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Abortion

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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. In medicine, all terminations of pregnancy not resulting in live birth are defined as abortions. In common parlance, the terms miscarriage or stillbirth are applied to spontaneous (non-induced) abortions. The ethics and morality of induced abortion has become the subject of an intense debate, especially in the United States. This article focuses on induced abortions.

Abortion definitions

  • Spontaneous abortion: An abortion due to accidental trauma or natural causes. Also known as a stillbirth or miscarriage.
  • Induced abortion: Deliberate (human induced) abortion. Induced abortions are subcatagorized into therapeutic abortion and elective abortion.
  • Therapeutic abortion: An abortion requested because the pregnancy poses health risk to the pregnant woman (gravida).
  • Elective abortion: An abortion requested for any other reason by the gravida.

Reasons for induced abortions

Women have many reasons to seek an abortion. Some use it as a form of birth control, others seek an abortion because they are victims of rape and still others because of their physical health. 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. Women from 27 nations reported the following reasons for seeking an induced abortion:

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

In many areas of the world, especially the developing nations or where induced abortions are illegal, many women choose or are forced to perform abortions on themselves. These self-induced abortions are commonly unsafe abortions as described by the World Health Organization. Furthermore, some abortions are induced because of societal or legal pressure, such as under China's one-child policy. These policies and societal pressures can lead to sex-selective abortion and infanticide, which is illegal in most countries, but difficult to stop.

Methods of inducing abortion

Depending on the gestational age of the developing embryo or fetus, different methods of abortion can be preformed to remove embryo or fetus from the womb.

Chemical abortion

Main article: Chemical abortion

Chemical abortion comprimising 10% of all abortions in the United States and Europe, is a method used to induce abortion by ingesting drugs, usually during the first nine weeks of pregnancy. The Morning-after pill must be taken very soon after the sperm and ovum fuse, forming a zygote, aborting any further development of the embryo by preventing from implanting in the uterus. 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.

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 the Electric 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.

Other means of abortion

Certain herbs are considered by some to be effective abortifacients. Using herbs in this way can cause serious side effects, including multiple organ failure and other serious injury, and are not recommended by physicians. Many herbal recipes were compiled and published in medieval times under the name of Peter of Spain.

Physical trauma to a pregnant woman's womb can cause an abortion. The severity of the impact required to cause an abortion carries high risk of injury to the pregnant woman, without necessarily inducing a miscarriage. Both accidental and deliberate abortions of this kind carry criminal liability in many countries.

Health risks

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. The risks of abortion should be counterpointed to the risks of childbirth.

Studies have found that in developed countries where abortion is legal, the risk of serious physical complications of an abortion is less than 1%. 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.

Other views

Early feminists took the view that abortion was a horrible tragedy, a disastrous crime, and a male-supported instrument to further power over women. Since then, the feminist movement has split into Pro-life feminists, while the majority of feminist groups are pro-choice. Further complicating the debate is the issue of paternal rights, involving what rights and responsibilities the father has regarding the unborn offspring in question.

Related topics

Sources

External links

Pro-life links

Pro-choice links

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