Difference between revisions of "Abortion" - New World Encyclopedia

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[[File:Vacuum-aspiration (single).png|thumb|400px|A vacuum aspiration abortion at eight weeks gestational age (six weeks after fertilization).<br />'''1:''' Amniotic sac<br />'''2:''' Embryo<br />'''3:''' Uterine lining<br />'''4:''' Speculum<br />'''5:''' Vacurette<br />'''6:''' Attached to a suction pump]]
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An '''abortion''' is the removal or expulsion of an [[embryo]] or [[fetus]] from the [[uterus]], resulting in or caused by its [[death]], when artificially induced by [[chemistry|chemical]], [[surgery|surgical]], or other means. When a fetus is expelled from the womb spontaneously it is called a [[miscarriage]] or "spontaneous abortion."
  
{{Abortion}}
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Abortions have been induced throughout history, using methods that were often unsafe and could result in serious harm or even death to the woman. A strong argument for permitting legal abortions has been to eliminate unsafe methods carried out without the support of the medical community, which were commonplace in societies where abortion was illegal.
  
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The [[moral]] and [[Abortion law|legal]] aspects of abortion are subject to intense debate in many parts of the world. While it is generally agreed that abortion is acceptable, even required, when the life of the woman is at risk, other cases are less clear-cut. The termination of [[pregnancy|pregnancies]] that result from [[rape]] or [[incest]] are often considered acceptable, as are those where the fetus is known to suffer from a severe [[congenital disorder]].  
An '''abortion''' is the removal or expulsion of an [[embryo]] or [[fetus]] from the [[uterus]], resulting in or caused by its death. This can occur spontaneously as a [[miscarriage]], or be artificially induced by [[chemistry|chemical]], [[surgery|surgical]] or other means. Commonly, "abortion" refers to an induced procedure at any point during [[pregnancy]]; medically, it is defined as miscarriage or induced termination before twenty weeks' [[gestation]], which is considered [[Viability|nonviable]].
 
  
Throughout [[History of abortion|history]] abortion has been induced by various methods. The [[Ethical aspects of abortion|moral]] and [[Abortion law|legal]] aspects of abortion are subject to intense [[Abortion debate|debate]] in many parts of the world.
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Abortion "on demand" as an after-the-fact [[contraception|contraceptive]] has been advocated for by those who value a [[human sexuality|sexually]] free lifestyle and a woman's right to choose what to do with her body. It dovetails with the [[feminism|feminist]] demand that women be equal to men, and a major obstacle to equality in the sexual sphere has been a woman's responsibility for childbearing. Elective abortion is vigorously challenged by those of the "pro-life" movement, which equates abortion with [[murder]] of the most innocent and defenseless.  
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While there are good arguments on both sides of the debate, the solution may lie less in permitting or banning abortions but more in the avoidance of unwanted pregnancies.
  
 
==Definitions==
 
==Definitions==
The following medical terms are used to define abortion:
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The following medical terms are used to categorize '''abortion''':
* ''Spontaneous abortion ([[miscarriage]])'': An abortion due to accidental trauma or [[Death by natural causes|natural causes]], such as chromosomal number discrepancy, early disease, or environmental factors.
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* [[Abortion#Spontaneous abortion|Spontaneous abortion]] ([[miscarriage]]): An abortion due to accidental trauma or [[Death by natural causes|natural causes]]. Most miscarriages are due to incorrect replication of [[chromosome]]s; they can also be caused by environmental factors.
*''Induced abortion'': Abortion deliberately caused. Induced abortions are further subcategorized into therapeutic, and elective:  
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* [[Abortion#Induced abortion|Induced abortion]]: Abortion that has been caused by deliberate human action. Induced abortions are further sub-categorized into therapeutic and elective:
**''Therapeutic abortion:''<ref>Roche, Natalie E. (2004). [http://www.emedicine.com/med/topic3311.htm Therapeutic Abortion]. Retrieved [[2006-03-08]].</ref>
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** '''Therapeutic abortion''' is performed for one of the following reasons:<ref name="roche1"> Frances E Casey, [https://emedicine.medscape.com/article/252560-overview Elective Abortion: Therapeutic Abortion], ''Medscape'', February 29, 2016. Retrieved August 23, 2022.</ref>
*** To save the life of the pregnant woman.  
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*** To save the life of the pregnant woman.
*** To preserve the woman's physical or mental health.  
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*** To preserve the woman's physical or mental health.
*** To terminate pregnancy that would result in a child born with a [[congenital disorder]] which would be [[fatal]] or associated with significant [[morbidity]].  
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*** To terminate pregnancy that would result in a child born with a [[congenital disorder]] that would be [[fatal]] or associated with significant [[morbidity]].
*** To [[selective reduction|selectively reduce]] the number of [[fetus]]es to lessen health risks associated with [[multiple birth|multiple pregnancy]].
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*** To [[selective reduction|selectively reduce]] the number of [[fetus]]es to lessen health risks associated with [[multiple birth|multiple pregnancy]].
**''Elective abortion'': Abortion performed for any other reason.
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** '''Elective abortion''': Abortion performed for any other reason.
  
In common parlance, the term "abortion" is synonymous with induced abortion. However, in medical texts, the word 'abortion' can also refer to ''spontaneous abortion'' (miscarriage).
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During the 1950s in the [[United States]], guidelines were set that allowed therapeutic abortion if
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# pregnancy would "gravely impair the physical and mental health of the mother,"
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# the child born was likely to have "grave physical and mental defects," or
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# the pregnancy was the result of [[rape]] or [[incest]].<ref> D. R. Mcfarlane, "Induced Abortion: An Historical Overview," ''American Journal of Gynecological Health'' 7(3) (May–June 1993): 77–82.</ref>
  
==Incidence==
 
The incidence of, and reasons for induced abortion vary regionally. It has been estimated that yearly, approximately 46 million abortions are performed. Of these, 26 million are said to occur in [[abortion law|places where abortion is legal]]; the other 20 million happen where it is illegal . Some countries, such as [[Belgium]] (11.2 per 100 known pregnancies) and the [[Netherlands]] (10.6 per 100), have a low rate of induced abortion, while others like [[Russia]] (62.6 per 100) and [[Vietnam]] (43.7 per 100) have a comparatively high rate. The world ratio is 26 induced abortions per 100 known pregnancies.<ref>Henshaw, Stanley K., Singh, Susheela, & Haas, Taylor. (1999). [http://www.guttmacher.org/pubs/journals/25s3099.html The Incidence of Abortion Worldwide]. ''International Family Planning Perspectives, 25 (Supplement)'', 30–8. Retrieved [[2006-01-18]].</ref>
 
 
===By gestational age and method===
 
[[Image:UKAbortionbyGestationalAgeChart2004.png|thumb|right|220px|The percentage of abortions by [[gestational age|gestational development]] in [[England and Wales]] during 2004.]]
 
 
Abortion rates also vary depending upon stage of [[pregnancy]] and method practiced. In 2002, from data collected in those areas of the [[United States]] which sufficiently reported [[gestational age]], it was found that 86.7% of abortions were conducted at or prior to 12 weeks, 9.9% from 13 to 20 weeks, and 1.4% at or after 21 weeks. 91.3% percent of these were classified as having been done by "[[curettage]]" ([[Suction-aspiration abortion|suction-aspiration]], [[Dilation and curettage|D&C]], [[Dilation and evacuation|D&E]]), 5.2% by "[[medical abortion|medical]]" means ([[mifepristone]]), 0.8% by "[[instillation abortion|intrauterine instillation]]" ([[saline (medicine)|saline]] or [[prostaglandin]]), and 1.5% by "other" ([[hysterotomy abortion|hysterotomy]] and [[hysterectomy]]).<ref name="cdc2002">Strauss, Lilo T., Herndon, Joy, Chang, Jeani, Parker, Wilda Y., Bowens, Sonya V., Berg, Cynthia J. Centers for Disease Control and Prevention. ([[2005-11-15]]). [http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5407a1.htm Abortion Surveillance - United States, 2002]. ''Morbidity and Mortality Weekly Report''. Retrieved [[2006-02-20]].</ref> The [[Guttmacher Institute]] estimated there were 2,200 [[intact dilation and extraction]] procedures in the U.S. during 2000; this accounts for 0.17% of the total number of abortions performed that year.<ref>Finer, Lawrence B. & Henshaw, Stanley K. (2003). [http://www.guttmacher.org/pubs/journals/3500603.html Abortion Incidence and Services in the United States in 2000]. ''Perspectives on Sexual and Reproductive Health, 35 (1).'' Retrieved [[2006-05-10]].</ref>  Similarly, in [[England]] and [[Wales]] in 2004, 87.6% of terminations occurred at or under 12 weeks, 10.7% between 13 to 19 weeks, and 1.5% at or over 20 weeks. 76% of those reported were by vacuum aspiration, 4% by D&E, 19% by a chemical agent, and 1% by [[feticide]].<ref>Government Statistical Service for the Department of Health. ([[2005-07-27]]). [http://www.dh.gov.uk/PublicationsAndStatistics/Publications/PublicationsStatistics/PublicationsStatisticsArticle/fs/en?CONTENT_ID=4116461&chk=6T9UTA Abortion statistics, England and Wales: 2004]. Retrieved [[2006-05-10]].</ref>
 
 
===By personal and social factors===
 
[[Image:AGIAbortionReasonsBarChart.png|thumb|left|320px|A [[bar chart]] depicting selected data from the 1998 [[Alan Guttmacher Institute|AGI]] [[meta-study]] on the reasons women stated for having an abortion.]]
 
 
A 1998 aggregated study, from 27 countries, on the reasons women seek to terminate their pregnancies concluded that common factors cited to have influenced the abortion decision were;  desire to delay or end [[childbirth|childbearing]], concern over the interruption of [[employment|work]] or [[education]], issues of financial or relationship stability, and perceived immaturity.<ref name="bankole98">Bankole, Akinrinola, Singh, Susheela, & Haas, Taylor. (1998). [http://www.guttmacher.org/pubs/journals/2411798.html Reasons Why Women Have Induced Abortions: Evidence from 27 Countries]. ''International Family Planning Perspectives, 24 (3)'', 117-127 & 152. Retrieved [[2006-01-18]].</ref> A 2004 study in which  [[United States|American]] women at [[abortion clinic|clinics]] answered a [[questionnaire]] yielded similar results.<ref name="finer2005">Finer, Lawrence B., Frohwirth, Lori F., Dauphinee, Lindsay A., Singh, Shusheela, & Moore, Ann M. (2005). [http://www.guttmacher.org/pubs/journals/3711005.pdf Reasons U.S. women have abortions: quantative and qualitative perspectives]. ''Perspectives on Sexual and Reproductive Health, 37 (3),'' 110-8. Retrieved [[2006-01-18]].</ref> In [[Finland]] and the  [[United States]], concern for the health risks posed by pregnancy in individual cases was not a factor commonly given; however, in [[Bangladesh]], [[India]], and [[Kenya]] health concerns were cited by women more frequently as reasons for having an abortion.<ref name="bankole98" /> 1% of women in the 2004 survey-based U.S. study became pregnant as a result of [[rape]] and 0.5% as a result of [[incest]].<ref name="finer2005"/> Another American study in 2002 concluded that 54% of women who had an abortion were using a form of [[birth control|contraception]] at the time of becoming pregnant while 46% were not. Inconsistent use was reported by 49% of those using [[condom]]s and 76% of those using [[oral contraception]]; 42% of those using condoms reported failure through slipping or breakage.<ref>Jones, Rachel K., Darroch, Jacqueline E., Henshaw, Stanley K. (2002). [http://www.guttmacher.org/pubs/journals/3429402.pdf Contraceptive Use Among U.S. Women Having Abortions in 2000-2001]. ''Perspectives on Sexual and Reproductive Health, 34 (6).'' Retrieved [[June 15]], [[2006]].</ref>
 
 
Some abortions are undergone as the result of societal pressures.  These might include the stigmatization of [[disabled]] persons, preference for children of a specific [[sex]], disapproval of [[single parent|single motherhood]], insufficient economic support for [[family|families]], lack of access to or rejection of contraceptive methods, or efforts toward [[population control]] (such as [[People's Republic of China|China]]'s [[one-child policy]]). These factors can sometimes result in compulsory abortion or [[sex-selective abortion]]. In many areas, especially in [[developing country|developing nations]] or where abortion is illegal, women sometimes resort to "[[back-alley abortion|back-alley]]" or [[self-induced abortion|self-induced]] procedures. The [[World Health Organization]] suggests that there are 19 million terminations annually which fit its criteria for an [[Abortion#Unsafe abortion|unsafe abortion]].<ref name="whounsafe">World Health Organization. (2004). [http://www.who.int/reproductive-health/publications/unsafe_abortion_estimates_04/estimates.pdf Unsafe abortion: global and regional estimates of unsafe abortion and associated mortality in 2000]. Retrieved [[2006-01-12]].</ref> See [[Abortion#Social issues|social issues]]
 
 
==Forms of abortion==
 
 
===Spontaneous abortion===
 
===Spontaneous abortion===
{{main|Miscarriage}}
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Spontaneous abortions, generally referred to as [[miscarriage]]s, occur when an [[embryo]] or [[fetus]] is lost due to natural causes before the twentieth week of [[gestation]]. A [[pregnancy]] that ends earlier than 37 weeks of gestation, if it results in a [[Live birth|live-born]] [[infant]], is known as a "[[premature birth]]." When a fetus dies in the uterus at some point late in gestation, beginning at about 20 weeks, or during [[childbirth|delivery]], it is termed a "[[stillbirth]]." Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.
 
 
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Spontaneous abortions, generally referred to as miscarriages, occur when an [[embryo]] or [[fetus]] is lost due to natural causes before the 20th week of [[fetal development|development]]. A pregnancy that ends earlier than 37 weeks of [[gestation]], if it results in a [[Live birth|live-born]] [[infant]], is known as a "[[premature birth]]". When a fetus dies in the uterus at some point late in gestation, beginning at about 20 weeks, or during [[childbirth|delivery]], it is termed a "[[stillbirth]]". Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.
 
  
Most miscarriages occur very early in pregnancy. Between 10% and 50% of pregnancies end in miscarriage, depending upon the age and health of the pregnant woman.<ref>"[http://wuphysicians.wustl.edu/dept.asp?pageID=8&ID=35 Reproductive Endocrinology and Infertility: Recurrent Pregnancy Loss (Recurrent Miscarriage)]." (n.d.) Retrieved [[2006-01-18]] from Washington University School of Medicine, Department of Obstetrics and Gynecology web site.</ref>
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Most miscarriages occur very early in pregnancy. The risk of spontaneous abortion decreases sharply after the eighth week.<ref>[http://news.bbc.co.uk/2/hi/health/2176898.stm Q&A: Miscarriage], ''BBC News,'' August 6, 2002. Retrieved August 23, 2022.</ref><ref> Lennart Nilsson, ''A Child is Born'' (Delta, 2004, ISBN 0385337558). </ref> About 10 to 20 percent of known pregnancies end in miscarriage. However, the number is likely to be much higher because many miscarriages occur so early in the pregnancy that the woman is not even aware that she was pregnant.<ref>Department of Obstetrics and Gynecology, [https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298 Miscarriage], ''Mayo Clinic''. Retrieved January 26, 2017.</ref>  
  
The risk of spontaneous abortion decreases sharply after the 8th week, i.e. when the fetal stage begins.<ref>[http://news.bbc.co.uk/2/hi/health/2176898.stm Q&A: Miscarriage]. (August 6 , 2002). ''BBC News.'' Retrieved January 10, 2007.</ref>  The risk for spontaneous abortion is greater in those with a history of more than three previous (known) spontaneous abortions, those who have had a previous induced abortion, those with systemic diseases, and those over age 35. Other causes can be infection (of either the woman or the fetus), immune response, or serious systemic disease. A spontaneous abortion can also be caused by accidental [[Physical trauma|trauma]]; intentional trauma to cause miscarriage is considered induced abortion.
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The risk or miscarriage is greater in those with a known history of several spontaneous abortions or an induced abortion, those with systemic [[disease]]s, and those over age 35. Other causes can be infection (of either the woman or fetus), immune response, or serious systemic disease. A spontaneous abortion can also be caused by accidental [[Physical trauma|trauma]]; intentional trauma to cause miscarriage is considered an induced abortion.
  
 
===Induced abortion===
 
===Induced abortion===
A pregnancy can be intentionally aborted in many ways. The manner selected depends chiefly upon the [[gestational age]] of the [[fetus]], in addition to the legality, regional availability, and/or doctor-patient preference for specific procedures.
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A pregnancy can be intentionally aborted in many ways. The manner selected depends chiefly upon the [[gestational age]] of the [[fetus]], in addition to the legality, regional availability, and doctor–patient preference for specific procedures.
  
 
====Surgical abortion====
 
====Surgical abortion====
[[Image:Abortionmethods.png|thumb|380px|right|[[Gestational age]] may determine which abortion methods are practiced.]]
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[[Image:Abortionmethods.png|thumb|400px|right|[[Gestational age]] may determine which abortion methods are practiced.]]
In the first twelve weeks, [[suction-aspiration abortion|suction-aspiration]] or vacuum abortion is the most common method.<ref>Healthwise. [http://www.webmd.com/hw/womens_conditions/tw1078.asp#tw1112 Manual and vacuum aspiration for abortion]. (2004). ''WebMD.'' Retrieved [[2006-08-19]].</ref>   ''[[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 an electric [[pump]]. These techniques are comparable, differing in the mechanism used to apply suction, how early in pregnancy they can be used, and whether cervical dilation is necessary. MVA, also known as "mini-suction" and [[menstrual extraction]], can be used in very early pregnancy, and does not require cervical dilation. Surgical techniques are sometimes referred to as ''STOP'': 'Suction (or surgical) Termination Of Pregnancy'. From the fifteenth week until approximately the twenty-sixth week, a [[dilation and evacuation]] (D & E) is used. D & E consists of opening the [[cervix]] of the [[uterus]] and emptying it using surgical instruments and suction.
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In the first twelve weeks, [[suction-aspiration abortion|suction-aspiration]] or vacuum abortion is the most common method.<ref>Healthwise Staff, [https://www.webmd.com/women/abortion-procedures Manual and vacuum aspiration for abortion], ''WebMD.'' Retrieved August 23, 2022.</ref> ''[[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 an electric [[pump]]. These techniques are comparable, differing in the mechanism used to apply suction, how early in pregnancy they can be used, and whether cervical dilation is necessary. MVA, also known as "mini-suction" and [[menstrual extraction]], can be used in very early pregnancy, and does not require cervical dilation. Surgical techniques are sometimes referred to as ''STOP'': "Suction (or surgical) Termination Of Pregnancy." From the fifteenth week until approximately the twenty-sixth week, a [[dilation and evacuation]] (D and E) method is used. D and E consists of opening the [[cervix]] of the [[uterus]] and emptying it using surgical instruments and suction.
  
''[[Dilation and curettage]]'' (D & C) is a standard gynecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion. ''[[Curettage]]'' refers to cleaning the walls of the [[uterus]] with a [[curette]]. The [[World Health Organization]] recommends this procedure, also called Sharp Curettage, only when MVA is unavailable.<ref>World Health Organization. (2003). [http://www.who.int/reproductive-health/impac/Procedures/Dilatetion_P61_P63.html Managing complications in pregnancy and childbirth: a guide for midwives and doctors]. Retrieved [[2006-08-19]].</ref>  Sharp curettage only accounted for 2.4% of abortion procedures in the US in 2002.<ref name="cdc2002" /> The term "D and C", or sometimes ''suction curette'', is used as a euphemism for the first trimester abortion procedure, irrespective of the method used to perform it.  
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[[Dilation and curettage]] (D and C) is a standard [[gynecology|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]].  
  
