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Abortion

Abortion

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Abortion

From Wikipedia, the free encyclopedia

Induced abortion

Classification and external resources

ICD-10

O04.

ICD-9

779.6

DiseasesDB

4153

MedlinePlus

002912

eMedicine

article/252560

Abortion is the termination of a pregnancy by the removal or expulsion of a fetus or embryo from the uterus, resulting in or caused by its biological death.[1]An abortion can occur spontaneously due to complications during pregnancy or can be induced in humans and other species. In the context of human pregnancies, an abortion induced to preserve the health of the gravida (pregnant female) is termed a therapeutic abortion, while an abortion induced for any other reason is termed an elective abortion. The term abortion most commonly refers to the induced abortion of a human pregnancy, while spontaneous abortions are usually termed miscarriages. Abortion has a low risk of maternal mortality except for abortions performed unsafely, which result in 70,000 deaths and 5 million disabilities per year globally.[2] Abortions are unsafe when performed by persons without the proper skills or outside of a medically safe environment. An estimated 42 million abortions are performed annually with 20 million of those abortions done unsafely around the world.[2] Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits.[3] Abortion has a long history and has been induced by various methods including herbal abortifacients, the use of sharpened tools, physical trauma, and other traditional methods. Contemporary medicine utilizes medications and surgical procedures to induce abortion. The legality, prevalence, cultural status, and religious status of abortion vary substantially around the world. In many parts of the world there is prominent and divisive public controversy over the ethical and legal issues of abortion. Abortion and abortion-related issues

feature prominently in the national politics in many nations, often involving the opposing pro-life and prochoice worldwide social movements (both self-named). Incidence of abortion has declined worldwide as access to family planning education and contraceptive services has increased.[4]
Contents
[hide]

1 Types

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1.1 Induced 1.2 Spontaneous

2 Methods

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2.1 Medical 2.2 Surgical 2.3 Other methods

3 Complications

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3.1 Physical health 3.2 Mental health

4 Incidence

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4.1 By gestational age and method 4.2 By personal and social factors 4.3 Unsafe abortion

5 History 6 Society and culture

o o o o o

6.1 Abortion debate 6.2 Abortion law 6.3 Sex-selective 6.4 Anti-abortion violence 6.5 Art, literature and film

7 In other animals 8 References 9 External links

Types
Induced

depending upon the age and health of the pregnant woman.[7] An abortion is referred to as elective when it is performed at the request of the woman "for reasons other than maternal health or fetal disease. An abortion is medically referred to as a therapeutic abortion when it is performed to: save the life of the pregnant woman.[7] or     selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy. they occur so early in the pregnancy that the woman is not even aware that she was pregnant. which increases in size as the pregnancy progresses. the definition by gestational age varies by country. The manner selected often depends upon the gestational age of the embryo or fetus. it is usually termed "stillborn". without the knowledge of the once pregnant woman. A pregnancy that ends before 37 weeks of gestation resulting in a liveborn infant is known as a "premature birth".[10][12] One study of 232 pregnant women showed "virtually complete [pregnancy loss] by the end of the embryonic period" (10 weeks LMP) with a pregnancy loss rate of only 2 percent after 8.7% of these losses occurred subclinically. in most cases. or during delivery.[11] The risk of spontaneous abortion decreases sharply after the 10th week from the last menstrual period (LMP).[6] Specific procedures may also be selected due to legality.More than one third of the approximately 205 million pregnancies that occur each year worldwide are unintended and about 20% of them end in induced abortion.[13] .[9] Most miscarriages are due to incorrect replication of chromosomes. Between 10% and 50% of pregnancies end in clinically apparent miscarriage.[10] Most miscarriages occur very early in pregnancy.9% of conceptuses were lost prior to 12 weeks.[5] A pregnancy can be intentionally aborted in several ways.[7] preserve the woman's physical or mental health. regional availability. and 91. and doctor-patient preference. One study testing hormones for ovulation and pregnancy found that 61.[7] terminate pregnancy that would result in a child born with a congenital disorder that would be fatal or associated with significant morbidity.5 weeks LMP. Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap. Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. they can also be caused by environmental factors. When a fetus dies in utero after about 22 weeks."[8] Spontaneous Main article: Miscarriage Spontaneous abortion (also known as miscarriage) is the expulsion of an embryo or fetus due to accidental trauma or natural causes before approximately the 22nd week of gestation.

