC's 'Law & Order' to Take on Abortion Issue". New York Times. Archived from the original on July 26, 2011. Retrieved July 26, 2011. {{cite news}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
115. Spencer, James (1911). Sheep Husbandry in Canada. p. 124.
116. "Beef cattle and Beef production: Management and Husbandry of Beef Cattle". Encyclopaedia of New Zealand. 1966.
117. McKinnon, Angus O.; Voss, James L. (1993). Equine Reproduction. Wiley-Blackwell. p. 563. ISBN 0812114272.
118. Berger, Joel W; Vuletić, L; Boberić, J; Milosavljević, A; Dilparić, S; Tomin, R; Naumović, P (May 5, 1983). "Induced abortion and social factors in wild horses". Nature. 303 (5912): 59–61. doi:10.1038/303059a0. PMID 7 668248 7. {{cite journal}}: Check |pmid= value (help)
119. Pluháček, Jan; Bartos, L (2000). "Male infanticide in captive plains zebra, Equus burchelli" (PDF). Animal Behaviour. 59 (4): 689–694. doi:10.1006/anbe.1999.1371. PMID 10792924.
120. Pluháček, Jan (2005). "Further evidence for male infanticide and feticide in captive plains zebra, Equus burchelli" (PDF). Folia Zool. 54 (3): 258–262.
121. Kirkpatrick, J. F.; Turner, J. W. (1991). "Changes in Herd Stallions among Feral Horse Bands and the Absence of Forced Copulation and Induced Abortion". Behavioral Ecology and Sociobiology. 29 (3): 217–219. doi:10.1007/BF00166404. JSTOR 4600608.
122. Agoramoorthy, G.; Mohnot, S. M.; Sommer, V.; Srivastava, A. (1988). "Abortions in free ranging Hanuman langurs (Presbytis entellus) — a male induced strategy?". Human Evolution. 3 (4): 297–308. doi:10.1007/BF02435859.

Notes

1. The definition of abortion, as with many words, varies from source to source. The following is a partial list of definitions as stated by obstetrics and gynecology (OB/GYN) textbooks, dictionaries, and other encyclopedias:

   Major OB/GYN textbooks

   • The National Center for Health Statistics defines an "abortus" as " fetus or embryo removed or expelled from the uterus during the first half of gestation—20 weeks or less, or in the absence of accurate dating criteria, born weighing < 500 g." They also define "birth" as "he complete expulsion or extraction from the mother of a fetus after 20 weeks' gestation. in the absence of accurate dating criteria, fetuses weighing <500 g are usually not considered as births, but rather are termed abortuses for purposes of vital statistics." Cunningham, FG; Leveno, KJ; Bloom, SL; Hauth, JC; Rouse, DJ; Spong, CY, eds. (2010). "1. Overview of Obstetrics". Williams Obstetrics (23 ed.). McGraw-Hill Medical. ISBN 978-0-07-149701-5.
   • "he standard medical definition of abortion termination of a pregnancy when the fetus is not viable". Annas, George J.; Elias, Sherman (2007). "51. Legal and Ethical Issues in Obstetric Practice". In Gabbe, Steven G.; Niebyl, Jennifer R.; Simpson, Joe Leigh (eds.). Obstetrics: Normal and Problem Pregnancies (5 ed.). Churchill Livingstone. ISBN 978-0-443-06930-7.
   • "Termination of a pregnancy, whether spontaneous or induced." Kottke, Melissa J.; Zieman, Mimi (2008). "33. Management of Abortion". In Rock, John A.; Jones III, Howard W. (eds.). TeLinde's Operative Gynecology (10 ed.). Lippincott Williams & Wilkins. ISBN 978-0-7817-7234-1.

   Other OB/GYN textbooks

   • "Termination of pregnancy before 20 weeks' gestation calculated from date of onset of last menses. An alternative definition is delivery of a fetus with a weight of less than 500 g. If abortion occurs before 12 weeks' gestation, it is called early; from 12 to 20 weeks it is called late." Katz, Vern L. (2007). "16. Spontaneous and Recurrent Abortion - Etiology, Diagnosis, Treatment". In Katz, Vern L.; Lentz, Gretchen M.; Lobo, Rogerio A.; Gershenson, David M. (eds.). Katz: Comprehensive Gynecology (5 ed.). Mosby. ISBN 9780323029513.
   • "Abortion is the spontaneous or induced termination of pregnancy before fetal viability. Because popular use of the word abortion implies a deliberate pregnancy termination, some prefer the word miscarriage to refer to spontaneous fetal loss before viability The National Center for Health Statistics, the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO) define abortion as pregnancy termination prior to 20 weeks' gestation or a fetus born weighing less than 500 g. Despite this, definitions vary widely according to state laws." Schorge, John O.; Schaffer, Joseph I.; Halvorson, Lisa M.; Hoffman, Barbara L.; Bradshaw, Karen D.; Cunningham, F. Gary, eds. (2008). "6. First-Trimester Abortion". Williams Gynecology (1 ed.). McGraw-Hill Medical. ISBN 978-0-07-147257-9.