Other techniques must be used to induce abortion in the third [[trimester]]. Premature delivery can be induced with [[prostaglandin]]; this can be coupled with injecting the [[amniotic sac|amniotic fluid]] with caustic solutions containing [[saline (medicine)|saline]] or [[urea]]. Very late abortions can be induced by [[intact dilation and extraction]] (intact D & X) (also called [[Intrauterine cranial decompression]]), which requires surgical decompression of the fetus's head before evacuation, and is sometimes termed "[[partial-birth abortion]]." A [[hysterotomy abortion]], similar to a [[caesarian section]] but resulting in a terminated fetus, can also be used at late stages of pregnancy. It can be performed vaginally, with an incision just above the [[cervix]], in the late mid-trimester.{{fact}}
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Other techniques must be used to induce abortion in the third trimester. Premature delivery can be induced with [[prostaglandin]]; this can be coupled with injecting the [[amniotic sac|amniotic fluid]] with caustic solutions containing [[saline (medicine)|saline]] or [[urea]]. Very late abortions can be induced by [[intact dilation and extraction]] (IDX) (also called intrauterine cranial decompression), which requires surgical decompression of the fetus's head before evacuation. IDX is sometimes termed "partial-birth abortion." A [[hysterotomy abortion]], similar to a [[caesarian section]] but resulting in a terminated fetus, can also be used at late stages of pregnancy.  
  
From the 20th to 23rd week of gestation, an [[medical injection|injection]] to stop the fetal heart can be used as the first phase of the surgical abortion procedure.<ref>Vause S, Sands J, Johnston TA, Russell S, Rimmer S. (2002). PMID 12521492 Could some fetocides be avoided by more prompt referral after diagnosis of fetal abnormality? J Obstet Gynaecol. 2002 May;22(3):243-5. Retrieved [[2006-03-17]].</ref><ref>Dommergues M, Cahen F, Garel M, Mahieu-Caputo D, Dumez Y. (2003). PMID 12576743 Feticide during second- and third-trimester termination of pregnancy: opinions of health care professionals. Fetal Diagn Ther. 2003 Mar-Apr;18(2):91-7. Retrieved [[2006-03-17]].</ref><ref>Bhide A, Sairam S, Hollis B, Thilaganathan B. (2002). PMID 12230443 Comparison of feticide carried out by cordocentesis versus cardiac puncture. Ultrasound Obstet Gynecol. 2002 Sep;20(3):230-2. Retrieved [[2006-03-17]].</ref><ref>Senat MV, Fischer C, Bernard JP, Ville Y. (2003). PMID 12628271 The use of lidocaine for fetocide in late termination of pregnancy. BJOG. 2003 Mar;110(3):296-300. Retrieved [[2006-03-17]].</ref><ref>Senat MV, Fischer C, Ville Y. (2002). PMID 12001185 Funipuncture for fetocide in late termination of pregnancy. Prenat Diagn. 2002 May;22(5):354-6. Retrieved [[2006-03-17]].</ref>
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From the twentieth to twenty-third week of gestation, an [[medical injection|injection]] to stop the fetal heart can be used as the first phase of the surgical abortion procedure.
  
 
====Medical abortion====
 
====Medical abortion====
{{main|Medical abortion}}
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Effective in the first trimester of pregnancy, medical (sometimes called "chemical abortion"), or non-surgical abortions comprise 10 percent of all abortions in the [[United States]] and [[Europe]]. Combined regimens include [[methotrexate]] or [[mifepristone]] (also known as RU-486), followed by a [[prostaglandin]] (either [[misoprostol]] or [[gemeprost]]: misoprostol is used in the U.S.; gemeprost is used in the [[United Kingdom|UK]] and [[Sweden]]). When used within 49 days gestation, approximately 92 percent of women undergoing medical abortion with a combined regimen completed it without surgical intervention.<ref>I. M. Spitz, [https://www.nejm.org/doi/full/10.1056/nejm199804303381801 "Early pregnancy termination with mifepristone and misoprostol in the United States,"] ''New England Journal of Medicine'' 338(18) (1998). Retrieved August 23, 2022.</ref> Misoprostol can be used alone, but has a lower efficacy rate than combined regimens. In cases of failure of medical abortion, vacuum or manual aspiration is used to complete the abortion surgically.
 
 
Effective in the first trimester of pregnancy, medical (sometimes called ''chemical abortion''), or non-surgical abortions comprise 10% of all abortions in the [[United States]] and Europe. 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 experience completed it without surgical intervention.<ref>{{cite journal|author=Spitz, I.M. et al|title=Early pregnancy termination with mifepristone and misoprostol in the United States|journal=New England Journal of Medicine|year=1998|volume=338|issue=18|id=PMID 9562577}}</ref> Misoprostol can be used alone, but has a lower efficacy rate than combined regimens. In cases of failure of medical abortion, vacuum or manual aspiration is used to complete the abortion surgically.
 
  
 
====Other means of abortion====
 
====Other means of abortion====
[[Image:Angkordemon.jpg|thumb|left|240px|A visual representation of an abortion caused by pounding a woman with a mallet at [[Angkor Wat]].]]
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Historically, a number of [[herb]]s reputed to possess [[abortifacient]] properties have been used in [[folk medicine]]: [[tansy]], [[pennyroyal]], [[black cohosh]], and the now-extinct [[silphium]].<ref name="riddle2">John M. Riddle, ''Eve's Herbs: A History of Contraception and Abortion in the West'' (Cambridge, MA: Harvard University Press, 1999).</ref> The use of herbs in such a manner can cause serious—even lethal—side effects, such as [[multiple organ dysfunction syndrome|multiple organ failure]], and is not recommended by [[physician]]s.<ref>C. Ciganda and A. Laborde, "Herbal infusions used for induced abortion," ''J Toxicol Clin Toxicol'' 41(3) (2003): 235–239. </ref>
Historically, a number of [[herb]]s reputed to possess [[abortifacient]] properties have been used in [[folk medicine]]: [[tansy]], [[pennyroyal]], [[black cohosh]], and the now-extinct [[silphium]] (see [[Abortion#History of abortion|history of abortion]]).<ref name="riddle2">Riddle, John M. (1997). ''Eve's Herbs: A History of Contraception and Abortion in the West.'' Cambridge, MA: Harvard University Press.</ref> The use of herbs in such a manner can cause serious — even lethal — side effects, such as [[multiple organ dysfunction syndrome|multiple organ failure]], and is not recommended by [[physician]]s.<ref>Ciganda, C., & Laborde, A. (2003). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12807304&query_hl=9 Herbal infusions used for induced abortion]. ''J Toxicol Clin Toxicol, 41(3),'' 235-9. Retrieved [[2006-01-25]].</ref>  
 
  
Abortion is sometimes attempted by causing trauma to the [[abdomen]]. The degree of force, if severe, can cause serious internal injuries without necessarily succeeding in inducing [[miscarriage]].<ref>Education for Choice. ([[2005-05-06]]). [http://www.efc.org.uk/Foryoungpeople/Factsaboutabortion/Unsafeabortion Unsafe abortion]. Retrieved [[2006-01-11]].</ref>  Both accidental and deliberate abortions of this kind can be subject to criminal liability in many countries. In [[Myanmar|Burma]], [[Indonesia]], [[Malaysia]], the [[Philippines]], and [[Thailand]], there is an ancient tradition of attempting abortion through forceful abdominal [[massage]].<ref name="potts">Potts, Malcolm, & Campbell, Martha. (2002). [http://big.berkeley.edu/ifplp.history.pdf History of contraception]. ''Gynecology and Obstetrics'', vol. 6, chp. 8. Retrieved [[2005-01-25]].</ref>  
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Abortion is sometimes attempted by causing trauma to the [[abdomen]]. The degree of force, if severe, can cause serious internal injuries without necessarily succeeding in inducing [[miscarriage]]. Both accidental and deliberate abortions of this kind can be subject to criminal liability in many countries. In [[Myanmar]], [[Indonesia]], [[Malaysia]], the [[Philippines]], and [[Thailand]], there is an ancient tradition of attempting abortion through forceful abdominal [[massage]].<ref name="potts">Malcolm Potts and Martha Campbell, [https://www.glowm.com/section-view/heading/History%20of%20Contraception/item/375#.YwUESXbMK70 History of contraception], ''Glob. libr. women's med.'' (2009). Retrieved August 23, 2022.</ref>
  
 
Reported methods of unsafe, [[self-induced abortion]] include misuse of [[misoprostol]], and insertion of non-surgical implements such as [[knitting needle]]s and [[clothes hanger]]s into the [[uterus]].
 
Reported methods of unsafe, [[self-induced abortion]] include misuse of [[misoprostol]], and insertion of non-surgical implements such as [[knitting needle]]s and [[clothes hanger]]s into the [[uterus]].
  
==Health effects==
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==History==
<!--MAJOR REORG NEEDED. Entire section is argumentative, and biased: See Talk. —>
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[[Image:FrenchPeriodicalPills-January61845,BostonDailyTimes.jpg|thumb|right|300px|"French Periodical Pills." An example of a clandestine advertisement published in an 1845 edition of the ''Boston Daily Times.'']]
Early-term surgical abortion is a simple procedure. When performed before the 16th week by competent [[Physician|doctor]]s — or, in some states, [[nurse practitioner]]s, [[nurse midwife|nurse midwives]], and [[physician assistant]]s — it is safer than [[childbirth]].<ref>Cates W., Jr, & Tietze C. (1978). Standardized mortality rates associated with legal abortion: United States, 1972-1975 [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=639966&dopt=Abstract Electronic version]. ''Family Planning Perspectives, 10 (2)'', 109-12. Retrieved [[2006-01-28]].</ref>  <ref name="grimes">Grimes, D.A. (1994). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8178896&dopt=Abstract The morbidity and mortality of pregnancy: still risky business]. ''American Journal of Obstetrics and Gynecology, 170 (5 Pt 2)'', 1489-94. Retrieved [[December 21]], [[2006]].</ref> <!-- As I pointed out earlier, listing the negatives of this generally safe procedure first would be biased. —>
 
  
Abortion methods, like most surgical procedures, carry a small risk of potentially serious complications. These risks include: a perforated [[uterus]],<ref>Legarth, J., Peen, U.B., & Michelsen, J.W. (1991).
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Induced abortion, according to [[anthropology|anthropologists]], can be traced to ancient times.<ref name="devereux">George Devereux, "A typological study of abortion in 350 primitive, ancient, and pre-industrial societies," in ''Abortion in America: Medical, Psychiatric, Legal, Anthropological, and Religious Considerations,'' ed. Harold Rosen (Boston: Beacon Press, 1971). </ref> There is evidence to suggest that, historically, pregnancies were terminated through a number of methods, including the administration of [[abortifacient]] [[herb]]s, the use of sharpened implements, the application of abdominal pressure, and other techniques.
[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=1936497&query_hl=2&itool=pubmed_docsum Mifepristone or vacuum aspiration in termination of early pregnancy]. ''European Journal of Obstetrics, Gynecology, and Reproductive Biology, 41 (2),'' 91-6. Retrieved [[December 21]], [[2006]].</ref><ref>Mittal, S., & Misra, S.L. (1985). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?itool=abstractplus&db=pubmed&cmd=Retrieve&dopt=abstractplus&list_uids=2860032 Uterine perforation following medical termination of pregnancy by vacuum aspiration]. ''International Journal of Gynaecology and Obstetrics, 23 (1),'' 45-50. Retrieved [[December 21]], [[2006]].</ref> perforated [[bowel]]<ref>WHO Health Organization. Medical Methods for termination of pregnancy. WHO Technical Report Series 871, 1997</ref> or [[urinary bladder|bladder]],{{fact}} [[septic shock]],<ref>Dzhavakhadze, M.V., & Daraselia, M.I. (2005).
 
[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16308436&query_hl=98&itool=pubmed_docsum  Mortality case analyses of obstetric-gynecologic sepsis]. ''Georgian Medical News, 127,'' 26-9. Retrieved [[December 21]], [[2006]].</ref> [[infertility|sterility]],<ref>Tzonou, A., Hsieh, C.C., Trichopoulos, D., Aravandinos, D., Kalandidi, A., Margaris, D., Goldman, M., ''et al''. (1993) [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=8436890&query_hl=37&itool=pubmed_docsum Induced abortions, miscarriages, and tobacco smoking as risk factors for secondary infertility]. ''Journal of Epidemiology and Community Health, 47 (1)'', 36-9. Retrieved [[December 21]], [[2006]].</ref> and death.<ref>Lanska, M.J., Lanska, D., & Rimm, A.A. (1983). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=6854898&query_hl=26&itool=pubmed_docsum Mortality from abortion and childbirth]. ''Journal of the American Medical Association, 250(3),'' 361-2. Retrieved [[December 21]], [[2006]].</ref> The risk of complications can increase depending on how far [[pregnancy]] has progressed,<ref name="pauli">Pauli, E., Haller, U., Zimmermann, R. (2005).
 
[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=15818053&query_hl=102&itool=pubmed_docsum Morbidity of dilatation and evacuation in the second trimester: an analysis]. ''Gynakol Geburtshilfliche Rundsch, 45 (2)'', 107-15. Retrieved [[December 26]], [[2006]].</ref><ref name="bartley">Bartley, J., Tong, S., Everington, D.,& Baird, D.T. (2000). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=11239616&query_hl=86&itool=pubmed_DocSum Parity is a major determinant of success rate in medical abortion: a retrospective analysis of 3161 consecutive cases...]. ''Contraception, 62(6)'', 297-303. Retrieved [[December 26]], [[2006]].</ref> but remains less than [[Complications of pregnancy|complications]] that may occur from carrying pregnancy to term.<ref name="grimes" />
 
  
Assessing the risks of induced abortion depends on a number of factors. First, there are relative health risks of induced abortion and pregnancy, which are both affected by wide variation in the quality of health services in different [[Society|societies]] and among different [[socio-economic]] groups, a lack of uniform [[definition]]s of terms, and difficulties in patient follow-up and after-care. The degree of risk is also dependent upon the skill and experience of the practitioner; maternal age, health, and [[Parity (medicine)|parity]];<ref name="bartley" /> [[gestational age]];<ref name="bartley" /><ref name="pauli" /> pre-existing conditions; methods and instruments used; [[medication]]s used; the skill and experience of those assisting the practitioner; and the quality of recovery and follow-up care.
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The [[Hippocratic Oath]], the chief statement of [[medical ethics]] in [[Ancient Greece]], forbade all doctors from helping to procure an abortion by [[pessary]]. Nonetheless, [[Soranus (Greek physician)|Soranus]], a second-century Greek [[physician]], suggested in his work ''Gynaecology'' that women wishing to abort their pregnancies should engage in violent exercise, energetic jumping, carrying heavy objects, and riding animals. He also prescribed a number of recipes for herbal baths, pessaries, and [[bloodletting]], but advised against the use of sharp instruments to induce miscarriage due to the risk of organ [[perforation]].<ref>Mary R. Lefkowitz and Maureen R. Fant, ''Women's Life in Greece and Rome: A Source Book in Translation'' (Baltimore: Johns Hopkins University Press, 2016, ISBN 978-1421421131). </ref> It is also believed that, in addition to using it as a [[contraceptive]], the ancient Greeks relied upon [[silphium]] as an abortifacient. Such folk remedies, however, varied in effectiveness and were not without risk.  
  
In the [[United Kingdom]], the number of deaths directly due to legal abortion between the years of 1991 and 1993 was 5, compared to 3 deaths following spontaneous miscarriage and 8 deaths caused by [[ectopic pregnancy]] during the same time frame.<ref>Department of Health. (1998). ''[http://www.archive.official-documents.co.uk/document/doh/wmd/wmd-hm.htm Why Mothers Die: Report on Confidential Enquiries into Maternal Deaths in the United Kingdom 1994–1996].'' London: The Stationery Office. Retrieved [[2006-01-11]].</ref> In the [[United States]], during the year 1999, there were 4 deaths due to legal abortion, 10 due to [[miscarriage]], and 525 due to pregnancy-related reasons.<ref>Elam-Evans, Laurie. D., Strauss, Lilo T., Herndon, Joy, Parker, Wilda Y., Bowens, Sonya V., Zane, Suzanne, ''et al.'' Centers for Disease Control and Prevention. ([[2003-11-23]]). ''[http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5212a1.htm Abortion Surveillance - United States, 2000].'' Morbidity and Mortality Weekly Report. Retrieved [[2006-01-11]].</ref><ref>Centers for Disease Control and Prevention. ([[2003-02-20]]). [http://www.cdc.gov/od/oc/media/pressrel/fs030220.htm Fact Sheet: Pregnancy-Related Mortality Surveillance - United States, 1991-1999]. Retrieved [[2006-04-02]].</ref>
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[[Abortion#Abortion law|Abortion law]]s and their enforcement have fluctuated through the various eras. Many early laws and Church doctrine focused on "[[quickening]]," when a [[fetus]] began to move on its own, as a way to differentiate when an abortion became impermissible. In the eighteenth and nineteenth centuries, various doctors, clerics, and social reformers successfully pushed for an all-out ban on abortion. During the twentieth century, abortion became legal in many Western countries, but it is regularly subjected to legal challenges and restrictions by [[pro-life]] groups.<ref name="frontline">Frontline, [https://www.pbs.org/wgbh/pages/frontline/clinic/ The Last Abortion Clinic], ''Public Broadcasting Service.'' Retrieved August 23, 2022.</ref>
  
Some practitioners advocate using minimal [[anaesthesia]] so the patient can alert them to possible complications. Others recommend [[general anaesthesia]], to prevent patient movement, which might cause a perforation. General anaesthesia carries its own risks, including death, which is why public health officials recommend against its routine use.
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=== Prehistory to fifth century ===
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[[Image:Silphium.jpg|thumb|right|300px|[[Cyrene|Cyrenian]] [[coin]] with an image of [[silphium]].]]
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The first recorded evidence of induced abortion is from a [[China|Chinese]] document which records abortions performed upon royal concubines in China between the years 500 and 515 B.C.E.<ref name="ancientchina">F. Glenc, "Induced abortion: a historical outline," ''Polski Tygodnik Lekarski,'' 29(45) (1974): 1957–1958. </ref> According to [[Chinese folklore]], the legendary Emperor [[Shennong]] prescribed the use of [[mercury (element)|mercury]] to induce abortions nearly 5,000 years ago.<ref name="shennong">Christopher Tietze and Sarah Lewit, "Abortion," ''Scientific American'' 220 (1969): 21.</ref>
  
[[Dilation]] of the [[cervix]] carries the risk of cervical tears or perforations, including small tears that might not be apparent and might cause [[cervical incompetence]] in future pregnancies. Most practitioners recommend using the smallest possible dilators, and using [[osmotic]] rather than [[Machine|mechanical]] dilators after the first [[trimester]].  
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Abortion, along with [[infanticide]], was well known in the ancient Greco-Roman world. Numerous methods of abortion were used; the more effective of which were exceedingly dangerous. Several common methods involved either dosing the pregnant woman with a near-fatal amount of [[poison]], in order to induce a [[miscarriage]], introducing poison directly into the [[uterus]], or prodding the uterus with one of a variety of "long needles, hooks, and knives."<ref name="stark"> Rodney Stark, ''The Rise of Christianity'' (Princeton, NJ: Princeton University Press, 1996, ISBN 0691027498), 119.</ref> Unsurprisingly, these methods often led to the death of the woman as well as the fetus.
  
