Abortion, the medical or surgical termination of a pregnancy, is one of the oldest, most common, and most controversial medical procedures. Research shows people who are denied abortions are more likely to experience higher levels of anxiety, lower life satisfaction, and lower self-esteem compared with those who are able to obtain abortions.
Key facts
- Abortion is a common health intervention. It is safe when carried out using a method recommended by WHO, appropriate to the pregnancy duration and by someone with the necessary skills.
- Six out of 10 of all unintended pregnancies end in an induced abortion.
- Around 45% of all abortions are unsafe, of which 97% take place in developing countries.
- Unsafe abortion is a leading – but preventable – cause of maternal deaths and morbidities. It can lead to physical and mental health complications and social and financial burdens for women, communities and health systems.
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Legal Framework:
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- Analysis of the legal status of abortion in different countries, ranging from restrictive to permissive laws.
- Exploration of landmark court cases and legislative developments that have shaped abortion laws
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- Discussion of the ethical debates surrounding abortion, including competing viewpoints on when personhood begins and the moral status of the fetus.
- Examination of ethical frameworks such as utilitarianism, deontology, and rights-based approaches applied to the abortion debate.
TYPES OF ABORTION
- Medication Abortion (Abortion Pill): Medication abortion, also known as the abortion pill or medical abortion, involves taking a combination of medications to terminate a pregnancy. Typically, this method is used within the first 10 weeks of pregnancy. The process involves taking two medications: mifepristone (RU-486) and misoprostol. Mifepristone is taken first to block the hormone progesterone, which is necessary for maintaining pregnancy. Misoprostol is then taken to cause contractions and expel the pregnancy from the uterus. Medication abortion is typically done under medical supervision, and follow-up care is necessary.
- Aspiration or Vacuum Aspiration: Aspiration abortion, also known as vacuum aspiration or suction abortion, is a common method used for terminating pregnancies in the first trimester (up to 12 weeks). The procedure involves dilating the cervix and using a suction device to remove the contents of the uterus. This is typically performed in a clinic or healthcare facility under local anesthesia or conscious sedation.
- Dilation and Curettage (D&C): Dilation and curettage, or D&C, is a surgical procedure that involves dilating the cervix and scraping the lining of the uterus to remove the pregnancy. It is commonly used in the first trimester or for cases of incomplete miscarriage. This procedure is performed in a hospital or clinic under general or regional anesthesia.
- Dilation and Evacuation (D&E): Dilation and evacuation, or D&E, is a surgical procedure used for terminating pregnancies in the second trimester (typically between 13 and 24 weeks). The cervix is dilated, and a combination of suction and surgical instruments is used to remove the pregnancy. This procedure is typically performed in a hospital or specialized clinic under general anesthesia.
- Induction Abortion: Induction abortion is a method used for terminating pregnancies in the second trimester (beyond 24 weeks). It involves the induction of labor using medications, such as misoprostol or oxytocin, to initiate contractions and deliver the fetus. This procedure is usually performed in a hospital under close medical supervision.
When an abortion can be carried out
The timing for when an abortion can be carried out depends on several factors, including legal regulations, medical guidelines, and individual circumstances. It is important to note that laws regarding abortion vary widely from country to country, and even within different regions of the same country. Additionally, medical guidelines and restrictions may differ based on the gestational age of the pregnancy and the specific healthcare provider’s policies.
In general, here are some common guidelines regarding the timing of abortion:
- First Trimester: Abortion during the first trimester, typically up to 12 weeks of pregnancy, is generally more accessible and less invasive. In many countries, it is legally permitted and widely available during this period. Methods such as medication abortion (using a combination of medications) or vacuum aspiration (also known as suction aspiration) are commonly used during the first trimester.
- Second Trimester: As the pregnancy progresses into the second trimester, the availability of abortion may be more restricted, and the procedures may vary. The specific gestational age limit for legal abortion in the second trimester varies by country. Generally, second-trimester abortions are performed using methods such as dilation and evacuation (D&E) or induction abortion, which involves inducing labor to deliver the fetus.
- Third Trimester: Abortions in the third trimester, typically after 24 weeks of pregnancy, are highly regulated and restricted in most countries. They are generally limited to cases where the mother’s life is at risk or in situations involving severe fetal abnormalities. Laws and regulations surrounding third-trimester abortions vary significantly and are often subject to specific legal requirements and medical justifications.
Risks of an abortion
- Common Risks:
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- Cramping and abdominal pain: It is common to experience cramping and abdominal pain during and after the abortion procedure.
- Vaginal bleeding: Bleeding is expected after an abortion and can last for several days. However, excessive or prolonged bleeding may require medical attention.
- Nausea and vomiting: Some individuals may experience nausea and vomiting as side effects of the medications or anesthesia used during the procedure.
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- Infection:
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- Any medical procedure that involves the uterus carries a risk of infection. Signs of infection may include fever, severe abdominal pain, heavy bleeding with foul odor, or abnormal vaginal discharge. Prompt medical attention is necessary if infection is suspected.
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- Incomplete Abortion:
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- In some cases, the abortion may not be complete, and some pregnancy tissue may remain in the uterus. This can result in persistent bleeding, cramping, or the need for additional intervention or procedures to ensure complete removal of the pregnancy tissue.
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- Uterine Perforation:
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- Rarely, the instruments used during surgical abortions may accidentally perforate the uterus or damage surrounding organs. This risk is higher in procedures performed later in pregnancy or if the uterus is in an abnormal position.
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- Anesthesia-related Risks:
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- If general anesthesia or conscious sedation is used during the procedure, there is a small risk of complications associated with anesthesia, such as allergic reactions or adverse effects on the respiratory or cardiovascular systems.
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- Emotional and Psychological Impact:
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- Some individuals may experience emotional or psychological reactions following an abortion, such as feelings of sadness, grief, guilt, or relief. It’s important to have access to appropriate support systems, counseling, or mental health services if needed.