S. categorically called abortifacients. diabetes. gemeprost is used in the UK and Sweden. Surgical . followed by a prostaglandin (either misoprostol or gemeprost: misoprostol is used in the U.) When used within 49 days gestation.The most common cause of spontaneous abortion during the first trimester is chromosomal abnormalities of the embryo/fetus.[18] Combined regimens includemethotrexate or mifepristone.[16] Methods Gestational age may determine which abortion methods are practiced.. In 2005.[15] A spontaneous abortion can also be caused by accidental trauma. infection.[14] accounting for at least 50% of sampled early pregnancy losses. In cases of failure of medical abortion. other hormonal problems. and abnormalities of the uterus. vacuum or manual aspiration is used to complete the abortion surgically. Medical Main article: Medical abortion "Medical abortions" are non-surgical abortions that use pharmaceutical drugs. approximately 92% of women undergoing medical abortion with a combined regimen completed it without surgical intervention. medical abortions constituted 13% of all abortions in the United States.[17] in 2010 the figure increased to 17%.[19] Misoprostol can be used alone. but has a lower efficacy rate than combined regimens.[15]Other causes include vascular disease (such as lupus). intentional trauma or stress to cause miscarriage is considered induced abortion or feticide.[14] Advancing maternal age and a patient history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion.

also known as "mini-suction" and "menstrual extraction". Surgical techniques are sometimes referred to as 'Suction (or surgical) Termination Of Pregnancy' (STOP). which requires surgical decompression of the fetus's head before evacuation. These techniques are comparable. 1: Amniotic sac 2: Embryo 3: Uterine lining 4: Speculum 5: Vacurette 6: Attached to a suction pump In the first 12 weeks.dilation and evacuation (D&E) is used. is a standard gynecological procedure performed for a variety of reasons. and abortion. how early in pregnancy they can be used. and does not require cervical dilation. After the 16th week of gestation. abortions can be induced by intact dilation and extraction (IDX) (also called intrauterine cranial decompression)." which has been federally banned in the United States. investigation of abnormal bleeding. The World Health Organization recommends this procedure. MVA.[20] Manual vacuum aspiration (MVA) abortion consists of removing the fetus or embryo. also called sharp curettage. Premature delivery can be induced with prostaglandin. A hysterotomy abortion is a procedure similar to a caesarean section and is . D&E consists of opening the cervix of the uterus and emptying it using surgical instruments and suction.[21] Other techniques must be used to induce abortion in the second trimester. Dilation and curettage (D&C). can be used in very early pregnancy. IDX is sometimes called "partial-birth abortion. placenta and membranes by suction using a manual syringe. From the 15th week until approximately the 26th. the second most common method of surgical abortion.A vacuum aspiration abortion at eight weeks gestational age (six weeks after fertilization). while electric vacuum aspiration (EVA) abortion uses an electric pump. and differ in the mechanism used to apply suction. Curettage refers to cleaning the walls of the uterus with a curette. suction-aspiration or vacuum abortion is the most common method. including examination of the uterine lining for possible malignancy. and whether cervical dilation is necessary. only when MVA is unavailable. this can be coupled with injecting the amniotic fluid with hypertonic solutions containing saline or urea.

2 per 100. In Southeast Asia. 1150. and insertion of non-surgical implements such as knitting needles and clothes hangers into the uterus.[32][33][34][35] In comparison. c. These methods are rarely seen in developed countries where surgical abortion is legal and available.[23] Other methods Bas-relief at Angkor Wat. when legally performed in developed countries.2±1.[26] Abortion is sometimes attempted by causing trauma to the abdomen. can cause serious internal injuries without necessarily succeeding in inducing miscarriage. and is not recommended by physicians. black cohosh. such as multiple organ failure. depicting a demon inducing an abortion by pounding the abdomen of a pregnant woman with a pestle. if severe. there is an ancient tradition of attempting abortion through forceful abdominal massage. is among the safest procedures in medicine. It requires a smaller incision than a caesarean section and is used during later stages of pregnancy. and the now-extinct silphium (see history of abortion).[22] The Royal College of Obstetricians and Gynaecologists has recommended that an injection be used to stop the fetal heart during the first phase of the surgical abortion procedure to ensure that the fetus is not born alive. self-induced abortion include misuse of misoprostol. Cambodia. a number of herbs reputed to possess abortifacient properties have been used in folk medicine: tansy. pennyroyal.performed under general anesthesia. [24] Historically. by .[25] The use of herbs in such a manner can cause serious²even lethal²side effects.[30][31] In such settings.[27] Both accidental and deliberate abortions of this kind can be subject to criminal liability in many countries. risk of maternal death is between 0.[29] Complications See also: Health risks of unsafe abortion Abortion.[28] Reported methods of unsafe.000 procedures. The degree of force.[28] One of the bas reliefs decorating the temple ofAngkor Wat in Cambodia depicts a demon performing such an abortion upon a woman who has been sent to the underworld.