Instruments that are placed within the uterus can, on rare occasions, cause [[perforation]]<ref name="pauli" /> or [[laceration]] of the uterus, and damage structures surrounding the uterus. Laceration or perforation of the uterus or cervix can, again on rare occasions, lead to more serious complications.
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Many of the methods employed in early and [[primitive culture]]s were non-surgical. Physical activities like strenuous labor, [[climbing]], [[paddling]], [[weightlifting]], or [[diving]] were a common technique. Others included the use of irritant leaves, [[fasting]], [[bloodletting]], pouring hot water onto the abdomen, and lying on a heated [[coconut]] shell.<ref name="devereux"/> In primitive cultures, techniques developed through observation, adaptation of obstetrical methods, and [[transculturation]].<ref>George Devereux, "Techniques of abortion," in ''A Study of Abortion in Primitive Societies,'' (Literary Licensing, LLC, 2011, ISBN 978-1258131432). </ref>
  
Incomplete emptying of the uterus can cause [[hemorrhage]] and infection. Use of [[ultrasound]] verification of the location and duration of the pregnancy prior to abortion, with immediate follow-up of patients reporting continuing pregnancy symptoms after the procedure, will virtually eliminate this risk. The sooner a complication is noted and properly treated, the lower the risk of permanent injury or death.  
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=== Fifth to sixteenth centuries ===
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[[Image:Medievalpreg.jpg|thumb|right|350px|Art from a thirteenth-century [[illuminated manuscript]] features a [[herbalism|herbalist]] preparing a concoction containing [[pennyroyal]] for a woman.]]
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An eighth-century [[Sanskrit]] text instructs women wishing to induce an abortion to sit over a pot of steam or stewed [[onion]]s.<ref name="yale">Kathleen London, [https://teachersinstitute.yale.edu/curriculum/units/1982/6/82.06.03.x.html The History of Birth Control], ''The Changing American Family: Historical and Comparative Perspectives'' (Yale/New Haven Teachers Institute, 1982). Retrieved August 23, 2022.</ref>
  
In rare cases, abortion will be unsuccessful and pregnancy will continue. An unsuccessful abortion can result in delivery of a live [[neonate]], or infant. This, termed a failed abortion, is very rare and can only occur late in pregnancy. Some doctors have voiced concerns about the ethical and legal ramifications of letting the neonate die. As a result, recent investigations have been launched in the [[United Kingdom]] by the Confidential Enquiry into Maternal and Child Health (CEMACH) and the Royal College of Obstetricians and Gynecologists, in order to determine how widespread the problem is and what an ethical response in the treatment of the infant might be.<ref>Rogers, Lois. ([[2005-11-27]]). "[http://www.timesonline.co.uk/article/0,,2087-1892696,00.html Fifty babies a year are alive after abortion]." ''The Sunday Times.'' Retrieved [[2006-01-11]].</ref>  
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The technique of [[massage]] abortion, involving the application of pressure to the pregnant [[abdomen]], has been practiced in [[Southeast Asia]] for centuries. One of the [[bas relief]]s decorating the temple of [[Angkor Wat]] in [[Cambodia]], dated circa 1150, depicts a [[demon]] performing such an abortion upon a woman who has been sent to the [[underworld]]. This is believed to be the oldest known visual representation of abortion.<ref name="potts"/>
  
[[#unsafe abortion|Unsafe abortion]] methods (e.g. use of certain drugs, herbs, or insertion of non-surgical objects into the [[uterus]]) are potentially dangerous, carrying a significantly elevated risk for permanent injury or death, as compared to abortions done by [[physician]]s.
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[[Japan]]ese documents show records of induced abortion from as early as the twelfth century. It became much more prevalent during the [[Edo period]], especially among the [[peasant]] class, who were hit hardest by the recurrent [[famine]]s and high [[taxation]] of the age.<ref name="japan1"> M. Obayashi, "Historical background of the acceptance of induced abortion," ''Josanpu Zasshi'' 36(12) (1982): 1011–1016. </ref> [[Statue]]s of the [[Boddhisattva]] [[Ksitigarbha|Jizo]], erected in memory of an abortion, [[miscarriage]], [[stillbirth]], or young childhood death, began appearing at least as early as 1710 at a [[temple]] in [[Yokohama]].<ref name="japan2">Anne Page Brookes, [https://nirc.nanzan-u.ac.jp/nfile/2226 ''Mizuko kuyō'' and Japanese Buddhism], ''Japanese Journal of Religious Studies'' 8(3–4) (September–December 1981): 119–147. Retrieved August 23, 2022.</ref>
  
===Suggested effects===
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Physical means of inducing abortion, such as battery, exercise, and tightening the [[girdle]]—special bands were sometimes worn in pregnancy to support the belly—were reported among [[England|English]] women during the early modern period.<ref name="mcfarlane">Alan Mcfarlane, [http://www.alanmacfarlane.com/savage/A-ABORT.PDF Abortion methods in England], 2002. Retrieved August 23, 2022.</ref>
There is controversy over a number of proposed risks and effects of abortion. Evidence, whether in support of or against such claims, might be influenced by the political and religious beliefs of the parties behind it.
 
  
====Breast cancer====
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===Seventeenth to nineteenth centuries===
{{main|Abortion-breast cancer hypothesis|Breast cancer}}
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[[Image:JapaneseAbortionWoodblock.jpg|thumb|right|300px|"Admonition against abortion." Late nineteenth-century [[Japan]]ese [[Ukiyo-e]] [[woodblock printing|woodblock print.]]]]
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Nineteenth-century medicine saw advances in the fields of [[surgery]], [[anesthesia]], and [[sanitation]], in the same era that doctors with the [[American Medical Association]] lobbied for bans on abortion in the [[United States]]<ref> Frederick N. Dyer, ''The Physicians' Crusade Against Abortion'' (Science History Publications, 2005, ISBN 978-0881353785).</ref> and the [[British Parliament]] passed the [[Offences Against The Person Act 1861|Offences Against the Person Act]].
  
The abortion-breast cancer (ABC) hypothesis posits a [[causality|causal relationship]] between induced abortion and increased risk of developing [[breast cancer]].  In early [[pregnancy]] the level of [[estrogen]]s increases, leading to [[breast]] [[cellular differentiation|growth]] in preparation for [[lactation]]. The ABC hypothesis proposes that if this process is interrupted with abortion &ndash; before full differentiation in the third [[trimester]] &ndash; then more relatively vulnerable undifferentiated cells could be left than there were prior to the pregnancy, resulting in greater potential risk of breast cancer.  The hypothesis, however, has not been scientifically verified, and abortion is not considered a breast cancer risk by any major cancer organization.
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Various methods of abortion were documented regionally in the nineteenth and early twentieth centuries. After a rash of unexplained miscarriages in [[Sheffield]], [[England]], were attributed to [[lead poisoning]] caused by the metal [[water pipe|pipe]]s that fed the city's water supply, a woman confessed to having used diachylon—a lead-containing [[plaster]]—as an abortifacient in 1898.<ref name="potts"/>
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[[Image:National Police Gazette Restell.jpg|thumb|right|300px|"The Female Abortionist." [[Madame Restell]] is portrayed as a [[villain]]ess in an 1847 copy of the ''National Police Gazette.'']]
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A well-known example of a [[Victorian era|Victorian-era]] abortionist was [[Madame Restell]], or Ann Lohman, who over a 40-year period illicitly provided both surgical abortion and abortifacient pills in the northern United States. She began her business in [[New York]] during the 1830s, and, by the 1840s, had expanded to include [[franchise]]s in [[Boston]] and [[Philadelphia]].
  
A [[Epidemiology|epidemiological]] study by Dr. Mads Melbye et al. in 1997, with data from two national [[registry|registries]] in [[Denmark]], reported the correlation to be negligible to non-existent after [[statistical hypothesis testing|statistical adjustment]].<ref>Melbye M. et al. (1997) ''Induced abortion and the risk of breast cancer.'' [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=8988884 (abstract)] New England Journal of Medicine, 336, 81-5. Retrieved [[2006-01-11]] from PubMed.</ref>  The [[National Cancer Institute]] conducted an official workshop with numerous experts on the issue in [[February 2003]], which concluded with its highest strength rating for the selected evidence it considered that "induced abortion is not associated with an increase in breast cancer risk."<ref>National Cancer Institute. ([[2003-03-04]]). [http://www.cancer.gov/cancerinfo/ere-workshop-report Summary Report: Early Reproductive Events and Breast Cancer Workshop]. Retrieved [[2006-01-11]].</ref> In 2004, Beral et al. published a collaborative reanalysis of 53 epidemiological studies and concluded that abortion does "not increase a woman's risk of developing breast cancer."<ref>Beral V. et al. (2004) ''Breast cancer and abortion: collaborative reanalysis of data from 53 epidemiological studies, including 83,000 women with breast cancer from 16 countries.'' [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15051280 (abstract)] ''The Lancet, 363,'' 1007-16. Retrieved [[2006-04-12]] from PubMed.</ref>
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Women of [[Judaism|Jewish descent]] in Lower East Side, [[Manhattan]] are said to have carried the ancient [[India]]n practice of sitting over a pot of steam into the early twentieth century.<ref name="yale"/> Evelyn Fisher wrote of how women living in a [[mining]] town in [[Wales]] during the 1920s used candles intended for [[Roman Catholic]] ceremonies to dilate the [[cervix]] in an effort to self-induce abortion.<ref name="potts"/> Similarly, the use of candles and other objects, such as glass rods, penholders, [[hair iron|curling iron]]s, spoons, sticks, knives, and [[catheter]]s was reported during the nineteenth century in the United States.<ref name="king">C. R. King, "Abortion in nineteenth century America: a conflict between women and their physicians," ''Women's Health Issues'' 2(1) (Spring 1992): 32–39. </ref>  
  
Of over 100 experts at the National Cancer Institute workshop, [[Joel Brind|Dr. Joel Brind]], the primary advocate of an abortion-breast cancer link and an invitee to the workshop, filed the only dissenting opinion criticizing the NCI's and Melbye's conclusions.<ref>Brind, Joel. ([[2003-03-10]]). [http://www.bcpinstitute.org/nci_minority_rpt.htm Early Reproductive Events and Breast Cancer: A Minority Report]. Retrieved [[2006-03-24]].</ref>  Brind argues that the majority of interview-based studies have indicated a link and some are [[statistically significant]],<ref>[http://www.etters.net/cancerTP.htm#3 Etters.net] &ndash; American abortion-breast cancer studies</ref>  but there remains debate as to the reliability of these retrospective studies because of possible [[response bias]]. Most medical professionals agree with the recent prospective studies that conclude no abortion-breast cancer association,<ref>American Cancer Society. ([[2006-10-03]]) [http://www.cancer.org/docroot/CRI/content/CRI_2_4_2X_What_are_the_risk_factors_for_breast_cancer_5.asp  Cancer.org] – ''What Are the Risk Factors for Breast Cancer?'' Retrieved [[2006-03-30]].</ref> and the ABC issue is seen by some as merely a part of the current [[pro-life]] "women-centered" strategy against abortion.<ref>Arthur, Joyce. (2002) [http://www.prochoiceactionnetwork-canada.org/articles/abclink.shtml ProChoiceActionNetwork-Canada.org] – ''Abortion and Breast Cancer — A Forged Link''</ref>  Nevertheless, the subject continues to be one of mostly political but some scientific contention.<ref>Jasen, P. (2005) [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1251638 Breast Cancer and the Politics of Abortion in the United States]. ''Medical History 2005 October 1; 49(4): 423–444.''</ref>
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A paper published in 1870 on the abortion services to be found in [[Syracuse, New York]], concluded that the method most often practiced there during this time was to [[douche|flush]] the inside of the [[uterus]] with injected water. The article's author, Ely Van de Warkle, claimed this procedure was affordable even to a [[maid]], as a man in town offered it for $10 on an [[installment plan]].<ref>Ely Van de Warkle, "The detection of criminal abortion," ''Journal of the Boston Historical Society'' 4–5 (1870).</ref> Other prices which nineteenth-century abortionists are reported to have charged were much more steep. In [[Great Britain]], it could cost from 10 to 50 [[Guinea (British coin)|guinea]]s, or 5 percent of the [[Per capita income|yearly income]] of a lower [[middle class]] household.<ref name="potts"/>
  
====Fetal pain====
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[[Māori]] who lived in [[New Zealand]] before or at the time of [[colonization]] terminated pregnancies via miscarriage-inducing drugs, ceremonial methods, and girding of the abdomen with a restrictive belt.<ref name="maori1">R. B. Hunton, "Maori abortion practices in pre and early European New Zealand," ''New Zealand Medical Journal'' 86(602) (1977): 567–570. </ref> They were afraid to practice abortion directly, for fear of [[Makutu]], and so the results of their efforts were viewed as miscarriages or [[feticide]].<ref name="maori2"> L. K. Gluckman, "Abortion in the nineteenth century Maori: a historical and ethnopsychiatric review," ''New Zealand Medical Journal'' 93(685) (1981): 384–386.</ref>
{{main|Fetal pain}}
 
  
The existence or absence of fetal sensation during abortion is a matter of medical, ethical and public policy interest. Evidence conflicts, with some authorities holding that the fetus is capable of feeling [[Pain and nociception|pain]] from the first [[trimester]],<ref>{{cite press release | title = Open Letter to President Reagan | publisher = Schmidt, Dr. Richard T. F., et. al. | date = 1984-02-13|url = http://www.mpomerle.com/NoAbort/Reagan_Fetal_Pain.shtml| accessdate = 2006-11-18 }}</ref> and others maintaining that the [[neuroanatomy|neuro-anatomical]] requirements for such experience do not exist until the second or third trimester.<ref> BBC News Article (2005). "[http://news.bbc.co.uk/1/hi/health/4180592.stm Foetuses 'no pain up to 29 weeks']." Retrieved [[2006-07-18]].</ref>
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===Twentieth century===
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Although prototypes of the modern [[curette]] are referred to in ancient texts, the instrument which is used today was initially designed in [[France]] in 1723, but was not applied specifically to a gynecological purpose until 1842.<ref name="nafhistory">C. Joffe, "Abortion in Historical Perspective," in ''A Clinician’s Guide to Medical and Surgical Abortion,'' ed. Maureen Paul, E. Steven Lichtenberg, Lynn Borgatta, David A. Grimes, and Phillip G. Stubblefield (Philadelphia: Churchill Livingstone, 1999, ISBN 978-0443075292). </ref> [[Dilation and curettage]] has been practiced since the late nineteenth century.<ref name="nafhistory"/>  
  
Pain receptors begin to appear in the seventh week of gestation. The [[thalamus]], the part of the brain which receives signals from the [[nervous system]] and then relays them to the [[cerebral cortex]], starts to form in the fifth week. However, other anatomical structures involved in the [[Pain and nociception|nociceptic]] process are not present until much later in [[gestation]]. Links between the thalamus and cerebral cortex form around the 23rd week.<ref>Parliamentary Office of Science and Technology. (1997). ''[http://www.parliament.uk/post/pn094.pdf Fetal Awareness].'' Retrieved [[2006-01-11]].</ref> There has been suggestion that a fetus cannot feel pain at all, as it requires mental development that only occurs outside the womb.<ref>BBC News Article (2006). "[http://news.bbc.co.uk/1/hi/health/4905892.stm Foetuses 'cannot experience pain']." Retrieved [[2006-07-18]].</ref>  
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The twentieth century saw improvements in abortion technology, increasing its safety, and reducing its [[Adverse effect (medicine)|side-effect]]s. [[Vacuum]] devices, first described in medical literature in the 1800s, allowed for the development of [[suction-aspiration abortion]].<ref name="nafhistory"/> This method was practiced in the [[Soviet Union]], [[Japan]], and [[China]], before being introduced to [[UK|Britain]] and the [[United States]] in the 1960s.<ref name="nafhistory"/> The invention of the [[Karman canula|Karman cannula]], a flexible [[plastic]] [[cannula]] which replaced earlier metal models in the 1970s, reduced the occurrence of perforation and made suction-aspiration methods possible under [[local anesthesia]].<ref name="nafhistory" /> In 1971, [[Lorraine Rothman]] and [[Carol Downer]], founding members of the [[feminism|feminist]] self-help movement, invented the Del-Em, a safe, cheap suction device that made it possible for people with minimal training to perform early abortions called [[menstrual extraction]].<ref name="nafhistory"/>
  
Researchers have observed changes in heart rates and [[hormones|hormonal levels]] of newborn [[infants]] after [[circumcision]], [[blood tests]], and surgery — effects which were alleviated with the administration of [[anesthesia]].<ref>Anand, K., Phil, D., & Hickey, P.R. (1987). Pain and its effects on the human neonate and fetus. ''New England Journal of Medicine, 316 (21),'' 1321-9. Retrieved [[2006-01-11]] from [http://www.cirp.org/library/pain/anand/ The Circumcision Reference Library].</ref> Others suggest that the human experience of pain, being more than just [[physiology|physiological]], cannot be measured in such [[reflexive]] responses.<ref>Lee, Susan J., Ralston, Henry J. Peter, Drey, Eleanor A., Partridge, John Colin, & Rosen, Mark A. (2005). [http://jama.ama-assn.org/cgi/content/short/294/8/947 Fetal Pain: A Systematic Multidisciplinary Review of the Evidence]. ''Journal of the American Medical Association, 294 (8)'', 947-954. Retrieved [[November 10]], [[2006]]. </ref>
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[[Intact dilation and extraction]] was developed by James McMahon in 1983. It resembles a procedure used in the nineteenth century to save a woman's life in cases of obstructed labor, in which the fetal skull was first punctured with a perforator, then crushed and extracted with a [[forceps]]-like instrument, known as a [[cranioclast]].<ref> F. C. Galuptos, Jr., [http://www.fcgapultoscollection.com/dobfor.html Destructive OB Forceps], ''The Galuptos Collection.'' Retrieved August 23, 2022.</ref> In 1980, researchers at [[Roussel Uclaf]] in [[France]] developed [[mifepristone]], a chemical compound which works as an abortifacient by blocking [[hormone]] action. It was first marketed in France under the [[trade name]] Mifegyne in 1988.
  
====Mental health====
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==Debate==
{{Main|Post-abortion syndrome|Mental health}}
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Over the course of the history, induced abortion has been the source of considerable [[debate]], [[controversy]], and [[activism]]. The [[ethics|ethical]], [[moral]], [[philosophy|philosophical]], [[Biology|biological]], and [[abortion law|legal]] issues are complex. Opinions regarding abortion may be best described as being a combination of beliefs on its morality, and on the responsibility, ethical scope, and proper extent of [[government]]al [[authority|authorities]] in [[public policy]]. [[religion|Religious ethics]] also has an influence upon both personal opinion and the greater debate over abortion.
[[Post-abortion syndrome]] (PAS) is a term used to describe a set of [[mental health]] characteristics which some researchers claim to have observed in women following an abortion.<ref name="gomez"> Gomez, Lavin C., & Zapata, Garcia R. (2005).
 
- [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15999304&dopt=Abstract "Diagnostic categorization of post-abortion syndrome"]. ''Actas Esp Psiquiatr, 33 (4),'' 267-72. Retrieved Setepmber 8, 2006.</ref> The [[Psychopathology|psychopathological]] symptoms attributed to PAS are similar to those of [[post-traumatic stress disorder]], but have also included, "repeated and persistent dreams and [[nightmare]]s related with the abortion, intense feelings of [[guilt]] and the 'need to repair'".<ref name="gomez" /> Whether this would warrant [[nosology|classification]] as an independent [[syndrome]] is disputed by other researchers.<ref>Stotland, N.L. (1992).  [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1404747 The myth of the abortion trauma syndrome]. ''Journal of the American Medical Association, 268 (15),'' 2078-9. Retrieved [[December 7]], [[2006]].</ref> PAS is listed in neither the [[DSM-IV-TR]] nor the [[ICD|ICD-10]].  
 