   Major medical dictionaries

   • "The spontaneous or induced termination of pregnancy before the fetus reaches a viable age." "Taber's Medical Dictionary: abortion". Taber's Cyclopedic Medical Dictionary. F.A. Davis. Archived from the original on June 14, 2011. Retrieved June 14, 2011. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
   • "Expulsion from the uterus an embryo or fetus prior to the stage of viability (20 weeks' gestation or fetal weight <500g). A distinction made between and premature birth: premature infants are those born after the stage of viability but prior to 37 weeks." Stedman's Medical Dictionary (27 ed.). Lippincott Williams & Wilkins. ISBN 0683400088.
   • "remature expulsion from the uterus of the products of conception, either the embryo or a nonviable fetus." Dorland's Illustrated Medical Dictionary (31 ed.). Saunders. 2007. ISBN 9781416023647.

   Other medical dictionaries

   • "he termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus". "Medical Dictionary". Merriam-Webster's Medical Dictionary. Springfield, Mass.: Merriam-Webster. Archived from the original on June 15, 2011. Retrieved June 15, 2011.
   • "Induced termination of pregnancy, involving destruction of the embryo or fetus." "abortion." The American Heritage Science Dictionary. Boston: Houghton Mifflin. 2005. ISBN 9780618455041.
   • "Interruption of pregnancy before the fetus has attained a stage of viability, usually before the 24th gestational week." "abortion." Cambridge Dictionary of Human Biology and Evolution. Cambridge; New York: Cambridge University Press. 2005. OCLC 54374716.
   • " spontaneous or deliberate ending of pregnancy before the fetus can be expected to survive." "abortion." Mosby's Emergency Dictionary. Philadelphia: Elsevier Health Sciences. 1998. OCLC 37553784.
   • " situation where a fetus leaves the uterus before it is fully developed, especially during the first 28 weeks of pregnancy, or a procedure which causes this to happen...o have an abortion to have an operation to make a fetus leave the uterus during the first period of pregnancy." ""abortion"". Dictionary of Medical Terms. London: A & C Black. 2005. OCLC 55634250.
   • "1. Induced termination of a pregnancy with destruction of the fetus or embryo; therapeutic abortion. 2. Spontaneous abortion." The American Heritage Medical Dictionary (reprint ed.). Houghton Mifflin. 2008. p. 2. ISBN 0618947256. OCLC 608212441.
   • ”Although the term abortion is generic and implies a premature termination of pregnancy for any reason, the lay public better understands the word ‘miscarriage’ for involuntary fetal loss or fetal wastage.” The Dictionary of Modern Medicine. Parthenon Publishing. 1992. p. 3. ISBN 1850703213.
   • ”The termination of pregnancy or premature expulsion of the products of conception by any means, usually before fetal viability.” Churchill’s Medical Dictionary. Churchill Livingstone. 1989. p. 3. ISBN 0443086915.

   Major English dictionaries (general-purpose)

   • "1. a. The expulsion or removal from the womb of a developing embryo or fetus, spec. (Med.) in the period before it is capable of independent survival, occurring as a result either of natural causes (more fully spontaneous abortion) or of a deliberate act (more fully induced abortion); the early or premature termination of pregnancy with loss of the fetus; an instance of this." "abortion, n.". Oxford English Dictionary (Third ed.). Oxford University Press. September 2009; online version September 2011. {{cite book}}: Check date values in: |date= (help); External link in |chapterurl= (help); Unknown parameter |chapterurl= ignored (|chapter-url= suggested) (help)
   • "n operation or other procedure to terminate pregnancy before the fetus is viable" or "he premature termination of pregnancy by spontaneous or induced expulsion of a nonviable fetus from the uterus". "abortion". Collins English Dictionary - Complete & Unabridged 10th Edition. HarperCollins Publishers. Retrieved June 27, 2011.
   • "he removal of an embryo or fetus from the uterus in order to end a pregnancy" or "ny of various surgical methods for terminating a pregnancy, especially during the first six months." "abortion". Dictionary.com Unabridged. Random House, Inc. June 27, 2011.
   • "he termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus: as (a) spontaneous expulsion of a human fetus during the first 12 weeks of gestation (b) induced expulsion of a human fetus (c) expulsion of a fetus by a domestic animal often due to infection at any time before completion of pregnancy." Merriam-Webster Dictionary, from Merriam-Webster, an Encyclopedia Brittanica Company.
   • "1. medicine the removal of an embryo or fetus from the uterus before it is sufficiently developed to survive independently, deliberately induced by the use of drugs or by surgical procedures. Also called termination or induced abortion. 2. medicine the spontaneous expulsion of an embryo or fetus from the uterus before it is sufficiently developed to survive independently. Also called miscarriage, spontaneous abortion." Chambers 21st Century Dictionary. London: Chambers Harrap, 2001.
   • "a medical operation to end a pregnancy so that the baby is not born alive". Longman Dictionary of Contemporary English, online edition.