[45] With more advanced gestation there is a higher risk of uterine perforation and retained products of conception. like most minimally invasive procedures. hematometra (in the uterus).[52][53] The National Cancer Institute.[32][36][37][38][39][40] Unsafe abortions (defined by the World Health Organization as those performed by unskilled individuals. health risks associated with medical abortion are generally considered no greater than for surgical abortion. carry a small potential for serious complications. uterine or pelvic infection. incidence of major complications is highest after 20 weeks of gestation and lowest before the 8th week. mortality from childbirth in developed countries was 11 times greater. nor does it increase the risk of future premature births.1996.[56][57] Mental health Main article: Abortion and mental health .000 (70.[43] Surgical abortion is generally safe and the rate of major complications is low[44] but varies depending on how far pregnancy has progressed and the surgical method used.[2][42] Physical health Surgical abortion methods. incomplete abortion. ongoing intrauterine pregnancy. ectopic pregnancy. leiomyomas or had previous difficult first-trimester abortion are contraindicated to undertake surgical abortion unless ultrasonography is immediately available and the surgeon is experienced in its intraoperative use. with hazardous equipment. misdiagnosed/unrecognized ectopic pregnancy.[46] and specific procedures like dilation and evacuation may be required.[51] Although some epidemiological studies suggest an association between abortion and breast cancer. or miscarriage.[47] Concerning the methods used.[45] Possible complications includehemorrhage. general incidence of major complications for surgical abortion varies from lower for suction curettage.[55] and other major medical bodies have concluded that abortion does not cause breast cancer. infertility.[54] the Royal College of Obstetricians and Gynaecologists.[49] Women who have uterine anomalies. or in unsanitary facilities) carry a high risk of maternal death and other complications. the mortality rate has been estimated at 367 per 100.[48] Use of general anesthesia increases the risk of complications because it relaxes uterine musculature making it easier to perforate. the World Health Organization has concluded from large cohort studies that there is "no consistent effect of first trimester induced abortion upon a woman's risk of breast cancer later in life".000 women per year worldwide).[41] For unsafe procedures.[31] In the first trimester.[50] Abortion does not impair subsequent pregnancies. to higher for saline instillation. uterine perforation and cervical laceration.[45] Concerning gestational age.

assuming no change in abortion laws.number of abortions per 1000 women between 15 and 44 years of age   Abortion ratio . the abortion rate in developing countries is largely attributable to lack of access to modern contraceptives.35 per 1000 women.[66] According to the Guttmacher Institute and the United Nations Population Fund. the world rate . the frequency of abortions is similar in developing countries (where abortion is generally restricted) to the frequency in developed countries (where abortion is generally much less restricted).[60] Some proposed negative psychological effects of abortion have been referred to by pro-life advocates as a separate condition called "post-abortion syndrome.[65] and pro-life groups have criticized researchers for allegedly jumping to conclusions about those numbers. providing that access to contraceptives would result in about 25 million fewer abortions annually. The greatest decrease has occurred in the developed world with a drop from 39 to 26 per 1000 women in comparison to the developing world.[69] . the existence of "post-abortion syndrome" is not recognized by any medical or psychological organization.number of abortions out of 100 known pregnancies (excluding miscarriages and stillbirths) The number of abortions performed worldwide has decreased between 1995 and 2003 from 45." However.2 out of 100 known pregnancies) and the Netherlands (10.[61][62][63] Incidence There are two commonly used methods of measuring incidence of abortion: Abortion rate .[67] The incidence of induced abortion varies regionally. Some countries. which means a decrease in abortion rate from 35 to 29 per 1000 women.6 million to 41. Romania (63 out of 100)[68] and Vietnam (43. such as emotional attachment to the pregnancy. such as Belgium (11.6 per 100).[3][64] Abortion rates are very difficult to measure in locations where those abortions are illegal. Others like Russia (62. had a comparatively low ratio of induced abortion.7 out of 100) had a high ratio (data for last three countries of unknown completeness). and conservative views on abortion increase the likelihood of experiencing negative feelings after an abortion.6 million. Out of a total of about 42 million abortions 22 million occurred safely and 20 million unsafely.[58] Some factors in a woman's life. pre-existing psychiatric illness.6 out of 100). which had a decrease from 34 to 29 per 1000 women.[2] On average. lack of social support.[59] The American Psychological Association (APA) concluded that abortion does not lead to increased mental health problems. including almost 15 million fewer unsafe abortions.No scientific research has demonstrated that abortion is a cause of poor mental health in the general population. However there are groups of women who may be at higher risk of coping with problems and distress following abortion. The estimated world ratio was 26%.