  
Some studies have shown abortion to have neutral or positive effects on the mental well-being of some patients.  A 1989 study of [[teenager]]s who sought [[pregnancy test]]s found that, counting from the beginning of pregnancy until two years later, the level of [[Stress (medicine)|stress]] and [[anxiety]] of those who had an abortion did not differ from that of those who had not been pregnant or who had carried their pregnancy to term.<ref>Zabin, L.S., Hirsch, M.B., Emerson, M.R. (1989). [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2620716&dopt=Abstract When urban adolescents choose abortion: effects on education, psychological status and subsequent pregnancy]. ''Family Planning Perspectives, 21 (6),'' 248-55. Retrieved [[September 8]], [[2006]].</ref> Another study in 1992 suggested a link between elective abortion and later reports of positive [[self-esteem]]; it also noted that adverse emotional reactions to the procedure are most strongly influenced by pre-existing [[psychology|psychological]] conditions and other negative factors.<ref name="russo">Russo, N. F., & Zierk, K.L. (1992). [http://content.apa.org/journals/pro/23/4/269 Abortion, childbearing, and women]. ''Professional Psychology: Research and Practice, 23(4),'' 269-280. Retrieved [[September 8]], [[2006]].</ref> Abortion, as compared to completion, of an undesired [[Gravidity|first pregnancy]] was not found to directly pose the risk of significant depression in a 2005 study.<ref>Schmiege, S. & Russo, N.F. (2005). Depression and unwanted first pregnancy: longitudinal cohort study [http://bmj.bmjjournals.com/cgi/content/full/331/7528/1303 Electronic version] . ''British Medical Journal, 331 (7528),'' 1303. Retrieved [[2006-01-11]].</ref>
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Abortion debates, especially pertaining to [[Abortion#Abortion law|abortion law]]s, are often spearheaded by [[advocacy|advocacy groups]] belonging to one of two camps. In the [[United States]], most often those in favor of legal prohibition of abortion describe themselves as "[[pro-life]]" while those against legal restrictions on abortion describe themselves as "[[pro-choice]]." Both are used to indicate the central principles in arguments for and against abortion: "Is the fetus a human being with a fundamental right to ''life''?" for pro-life advocates, and, for those who are pro-choice, "Does a woman have the right to ''choose'' whether or not to continue a pregnancy?"
  
Other studies have shown a correlation between abortion and negative psychological impact.  A 1996 study found that suicide is more common after miscarriage and especially after induced abortion, than in the general population.<ref>Gissler, M., Hemminki, E., & Lonnqvist, J. (1996). Suicides after pregnancy in Finland, 1987-94: register linkage study [http://bmj.bmjjournals.com/cgi/content/full/313/7070/1431 Electronic version]. ''British Medical Journal, 313,'' 1431-4. Retrieved [[2006-01-11]].</ref>
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In both public and private debate, arguments presented in favor of or against abortion focus on either the moral permissibility of an induced abortion, or justification of [[law]]s permitting or restricting abortion. Arguments on morality and legality tend to collide and combine, complicating the issue at hand.
Additional research in 2002 reported that the risk of clinical depression was higher for women who chose to have an abortion compared to those who opted to carry to term — even if the pregnancy was unwanted.<ref>Reardon, D.C. & Cougle, J.R. (2002): Depression and unintended pregnancy in the National Longitudinal Survey of Youth: a cohort study. BMJ (British Medical Journal) 19.1.2002 324:151-2. [http://bmj.bmjjournals.com/cgi/content/full/324/7330/151?ijkey=6e69d766b00a6b5f6d244e90d4a8b9f9bcd165c5&keytype2=tf_ipsecsha Electronic version.]</ref> Another study in 2006, which used data gathered over a 25-year period, found an increased occurrence of [[clinical depression]], [[anxiety]], [[suicide|suicidal]] behavior, and [[substance abuse]] among women who had previously had an abortion.<ref>{{cite journal|author=Fergusson D.M., Horwood L.J., & Ridder E.M.|title=Abortion in young women and subsequent mental health|journal=Journal of Child Psychology & Psychiatry|year=2006|volume=47|issue=1|page=16-24|id=PMID 16405636}}</ref>
 
  
[[Miscarriage]], or spontaneous abortion, is known to present an increased risk of depression.<ref>''[http://www.chmeds.ac.nz/research/chds/view1.pdf Depression Risk Increased After Miscarriage].'' ([[2002-04-01]]). Retrieved [[2006-01-11]].</ref> [[Childbirth]] can also sometimes result in [[maternity blues]] or [[postpartum depression]].
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Debate also focuses on whether the [[pregnancy|pregnant]] woman should have to notify and/or have the [[consent]] of others in distinct cases: a [[minor (law)|minor]], her [[parent]]s; a [[marriage|legally-married]] or [[common-law marriage|common-law]] wife, her husband; or a pregnant woman, the biological father. In a 2003 [[Gallup]] poll in the [[United States]], 72 percent of respondents were in favor of spousal notification, with 26 percent opposed; of those polled, 79 percent of males and 67 percent of females responded in favor.<ref>[https://www.pewresearch.org/politics/2005/11/02/public-opinion-supports-alito-on-spousal-notification-even-as-it-favors-iroe-v-wadei/ Public Opinion Supports Alito on Spousal Notification Even as It Favors ''Roe v. Wade''] ''Pew Research Center'', November 2, 2005. Retrieved August 23, 2022.</ref>
  
==History of abortion==
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===Ethical issues===
[[Image:FrenchPeriodicalPills-January61845,BostonDailyTimes.jpg|thumb|right|140px|"French Periodical Pills." An example of a clandestine advertisement published in an 1845 edition of the ''Boston Daily Times''.]]
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[[Ethics]] discusses what one "ought" to do or what ''should be'' legal, rather than the law itself. Regarding abortion, the ethics debate usually surrounds the questions of whether an [[embryo]] has rights, and whether those rights should take precedence over a woman's. For many, there is a strong correlation between religion and abortion ethics.
{{main|History of abortion}}
 
Induced abortion, according to some [[anthropologists]], can be traced to ancient times.<ref name="devereux">Devereux, G. (1967). [http://db.jhuccp.org/ics-wpd/exec/icswppro.dll?AC=GET_RECORD&XC=/ics-wpd/exec/icswppro.dll&BU=http%3A%2F%2Fdb.jhuccp.org%2Fics-wpd%2Fpopweb%2F&TN=popline&SN=AUTO32204&SE=1493&RN=24&MR=50&TR=0&TX=0&ES=0&CS=1&XP=&RF=ShortRecordDisplay&EF=&DF=LongRecordDisplay&RL=1&EL=0&DL=1&NP=0&ID=&MF=&MQ=&TI=0&DT=&ST=0&IR=77430&NR=0&NB=0&SV=0&BG=&FG=&QS=&OEX=ISO-8859-1&OEH=ISO-8859-1 A typological study of abortion in 350 primitive, ancient, and pre-industrial societies]. Retrieved [[April 22]], [[2006]]. In ''Abortion in America: medical, psychiatric, legal, anthropological, and religious considerations.'' Boston: Beacon Press. Retrieved [[April 22]], [[2006]].</ref> There is evidence to suggest that, historically, pregnancies were terminated through a number of methods, including the administration of [[abortifacient]] herbs, the use of sharpened implements, the application of abdominal pressure,  and other techniques.
 
  
The [[Hippocratic Oath]], the chief statement of [[medical ethics]] in [[Ancient Greece]], forbade all doctors from helping to procure an abortion by [[pessary]].  Nonetheless, [[Soranus (Greek Physician)|Soranus]], a second-century Greek [[physician]], suggested in his work ''[[Gynaecology]]'' that women wishing to abort their pregnancies should engage in violent exercise, energetic jumping, carrying heavy objects, and riding animals. He also prescribed a number of recipes for herbal baths, pessaries, and [[bloodletting]], but advised against the use of sharp instruments to induce miscarriage due to the risk of organ [[perforation]].<ref>Lefkowitz, Mary R. & Fant, Maureen R. (1992). ''[http://www.stoa.org/diotima/anthology/wlgr/ Women's life in Greece & Rome: a source book in translation].'' Baltimore, MD: John Hopkins University Press. Retrieved [[2006-01-11]].</ref> It is also believed that, in addition to using it as a [[contraceptive]], the ancient Greeks relied upon [[silphium]] as an [[abortifacient]].  Such folk remedies, however, varied in effectiveness and were not without risk. [[Tansy]] and [[pennyroyal]], for example, are two [[poison|poisonous]] [[herbs]] with serious [[Adverse effect (medicine)|side effects]] that have at times been used to terminate pregnancy.
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====Personhood====
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Some argue that abortion is ''wrong'' based on a belief that an [[embryo]] is an innocent person with a [[right to live]].<ref name=warren1>Mary Ann Warren, "On the Moral and Legal Status of Abortion," in ''Biomedical Ethics,'' ed. Thomas A. Mappes and David DeGrazia (New York: McGraw-Hill, 2001, ISBN 0072303654).</ref> Others argue that the embryo's potentiality to become a person is not the same as being a person.  
  
Abortion in the 19th century continued, despite bans in both the [[United Kingdom]] and the [[United States]], as the disguised, but nonetheless open, advertisement of services in the [[Victorian era]] suggests.<ref>''[http://users.telerama.com/~jdehullu/abortion/abhist.htm Histories of Abortion].'' (n.d.) Retrieved [[2006-01-11]].</ref>
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Some would judge [[personhood]] by a set of criteria—a being need not exhibit every criterion to qualify as a person, but failure to exhibit most is proposed as disqualification. Suggested criteria include [[consciousness]] (at least the capacity to feel [[pain]]), [[reasoning]], [[self motivation]], the ability to [[Communication|communicate]] on ''many'' possible topics, [[self-awareness]],<ref name=warren1/> self-consciousness,<ref>Michael Tooley, "Abortion and Infanticide," ''Philosophy and Public Affairs'' 2(1) (1972): 44.</ref> rationality,<ref>Peter Singer, ''Writings on an Ethical Life'' (Ecco Press, 2000, ISBN 0060198389), 128, 156–157.</ref> and autonomy.<ref name=McMahan>Jeff McMahan, ''The Ethics of Killing: Problems at the Margins of Life'' (Oxford University Press, 2002 ISBN 0195169824).</ref> According to these criteria, an embryo is not a person because it satisfies only one criterion, namely consciousness (and this only after it becomes [[fetal pain|susceptible to pain]]).<ref name=warren1/>  
  
==Social issues==
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Criticism of this line of reasoning begins with two classes of persons (after birth) in which these criteria do not confer personhood: those who are [[comatose]], and [[infant]]s. Just like embryos, comatose patients (even when the coma is reversible) do not satisfy the criteria—they are not conscious, do not communicate, and so on. Therefore, based on the criteria, these are not "persons" and lack a right to life.<ref name=Marquis>Don Marquis, "Why Abortion is Immoral," ''Journal of Psychology'' 86(4) (April 1989): 183-202.</ref><ref name=Schwarz> Stephen D. Schwarz, ''The Moral Question of Abortion'' (Chicago: Loyola University Press, 1990 ISBN 0829406239).</ref><ref> David Boonin, ''A Defense of Abortion'' (Cambridge University Press, 2003, ISBN 0521520355), 64–70.</ref><ref> Singer, 137.</ref> One response is that the reversibly comatose "retain all their ''unconscious'' mental states,"<ref> Dean Stretton, "Essential Properties and the Right to Live: A Response to Lee," ''Bioethics'' 18(3) (June 2004): 267.</ref> [[Mary Ann Warren]] concedes that infants are not "persons" by these criteria,<ref> Mary Ann Warren, "Postscript on Infanticide," in ''Biomedical Ethics,'' ed. Thomas A. Mappes and David DeGrazia (New York: McGraw-Hill, 2001, ISBN 0072303654).</ref> which leads to the conclusion that [[infanticide]] could be morally acceptable under some circumstances, such as if the infant is severely disabled.<ref>Singer, 186–193.</ref> or in order to save the lives of other infants.<ref name=McMahan/>
  
A number of complex issues exist in the debate over abortion. These, like the suggested effects upon health listed above, are a focus of research and a fixture of discussion among members on all sides of the controversy.
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An alternate definition of personhood relies on a being's ''natural'' capacity instead of its ''current'' observable capacity. It is argued that being the ''kind'' of being that can develop itself to the point of exhibiting the criteria is what is crucial. Biological humans have this natural capacity—and have it ''[[Essential property|essentially]].'' By this view, personhood begins at [[conception]], the point at which the organism becomes ''biologically'' human, and it is not possible for an embryo to ''fail'' to have a right to life.<ref>Patrick Lee, ''Abortion and Unborn Human Life'' (Catholic University of America Press, 1996, ISBN 0813208467).</ref><ref name=Schwarz/>
  
===Effect upon crime rate===
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[[Image:Pro-Life Demonstration at Supreme Court.jpg|thumb|right|400px|Pro-life demonstrators in [[Washington, D.C.]] symbolically cover their mouths with red tape.]]
{{Main|Legalized abortion and crime effect}}
 
  
A controversial theory attempts to draw a [[correlation]] between the United States' unprecedented nationwide decline of the overall [[crime rate]] during the 1990s and the decriminalization of abortion 20 years prior.
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====Deprivation====
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Some argue that abortion is ''wrong'' because it deprives the [[embryo]] of a valuable future. By this argument, killing any human being is wrong because it deprives the victim of a valuable future: any experiences, activities, projects, and enjoyments that would have been enjoyed<ref name=Marquis/> Thus, if a being has a valuable future ahead of it—a "future like ours"—then killing that being would be seriously wrong. The type of wrongness appealed to here is presumptive or [[prima facie]] wrongness: it may be overridden in exceptional circumstances.<ref name=Marquis/> As an embryo has a valuable future, the "overwhelming majority" of deliberate abortions are placed in the "same moral category" as killing an innocent adult human being.<ref name=Marquis/> Not ''all'' abortions are deemed to be seriously wrong. According to this formulation, abortion may be justified if the same justification can be applied to killing a postnatal human.
  
The suggestion was brought to widespread attention by a 1999 [[academic paper]], ''[[The Impact of Legalized Abortion on Crime]]'', authored by the [[economist]]s [[Steven Levitt|Steven D. Levitt]] and John Donohue. They attributed the drop in crime to a reduction in individuals said to have a higher statistical probability of committing crimes: unwanted children, especially those born to mothers who are [[African-American]], [[poverty|impoverished]], [[teenage pregnancy|adolescent]], [[education|uneducated]], and [[single parent|single]]. The change coincided with what would have been the adolescence, or peak years of potential criminality, of those who had not been born as a result of ''[[Roe v. Wade]]'' and similar cases. Donohue and Levitt's study also noted that states which legalized abortion before the rest of the nation experienced the lowering crime rate pattern earlier, and those with higher abortion rates had more pronounced reductions.<ref>Donohue, John J. and Levitt, Steven D. (2001). [http://ssrn.com/abstract=174508 The impact of legalized abortion on crime].''Quarterly Journal of Economics'' Retrieved [[2006-02-11]]. </ref>
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Criticism of this line of reasoning follows several threads. Some argue that the [[Personal identity (philosophy)|personal identity]] of the embryo is questionable, arguing that humans are not ''biological'' organisms, but rather ''embodied minds'' that come into existence when the brain gives rise to certain developed psychological capacities.<ref name=McMahan/> By this criticism, the embryo would not ''itself'' have a future of value, but would merely have the potential to give rise to a ''different entity'' that would have a future of value. Some argue that deprivation of a valuable future is not possible if there are no psychological connections ([[memory]], [[belief]], [[desire]], and so forth) between the being as it is at death and the being as it would have become.<ref name=McMahan/>  
  
Fellow economists Christopher Foote and Christopher Goetz criticized the [[methodology]] in the Donohue-Levitt study, noting a lack of accommodation for statewide yearly variations such as [[cocaine]] use, and recalculating based on incidence of crime [[per capita]]; they found no [[statistically significant]] results.<ref>Foote, Christopher L. and Goetz, Christopher F. (2005). [http://www.bos.frb.org/economic/wp/wp2005/wp0515.pdf Testing economic hypotheses with state-level data: a comment on Donohue and Levitt (2001)]. ''Working Papers, 05-15''. Retrieved [[2006-02-11]].</ref>  Levitt and Donohue responded to this by presenting an adjusted [[data set]] which took into account these concerns and reported that the data maintained the statistical significance of their initial paper.<ref>Donohue, John J. and Levitt, Steven D. (2006). Measurement error, legalized abortion, and the decline in crime: a response to Foote and Goetz (2005). Retrieved [[2006-02-17]], from University of Chicago, Initiative on Chicago Price Theory web site: [http://pricetheory.uchicago.edu/levitt/Papers/ResponseToFooteGoetz2006.pdf ResponseToFooteGoetz2006.pdf].</ref>
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====Bodily rights====
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Some argue that abortion is ''right'' (or ''permissible'') because it allows a woman her right to control her body. This formulation argues that the decision to carry an [[embryo]] to term falls within the prerogative of each woman. Forcing a woman to continue an unwanted [[pregnancy]] is made analogous to forcing one person's body to be used as a [[dialysis]] machine for another person suffering from [[kidney]] failure.  
  
Such research has been criticized by some as being [[utilitarian]], [[discrimination|discriminatory]] as to [[race]] and [[social class|socioeconomic class]], and as promoting [[eugenic]]s as a solution to [[crime]].<ref>"Crime-Abortion Study Continues to Draw Pro-life Backlash." ([[1999-08-11]]). ''The Pro-Life Infonet.'' Retrieved [[2006-02-17]] from [http://ohioroundtable.org/library/articles/life/crimeabortion.html Ohio Roundtable Online Library].</ref><ref>"[http://www.americancatholic.org/Messenger/Jan2000/Editorial.asp Abortion and the Lower Crime Rate]." (2000, January). ''St. Anthony Messenger.'' Retrieved [[2006-02-17]].</ref> Levitt states in his book, ''[[Freakonomics]]'', that they are neither promoting nor negating any course of action &mdash; merely reporting data as economists.
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Critics of this line of reasoning argue that the analogy with dialysis is poor. It overlooks tacit consent<ref name=warren1/> and subsequent responsibility<ref name=McMahan/> for having participated in intercourse; the embryo is the woman's child as opposed to a stranger; and that abortion kills the embryo, not merely letting it die.<ref name=McMahan/><ref name=Schwarz/>
  
===Sex-selective abortion===
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Related to the issue of bodily rights is the questionable quality of life for unwanted children when a woman is forced to carry a pregnancy to term. This is particularly relevant in the case of [[rape]] or [[incest]] victims, as well as women who, due to youth or disability, are incapable of caring for a child, or of having given consent to the act of intercourse that led to the pregnancy. While the issue of quality of life of the infant after delivery may be resolved through the option of [[adoption]], the issue of whether the nature of the act and the relationship of the biological parents is significant in [[conception]], and whether the attitude of the mother toward the [[fetus]] during pregnancy affects the quality of life in the future are still areas of concern.
{{Main|Sex-selective abortion and infanticide}}
 
  
The advent of both [[ultrasound]] and [[amniocentesis]] has allowed parents to determine [[sex]] before [[childbirth|birth]]. This has led to the occurrence of [[sex-selective abortion and infanticide|sex-selective abortion]] or the targeted termination of a [[fetus]] based upon its sex.
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===Social issues===
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A number of complex social and [[health]] issues exist in the debate over abortion. Some of these are discussed below.
  
It is suggested that sex-selective abortion might be partially responsible for the noticeable disparities between the [[birth rate]]s of male and female children in some places. The preference for male children is reported in many areas of Asia, and abortion used to limit female births has been reported in [[Mainland China]], [[Republic of China|Taiwan]], [[South Korea]], and [[India]].<ref>Banister, Judith. ([[1999-03-16]]). [http://www.census.gov/ipc/www/ebspr96a.html Son Preference in Asia - Report of a Symposium]. Retrieved [[2006-01-12]].</ref>
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====Sex-selective abortion====
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The advent of both [[Medical ultrasonography|sonography]] and [[amniocentesis]] has allowed parents to determine [[gender]] before [[childbirth|birth]]. This has led to the occurrence of gender-selective abortion and [[infanticide]], or the targeted termination of a [[fetus]] based upon its gender. The preference for male children is reported in many areas of [[Asia]], and abortion used to limit female births has been reported in [[People's Republic of China|China]], [[Taiwan]], [[South Korea]], and [[India]].
  
