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As the ] grows, other techniques must be used to induce abortion in the third ]. Premature delivery of the human fetus can be induced with ]; this can be coupled with injecting the ] with caustic solutions containing ] or ]. Very late abortions can be brought about by the controversial ] (intact D & X) which requires the surgical decompression of the fetus's head before evacuation and is controversially termed "]". A ], similar to a ] but ending with a dead fetus, can also be used at late stages of pregnancy. As the ] grows, other techniques must be used to induce abortion in the third ]. Premature delivery of the human fetus can be induced with ]; this can be coupled with injecting the ] with caustic solutions containing ] or ]. Very late abortions can be brought about by the controversial ] (intact D & X) which requires the surgical decompression of the fetus's head before evacuation and is controversially termed "]". A ], similar to a ] but ending with a dead fetus, can also be used at late stages of pregnancy.


===Alternatives that cannot be recommended===
===Herbal abortifacients===


Although herbs can be used as ]s, this method can be dangerous, often does not end the pregnancy, and is considered unsafe by the medical community. Many herbal recipes were compiled and published in ] times allegedly by ]. Although herbs can be used as ]s, this method can be dangerous, often does not end the pregnancy, and is considered unsafe by the medical community. Many herbal recipes were compiled and published in ] times allegedly by ].

===Trauma-induced abortion===


Subjecting the gravida's abdomen to physical abuse can also induce an abortion of sorts. However, the impact required to cause a miscarriage carries a serious risk of injury to the woman, a miscarriage often does not result, and there is potential criminal liability for anyone assisting. Subjecting the gravida's abdomen to physical abuse can also induce an abortion of sorts. However, the impact required to cause a miscarriage carries a serious risk of injury to the woman, a miscarriage often does not result, and there is potential criminal liability for anyone assisting.

Revision as of 07:27, 11 June 2005

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Abortion is the termination of a pregnancy associated with the death and expulsion of the embryo or fetus from the womb. When an abortion occurs naturally or accidentally it is called a miscarriage (spontaneous abortion), but if the development of the fetus or embryo is deliberately aborted it is an induced abortion. Abortion induced because the pregnancy poses a health risk to the gravida (pregnant woman) is known as therapeutic abortion, while abortion induced at the request of the gravida is known as elective abortion.

Methods of inducing abortion

Depending on the gestational age of the developing offspring, abortion can describe a number of different ways to destroy and remove the embryo or fetus from the womb.

Medical abortion

Chemical abortion is a method used to induce abortion by ingesting drugs, usually during the first nine weeks of pregnancy. Very soon after a sperm and ovum unite, the Morning-after pill can be taken as an abortifacient to prevent the resulting embryo from implanting in the uterus, thereby aborting any further development of the embryo. Further into the pregnancy chemical abortion is accomplished by administering either methotrexate or mifepristone (RU-486) followed by administration of misoprostol. Approximately eight percent of these abortions require surgical follow-up, usually by vacuum aspiration (See below). Methotrexate may also treat undiagnosed or concomitant tubal pregnancies, which occur in about two percent of all patients who desire to terminate their pregnancy. About 10 % of abortions in the United States and Europe are induced medically.

Surgical abortion

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

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

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

Alternatives that cannot be recommended

Although herbs can be used as abortifacients, this method can be dangerous, often does not end the pregnancy, and is considered unsafe by the medical community. Many herbal recipes were compiled and published in medieval times allegedly by Peter of Spain.

Subjecting the gravida's abdomen to physical abuse can also induce an abortion of sorts. However, the impact required to cause a miscarriage carries a serious risk of injury to the woman, a miscarriage often does not result, and there is potential criminal liability for anyone assisting.

Health risks

Complications

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

Physical health

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

Mental health

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

Abortion law

Main Article: abortion law

Abortion has been a controversial subject throughout history due to the moral and ethical issues that surround it.

Both Human rights and constitutional rights are major issues. A human right to self-determination, regardless of gender, is recognised by most countries, often in their constitution. A human right to life is recognized by all countries. 25 countries have officially recognized this right being from the moment of conception in the "American Convention on Human Rights", which the United States has signed, but not ratified.