A 1998 study from 27 countries on the reasons women seek to terminate their pregnancies concluded that the most common reason women cited for having an abortion was to postpone childbearing to a more suitable time or to focus energies and resources on existing children. 89% of terminations occurred at or under 12 weeks.17% of the total number of abortions performed that year. India. during 2000. 7. 6% by D&E.5 weeks.[72] In 2009 in Scotland. in England and Wales in 2006.1% of all terminations were performed at less than 9 weeks. 0. this accounts for 0. 62. and 1.[74] By personal and social factors A bar chart depicting selected data from the 1998 AGI meta-study on the reasons women stated for having an abortion. it was found that 88.S.0% by "other" (including hysterotomy andhysterectomy).By gestational age and method Histogram of abortions by gestational age in England and Wales during 2004. with medical termination accounting for nearly 70%.[70] The Guttmacher Institute estimated there were 2. (Data source: Centers for Disease Control and Prevention) (right) Abortion rates also vary depending on the stage of pregnancy and the method practiced. Dilation and curettage.4% by "intrauterine instillation" (saline or prostaglandin).[71] Similarly. and 1.9% of these were classified as having been done by "curettage" (suction-aspiration. and 1. 9% between 13 to 19 weeks. 90. Dilation and evacuation). and 30% were medical. 64% of those reported were by vacuum aspiration.4% at or after 21 weeks.2% of abortions were conducted at or prior to 12 weeks.[73] Later abortions are more common in China. and other developing countries than in developed countries. Average is 9.7% by "medical" means (mifepristone). The most commonly reported reasons were . (left) Abortion in the United States by gestational age.5% at or over 20 weeks. 10.200 intact dilation and extraction procedures in the U.4% from 13 to 20 weeks. In 2003. 2004. from data collected in those areas of the United States that sufficiently reported gestational age.

[76] In Finland and the United States. preference for children of a specific sex. the perception that she is too young. warning against midwives performing abortions. Unsafe abortion Soviet poster circa 1925. lack of access to or rejection of contraceptive methods. study. 1% of women having abortions became pregnant as a result of rape and 0.S. and unemployment. desire to provide schooling for existing children." Main article: Unsafe abortion Women seeking to terminate their pregnancies sometimes resort to unsafe methods. Inconsistent use was reported by 49% of those using condoms and 76% of those using the combined oral contraceptive pill. inability to afford additional children.[79] . insufficient economic support for families. Title translation: "Abortions performed by either trained or self-taught midwives not only maim the woman. particularly when access to legal abortion is restricted. 42% of those using condoms reported failure through slipping or breakage.[75] In the 2004 survey-based U.socioeconomic factors such as being unable to afford a child either in terms of the direct costs of raising a child or the loss of income while she is caring for the child. disapproval of single motherhood. lack of support from the father. concern for the health risks posed by pregnancy in individual cases was not a factor commonly given. or efforts toward population control (such as China's one-child policy). [75] A 2004 study in which American women at clinics answered a questionnaire yielded similar results.[76] Another American study in 2002 concluded that 54% of women who had an abortion were using a form of contraception at the time of becoming pregnant while 46% were not. India.[77] The Guttmacher Institute estimated that "most abortions in the United States are obtained by minority women" because minority women "have much higher rates of unintended pregnancy. relationship problems with a husband or partner. About one in eight pregnancy-related deaths worldwide are associated with unsafe abortion. These might include the stigmatization of disabled people. in Bangladesh. they also often lead to death."[78] Some abortions are undergone as the result of societal pressures. These factors can sometimes result in compulsory abortion or sex-selective abortion. however. and Kenya health concerns were cited by women more frequently as reasons for having an abortion.5% as a result of incest. disruption of education.