In [[India]], the [[economic]] role of men, the costs associated with [[dowry|dowries]], and a [[Hindu]] tradition which dictates that [[funeral|funeral rites]] must be performed by a male relative have led to a [[culture|cultural]] preference for [[son]]s.<ref>Mutharayappa, Rangamuthia, Kim Choe, Minja, Arnold, Fred, & Roy, T.K. (1997). [http://www2.eastwestcenter.org/pop/misc/subj-3.pdf Son Preferences and Its Effect on Fertility in India]. ''National Family Health Survey Subject Reports, Number 3.'' Retrieved [[2006-01-12]].</ref>  The widespread availability of diagnostic testing, during the 1970s and '80s, led to advertisements for services which read, "Invest 500 [[rupee]]s [for a sex test] now, save 50,000 rupees [for a dowry] later."<ref>Patel, Rita. (1996). The practice of sex selective abortion in India: may you be the mother of a hundred sons. Retrieved [[2006-01-11]], from University of North Carolina, University Center for International Studies web site: [http://www.ucis.unc.edu/resources/pubs/carolina/abortion.pdf abortion.pdf].</ref> In 1991, the male-to-female [[sex ratio]] in India was skewed from its biological norm of 105 to 100, to an average of 108 to 100.<ref>Sudha, S., & Irudaya Rajan, S. (1999). [http://www.hsph.harvard.edu/organizations/healthnet/gender/docs/sudha.html Female Demographic Disadvantage in India 1981-1991: Sex Selective Abortion, Female Infanticide and Excess Female Child Mortality]. Retrieved [[2006-01-12]] </ref>  Researchers have asserted that between 1985 and 2005 as many as 10 million female fetuses may have been selectively aborted.<ref>Reaney, Patricia. ([[2006-01-09]]). "[http://www.alertnet.org/thenews/newsdesk/L06779563.htm Selective abortion blamed for India's missing girls]." ''Reuters AlertNet.'' Retrieved [[2006-01-09]].</ref> The Indian government passed an official ban of pre-natal sex screening in 1994 and moved to pass a complete ban of sex-selective abortion in 2002.<ref>Mudur, Ganapati. (2002). "[http://bmj.bmjjournals.com/cgi/content/abridged/324/7334/385/b India plans new legislation to prevent sex selection]." ''British Medical Journal: News Roundup.'' Retrieved [[2006-01-12]].</ref>  
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In India, the [[economy|economic]] role of men, the costs associated with [[dowry|dowries]], and a [[Hindu]] tradition which dictates that [[funeral|funeral rites]] must be performed by a male relative have led to a [[culture|cultural]] preference for sons. Researchers have asserted that between 1985 and 2005 as many as 10 million female fetuses were selectively aborted.<ref>Sam Savage, [https://www.redorbit.com/news/international/350602/selective_abortion_blamed_for_indias_missing_girls/ Selective abortion blamed for India's missing girls], ''Reuters,'' January 8, 2006. Retrieved August 23, 2022.</ref> The Indian government officially banned prenatal sex screening in 1994 and moved to pass a complete ban of sex-selective abortion in 2002.<ref>Ganapati Mudur, [https://www.bmj.com/content/324/7334/385.3 India plans new legislation to prevent sex selection], ''British Medical Journal: News Roundup,'' February 16, 2002. Retrieved August 23, 2022.</ref>
  
In the [[People's Republic of China]], there is also a historic son preference. The implementation of the [[one-child policy]] in 1979, in response to population concerns, led to an increased disparity in the sex ratio as parents attempted to circumvent the law through sex-selective abortion or the abandonment of unwanted daughters.<ref>Graham, Maureen J., Larsen, Ulla, & Xu, Xiping. (1998). [http://www.agi-usa.org/pubs/journals/2407298.html Son Preference in Anhui Province, China]. ''International Family Planning Perspectives, 24 (2).'' Retrieved [[2006-01-12]].</ref>  Sex-selective abortion might be an influence on the shift from the baseline male-to-female birth rate to an elevated national rate of 117:100 reported in 2002.  The trend was more pronounced in rural regions: as high as 130:100 in [[Guangdong]] and 135:100 in [[Hainan]].<ref>Plafker, Ted. ([[2002-05-25]]). [http://bmj.bmjjournals.com/cgi/content/full/324/7348/1233/a?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext Sex selection in China sees 117 boys born for every 100 girls]. ''British Medical Journal: News Roundup.'' Retrieved [[2006-01-12]].</ref>  A ban upon the practice of sex-selective abortion was enacted in 2003.<ref>"[http://www.china.org.cn/english/2003/Mar/59194.htm China Bans Sex-selection Abortion]." ([[2002-03-22]]). ''Xinhua News Agency.'' Retrieved [[2006-01-12]].</ref>
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In the [[People's Republic of China]] there is also a historical preference for sons. The implementation of the [[one-child policy]] in 1979, in response to population concerns, led to an increased disparity in the sex ratio as parents attempted to circumvent the law through sex-selective abortion or the abandonment of unwanted daughters. A ban upon the practice of sex-selective abortion was enacted in 2003.<ref>Xinhua News Agency, [http://www.china.org.cn/english/2003/Mar/59194.htm China Bans Sex-selection Abortion], March 22, 2003. Retrieved August 23, 2022.</ref>
  
===Unsafe abortion===
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====Unsafe abortion====
[[Image:RussianAbortionPoster.jpg|thumb|240px|left|[[Soviet Union|Soviet]] [[Propaganda|poster]] circa 1925. Title translation: "Abortions performed by either trained or self-taught midwives not only maim the woman, they also often lead to death."]]
 
{{main|Unsafe abortion}}
 
 
Where and when access to safe abortion has been barred, due to explicit sanctions or general unavailability, women seeking to terminate their pregnancies have sometimes resorted to unsafe methods.
 
Where and when access to safe abortion has been barred, due to explicit sanctions or general unavailability, women seeking to terminate their pregnancies have sometimes resorted to unsafe methods.
  
"[[Back-alley abortion]]" is a [[slang]] term for any abortion not practiced under generally accepted standards of [[sanitation]] and [[professional|professionalism]]. The [[World Health Organization]] defines an unsafe abortion as being, "a procedure...carried out by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both."<ref name="whounsafe" /> This can include a person without medical training, a professional health provider operating in sub-standard conditions, or the woman herself.  
+
The [[World Health Organization]] (WHO) defines an unsafe abortion as being, "a procedure…carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both."<ref name="whounsafe">[https://www.who.int/publications/i/item/WHO-RHR-HRP-08.06 Impact of HRP research in medical (non-surgical) induced abortion: a case study] ''World Health Organization''. Retrieved August 23, 2022.</ref> This can include a person without medical training, a professional health provider operating in sub-standard conditions, or the woman herself.
  
Unsafe abortion remains a [[public health]] concern today due to the higher incidence and severity of its associated complications, such as incomplete abortion, [[sepsis]], [[hemorrhage]], and damage to internal organs. WHO estimates that 19 million unsafe abortions occur around the world annually and that 68,000 of these result in the woman's death.<ref name="whounsafe" /> Complications of unsafe abortion are said to account, globally, for approximately 13% of all [[maternal death|maternal mortalities]], with regional estimates including 12% in Asia, 25% in [[Latin America]], and 13% in [[sub-Saharan Africa]].<ref>Salter, C., Johnson, H.B., and Hengen, N. (1997). [http://www.infoforhealth.org/pr/l10edsum.shtml Care for postabortion complications: saving women's lives]. ''Population Reports, 25 (1).'' Retrieved [[2006-02-22]].</ref>  [[Health education]], access to [[family planning]], and improvements in [[health care]] during and after abortion have been proposed to address this phenomenon.<ref>World Health Organization. (1998). [http://www.who.int/docstore/world-health-day/en/pages1998/whd98_10.html Address Unsafe Abortion]. Retrieved [[2006-03-01]].</ref>
+
Unsafe abortion remains a [[public health]] concern today due to the severity of its associated complications, such as incomplete abortion, [[sepsis]], [[hemorrhage]], and damage to internal organs. WHO estimates that 19 million unsafe abortions occur around the world annually and that 68,000 of these result in the woman's death.<ref name="whounsafe"/> Complications of unsafe abortion are said to account, globally, for approximately 13 percent of all [[maternal death|maternal mortalities]]. [[Health education]], access to [[family planning]], and improvements in [[health care]] during and after abortion have been proposed to address this phenomenon.<ref>[https://apps.who.int/iris/bitstream/handle/10665/112321/WHO_RHR_14.09_eng.pdf Preventing unsafe abortion] ''World Health Organization''. Retrieved August 23, 2022.</ref>
  
==Abortion debate==
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===Religious Views===
[[Image:March.jpg|thumb|right|240px||Pro-choice activists before the [[Washington Monument]] at the [[March for Women's Lives]].]]
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[[Image:BentoXVI-37-10052007.jpg|thumb|right|400px|"No to abortion" at a 2007 meeting with [[Pope Benedict XVI]] in [[São Paulo]], [[Brazil]].]]
[[Image:Pro-life protest.jpg|thumb|right|240px||Pro-life activists at the [[March for Life]] in 2002. The rally is held annually in [[Washington, DC]].]]
 
{{main|Abortion debate}}
 
Over the course of the [[history of abortion]], induced abortion has been the source of considerable [[debate]], [[controversy]], and [[activism]]. An [[opinion|individual's position]] on the complex [[ethical]], [[moral]], [[philosophical]], [[Biology|biological]], and [[legal]] issues is often related to his or her [[value system]]. Opinions of abortion may be best described as being a combination of beliefs on its morality, and beliefs on the responsibility, ethical scope, and proper extent of [[government]]al [[authority|authorities]] in [[public policy]].  [[religion|Religious ethics]] also has an influence upon both personal opinion and the greater debate over abortion (see [[religion and abortion]]).
 
  
Abortion debates, especially pertaining to [[abortion law]]s, are often spearheaded by [[advocacy|advocacy groups]] belonging to one of two camps. Most often those in favor of legal prohibition of abortion describe themselves as [[pro-life]] while those against legal restrictions on abortion describe themselves as [[pro-choice]].  Both are used to indicate the central principles in arguments for and against abortion:  "Is the fetus a human being with a fundamental right to ''life''?" for pro-life advocates, and, for those who are pro-choice, "Does a woman have the right to ''choose'' whether or not to have an abortion?"
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====Roman Catholicism====
 +
The [[Catholic Church]] since the eighteenth century has maintained that life begins at [[conception]], and therefore intentional abortion is the willful taking of a life. However, the church came to this position only in modern times, in response to advances in the scientific understanding of life as beginning at the cellular level, at conception. The traditional Christian position was that the fetus becomes human only when it receives a soul, which occurs when it begins to take on the shape of a human being and shows signs of movement—near the end of the first trimester. [[Aristotle]] wrote, "[T]he line between lawful and unlawful abortion will be marked by the fact of having sensation and being alive."<ref>Aristotle,'' Politics,'' bk. 7, ch. 6 at 294 (T.A. Sinclair trans. 1962) (325 B.C.E. or thereabouts)</ref> By "alive" he meant that it had become a ''fetus animatus,'' showing signs of movement. This was the view of [[Augustine of Hippo|St. Augustine]], who wrote that participating in an abortion becomes a grave offense after "ensoulment" occurs, at 40 days for males and 90 for females.<ref>Allan D. Fitzgerald (ed.), ''Augustine through the Ages'' (Eerdmans, 2009, ISBN 978-0802864796).</ref> As to early term abortions, Augustine was skeptical whether they were fully human beings who could participate in the resurrection of the dead:
 +
<blockquote>"But who is not rather disposed to think that unformed fetuses perish like seeds which have not fructified?" ([[Augustine of Hippo|Saint Augustine]], ''Enchiridion,'' ch. 85.)<ref name="Enchiridion"> Augustine, [http://www.leaderu.com/cyber/books/augenchiridion/enchiridion78-96.html ''Enchiridion'']. Cyber Library. Retrieved August 23, 2022.</ref></blockquote>
  
In both public and private debate, arguments presented in favor of or against abortion focus on either the moral permissibility of an induced abortion, or justification of [[laws]] permitting or restricting abortion. Arguments on morality and legality tend to collide and combine, complicating the issue at hand.
+
This view continued to be Church policy into the Middle Ages. The first authoritative collection of [[Canon law]]  by [[John Gratian]] (1140) held that the moral crime of early abortion was not equivalent to that of [[homicide]]. [[Pope Innocent III]] wrote that when "quickening" occurred, abortion was [[homicide]]. Before that, abortion was considered a less serious [[sin]]. [[St. Thomas Aquinas]] lumped abortion with [[contraception]] and as crimes against [[nature]] and sins against [[marriage]]—sins of a different category than murder.
  
Debate also focuses on whether the [[pregnancy|pregnant]] woman should have to notify and/or have the [[consent]] of others in distinct cases: a [[minor (law)|minor]], her parents; a [[marriage|legally-married]] or [[common-law marriage|common-law]] wife, her husband; or a pregnant woman, the biological father.  In a 2003 [[Gallup]] poll in the [[United States]], 72% of respondents were in favor of spousal notification, with 26% opposed; of those polled, 79% of males and 67% of females responded in favor.<ref>The Pew Research Center for the People and the Press. ([[2005-11-02]]). "[http://people-press.org/commentary/display.php3?AnalysisID=122 Public Opinion Supports Alito on Spousal Notification Even as It Favors Roe v. Wade]." ''Pew Research Center Pollwatch.'' Retrieved [[2006-03-01]].</ref>  
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The [[Roman Catholic Church]] today firmly holds that "the first right of the human person is his life" and that human life is assumed to begin at fertilization. The Papal Encyclical, [[Humanae Vitae]], states that: "We are obliged once more to declare that the direct interruption of the generative process already begun and, above all, all direct abortions, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children."<ref>Pope Pius VI, [https://www.vatican.va/content/paul-vi/en/encyclicals/documents/hf_p-vi_enc_25071968_humanae-vitae.html ''Encyclical Humanae Vitae,''] Paragraph 14, condemnation of abortion issued July 25, 1968. Retrieved August 23, 2022.</ref> The current Catholic Code of Canon Law states "A person who procures a completed abortion incurs a ''latae sententiae'' excommunication."<ref>Vatican, [https://www.vatican.va/archive/cod-iuris-canonici/cic_index_en.html ''Code of Canon Law.'' Can. 1398,] excommunication of those who procure abortions. Retrieved August 23, 2022.</ref>  
  
===Public opinion===
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The equality of all human life in Catholicism is fundamental and complete, any discrimination is evil.  Therefore, even when a woman's life appears jeopardized, choosing her life over her child's is no less discrimination between two lives—and therefore morally unacceptable.<ref>Sacred Congregation for the Doctrine of the Faith, [https://www.vatican.va/roman_curia/congregations/cfaith/documents/rc_con_cfaith_doc_19741118_declaration-abortion_en.html ''Declaration of Procured Abortion.''] Retrieved August 23, 2022.</ref> The Roman Catholic Church also considers the destruction of any embryo to be equivalent to abortion.
{{Main|Societal attitudes towards abortion}}
 
  
A number of [[opinion poll]]s around the world have explored [[public opinion]] regarding the issue of abortion. Results have varied from poll to poll, country to country, and region to region, while varying with regard to different aspects of the issue.
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====Protestantism====
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[[Protestant]] positions have likewise varied over time. Historically, [[Fundamentalism|Fundamentalist]] [[Protestant]] denominations such as the [[Southern Baptist]] Convention supported [[pro-choice| abortion rights]]. It was not until [[1980]] that fundamentalist Protestants began to organize in opposition to abortion.<ref>Randall Balmer, ''Thy Kingdom Come: An Evangelical's Lament'' (Basic Books, 2007, ISBN 978-0465005208). </ref> Today most fundamentalist churches hold that abortion is a form of [[infanticide]]. There is no consensus, however, on whether exceptions can be made if the mother's life is in danger or when the pregnancy is the result of [[rape]] or [[incest]].
  
A May 2005 survey examined attitudes toward abortion in 10 [[Europe|European]] countries, asking polltakers whether they agreed with the statement, "If a woman doesn't want children, she should be allowed to have an abortion". The highest level of approval was 81% in the [[Czech Republic]] and the highest level of disapproval was 48% in [[Poland]]. <ref>TNS Sofres. (May 2005). [http://www.thebrusselsconnection.be/tbc/upload/attachments/European%20Values%20Overall%20EN.pdf European Values]. Retrieved January 11, 2007.</ref>
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Among mainstream Protestants, most [[Lutheranism|Lutheran]]s and [[Anglican church|Anglicans]] agree with the Roman Catholic position. The [[Methodist church|Methodist Church]], [[Presbyterian church|Presbyterian Church]], [[United Church of Christ]] and [[Episcopal church|Episcopal Church]] in the USA all take a [[pro-choice]] stand. Anglicans in [[Australia]] in 2007 took the ethical position that "the moral significance [of the embryo] increases with the age and development of the foetus."<ref>[https://hoydenabouttown.com/2007/12/22/melbourne-anglican-diocese-supports-the-decriminalisation-of-abortion/ Melbourne Anglican Diocese supports the decriminalisation of abortion] ''Hoyden About Town'', December 22, 2007. Retrieved August 23, 2022.</ref> This is a return to the traditional Christian view of [[Augustine of Hippo|Saint Augustine]].
  
In [[North America]], a December 2001 poll surveyed [[Abortion_in_Canada#Opinion_polls|Canadian opinion on abortion]], asking [[Canada|Canadians]] in what circumstances they believe abortion should be permitted; 32% responded that they believe abortion should be legal in all circumstances, 52% that it should be legal in certain circumstances, and 14% that it should be legal in no circumstances. A similar poll in January 2006 surveyed people in the [[United States]] about [[Abortion_in_the_United_States#Public_Opinion|U.S. opinion on abortion]]; 33% said that abortion should be "permitted only in cases such as rape, incest or to save the woman's life", 27% said that abortion should be "permitted in all cases", 15% that it should be "permitted, but subject to greater restrictions than it is now", 17% said that it should "only be permitted to save the woman's life", and 5% said that it should "never" be permitted.<ref>''[http://www.pollingreport.com/abortion.htm The Polling Report].'' (2006). Retrieved [[2006-01-11]].</ref> A November 2005 poll in [[Mexico]] found that 73.4% think abortion should not be legalized while 11.2% think it should. <ref>"[http://www.angus-reid.com/polls/index.cfm/fuseaction/viewItem/itemID/10042 Mexicans Support Status Quo on Social Issues]." (December 1, 2005). ''Angus Reid Global Monitor.'' Retrieved January 10, 2006.</ref>
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The Bible has been invoked to support all sides of the abortion controversy. A text that is adduced to support the view that fully human life begins at conception is [[Jeremiah]] 1:5: "Before I formed you in the womb I knew you." On the other side, [[Book of Genesis|Genesis]] 2:7 has been used to support the notion a fetus, while alive in an animal sense, only receives its immortal soul (and thus becomes fully human) at birth. There is no direct reference to abortion in the [[New Testament]].
  