Historically, some cultures have offered legal protection to unborn human offspring. Abortion has been banned and otherwise limited. Almost two thirds of the world's women currently reside in countries where abortion may be obtained for some reasons. Abortion laws vary widely by country, with some countries allowing nearly total liberalization (extreme examples being the United States and Russia), and others banning abortion under any circumstances. In the United States, the Supreme Court has held that state laws restricting abortion contradict an implied constitutional right of privacy, while the German Supreme Court struck down state laws legalizing abortion, holding that they contradict the constitution's human rights guarantees. There are also countries that do not have any laws restricting abortion, such as Canada (see Abortion in Canada).

Paternal rights

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

Abortion as a political issue

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

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

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

Even so, abortion access in the US has routinely been upheld in court decisions due to the concept of undue burden, in which a woman forced to bear an unwanted child is thought to suffer undue hardship, including health and financial concerns. A key case would be the US Supreme Court's decision in Planned Parenthood v. Casey, which established that the government cannot place an "undue burden" on a women's right to terminate a non-viable fetus. Many religous group oppose this, because it seems to them nothing less than murder.

In many other countries, abortion is less of a political issue. For a long time, it has not been a mainstream political issue in the United Kingdom. In the lead up to the 2005 General Election, Michael Howard, the leader of the Conservatives, stated that he, personally, might support a reduction in the limit from 24 weeks to 20 weeks, but the issue was not included in the party's manifesto for the election.

Debate on abortion

Main article: Morality and legality of abortion

Pro-choice-stance

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

Pro-life movement

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

Choice

There is one shared belief among both the pro-choice and pro-life movements that makes their debate possible despite the acrimony: many pregnant women feel pressure that makes abortion seem to be the only reasonable option given the lack of viable alternatives. While strongly opposing all abortion regardless of circumstances, pro-life groups have long offered extensive long-term financial, social and medical assistance to women facing a crisis pregnancy, and today pro-life-feminists lobby universities and other institutions to offer women reasonable options that don't force women to choose between continuing either their pregnancy or their career/education. Pro-choice groups strongly advocate wide availability of abortion, and continue to offer abortion as a choice that should be available for those who truly do not want to bear the child for a variety of reasons, often attributing the social pressure on women to economic and social policies that disadvantage women and do not alleviate all poverty.

"Rape, incest and health" debate

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

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

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

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

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

U.S. political parties

The official platforms of the major political parties in the US are as follows:

The US Republican Party's stance:

"Ban abortion with Constitutional amendment. We say the unborn child has a fundamental right to life. We support a human life amendment to the Constitution and we endorse legislation that the 14th Amendment’s protections apply to unborn children. Our purpose is to have legislative and judicial protection of that right against those who perform abortions. We oppose using public revenues for abortion and will not fund organizations which advocate it. We support the appointment of judges who respect the sanctity of innocent human life." (Source: Republican Platform adopted at GOP National Convention Aug 12, 2000)

"Alternatives like adoption, instead of punitive action. Our goal is to ensure that women with problem pregnancies have the kind of support, material and otherwise, they need for themselves and for their babies, not to be punitive towards those for whose difficult situation we have only compassion. We oppose abortion, but our pro-life agenda does not include punitive action against women who have an abortion. We salute those who provide alternatives to abortion and offer adoption services." (Source: Republican Platform adopted at GOP National Convention Aug 12, 2000)

The US Democratic Party's official statements:

"Support right to choose even if mother cannot pay. Because we believe in the privacy and equality of women, we stand proudly for a woman's right to choose, consistent with Roe v. Wade, and regardless of her ability to pay. We stand firmly against Republican efforts to undermine that right. At the same time, we strongly support family planning and adoption incentives. Abortion should be safe, legal, and rare." (Source: The Democratic Platform for America, p.36 Jul 10, 2004)

"Choice is a fundamental, constitutional right. Democrats stand behind the right of every woman to choose. We believe it is a constitutional liberty. This year’s Supreme Court ruling show us that eliminating a woman’s right to choose is only one justice away. Our goal is to make abortion more rare, not more dangerous. We support contraceptive research, family planning, comprehensive family life education, and policies that support healthy childbearing." (Source: Democratic National Platform Aug 15, 2000)

Feminism and abortion

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

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

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

Pro-life feminist groups continue to advance the views of the early feminists by rejecting the notion that abortion can ever be a right.

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

Related topics

External links

Pro-life links

Pro-choice links

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