[83] Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits.000 deaths and 5 million disabilities per year. unsafe procedures still accounted for 48% of all abortions performed in 2003.[81] Health education. Restrictive abortion laws are associated with a high rate of unsafe abortions. or both. or by a healthcare professional operating in sub-standard conditions.. 25% in Latin America.[2][81][82] In addition. Unsafe abortion remains a public health concern due to the higher incidence and severity of its associated complications." An example of a clandestine advertisement published in an 1845 edition of the Boston Daily Times. The legality of abortion is one of the main determinants of its safety. It has been estimated that the incidence of unsafe abortion could be reduced by as much as 73% without any change in abortion laws if modern family planning and maternal health services were readily available globally..[3] While maternal mortality seldom results from safe abortions. unsafe abortions result in 70. a lack of access to safe and effective contraception contributes to unsafe abortion. such as incomplete abortion. and damage to internal organs. sepsis.[2] Complications of unsafe abortion are said to account for approximately 12% of maternal mortalities in Asia. carried out by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards."[80] They may be performed by the woman herself. and improvements in health care during and after abortion have been proposed to address this phenomenon. and 13% in sub-Saharan Africa. . by another person without medical training.The World Health Organization (WHO) defines an unsafe abortion as being "a procedure . hemorrhage.6 million in 2003.6 million in 1995 to 41.[85] History "French Periodical Pills. access to family planning.[84] Although the global rate of abortion declined from 45.

600 in 1968 to 1. suggested in his work Gynaecology that women wishing to abort their pregnancies should engage in energetic exercise.5 million in 1980.[86] There is evidence to suggest that. Soranus. The Hippocratic Oath. however.[92] In 1935 Nazi Germany. Please help improve this article by adding reliable references. are two poisonous herbs with serious side effects that have at times been used to terminate pregnancy. However. due to a confluence of factors.[97] In the United States. and riding animals. the ancient Greeks relied upon silphium as an abortifacient. in addition to using it as a contraceptive. pregnancies were terminated through a number of methods. Tansy and pennyroyal. advertisement of services in the Victorian era suggests. A medieval female physician.[87] It is also believed that. but advised against the use of sharp instruments to induce miscarriage due to the risk of organ perforation.´ which was sometimes a code for early abortifacients. energetic jumping. the use of sharpened implements. the number of reported abortions spiked from 2. the procedure remained relatively rare until the late 1960s. Such folk remedies. the number of abortions exploded worldwide. for example. despite bans in both the United Kingdom and the United States.[89] Pope Sixtus V (1585±90) is noted as the first Pope to declare that abortion is homicide regardless of the stage of pregnancy. varied in effectiveness and were not without risk. a 2nd-century Greek physician. He also prescribed a number of recipes for herbal baths.Main article: History of abortion Induced abortion can be traced to ancient times. Wade may have affected the number of reported abortions prior to 1973. from 4. andbloodletting.[91][non-primary source needed] In the 20th century the Soviet Union (1919). as the disguised.[88] administered a number of remedies for the ³retention of menstrua. In late 1960s and early 1970s.800 in 1968 to 87. a law was passed permitting abortions for those deemed "hereditarily ill. historically.[93][94][95][96] However. carrying heavy objects. forbade doctors from helping to procure an abortion by pessary. the fact that abortion remained illegal in many states prior to the landmark 1973 decision of Roe v. Iceland (1935) and Sweden (1938) were among the first countries to legalize certain or all forms of abortion.702 in 1980. the application of abdominal pressure. some sources show an even greater increase.[90] Abortion in the 19th century continued. but nonetheless open. Unsourced material may be challenged and removed. pessaries. In West Germany. (November 2008) . Trotula of Salerno. the chief statement of medical ethics for Hippocratic physicians in Ancient Greece." while women considered of German stock were specifically prohibited from having abortions. and other techniques. Society and culture Abortion debate This section needs additional citations for verification. including the administration of abortifacient herbs.

(right) Main article: Abortion debate See also: Religion and abortion In the history of abortion. 79% of male and 67% of female respondents were in favor of legalized mandatory spousal notification. Generally. An individual's position on the complex ethical. philosophical. her husband. making abortion tantamount to murder. her parents. controversy. In a 2003 Gallup poll in the United States. Abortion debates. ethical scope. the former position argues that a human fetus is a human being with a right to life. and proper extent of governmental authorities in public policy. biological. and beliefs on the responsibility. moral. and legal issues is often related to his or her value system. Opinions of abortion may be described as being a combination of beliefs on its morality. (left) Pro-life activists near the Washington Monument at the annual 2009 March for Life in Washington.[98] Abortion law . Debate also focuses on whether the pregnant woman should have to notify and/or have the consent of others in distinct cases: a minor. In both public and private debate. those in favor of greater legal restrictions on. the biological father. are often spearheaded by groups advocating one of these two positions. In the United States. DC. overall support was 72% with 26% opposed.Pro-choice activists near the Washington Monument at the March for Women's Lives in 2004. or even complete prohibition of abortion. or justification of laws permitting or restricting abortion. especially the choice whether or not to carry a pregnancy to term. The latter position argues that a woman has certain reproductive rights. and activism. or. most often describe themselves as "pro-life" while those against legal restrictions on abortion describe themselves as "pro-choice". The main positions are one that argues in favor of access to abortion and one argues against access to abortion. arguments presented in favor of or against abortion access focus on either the moral permissibility of an induced abortion. especially pertaining to abortion laws. induced abortion has been the source of considerable debate. a legally married or common-law wife. Religious ethics also has an influence upon both personal opinion and the greater debate over abortion (see religion and abortion). for any case.