Of attitutes in [[South America|South]] and [[Central America]], a December 2003 survey found that 30% of [[Argentina|Argentines]] thought that [[abortion in Argentina]] should be allowed "regardless of situation", 47% that it should be allowed "under some circumstances", and 23% that it should not be allowed "regardless of situation".<ref>"[http://www.angus-reid.com/polls/index.cfm/fuseaction/viewItem/itemID/2029 Argentines Assess Abortion Changes]." (Mar. 4, 2004). ''Angus Reid Global Monitor''. Retrieved January 10, 2006.</ref> A poll regarding the [[Abortion in Brazil|abortion law in Brazil]] found that 63% of [[Brazil|Brazilians]] believe that it "should not be modified", 17% that it should be expanded "to allow abortion in other cases", 11% that abortion should be "decriminalized", and 9% were "unsure". <ref>"[http://www.angus-reid.com/polls/index.cfm/fuseaction/viewItem/itemID/12850 Brazilians Satisfied with Abortion Law]." (August 20, 2006). ''Angus Reid Global Monitor''. Retrieved January 10, 2006.</ref> A July 2005 poll in [[Colombia]] found that 65.6% said they thought that abortion should remain illegal, 26.9% that it should be made legal, and 7.5% that they were unsure. <ref>"[http://www.angus-reid.com/polls/index.cfm/fuseaction/viewItem/itemID/8333 Colombians Reject Legalizing Abortion]. (August 2, 2005). ''Angus Reid Global Monitor''. Retrieved January 10, 2006.</ref>
+
====Judaism====
 +
[[Orthodox Judaism]] prohibits elective abortions: "It is a capital crime to destroy the embryo in the womb" (''[[Talmud]],'' Sanhedrin 57b). However, therapeutic abortion is permitted, since according to the ''[[Mishnah]],'' the life of the woman has priority over that of the child:
 +
<blockquote>If a woman is in hard travail, one cuts up the child in her womb and brings it forth member by member, because her life comes before the child (''Mishnah,'' Ohalot 7.6).</blockquote>
 +
Many [[reform Judaism|reform]] and [[conservative Judaism|conservative]] [[Jew]]s derive from this passage a trajectory within [[Judaism]] towards affirming a woman's right to choose.
  
==Abortion law==
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====Islam====
{{main|Abortion law|History of abortion}}
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The [[Qur'an]] generally forbids abortion out of respect for God as the cause of life. There are two exceptions to this rule: when the woman's life is in danger and when the pregnancy is the result of [[rape]] without [[marriage]].
[[Image:AbortionLawsMap.png|thumb|240px|right|International status of abortion law ([[:Image:AbortionLawsMap.png|Detail]])]]
 
[[Image:Signing_the_Partial-Birth_Abortion_ban.jpg|thumb|240px|right|[[President of the United States|United States President]] [[George W. Bush]] signs the ''[[Partial-Birth Abortion Ban Act]] of 2003'']]
 
  
Before the scientific discovery that human development began at fertilization, British common law allowed abortions to be performed before [[quickening]], the earliest perception of fetal movement by a woman during the second trimester of pregnancy. In 1861, the [[British Parliament]] passed the [[Offences Against The Person Act 1861|Offences Against the Person Act]], which put the [[common law]] offence of abortion into statute throughout the [[British Empire]]. The [[Soviet Union]], with legislation in 1920, and [[Iceland]], with legislation in 1935, were two of the first countries to generally allow abortion. The second half of the 20th century saw the liberalization of abortion laws in other countries. The [[Abortion Act 1967]] allowed abortion for limited reasons in the [[United Kingdom]]. In the 1973 case, ''[[Roe v. Wade]]'', the [[Supreme Court of the United States|United States Supreme Court]] struck down state laws banning abortion in the first trimester, ruling that such laws violated an implied [[right to privacy]] in the [[United States Constitution]].  The [[Supreme Court of Canada]], similarly, in the case of ''[[R. v. Morgentaler]]'', discarded its criminal code regarding abortion in 1988, after ruling that such restrictions violated the security of person guaranteed to women under the [[Canadian Charter of Rights and Freedoms]]. [[Canada]] later struck down provincial regulations of abortion in the case of ''[[R. v. Morgentaler (1993)]].'' By contrast, [[Abortion in Ireland]] was affected by the addition of an [[Eighth Amendment of the Constitution of Ireland|amendment]] to the [[Republic of Ireland|Irish]] [[Constitution of Ireland|Constitution]] in 1983 by popular [[referendum]], recognizing "the right to life of the unborn".
+
====Eastern Religions====
 +
In [[Hinduism]], abortion is not acceptable and is considered to be [[murder]], as conception is the moment when a person's [[spirit]] is united with their matter (Kaushitake Upanishad 111.1).  
  
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]], and the right to [[security of person]] are major issues of [[human rights]] that are sometimes used as justification for the existence or the absence of laws controlling abortion. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained, often, but not always, using a [[trimester]]-based system to regulate the window in which abortion is still legal to perform:
+
[[Buddhism]], too, condemns abortion as murder. Buddhism does, however, focus on a person's good intentions, creating leeway for those who pursue abortions in order to spare the unborn child a difficult life due to congenital deformities or other such hardships.
  
* In the United States, some states impose a 24-hour waiting period before the procedure, prescribe the distribution of information on [[fetal development]], or require that [[minors and abortion|parents be contacted]] if their [[Minor (law)|minor]] daughter requests an abortion.
+
Traditional [[China|Chinese]] religions operate under the belief that life begins at birth, which led to a less restrictive view of abortion.
* In the United Kingdom, as in some other countries, two doctors must first certify that an abortion is medically or socially necessary before it can be performed.
 
Other countries, in which abortion is normally illegal, will allow one to be performed in the case of [[rape]], [[incest]], or danger to the pregnant woman's life or health. A handful of nations ban abortion entirely: [[Abortion in Chile|Chile]], [[El Salvador]], [[Malta]], and [[Abortion in Nicaragua|Nicaragua]], although in 2006 the [[Politics of Chile|Chilean government]] begun the free distribution of [[emergency contraception]].<ref>Ross, Jen. ([[September 12]], [[2006]]). "[http://www.csmonitor.com/2006/0912/p01s04-woam.html In Chile, free morning-after pills to teens]." ''The Christian Science Monitor.'' Retrieved 2006-12-07.</ref><ref>Gallardoi, Eduardo. ([[September 26]], [[2006]]). "[http://www.washingtonpost.com/wp-dyn/content/article/2006/09/26/AR2006092600770.html Morning-After Pill Causes Furor in Chile]." ''The Washington Post.'' Retrieved 2006-12-07. </ref> In [[Bangladesh]], abortion is illegal, but the government has long supported a network of "menstrual regulation clinics", where [[menstrual extraction]] ([[manual vacuum aspiration]]) can be performed as menstrual hygiene.<ref>{{cite web|title=Surgical Abortion: History and Overview|publisher=National Abortion Federation|accessdate=2006-09-04|url=http://www.prochoice.org/education/resources/surg_history_overview.html}}</ref>
 
  
==See also==
+
==Recovery after abortion==
{|width=100%
+
The abortion procedure itself, when carried out under medical supervision, is generally safe although as with any procedure there are inherent potential risks. Physical problems after abortion, though, are relatively small in number and usually the physical recovery occurs quickly and without incident.
|-valign=top
 
|width=50%|
 
*[[List of articles about abortion by country|Abortion by country]]
 
*[[Abortion fund]]
 
*[[Contraception]]
 
*[[Fetal rights]]
 
*[[Ethical aspects of abortion]]
 
*[[Fertilisation]]
 
*[[Gynaecology]]
 
*[[Late-term abortion]]
 
*[[Legal protection of access to abortion]]
 
*[[Libertarian perspectives on abortion]]
 
|width=50%|
 
*[[Minors and abortion]]
 
*[[Obstetrics]]
 
*[[Paternal rights and abortion]]
 
*[[Pregnancy]]
 
*[[Religion and abortion]]
 
*[[Reproduction (disambiguation)|Reproduction]]
 
*[[Selective reduction]]
 
*[[Self-induced abortion]]
 
*[[Teenage pregnancy]]
 
*[[Violence in the abortion movement]]
 
|}
 
  
==References==
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More serious are the psychological impacts a woman faces following an abortion. While the most commonly reported feeling immediately after an abortion is relief, this relief and sense of well-being can be short-lived. Soon after, many women experience strong feelings of [[sadness]], not unlike those felt by women who [[miscarriage|miscarried]]. In the case of those who sought an abortion, however, there is confusion between this sadness and the relief that the [[pregnancy]] has been terminated. Added to the controversy over abortion, women may find it difficult to process these conflicting [[emotion]]s and to go through the [[grief|grieving]] process.<ref>Kimberly Drake, [https://psychcentral.com/depression/understanding-abortion-grief-and-the-recovery-process Coping with Grief and Depression After an Abortion] ''Psych Central'', July 24, 2022. Retrieved August 23, 2022.</ref>
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==External links==
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==Abortion law==
{{sisterlinks|abortion}}
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Before the scientific discovery that human development begins at [[fertilization]], English [[common law]] allowed abortions to be performed before "[[quickening]]," the earliest perception of fetal movement by a woman during [[pregnancy]]. Both pre- and post-quickening abortions were criminalized by Lord Ellenborough's Act in 1803.<ref> [https://definitions.uslegal.com/e/ellenboroughs-act/ Lord Ellenborough’s Act and Legal Definition]. ''USLegal.com''. Retrieved August 23, 2022.</ref> In 1861, the [[British Parliament]] passed the [[Offences Against The Person Act 1861|Offences Against the Person Act]], which continued to outlaw abortion and served as a model for similar prohibitions in other nations.<ref>[https://www.legislation.gov.uk/ukpga/Vict/24-25/100/crossheading/attempts-to-procure-abortion Attempts to procure Abortion] ''Offences against the Person Act 1861''. Retrieved August 23, 2022. </ref>
  
*[http://annualreview.law.harvard.edu/population/abortion/abortionlaws.htm Abortion Laws of the World]
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By the early twentieth century, countries began to legalize abortions when performed to protect the life or health of the woman.
*[http://www.un.org/esa/population/publications/abortion Abortion Policies: A Global Review]
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{{readout|In 1920 under [[Vladimir Lenin]] the [[Soviet Union]] was the first to legalize all abortions, but this was reversed in 1936 by [[Joseph Stalin]] in order to increase population growth.|left}}
*"[http://www.pbs.org/wgbh/pages/frontline/twenty/watch/abortion.html Abortion Clinic]:" a 1983 PBS ''Frontline'' episode.
+
In the 1930s, several countries including [[Sweden]], [[Iceland]], [[Poland]], [[Mexico]], and [[Germany]] legalized abortion in special cases. The second half of the twentieth century saw the liberalization of abortion laws in many countries. The [[Abortion Act 1967]] allowed abortion for limited reasons in the [[United Kingdom]]. In the 1973 case, ''[[Roe v. Wade]],'' the [[Supreme Court of the United States|United States Supreme Court]] struck down state laws banning abortion, ruling that such laws violated an implied [[right to privacy]] in the [[United States Constitution]]. However, this was overturned in 2022 in ''[[Dobbs v. Jackson Women's Health Organization]]'', with authority to regulate abortion returned to the states.<ref name=Dobbs>[https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf 19-1392 Dobbs v. Jackson Women's Health Organization] ''Supreme Court'', No. 19–1392. Argued December 1, 2021—Decided June 24, 2022. Retrieved August 17, 2022.</ref> By contrast, abortion in [[Ireland]] was affected by the addition of an amendment to the [[Republic of Ireland|Irish]] [[Constitution of Ireland|Constitution]] in 1983 by popular [[referendum]], recognizing "the right to life of the unborn."
 +
[[Image:Signing the Partial-Birth Abortion ban.jpg|thumb|400px|right|[[President of the United States|United States President]] [[George W. Bush]] signs the [[Partial-Birth Abortion Ban Act]] of 2003.]]
 +
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]], and the right to [[security of person]] are major issues of [[human rights]] that are sometimes used as justification for the existence or absence of laws controlling abortion. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained, often, but not always, using a trimester-based system to regulate the window of legality.
  
*[http://www.nlm.nih.gov/medlineplus/ency/article/002912.htm#Definition U.S. National Library of Medicine and National Institutes of Health MedlinePlus encyclopedia]
+
In the [[United States]], some states impose a 24-hour waiting period before the procedure, prescribe the distribution of information on [[prenatal development|fetal development]], or require that parents be contacted if their [[Minor (law)|minor]] daughter requests an abortion.
*[http://www.religioustolerance.org/abortion.htm Abortion: All sides to the issue] from the [[Ontario Consultants on Religious Tolerance]]
 
*[http://www.publicagenda.org/issues/frontdoor.cfm?issue_type=abortion Issue Guide on Abortion] from Public Agenda Online
 
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'''The following information resources may be created by those with a non-neutral position in the abortion debate:'''
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In the United Kingdom, as in some other countries, two doctors must first certify that an abortion is medically or socially warranted before it can be performed. However, since UK law stipulates that a woman seeking an abortion should never be barred from seeking another doctor's referral, and since some doctors believe that abortion is in all cases medically or socially warranted, in practice, women are never fully barred from obtaining an abortion.
*[http://www.guttmacher.org/ The Guttmacher Institute]
 
*[http://www.johnstonsarchive.net/policy/abortion Johnston's Archive: Abortion Statistics and Other Data]
 
*[http://justfacts.com/abortion.htm Just Facts: Abortion]
 
*[http://www.abortion.com/ Abortion.com: Abortion Clinics and Medical Providers]
 
  
'''The following links are to groups which advocate a specific position:'''
+
Other countries, in which abortion is normally illegal, will allow one to be performed in the case of [[rape]], [[incest]], or danger to the pregnant woman's life or health. A few nations ban abortion entirely: [[Chile]], [[El Salvador]], [[Malta]], and [[Nicaragua]], although in 2006 the Chilean government began the free distribution of emergency [[contraception]].<ref>Jen Ross, [https://www.csmonitor.com/2006/0912/p01s04-woam.html In Chile, Free Morning-After Pills to Teens], ''Christian Science Monitor,'' September 12, 2006. Retrieved August 23, 2022.</ref> In [[Bangladesh]], abortion is illegal, but the government has long supported a network of "menstrual regulation clinics," where [[menstrual extraction]] ([[manual vacuum aspiration]]) can be performed as menstrual hygiene.<ref name="nafhistory"/>
  
*[http://www.childrenbychoice.org.au Children by Choice] (Australia, pro-choice)
+
==Notes==
*[http://www.rtlaust.com Right to Life Australia] (pro-life)
+
<references/>
*[http://www.caral.ca Canadians for Choice] (pro-choice)
 
*[http://www.lifecanada.org LifeCanada] (pro-life)
 
*[http://www.alranz.org Abortion Law Reform Association of New Zealand] (pro-choice)
 
*[http://www.voiceforlife.org.nz Voice for Life] (New Zealand, pro-life)
 
*[http://www.abortionrights.org.uk Abortion Rights] (United Kingdom, pro-choice)
 
*[http://www.lifeuk.org LifeUK] (United Kingdom, pro-life)
 
*[http://www.all.org American Life League] (pro-life)
 
*[http://www.naral.org NARAL Pro-choice America] (pro-choice)
 
*[http://www.care-net.org CareNet] (international, pro-life)
 
*[http://www.plannedparenthood.com Planned Parenthood] (international, pro-choice)
 
  
{{BirthControl}}
+
==References==
 +
*Balmer, Randall. ''Thy Kingdom Come: An Evangelical's Lament''. Basic Books, 2007. ISBN 978-0465005208
 +
*Boonin, David. ''A Defense of Abortion.'' Cambridge University Press, 2002. ISBN 0521520355
 +
*Critchlow, Donald T. ''The Politics of Abortion and Birth Control in Historical Perspective.'' Pennsylvania State University Press, 1996. ISBN 0271015705
 +
*Critchlow, Donald T. ''Intended Consequences: Birth Control, Abortion, and the Federal Government in Modern America.'' Oxford University Press, 2001. ISBN 0195145933
 +
*Devereux, George. ''A Study Of Abortion In Primitive Societies''. Literary Licensing, LLC, 2011. ISBN 978-1258131432
 +
*Dyer,  Frederick N. ''The Physicians' Crusade Against Abortion''. Science History Publications, 2005. ISBN 978-0881353785
 +
*Fitzgerald, Allan D. (ed.). ''Augustine through the Ages''. Eerdmans, 2009. ISBN 978-0802864796
 +
*Garrow, David J. ''Liberty and Sexuality: The Right to Privacy and the Making of Roe V. Wade.'' Scribner, 1994. ISBN 0025427555
 +
*Hull, N. E. H. ''Roe v. Wade: The Abortion Rights Controversy in American History.'' University Press of Kansas, 2001. ISBN 0700611436
 +
*Hull, N. E. H., Williamjames Hoffer, and Peter Charles Hoffer, eds. ''The Abortion Rights Controversy in America: A Legal Reader.'' University of North Carolina Press, 2004. ISBN 0807855359
 +
*Lee, Patrick. ''Abortion and Unborn Human Life.'' Catholic University of America Press, 1996. ISBN 0813208467
 +
*Lefkowitz, Mary R., and Maureen R. Fant. ''Women's Life in Greece and Rome: A Source Book in Translation''. Baltimore: Johns Hopkins University Press, 2016. ISBN 978-1421421131
 +
*Mappes, Thomas A., and David DeGrazia. ''Biomedical Ethics.'' McGraw-Hill, 2001. ISBN 0072303654
 +
*McMahan, Jeff. ''The Ethics of Killing: Problems at the Margins of Life.'' Oxford University Press, 2002. ISBN 0195169824
 +
*Mohr, James C. ''Abortion in America: The Origins and Evolution of National Policy, 1800–1900.'' Oxford University Press, 1979. ISBN 0195026160
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*Paul, Maureen, E. Steven Lichtenberg, Lynn Borgatta, David A. Grimes, and Phillip G. Stubblefield (eds.). ''A Clinician’s Guide to Medical and Surgical Abortion''. Philadelphia: Churchill Livingstone, 1999. ISBN 978-0443075292
 +
*Reagan, Leslie J. ''When Abortion Was a Crime: Women, Medicine, and Law in the United State, 1867–1973.'' University of California Press, 1998. ISBN 0520216571
 +
*Riddle, John M. ''Eve's Herbs: A History of Contraception and Abortion in the West''. Harvard University Press, 1999. ISBN 978-0674270268
 +
*Rosen, Harold (ed.). ''Abortion in America: Medical, Psychiatric, Legal, Anthropological, and Religious Considerations''. Beacon Press, 1970. ISBN 0807021970
 +
*Rubin, Eva R. ''The Abortion Controversy: A Documentary History.'' Greenwood Press, 1994. ISBN 0313284768
 +
*Schwarz, Stephen D. ''The Moral Question of Abortion.'' Chicago: Loyola University Press, 1990. ISBN 0829406239
 +
*Singer, Peter. ''Writings on an Ethical Life.'' Ecco Press, 2000. ISBN 0060198389
 +
*Staggenborg, Suzanne. ''The Pro-Choice Movement: Organization and Activism in the Abortion Conflict.'' Oxford University Press, 1994. ISBN 0195089251
 +
*Stark, Rodney. ''The Rise of Christianity''. Princeton, NJ: Princeton University Press, 1996. ISBN 0691027498
  
[[Category:Abortion| ]]
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==External links==
[[Category:Biological reproduction]]
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All links retrieved June 14, 2023.
[[Category:Core issues in ethics]]
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*[https://www.pbs.org/wgbh/pages/frontline/twenty/watch/abortion.html Abortion Clinic] – 1983 PBS ''Frontline'' episode.
[[Category:Gynecology]]
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*[https://medlineplus.gov/ency/article/002912.htm Abortion] – ''MedlinePlus''
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Latest revision as of 06:28, 14 June 2023

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

An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death, when artificially induced by chemical, surgical, or other means. When a fetus is expelled from the womb spontaneously it is called a miscarriage or "spontaneous abortion."

Abortions have been induced throughout history, using methods that were often unsafe and could result in serious harm or even death to the woman. A strong argument for permitting legal abortions has been to eliminate unsafe methods carried out without the support of the medical community, which were commonplace in societies where abortion was illegal.

The moral and legal aspects of abortion are subject to intense debate in many parts of the world. While it is generally agreed that abortion is acceptable, even required, when the life of the woman is at risk, other cases are less clear-cut. The termination of pregnancies that result from rape or incest are often considered acceptable, as are those where the fetus is known to suffer from a severe congenital disorder.