   Other dictionaries

   • "The deliberate termination of a pregnancy, usually before the embryo or fetus is capable of independent life." The American Heritage New Dictionary of Cultural Literacy (3rd ed.). Houghton Mifflin Company. 2005.
   • "A term that, in philosophy, theology, and social debates, often means the deliberate termination of pregnancy before the fetus is able to survive outside the uterus. However, participants in these debates sometimes use the term abortion simply to mean the termination of pregnancy before birth, regardless of whether the fetus is viable or not." "abortion." Dictionary of World Philosophy. London: Routledge, 2001.
   • "1. An artificially induced termination of a pregnancy for the purpose of destroying an embryo or fetus. 2. The spontaneous expulsion of an embryo or fetus before viability;" Garner, Bryan A. (2009). Black's Law Dictionary (9th ed.). Thomson West. ISBN 9780314199492. {{cite book}}: Unknown parameter |month= ignored (help)

   Encyclopedias

   • "he expulsion of a fetus from the uterus before it has reached the stage of viability (in human beings, usually about the 20th week of gestation)." "Abortion (pregnancy)". Encyclopædia Britannica Online. Encyclopædia Britannica. 2011. Archived from the original on June 26, 2011. Retrieved June 26, 2011. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
   • "Expulsion of the products of conception before the embryo or fetus is viable. Any interruption of human pregnancy prior to the 28th week is known as abortion." "Abortion". The Columbia Encyclopedia. New York: Columbia University Press. 2008.
   • "The expulsion or removal of a fetus from the womb before it is capable of independent survival." "Abortion". World Encyclopedia. Oxford University Press. 2008. {{cite encyclopedia}}: |work= ignored (help)
   • " is commonly misunderstood outside medical circles. In general terms, the word 'abortion' simply means the failure of something to reach fulfilment or maturity. Medically, abortion means loss of the fetus, for any reason, before it is able to survive outside the womb. The term covers accidental or spontaneous ending, or miscarriage, of pregnancy as well as deliberate termination. The terms 'spontaneous abortion' and 'miscarriage' are synonymous and are defined as loss of the fetus before the twenty-eighth week of pregnancy. This definition implies a legal perception of the age at which a fetus can survive out of the womb. With great advances in recent years in the ability to keep very premature babies alive, this definition is in need of revision." "Abortion and miscarriage". The Royal Society of Medicine Health Encyclopedia. London: Bloomsbury Publishing. 2000.
   • "Abortion is the intentional removal of a fetus or an embryo from a mother's womb for purposes other than that of either producing a live birth or disposing of a dead embryo." "Abortion". Encyclopedia of Human Rights Issues since 1945 (1 ed.). Santa Barbara, California: Routledge. 1999. ISBN 978-1579581664.
2. Note that the defining line between miscarriage and premature birth or stillbirth varies among jurisdictions. "Documenting Stillbirth (Fetal Death)". United States Department of State. February 18, 2011. Archived from the original (PDF) on June 27, 2011. Retrieved June 27, 2011.
3. For example of such studies and why researchers have criticized them, see:
   • Charles, V. E.; Polis, C. B.; Sridhara, S. K.; Blum, R. W. (2008). "Abortion and long-term mental health outcomes: A systematic review of the evidence" (PDF). Contraception. 78 (6): 436–450. doi:10.1016/j.contraception.2008.07.005. PMID 19014789.
   • Munk-Olsen, T.; Laursen, T. M.; Pedersen, C. B.; Lidegaard, Ø.; Mortensen, P. B. (2011). "Induced First-Trimester Abortion and Risk of Mental Disorder". New England Journal of Medicine. 364 (4): 332–339. doi:10.1056/NEJMoa0905882. PMID 21268725.
   • "RCOG statement on BJPsych paper on mental health risks and abortion". Royal College of Obstetricians and Gynaecologists. September 1, 2011. Retrieved September 6, 2011. {{cite web}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
4. By 1930, medical procedures in the US had improved for both childbirth and abortion but not equally, and induced abortion in the first trimester had become safer than childbirth. In 1973, Roe vs. Wade acknowledged that abortion in the first trimester was safer than childbirth:
   • "The 1970s". Time communication 1940–1989: retrospective. Time, Inc. 1989. Blackmun was also swayed by the fact that most abortion prohibitions were enacted in the 19th century when the procedure was more dangerous than now.
   • Will, George (1990). Suddenly: the American idea abroad and at home, 1986–1990. Free Press. p. 312. ISBN 0029344352.
   • Lewis, J.; Shimabukuro, Jon O. (January 28, 2001). "Abortion Law Development: A Brief Overview". Congressional Research Service. Retrieved May 1, 2011.
     *Schultz, David Andrew (2002). Encyclopedia of American law. Infobase Publishing. p. 1. ISBN 0816043299.
   • Lahey, Joanna N. (September 24, 2009). "Birthing a Nation: Fertility Control Access and the 19th Century Demographic Transition" (PDF; preliminary version). Colloquium. Pomona College.

External links

• Template:Dmoz
• Abortion Policies: A Global Review, published by the United Nations

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• Abortion
• Reproduction
• Core issues in ethics
• Gynaecology
• Pregnancy
• Obstetrics
• Gender studies
• Fertility