Main article: Abortion law See also: Reproductive rights and History of Abortion Law Debate International status of abortion law: Legal on request. The new philosophies of the Axial Age. which began discussing the nature and value of human life in abstract terms. With the sole exception of Bracton. theory based medicine from traditional. Generally. but wives who procured abortions without their husband's knowledge could be severely punished.and post-quickening distinction from the ancient philosophies.[100] commentators on the English common law formulated the born alive rule. empirically based medicine. Abortion as such was not outlawed. abortions prior to quickening were treated as minor crimes.[103] .[102] justified stricter abortion laws. it was claimed that scientific knowledge of human development beginning at fertilization. and retained the pre. if at all. using language dating back to the Leges Henrici Primi. mental health. and in some countries physical and/or mental health Illegal with exception for maternal life. and/or fetal defects Illegal with exception for rape. health. This was part of a larger struggle on the part of the medical profession to distinguish modern. Even the Christian ecclesiastical courts of the Middle Ages imposed penance and no corporal punishment for abortion. and/or socioeconomic factors Illegal with exception for rape.[101] In the late 18th century. though various countries have different time limits Illegal with exception for rape. maternal life. health. and in some countries mental and/or physical health Illegal with no exceptions Varies by region No information [99] The earliest secular laws regulating abortion reflect a concern with class and caste purity and preservation of male prerogatives. including midwifery and herbalism. had little impact on existing abortion laws. fetal defects. mental health. excluding feticide from homicide law. as could slaves who induced abortions in highborn women. maternal life. maternal life.

The Abortion Act 1967 allowed abortion for limited reasons in the United Kingdom (except Northern Ireland). The Supreme Court of Canada. prescribe the distribution of information on fetal development. using a trimester-based system to regulate the window of legality: In the United States. Morgentaler (1993). often. as in some other countries. v. and Iceland.[110][111]  . By contrast. were two of the first countries to generally allow abortion. the Chilean government began the free distribution of emergency contraception. The second half of the 20th century saw the liberalization of abortion laws in other countries as well. In Nicaragua.and post-quickening abortions were criminalized by Lord Ellenborough's Act in 1803.Both pre. discarded its criminal code regarding abortion in 1988. and Nicaragua.[104] In 1861. some states impose a 24-hour waiting period before the procedure. or danger to the pregnant woman's life or health. and the right to reproductive health are major issues of human rights that are sometimes used as justification for the existence or absence of laws controlling abortion.[107]   In the United Kingdom. Malta. ruling that such laws violated an implied right to privacy in the United States Constitution. but not always. with legislation in 1920. Religious. v. In the 1973 case. similarly.[106] Canada later struck down provincial regulations of abortion in the case of R. Wade. in which abortion is normally illegal.[citation needed] Other countries. El Salvador. after ruling that such restrictions violated the security of person guaranteed to women under the Canadian Charter of Rights and Freedoms. moral. incest. abortion in Ireland was affected by the addition of an amendment to the Irish Constitution in 1983 by popular referendum. rises in maternal death directly and indirectly due to pregnancy have been noted.[105] The Soviet Union. in 2006. the right to liberty. the right to security of person. with legislation in 1935. A few nations ban abortion entirely: Chile. recognizing "the right to life of the unborn". Current laws pertaining to abortion are diverse. The right to life. the Parliament of the United Kingdompassed the Offences against the Person Act 1861. or require that parents be contacted if their minor daughter requests an abortion. the United States Supreme Court struck down state laws banning abortion. two doctors must first certify that an abortion is medically or socially necessary before it can be performed. which continued to outlaw abortion and served as a model for similar prohibitions in some other nations. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained. will allow one to be performed in the case of rape.[108][109] However. and cultural sensibilities continue to influence abortion laws throughout the world. Roe v. Morgentaler. in the case of R.