Abortion "on demand" as an after-the-fact contraceptive has been advocated for by those who value a sexually free lifestyle and a woman's right to choose what to do with her body. It dovetails with the feminist demand that women be equal to men, and a major obstacle to equality in the sexual sphere has been a woman's responsibility for childbearing. Elective abortion is vigorously challenged by those of the "pro-life" movement, which equates abortion with murder of the most innocent and defenseless.

While there are good arguments on both sides of the debate, the solution may lie less in permitting or banning abortions but more in the avoidance of unwanted pregnancies.

Definitions

The following medical terms are used to categorize abortion:

  • Spontaneous abortion (miscarriage): An abortion due to accidental trauma or natural causes. Most miscarriages are due to incorrect replication of chromosomes; they can also be caused by environmental factors.
  • Induced abortion: Abortion that has been caused by deliberate human action. Induced abortions are further sub-categorized into therapeutic and elective:
    • Therapeutic abortion is performed for one of the following reasons:[1]
      • To save the life of the pregnant woman.
      • To preserve the woman's physical or mental health.
      • To terminate pregnancy that would result in a child born with a congenital disorder that would be fatal or associated with significant morbidity.
      • To selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy.
    • Elective abortion: Abortion performed for any other reason.

During the 1950s in the United States, guidelines were set that allowed therapeutic abortion if

  1. pregnancy would "gravely impair the physical and mental health of the mother,"
  2. the child born was likely to have "grave physical and mental defects," or
  3. the pregnancy was the result of rape or incest.[2]

Spontaneous abortion

Spontaneous abortions, generally referred to as miscarriages, occur when an embryo or fetus is lost due to natural causes before the twentieth week of gestation. A pregnancy that ends earlier than 37 weeks of gestation, if it results in a live-born infant, is known as a "premature birth." When a fetus dies in the uterus at some point late in gestation, beginning at about 20 weeks, or during delivery, it is termed a "stillbirth." Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.

Most miscarriages occur very early in pregnancy. The risk of spontaneous abortion decreases sharply after the eighth week.[3][4] About 10 to 20 percent of known pregnancies end in miscarriage. However, the number is likely to be much higher because many miscarriages occur so early in the pregnancy that the woman is not even aware that she was pregnant.[5]

The risk or miscarriage is greater in those with a known history of several spontaneous abortions or an induced abortion, those with systemic diseases, and those over age 35. Other causes can be infection (of either the woman or fetus), immune response, or serious systemic disease. A spontaneous abortion can also be caused by accidental trauma; intentional trauma to cause miscarriage is considered an induced abortion.

Induced abortion

A pregnancy can be intentionally aborted in many ways. The manner selected depends chiefly upon the gestational age of the fetus, in addition to the legality, regional availability, and doctor–patient preference for specific procedures.

Surgical abortion

Gestational age may determine which abortion methods are practiced.

In the first twelve weeks, suction-aspiration or vacuum abortion is the most common method.[6] 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 an electric pump. These techniques are comparable, differing in the mechanism used to apply suction, how early in pregnancy they can be used, and whether cervical dilation is necessary. MVA, also known as "mini-suction" and menstrual extraction, can be used in very early pregnancy, and does not require cervical dilation. Surgical techniques are sometimes referred to as STOP: "Suction (or surgical) Termination Of Pregnancy." From the fifteenth week until approximately the twenty-sixth week, a dilation and evacuation (D and E) method is used. D and E consists of opening the cervix of the uterus and emptying it using surgical instruments and suction.

Dilation and curettage (D and C) 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.

Other techniques must be used to induce abortion in the third trimester. Premature delivery 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 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 termed "partial-birth abortion." A hysterotomy abortion, similar to a caesarian section but resulting in a terminated fetus, can also be used at late stages of pregnancy.

From the twentieth to twenty-third week of gestation, an injection to stop the fetal heart can be used as the first phase of the surgical abortion procedure.

Medical abortion

Effective in the first trimester of pregnancy, medical (sometimes called "chemical abortion"), or non-surgical abortions comprise 10 percent of all abortions in the United States and Europe. Combined regimens include methotrexate or mifepristone (also known as RU-486), 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 percent of women undergoing medical abortion with a combined regimen completed it without surgical intervention.[7] Misoprostol can be used alone, but has a lower efficacy rate than combined regimens. In cases of failure of medical abortion, vacuum or manual aspiration is used to complete the abortion surgically.

Other means of abortion

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.[8] 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.[9]

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. Both accidental and deliberate abortions of this kind can be subject to criminal liability in many countries. In Myanmar, Indonesia, Malaysia, the Philippines, and Thailand, there is an ancient tradition of attempting abortion through forceful abdominal massage.[10]

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.

History

"French Periodical Pills." An example of a clandestine advertisement published in an 1845 edition of the Boston Daily Times.

Induced abortion, according to anthropologists, can be traced to ancient times.[11] There is evidence to suggest that, historically, pregnancies were terminated through a number of methods, including the administration of abortifacient herbs, the use of sharpened implements, the application of abdominal pressure, and other techniques.

The Hippocratic Oath, the chief statement of medical ethics in Ancient Greece, forbade all doctors from helping to procure an abortion by pessary. Nonetheless, Soranus, a second-century Greek physician, suggested in his work Gynaecology that women wishing to abort their pregnancies should engage in violent exercise, energetic jumping, carrying heavy objects, and riding animals. He also prescribed a number of recipes for herbal baths, pessaries, and bloodletting, but advised against the use of sharp instruments to induce miscarriage due to the risk of organ perforation.[12] It is also believed that, in addition to using it as a contraceptive, the ancient Greeks relied upon silphium as an abortifacient. Such folk remedies, however, varied in effectiveness and were not without risk.

Abortion laws and their enforcement have fluctuated through the various eras. Many early laws and Church doctrine focused on "quickening," when a fetus began to move on its own, as a way to differentiate when an abortion became impermissible. In the eighteenth and nineteenth centuries, various doctors, clerics, and social reformers successfully pushed for an all-out ban on abortion. During the twentieth century, abortion became legal in many Western countries, but it is regularly subjected to legal challenges and restrictions by pro-life groups.[13]

Prehistory to fifth century

Cyrenian coin with an image of silphium.

The first recorded evidence of induced abortion is from a Chinese document which records abortions performed upon royal concubines in China between the years 500 and 515 B.C.E.[14] According to Chinese folklore, the legendary Emperor Shennong prescribed the use of mercury to induce abortions nearly 5,000 years ago.[15]

Abortion, along with infanticide, was well known in the ancient Greco-Roman world. Numerous methods of abortion were used; the more effective of which were exceedingly dangerous. Several common methods involved either dosing the pregnant woman with a near-fatal amount of poison, in order to induce a miscarriage, introducing poison directly into the uterus, or prodding the uterus with one of a variety of "long needles, hooks, and knives."[16] Unsurprisingly, these methods often led to the death of the woman as well as the fetus.

Many of the methods employed in early and primitive cultures were non-surgical. Physical activities like strenuous labor, climbing, paddling, weightlifting, or diving were a common technique. Others included the use of irritant leaves, fasting, bloodletting, pouring hot water onto the abdomen, and lying on a heated coconut shell.[11] In primitive cultures, techniques developed through observation, adaptation of obstetrical methods, and transculturation.[17]

Fifth to sixteenth centuries

Art from a thirteenth-century illuminated manuscript features a herbalist preparing a concoction containing pennyroyal for a woman.

An eighth-century Sanskrit text instructs women wishing to induce an abortion to sit over a pot of steam or stewed onions.[18]

The technique of massage abortion, involving the application of pressure to the pregnant abdomen, has been practiced in Southeast Asia for centuries. One of the bas reliefs decorating the temple of Angkor Wat in Cambodia, dated circa 1150, depicts a demon performing such an abortion upon a woman who has been sent to the underworld. This is believed to be the oldest known visual representation of abortion.[10]

Japanese documents show records of induced abortion from as early as the twelfth century. It became much more prevalent during the Edo period, especially among the peasant class, who were hit hardest by the recurrent famines and high taxation of the age.[19] Statues of the Boddhisattva Jizo, erected in memory of an abortion, miscarriage, stillbirth, or young childhood death, began appearing at least as early as 1710 at a temple in Yokohama.[20]

Physical means of inducing abortion, such as battery, exercise, and tightening the girdle—special bands were sometimes worn in pregnancy to support the belly—were reported among English women during the early modern period.[21]

Seventeenth to nineteenth centuries

"Admonition against abortion." Late nineteenth-century Japanese Ukiyo-e woodblock print.

Nineteenth-century medicine saw advances in the fields of surgery, anesthesia, and sanitation, in the same era that doctors with the American Medical Association lobbied for bans on abortion in the United States[22] and the British Parliament passed the Offences Against the Person Act.

Various methods of abortion were documented regionally in the nineteenth and early twentieth centuries. After a rash of unexplained miscarriages in Sheffield, England, were attributed to lead poisoning caused by the metal pipes that fed the city's water supply, a woman confessed to having used diachylon—a lead-containing plaster—as an abortifacient in 1898.[10]

"The Female Abortionist." Madame Restell is portrayed as a villainess in an 1847 copy of the National Police Gazette.

A well-known example of a Victorian-era abortionist was Madame Restell, or Ann Lohman, who over a 40-year period illicitly provided both surgical abortion and abortifacient pills in the northern United States. She began her business in New York during the 1830s, and, by the 1840s, had expanded to include franchises in Boston and Philadelphia.

Women of Jewish descent in Lower East Side, Manhattan are said to have carried the ancient Indian practice of sitting over a pot of steam into the early twentieth century.[18] Evelyn Fisher wrote of how women living in a mining town in Wales during the 1920s used candles intended for Roman Catholic ceremonies to dilate the cervix in an effort to self-induce abortion.[10] Similarly, the use of candles and other objects, such as glass rods, penholders, curling irons, spoons, sticks, knives, and catheters was reported during the nineteenth century in the United States.[23]

A paper published in 1870 on the abortion services to be found in Syracuse, New York, concluded that the method most often practiced there during this time was to flush the inside of the uterus with injected water. The article's author, Ely Van de Warkle, claimed this procedure was affordable even to a maid, as a man in town offered it for $10 on an installment plan.[24] Other prices which nineteenth-century abortionists are reported to have charged were much more steep. In Great Britain, it could cost from 10 to 50 guineas, or 5 percent of the yearly income of a lower middle class household.[10]

Māori who lived in New Zealand before or at the time of colonization terminated pregnancies via miscarriage-inducing drugs, ceremonial methods, and girding of the abdomen with a restrictive belt.[25] They were afraid to practice abortion directly, for fear of Makutu, and so the results of their efforts were viewed as miscarriages or feticide.[26]

Twentieth century

Although prototypes of the modern curette are referred to in ancient texts, the instrument which is used today was initially designed in France in 1723, but was not applied specifically to a gynecological purpose until 1842.[27] Dilation and curettage has been practiced since the late nineteenth century.[27]

The twentieth century saw improvements in abortion technology, increasing its safety, and reducing its side-effects. Vacuum devices, first described in medical literature in the 1800s, allowed for the development of suction-aspiration abortion.[27] This method was practiced in the Soviet Union, Japan, and China, before being introduced to Britain and the United States in the 1960s.[27] The invention of the Karman cannula, a flexible plastic cannula which replaced earlier metal models in the 1970s, reduced the occurrence of perforation and made suction-aspiration methods possible under local anesthesia.[27] In 1971, Lorraine Rothman and Carol Downer, founding members of the feminist self-help movement, invented the Del-Em, a safe, cheap suction device that made it possible for people with minimal training to perform early abortions called menstrual extraction.[27]

Intact dilation and extraction was developed by James McMahon in 1983. It resembles a procedure used in the nineteenth century to save a woman's life in cases of obstructed labor, in which the fetal skull was first punctured with a perforator, then crushed and extracted with a forceps-like instrument, known as a cranioclast.[28] In 1980, researchers at Roussel Uclaf in France developed mifepristone, a chemical compound which works as an abortifacient by blocking hormone action. It was first marketed in France under the trade name Mifegyne in 1988.

Debate

Over the course of the history, induced abortion has been the source of considerable debate, controversy, and activism. The ethical, moral, philosophical, biological, and legal issues are complex. Opinions regarding abortion may be best described as being a combination of beliefs on its morality, and on the responsibility, ethical scope, and proper extent of governmental authorities in public policy. Religious ethics also has an influence upon both personal opinion and the greater debate over abortion.

Abortion debates, especially pertaining to abortion laws, are often spearheaded by advocacy groups belonging to one of two camps. In the United States, most often those in favor of legal prohibition of abortion describe themselves as "pro-life" while those against legal restrictions on abortion describe themselves as "pro-choice." Both are used to indicate the central principles in arguments for and against abortion: "Is the fetus a human being with a fundamental right to life?" for pro-life advocates, and, for those who are pro-choice, "Does a woman have the right to choose whether or not to continue a pregnancy?"

In both public and private debate, arguments presented in favor of or against abortion focus on either the moral permissibility of an induced abortion, or justification of laws permitting or restricting abortion. Arguments on morality and legality tend to collide and combine, complicating the issue at hand.

Debate also focuses on whether the pregnant woman should have to notify and/or have the consent of others in distinct cases: a minor, her parents; a legally-married or common-law wife, her husband; or a pregnant woman, the biological father. In a 2003 Gallup poll in the United States, 72 percent of respondents were in favor of spousal notification, with 26 percent opposed; of those polled, 79 percent of males and 67 percent of females responded in favor.[29]

Ethical issues

Ethics discusses what one "ought" to do or what should be legal, rather than the law itself. Regarding abortion, the ethics debate usually surrounds the questions of whether an embryo has rights, and whether those rights should take precedence over a woman's. For many, there is a strong correlation between religion and abortion ethics.

Personhood

Some argue that abortion is wrong based on a belief that an embryo is an innocent person with a right to live.[30] Others argue that the embryo's potentiality to become a person is not the same as being a person.

Some would judge personhood by a set of criteria—a being need not exhibit every criterion to qualify as a person, but failure to exhibit most is proposed as disqualification. Suggested criteria include consciousness (at least the capacity to feel pain), reasoning, self motivation, the ability to communicate on many possible topics, self-awareness,[30] self-consciousness,[31] rationality,[32] and autonomy.[33] According to these criteria, an embryo is not a person because it satisfies only one criterion, namely consciousness (and this only after it becomes susceptible to pain).[30]

Criticism of this line of reasoning begins with two classes of persons (after birth) in which these criteria do not confer personhood: those who are comatose, and infants. Just like embryos, comatose patients (even when the coma is reversible) do not satisfy the criteria—they are not conscious, do not communicate, and so on. Therefore, based on the criteria, these are not "persons" and lack a right to life.[34][35][36][37] One response is that the reversibly comatose "retain all their unconscious mental states,"[38] Mary Ann Warren concedes that infants are not "persons" by these criteria,[39] which leads to the conclusion that infanticide could be morally acceptable under some circumstances, such as if the infant is severely disabled.[40] or in order to save the lives of other infants.[33]

An alternate definition of personhood relies on a being's natural capacity instead of its current observable capacity. It is argued that being the kind of being that can develop itself to the point of exhibiting the criteria is what is crucial. Biological humans have this natural capacity—and have it essentially. By this view, personhood begins at conception, the point at which the organism becomes biologically human, and it is not possible for an embryo to fail to have a right to life.[41][35]

Pro-life demonstrators in Washington, D.C. symbolically cover their mouths with red tape.

Deprivation

Some argue that abortion is wrong because it deprives the embryo of a valuable future. By this argument, killing any human being is wrong because it deprives the victim of a valuable future: any experiences, activities, projects, and enjoyments that would have been enjoyed[34] Thus, if a being has a valuable future ahead of it—a "future like ours"—then killing that being would be seriously wrong. The type of wrongness appealed to here is presumptive or prima facie wrongness: it may be overridden in exceptional circumstances.[34] As an embryo has a valuable future, the "overwhelming majority" of deliberate abortions are placed in the "same moral category" as killing an innocent adult human being.[34] Not all abortions are deemed to be seriously wrong. According to this formulation, abortion may be justified if the same justification can be applied to killing a postnatal human.

Criticism of this line of reasoning follows several threads. Some argue that the personal identity of the embryo is questionable, arguing that humans are not biological organisms, but rather embodied minds that come into existence when the brain gives rise to certain developed psychological capacities.[33] By this criticism, the embryo would not itself have a future of value, but would merely have the potential to give rise to a different entity that would have a future of value. Some argue that deprivation of a valuable future is not possible if there are no psychological connections (memory, belief, desire, and so forth) between the being as it is at death and the being as it would have become.[33]

Bodily rights

Some argue that abortion is right (or permissible) because it allows a woman her right to control her body. This formulation argues that the decision to carry an embryo to term falls within the prerogative of each woman. Forcing a woman to continue an unwanted pregnancy is made analogous to forcing one person's body to be used as a dialysis machine for another person suffering from kidney failure.

Critics of this line of reasoning argue that the analogy with dialysis is poor. It overlooks tacit consent[30] and subsequent responsibility[33] for having participated in intercourse; the embryo is the woman's child as opposed to a stranger; and that abortion kills the embryo, not merely letting it die.[33][35]

Related to the issue of bodily rights is the questionable quality of life for unwanted children when a woman is forced to carry a pregnancy to term. This is particularly relevant in the case of rape or incest victims, as well as women who, due to youth or disability, are incapable of caring for a child, or of having given consent to the act of intercourse that led to the pregnancy. While the issue of quality of life of the infant after delivery may be resolved through the option of adoption, the issue of whether the nature of the act and the relationship of the biological parents is significant in conception, and whether the attitude of the mother toward the fetus during pregnancy affects the quality of life in the future are still areas of concern.

Social issues

A number of complex social and health issues exist in the debate over abortion. Some of these are discussed below.

Sex-selective abortion

The advent of both sonography and amniocentesis has allowed parents to determine gender before birth. This has led to the occurrence of gender-selective abortion and infanticide, or the targeted termination of a fetus based upon its gender. The preference for male children is reported in many areas of Asia, and abortion used to limit female births has been reported in China, Taiwan, South Korea, and India.

In India, the economic role of men, the costs associated with dowries, and a Hindu tradition which dictates that funeral rites must be performed by a male relative have led to a cultural preference for sons. Researchers have asserted that between 1985 and 2005 as many as 10 million female fetuses were selectively aborted.[42] The Indian government officially banned prenatal sex screening in 1994 and moved to pass a complete ban of sex-selective abortion in 2002.[43]

In the People's Republic of China there is also a historical preference for sons. The implementation of the one-child policy in 1979, in response to population concerns, led to an increased disparity in the sex ratio as parents attempted to circumvent the law through sex-selective abortion or the abandonment of unwanted daughters. A ban upon the practice of sex-selective abortion was enacted in 2003.[44]

Unsafe abortion

Where and when access to safe abortion has been barred, due to explicit sanctions or general unavailability, women seeking to terminate their pregnancies have sometimes resorted to unsafe methods.

The World Health Organization (WHO) defines an unsafe abortion as being, "a procedure…carried out either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both."[45] This can include a person without medical training, a professional health provider operating in sub-standard conditions, or the woman herself.

Unsafe abortion remains a public health concern today due to the severity of its associated complications, such as incomplete abortion, sepsis, hemorrhage, and damage to internal organs. WHO estimates that 19 million unsafe abortions occur around the world annually and that 68,000 of these result in the woman's death.[45] Complications of unsafe abortion are said to account, globally, for approximately 13 percent of all maternal mortalities. Health education, access to family planning, and improvements in health care during and after abortion have been proposed to address this phenomenon.[46]

Religious Views

"No to abortion" at a 2007 meeting with Pope Benedict XVI in São Paulo, Brazil.