The selective termination of a female fetus is most common. during the 1970s and '80s. but the government has long supported a network of "menstrual regulation clinics". in order to obtain abortions. Other issues in abortion law may include the requirement that a minor obtain the consent of one or both parents to the abortion or that she notify one or both parents. The preference for male children is reported in many areas of Asia. the economic role of men. [113] In the US."[119] In 1991. and wrongful birth laws. The development of this technology has led to sex-selective abortion. South Korea.000 rupees [for a dowry] later. to an average of . Sex-selective Main article: Sex-selective abortion Sonography and amniocentesis allow parents to determine sex before childbirth. abortion is illegal. the requirement that abortion providers inform patients of the supposed health risks of the procedure. it is a legal offense to obstruct access to a clinic or doctor's office where abortions are performed. the male-to-female sex ratio in India was skewed from its biological norm of 105 to 100." regulating how close protesters can come to the clinic or to the patients. and abortion used to limit female births has been reported in China. "Invest 500 rupees [for a sex test] now. that is driven at least partly by differing limits on abortion according to gestational age or the scarcity of doctors trained and willing to do later abortions. the costs associated with dowries. "Buffer zones. may exist. the requirement that a woman obtain the consent of her husband to the abortion and the question of whether the fetus's father can prohibit an abortion. to Britain or other countries with less restrictive laws. Poland. the Republic of Ireland. It is suggested that sex-selective abortion might be partially responsible for the noticeable disparities between the birth rates of male and female children in some places. Women without the means to travel can resort to providers of illegal abortions or try to do it themselves.[117] In India. or the termination of a fetus based on sex.[112] In places where abortion is illegal or carries heavy social stigma. and other countries where elective abortion is illegal. and a common Indian tradition which dictates that funeral rites must be performed by a male relative have led to a cultural preference for sons. Taiwan.[114] However.[118] The widespread availability of diagnostic testing. led to advertisements for services which read. and India. In Bangladesh. where menstrual extraction (manual vacuum aspiration) can be performed as menstrual hygiene. about 8% of abortions are performed on women who travel from another state.[115][116] In the United States and some Canadian localities. save 50.[citation needed] Thousands of women every year travel from Northern Ireland. pregnant women may engage in medical tourism and travel to countries where they can terminate their pregnancies.

in response to population concerns.[133] The Cider House Rules (novel 1985. arson. including murder.[121] 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. four abortion providers²Drs. stalking. including receptionists and security guards.[124]A ban upon the practice of sex-selective abortion was enacted in 2003. film 1999) follows the story of Dr. Shelley Shannon. a Yale student proposed using aborted excretions and the induced abortion itself as a performance art project. In the United States. and other personnel at abortion clinics.[130] Art. and bombing. committed in order to protect the lives of fetuses. David Gunn. Larch an orphanage director who is a reluctant abortionist after seeing the consequences of back-alley abortions. Hundreds of bombings. arsons.[122] In the People's Republic of China. kidnapping. The trend was more pronounced in rural regions: as high as 130:100 in Guangdong and 135:100 in Hainan. and Paul Jennings Hill. Scott Roeder. John Britton. assault. Pro-life activist Børre Knudsen was linked to a 1994 art theft as part of a pro-life drive in Norway surrounding the 1994 Winter Olympics.[120] Researchers have asserted that between 1985 and 2005 as many as 10 million female fetuses may have been selectively aborted.[125] Anti-abortion violence Main article: Anti-abortion violence Doctors and facilities that provide abortion have been subjected to various forms of violence. invasions. have been killed in the United States and Australia.[123] 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. attempted murder. there is also a historic son preference.[126][127] Only a small fraction of those opposed to abortion commit violence. literature and film Art serves to humanize the abortion issue and illustrates the myriad of decisions and consequences it has. One of the earliest known representations of abortion is in a bas relief at Angkor Wat (c. 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. 1150). that had the head of a fetus attached to the body of a bird. Anti-abortion violence has been classified by governmental and scholarly sources as terrorism. acid attacks. Barnett Slepian.[132] In 2008. the first person to be executed in the United States for murdering an abortion provider. and George Tiller²have been assassinated. and incidents of vandalism against abortion providers have also occurred. The implementation of the one-child policy in 1979.[131] A Swiss gallery removed a piece from a Chinese art collection in 2005. and his orphan medical assistant . Attempted assassinations have also taken place in the United States and Canada.108 to 100. often rationalizing their actions asjustifiable homicide or defense of others.[128][129] Notable perpetrators of anti-abortion violence include Eric Robert Rudolph.

[139] On the abortion debate. rebellion and societal expectations. an irresponsible drug addict is used as a pawn in a power struggle between pro-choice and pro-life groups in Citizen Ruth (1996). The emotional impact of dealing with an unwanted pregnancy alone is the focus of Things You Can Tell Just By Looking At Her (2000) and Circle of Friends (1995).[138] Various options and realities of abortion have been dramatized in film. Irene Vilar revealed her past abuse and addiction to abortion in Impossible Motherhood. abortion may be caused by contagious disease. According to Vilar it was the result of a dark psychological cycle of power. ISBN 978-1-85941-215-2.[147] Male Gray langurmonkeys may attack females following male takeover. where she aborted 15 pregnancies in 17 years.[135] Doctor Susan Wicklund wrote This Common Secret (2007) about how a personal traumatic abortion experience hardened her resolve to provide compassionate care to women who decide to have an abortion. it may be caused by crowding through doors. has no opportunities. the heroine's abortion is contextualized spiritually by the goddesses Demeter. 14.[144][145][146] although the frequency in the wild has been questioned.[142] Abortion may also be induced in animals. in the context of animal husbandry.[137] In Annie Finch's mythic epic poem and opera libretto Among the Goddesses (2010). but can often be controlled by vaccination. Routledge. or that are pregnant with twin foals. As Wicklund crisscrosses the West to provide abortion services to remote clinics. or being chased by dogs. causing miscarriage. Gynaecology for Lawyers.[134] Feminist novels such as Braided Lives (1997) by Marge Piercy emphasize the struggles women had in dealing with unsafe abortion in various circumstances prior to legalization. abortion may be induced in mares that have been mated improperly. As a marriage was in trouble in the The Godfather Part II (1974) Kay knew the relationship was over when she aborted "a son" in secret. she tells the stories of women she's treated and the sacrifices she and her loved ones made. moves in with the father and finds herself involved with drugs.[136] In 2009. Kali.[148]References 1. In Riding in Cars with Boys (2001) an underage woman carries her pregnancy to term as abortion is not an affordable option. ^ Dutt T. in sheep. Matthews MP (1998). or that have been purchased by owners who did not realize the mares were pregnant.[141] In cows. and Inanna. and questioning if she loves her child. For example.[140] In other animals Further information: Miscarriage#In other animals Spontaneous abortion occurs in various animals. While in Juno (2007) a 16-year-old initially goes to have an abortion but decides to bear the child and allow a wealthy couple to adopt it.[143] Feticide can occur in horses and zebras due to male harassment of pregnant mares or forced copulation. such as Brucellosis or Campylobacter. . For example. affordability and dangers of illegal abortions.Homer who is against abortion. Other films Dirty Dancing (1987) and If These Walls Could Talk (1996) explore the availability.

In these instances. the wife of the previous Prime Minister. Through the provision of contraceptive services. or injury to the mental or physical health of the pregnant woman is greater than if the pregnancy is terminated. "Unsafe abortion: global and Abortion . Provide safe. in opening the Safe Motherhood Conference: Saving Mother's Lives . Tun Dr. However.000 women aged between 15 and 49 years old go for abortion in Malaysia and the rate of illegal abortions is 0.1% or 500 per 500.The Health Impact of Unsafe Abortion. ^ a b c d e f Shah I. provide education on dangers of unsafe abortions and post-abortion counselling" (source: The Star.000 live births yearly. in cases where the continuance of a pregnancy involves risk to the life of the pregnant woman. We have to address family planning. then a woman should have the right to informed choice and access to safe abortion. Our Services . treatment of complications and contraceptive services. sensitive.. non-judgmental and affordable abortion-related services. and a reduction in the incidence of unsafe abortion. Our Goal A universal recognition of a woman's right to have access to safe abortion. Ahman E (December 2009).2. unintended pregnancies and induced abortion can be significantly reduced. with special attention to young women and under-served and marginalised groups. Provide referrals for post-abortion care. Unsafe abortions are also preventable through improvement in accessibility of sexual and reproductive health information and services (including family planning). Current Situation Taking into consideration that 38 out of every 1.and post-abortion counselling should be made available. Our Objectives 1. Siti Hasmah Mohd Ali. 2.. elimination of unsafe abortion and ensure effective use of contraceptive to avoid unwanted pregnancies. information on safe abortion together with pre. said "The best way to prevent unsafe abortions is to prevent unintended or unwanted pregnancies. 10 October 2003).

contraceptive services to prevent future unplanned pregnancies. referrals for postabortion care and treatment and most importantly.and post-abortion counseling. with special attention to young women and under-served and marginalized groups.. sensitive. y y y y y Access Adolescents / Young People Advocacy AIDS/HIV Abortion .Provide safe. Services provided including pre. Please refer to State MAs for a complete list of clinic locations and services provided. non-judgmental and affordable abortion-related services. information on safe abortion. (The above services are provided through the State MA clinics.) The 5A's ..

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