Roman Catholicism

The Catholic Church since the eighteenth century has maintained that life begins at conception, and therefore intentional abortion is the willful taking of a life. However, the church came to this position only in modern times, in response to advances in the scientific understanding of life as beginning at the cellular level, at conception. The traditional Christian position was that the fetus becomes human only when it receives a soul, which occurs when it begins to take on the shape of a human being and shows signs of movement—near the end of the first trimester. Aristotle wrote, "[T]he line between lawful and unlawful abortion will be marked by the fact of having sensation and being alive."[47] By "alive" he meant that it had become a fetus animatus, showing signs of movement. This was the view of St. Augustine, who wrote that participating in an abortion becomes a grave offense after "ensoulment" occurs, at 40 days for males and 90 for females.[48] As to early term abortions, Augustine was skeptical whether they were fully human beings who could participate in the resurrection of the dead:

"But who is not rather disposed to think that unformed fetuses perish like seeds which have not fructified?" (Saint Augustine, Enchiridion, ch. 85.)[49]

This view continued to be Church policy into the Middle Ages. The first authoritative collection of Canon law by John Gratian (1140) held that the moral crime of early abortion was not equivalent to that of homicide. Pope Innocent III wrote that when "quickening" occurred, abortion was homicide. Before that, abortion was considered a less serious sin. St. Thomas Aquinas lumped abortion with contraception and as crimes against nature and sins against marriage—sins of a different category than murder.

The Roman Catholic Church today firmly holds that "the first right of the human person is his life" and that human life is assumed to begin at fertilization. The Papal Encyclical, Humanae Vitae, states that: "We are obliged once more to declare that the direct interruption of the generative process already begun and, above all, all direct abortions, even for therapeutic reasons, are to be absolutely excluded as lawful means of regulating the number of children."[50] The current Catholic Code of Canon Law states "A person who procures a completed abortion incurs a latae sententiae excommunication."[51]

The equality of all human life in Catholicism is fundamental and complete, any discrimination is evil. Therefore, even when a woman's life appears jeopardized, choosing her life over her child's is no less discrimination between two lives—and therefore morally unacceptable.[52] The Roman Catholic Church also considers the destruction of any embryo to be equivalent to abortion.

Protestantism

Protestant positions have likewise varied over time. Historically, Fundamentalist Protestant denominations such as the Southern Baptist Convention supported abortion rights. It was not until 1980 that fundamentalist Protestants began to organize in opposition to abortion.[53] Today most fundamentalist churches hold that abortion is a form of infanticide. There is no consensus, however, on whether exceptions can be made if the mother's life is in danger or when the pregnancy is the result of rape or incest.

Among mainstream Protestants, most Lutherans and Anglicans agree with the Roman Catholic position. The Methodist Church, Presbyterian Church, United Church of Christ and Episcopal Church in the USA all take a pro-choice stand. Anglicans in Australia in 2007 took the ethical position that "the moral significance [of the embryo] increases with the age and development of the foetus."[54] This is a return to the traditional Christian view of Saint Augustine.

The Bible has been invoked to support all sides of the abortion controversy. A text that is adduced to support the view that fully human life begins at conception is Jeremiah 1:5: "Before I formed you in the womb I knew you." On the other side, Genesis 2:7 has been used to support the notion a fetus, while alive in an animal sense, only receives its immortal soul (and thus becomes fully human) at birth. There is no direct reference to abortion in the New Testament.

Judaism

Orthodox Judaism prohibits elective abortions: "It is a capital crime to destroy the embryo in the womb" (Talmud, Sanhedrin 57b). However, therapeutic abortion is permitted, since according to the Mishnah, the life of the woman has priority over that of the child:

If a woman is in hard travail, one cuts up the child in her womb and brings it forth member by member, because her life comes before the child (Mishnah, Ohalot 7.6).

Many reform and conservative Jews derive from this passage a trajectory within Judaism towards affirming a woman's right to choose.

Islam

The Qur'an generally forbids abortion out of respect for God as the cause of life. There are two exceptions to this rule: when the woman's life is in danger and when the pregnancy is the result of rape without marriage.

Eastern Religions

In Hinduism, abortion is not acceptable and is considered to be murder, as conception is the moment when a person's spirit is united with their matter (Kaushitake Upanishad 111.1).

Buddhism, too, condemns abortion as murder. Buddhism does, however, focus on a person's good intentions, creating leeway for those who pursue abortions in order to spare the unborn child a difficult life due to congenital deformities or other such hardships.

Traditional Chinese religions operate under the belief that life begins at birth, which led to a less restrictive view of abortion.

Recovery after abortion

The abortion procedure itself, when carried out under medical supervision, is generally safe although as with any procedure there are inherent potential risks. Physical problems after abortion, though, are relatively small in number and usually the physical recovery occurs quickly and without incident.

More serious are the psychological impacts a woman faces following an abortion. While the most commonly reported feeling immediately after an abortion is relief, this relief and sense of well-being can be short-lived. Soon after, many women experience strong feelings of sadness, not unlike those felt by women who miscarried. In the case of those who sought an abortion, however, there is confusion between this sadness and the relief that the pregnancy has been terminated. Added to the controversy over abortion, women may find it difficult to process these conflicting emotions and to go through the grieving process.[55]

Abortion law

Before the scientific discovery that human development begins at fertilization, English common law allowed abortions to be performed before "quickening," the earliest perception of fetal movement by a woman during pregnancy. Both pre- and post-quickening abortions were criminalized by Lord Ellenborough's Act in 1803.[56] In 1861, the British Parliament passed the Offences Against the Person Act, which continued to outlaw abortion and served as a model for similar prohibitions in other nations.[57]

By the early twentieth century, countries began to legalize abortions when performed to protect the life or health of the woman.

Did you know?
In 1920 under Vladimir Lenin the Soviet Union was the first to legalize all abortions, but this was reversed in 1936 by Joseph Stalin in order to increase population growth.

In 1920 under Vladimir Lenin the Soviet Union was the first to legalize all abortions, but this was reversed in 1936 by Joseph Stalin in order to increase population growth.

In the 1930s, several countries including Sweden, Iceland, Poland, Mexico, and Germany legalized abortion in special cases. The second half of the twentieth century saw the liberalization of abortion laws in many countries. The Abortion Act 1967 allowed abortion for limited reasons in the United Kingdom. In the 1973 case, Roe v. Wade, the United States Supreme Court struck down state laws banning abortion, ruling that such laws violated an implied right to privacy in the United States Constitution. However, this was overturned in 2022 in Dobbs v. Jackson Women's Health Organization, with authority to regulate abortion returned to the states.[58] By contrast, abortion in Ireland was affected by the addition of an amendment to the Irish Constitution in 1983 by popular referendum, recognizing "the right to life of the unborn."

United States President George W. Bush signs the Partial-Birth Abortion Ban Act of 2003.

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, and the right to security of person are major issues of human rights that are sometimes used as justification for the existence or absence of laws controlling abortion. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained, often, but not always, using a trimester-based system to regulate the window of legality.

In the United States, some states impose a 24-hour waiting period before the procedure, prescribe the distribution of information on fetal development, or require that parents be contacted if their minor daughter requests an abortion.

In the United Kingdom, as in some other countries, two doctors must first certify that an abortion is medically or socially warranted before it can be performed. However, since UK law stipulates that a woman seeking an abortion should never be barred from seeking another doctor's referral, and since some doctors believe that abortion is in all cases medically or socially warranted, in practice, women are never fully barred from obtaining an abortion.

Other countries, in which abortion is normally illegal, will allow one to be performed in the case of rape, incest, or danger to the pregnant woman's life or health. A few nations ban abortion entirely: Chile, El Salvador, Malta, and Nicaragua, although in 2006 the Chilean government began the free distribution of emergency contraception.[59] In Bangladesh, abortion is illegal, but the government has long supported a network of "menstrual regulation clinics," where menstrual extraction (manual vacuum aspiration) can be performed as menstrual hygiene.[27]

Notes

  1. Frances E Casey, Elective Abortion: Therapeutic Abortion, Medscape, February 29, 2016. Retrieved August 23, 2022.
  2. D. R. Mcfarlane, "Induced Abortion: An Historical Overview," American Journal of Gynecological Health 7(3) (May–June 1993): 77–82.
  3. Q&A: Miscarriage, BBC News, August 6, 2002. Retrieved August 23, 2022.
  4. Lennart Nilsson, A Child is Born (Delta, 2004, ISBN 0385337558).
  5. Department of Obstetrics and Gynecology, Miscarriage, Mayo Clinic. Retrieved January 26, 2017.
  6. Healthwise Staff, Manual and vacuum aspiration for abortion, WebMD. Retrieved August 23, 2022.
  7. I. M. Spitz, "Early pregnancy termination with mifepristone and misoprostol in the United States," New England Journal of Medicine 338(18) (1998). Retrieved August 23, 2022.
  8. John M. Riddle, Eve's Herbs: A History of Contraception and Abortion in the West (Cambridge, MA: Harvard University Press, 1999).
  9. C. Ciganda and A. Laborde, "Herbal infusions used for induced abortion," J Toxicol Clin Toxicol 41(3) (2003): 235–239.
  10. 10.0 10.1 10.2 10.3 10.4 Malcolm Potts and Martha Campbell, History of contraception, Glob. libr. women's med. (2009). Retrieved August 23, 2022.
  11. 11.0 11.1 George Devereux, "A typological study of abortion in 350 primitive, ancient, and pre-industrial societies," in Abortion in America: Medical, Psychiatric, Legal, Anthropological, and Religious Considerations, ed. Harold Rosen (Boston: Beacon Press, 1971).
  12. Mary R. Lefkowitz and Maureen R. Fant, Women's Life in Greece and Rome: A Source Book in Translation (Baltimore: Johns Hopkins University Press, 2016, ISBN 978-1421421131).
  13. Frontline, The Last Abortion Clinic, Public Broadcasting Service. Retrieved August 23, 2022.
  14. F. Glenc, "Induced abortion: a historical outline," Polski Tygodnik Lekarski, 29(45) (1974): 1957–1958.
  15. Christopher Tietze and Sarah Lewit, "Abortion," Scientific American 220 (1969): 21.
  16. Rodney Stark, The Rise of Christianity (Princeton, NJ: Princeton University Press, 1996, ISBN 0691027498), 119.
  17. George Devereux, "Techniques of abortion," in A Study of Abortion in Primitive Societies, (Literary Licensing, LLC, 2011, ISBN 978-1258131432).
  18. 18.0 18.1 Kathleen London, The History of Birth Control, The Changing American Family: Historical and Comparative Perspectives (Yale/New Haven Teachers Institute, 1982). Retrieved August 23, 2022.
  19. M. Obayashi, "Historical background of the acceptance of induced abortion," Josanpu Zasshi 36(12) (1982): 1011–1016.
  20. Anne Page Brookes, Mizuko kuyō and Japanese Buddhism, Japanese Journal of Religious Studies 8(3–4) (September–December 1981): 119–147. Retrieved August 23, 2022.
  21. Alan Mcfarlane, Abortion methods in England, 2002. Retrieved August 23, 2022.
  22. Frederick N. Dyer, The Physicians' Crusade Against Abortion (Science History Publications, 2005, ISBN 978-0881353785).
  23. C. R. King, "Abortion in nineteenth century America: a conflict between women and their physicians," Women's Health Issues 2(1) (Spring 1992): 32–39.
  24. Ely Van de Warkle, "The detection of criminal abortion," Journal of the Boston Historical Society 4–5 (1870).
  25. R. B. Hunton, "Maori abortion practices in pre and early European New Zealand," New Zealand Medical Journal 86(602) (1977): 567–570.
  26. L. K. Gluckman, "Abortion in the nineteenth century Maori: a historical and ethnopsychiatric review," New Zealand Medical Journal 93(685) (1981): 384–386.
  27. 27.0 27.1 27.2 27.3 27.4 27.5 27.6 C. Joffe, "Abortion in Historical Perspective," in A Clinician’s Guide to Medical and Surgical Abortion, ed. Maureen Paul, E. Steven Lichtenberg, Lynn Borgatta, David A. Grimes, and Phillip G. Stubblefield (Philadelphia: Churchill Livingstone, 1999, ISBN 978-0443075292).
  28. F. C. Galuptos, Jr., Destructive OB Forceps, The Galuptos Collection. Retrieved August 23, 2022.
  29. Public Opinion Supports Alito on Spousal Notification Even as It Favors Roe v. Wade Pew Research Center, November 2, 2005. Retrieved August 23, 2022.
  30. 30.0 30.1 30.2 30.3 Mary Ann Warren, "On the Moral and Legal Status of Abortion," in Biomedical Ethics, ed. Thomas A. Mappes and David DeGrazia (New York: McGraw-Hill, 2001, ISBN 0072303654).
  31. Michael Tooley, "Abortion and Infanticide," Philosophy and Public Affairs 2(1) (1972): 44.
  32. Peter Singer, Writings on an Ethical Life (Ecco Press, 2000, ISBN 0060198389), 128, 156–157.
  33. 33.0 33.1 33.2 33.3 33.4 33.5 Jeff McMahan, The Ethics of Killing: Problems at the Margins of Life (Oxford University Press, 2002 ISBN 0195169824).
  34. 34.0 34.1 34.2 34.3 Don Marquis, "Why Abortion is Immoral," Journal of Psychology 86(4) (April 1989): 183-202.
  35. 35.0 35.1 35.2 Stephen D. Schwarz, The Moral Question of Abortion (Chicago: Loyola University Press, 1990 ISBN 0829406239).
  36. David Boonin, A Defense of Abortion (Cambridge University Press, 2003, ISBN 0521520355), 64–70.
  37. Singer, 137.
  38. Dean Stretton, "Essential Properties and the Right to Live: A Response to Lee," Bioethics 18(3) (June 2004): 267.
  39. Mary Ann Warren, "Postscript on Infanticide," in Biomedical Ethics, ed. Thomas A. Mappes and David DeGrazia (New York: McGraw-Hill, 2001, ISBN 0072303654).
  40. Singer, 186–193.
  41. Patrick Lee, Abortion and Unborn Human Life (Catholic University of America Press, 1996, ISBN 0813208467).
  42. Sam Savage, Selective abortion blamed for India's missing girls, Reuters, January 8, 2006. Retrieved August 23, 2022.
  43. Ganapati Mudur, India plans new legislation to prevent sex selection, British Medical Journal: News Roundup, February 16, 2002. Retrieved August 23, 2022.
  44. Xinhua News Agency, China Bans Sex-selection Abortion, March 22, 2003. Retrieved August 23, 2022.
  45. 45.0 45.1 Impact of HRP research in medical (non-surgical) induced abortion: a case study World Health Organization. Retrieved August 23, 2022.
  46. Preventing unsafe abortion World Health Organization. Retrieved August 23, 2022.
  47. Aristotle, Politics, bk. 7, ch. 6 at 294 (T.A. Sinclair trans. 1962) (325 B.C.E. or thereabouts)
  48. Allan D. Fitzgerald (ed.), Augustine through the Ages (Eerdmans, 2009, ISBN 978-0802864796).
  49. Augustine, Enchiridion. Cyber Library. Retrieved August 23, 2022.
  50. Pope Pius VI, Encyclical Humanae Vitae, Paragraph 14, condemnation of abortion issued July 25, 1968. Retrieved August 23, 2022.
  51. Vatican, Code of Canon Law. Can. 1398, excommunication of those who procure abortions. Retrieved August 23, 2022.
  52. Sacred Congregation for the Doctrine of the Faith, Declaration of Procured Abortion. Retrieved August 23, 2022.
  53. Randall Balmer, Thy Kingdom Come: An Evangelical's Lament (Basic Books, 2007, ISBN 978-0465005208).
  54. Melbourne Anglican Diocese supports the decriminalisation of abortion Hoyden About Town, December 22, 2007. Retrieved August 23, 2022.
  55. Kimberly Drake, Coping with Grief and Depression After an Abortion Psych Central, July 24, 2022. Retrieved August 23, 2022.
  56. Lord Ellenborough’s Act and Legal Definition. USLegal.com. Retrieved August 23, 2022.
  57. Attempts to procure Abortion Offences against the Person Act 1861. Retrieved August 23, 2022.
  58. 19-1392 Dobbs v. Jackson Women's Health Organization Supreme Court, No. 19–1392. Argued December 1, 2021—Decided June 24, 2022. Retrieved August 17, 2022.
  59. Jen Ross, In Chile, Free Morning-After Pills to Teens, Christian Science Monitor, September 12, 2006. Retrieved August 23, 2022.

References
ISBN links support NWE through referral fees

  • Balmer, Randall. Thy Kingdom Come: An Evangelical's Lament. Basic Books, 2007. ISBN 978-0465005208
  • Boonin, David. A Defense of Abortion. Cambridge University Press, 2002. ISBN 0521520355
  • Critchlow, Donald T. The Politics of Abortion and Birth Control in Historical Perspective. Pennsylvania State University Press, 1996. ISBN 0271015705
  • Critchlow, Donald T. Intended Consequences: Birth Control, Abortion, and the Federal Government in Modern America. Oxford University Press, 2001. ISBN 0195145933
  • Devereux, George. A Study Of Abortion In Primitive Societies. Literary Licensing, LLC, 2011. ISBN 978-1258131432
  • Dyer, Frederick N. The Physicians' Crusade Against Abortion. Science History Publications, 2005. ISBN 978-0881353785
  • Fitzgerald, Allan D. (ed.). Augustine through the Ages. Eerdmans, 2009. ISBN 978-0802864796
  • Garrow, David J. Liberty and Sexuality: The Right to Privacy and the Making of Roe V. Wade. Scribner, 1994. ISBN 0025427555
  • Hull, N. E. H. Roe v. Wade: The Abortion Rights Controversy in American History. University Press of Kansas, 2001. ISBN 0700611436
  • Hull, N. E. H., Williamjames Hoffer, and Peter Charles Hoffer, eds. The Abortion Rights Controversy in America: A Legal Reader. University of North Carolina Press, 2004. ISBN 0807855359
  • Lee, Patrick. Abortion and Unborn Human Life. Catholic University of America Press, 1996. ISBN 0813208467
  • Lefkowitz, Mary R., and Maureen R. Fant. Women's Life in Greece and Rome: A Source Book in Translation. Baltimore: Johns Hopkins University Press, 2016. ISBN 978-1421421131
  • Mappes, Thomas A., and David DeGrazia. Biomedical Ethics. McGraw-Hill, 2001. ISBN 0072303654
  • McMahan, Jeff. The Ethics of Killing: Problems at the Margins of Life. Oxford University Press, 2002. ISBN 0195169824
  • Mohr, James C. Abortion in America: The Origins and Evolution of National Policy, 1800–1900. Oxford University Press, 1979. ISBN 0195026160
  • Paul, Maureen, E. Steven Lichtenberg, Lynn Borgatta, David A. Grimes, and Phillip G. Stubblefield (eds.). A Clinician’s Guide to Medical and Surgical Abortion. Philadelphia: Churchill Livingstone, 1999. ISBN 978-0443075292
  • Reagan, Leslie J. When Abortion Was a Crime: Women, Medicine, and Law in the United State, 1867–1973. University of California Press, 1998. ISBN 0520216571
  • Riddle, John M. Eve's Herbs: A History of Contraception and Abortion in the West. Harvard University Press, 1999. ISBN 978-0674270268
  • Rosen, Harold (ed.). Abortion in America: Medical, Psychiatric, Legal, Anthropological, and Religious Considerations. Beacon Press, 1970. ISBN 0807021970
  • Rubin, Eva R. The Abortion Controversy: A Documentary History. Greenwood Press, 1994. ISBN 0313284768
  • Schwarz, Stephen D. The Moral Question of Abortion. Chicago: Loyola University Press, 1990. ISBN 0829406239
  • Singer, Peter. Writings on an Ethical Life. Ecco Press, 2000. ISBN 0060198389
  • Staggenborg, Suzanne. The Pro-Choice Movement: Organization and Activism in the Abortion Conflict. Oxford University Press, 1994. ISBN 0195089251
  • Stark, Rodney. The Rise of Christianity. Princeton, NJ: Princeton University Press, 1996. ISBN 0691027498

External links

All links retrieved June 14, 2023.


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