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Abortion

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Abortion, in its most common usage, refers to the voluntary or induced termination of pregnancy, generally through the use of surgical procedures or drugs. As a result, birth does not take place. Medically, the term also refers to the early termination of a pregnancy by natural causes ("spontaneous abortion" or miscarriage), which ends one in five of all pregnancies, usually within the first thirteen weeks, or to the cessation of normal growth of a body part or organ. What follows is a discussion of the issues related to deliberately induced abortion.

Since 1972, the medical definition of pregnancy in the United States requires that implantation has already occurred. According to this definition, emergency contraceptives do not interfere with pregnancy. The controversy arises when one considers that conception occurs before implantation. Some people believe the zygote is a human being with the same moral standing as an implanted embryo before pregnancy actually starts.

"Morning after" or "emergency" contraceptive drugs that are taken within 72 hours of sex interfere with the release of eggs from the ovary or with fertilization, and so are will be released anyway; in these cases, if conceptions occurs the zygote will implant successfully regardless of emergency contraception use. There is no fetotoxic 'backup chemical' found in current formulations of emergency contraception: if ovulation occurs, conception will probably follow and the emergency contraceptive will have failed. Some studies suggest that emergency contraceptives can thin the uterine lining and thus interfere with implantation of a zygote. If true, this also happens with normal birth control pills taken regularly as well. Because these drugs (i.e. the morning after pill and all hormonal contraceptives) are possibly abortifacient, some believe that their use is immoral.

Methods of abortion

Depending on the stage of pregnancy, an abortion is performed by a number of different methods. Chemical abortion (or Medical Abortion as opposed to Surgical Abortion) is the usual method when it is induced before the first nine weeks. The procedure consists of administering either methotrexate or mifepristone (RU-486) followed by administration of misoprostol. Approximately eight per cent of these abortions require surgical followup, usually by vacuum aspiration (See below).

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

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

As the fetus size increases, other techniques must be used to induce abortion in the third trimester. Premature expulsion of the fetus can be induced with prostaglandin; this can be coupled with injecting the amniotic fluid with saline or urea solution. Very late abortions can be brought about by the controversial intact dilation and extraction (D & X) or a hysterotomy abortion, similar to a caesarian section, and requiring the surgical decompression of the fetus's head before evacuation. (This is the procedure controversially termed "partial-birth abortion").

Possible side effects

Postabortion psychological issues

Research has been carried out on the question of whether abortion is associated with increased risk of clinical depression, but the results are mixed. According to a study of 1,884 women conducted by the National Longitudinal Survey of Youth, women who did not carry their first pregnancies to term are 65% more likely to be diagnosed with clinical depression around eight years later. However, other studies did not support a conclusion that depression may be caused by abortion. For example, a study of 2,525 women revealed that women who had an abortion were more likely to report depression or lower satisfaction with their lives. However, they also often reported rape, childhood physical and sexual abuse, and violent partners. After controlling for the history of abuse, partner characteristics, and background variables, abortion was not related to poorer mental health (Denious, J. & Russo, N. F. (2000). The Socio-Political Context of Abortion and its Relationship to Women's Mental Health. In J. Ussher (Ed.). Women's Health: Contemporary International Perspectives (pp. 431-439). London: British Psychological Society.).

A study in the Medical Science Monitor said that "Consistent with previous research, the data here suggest abortion can increase stress and decrease coping abilities, particularly for those women who have a history of adverse childhood events and prior traumata." In the study 65% of post-abortive American women and 13.1% of Russian women experienced multiple symptoms of increased arousal, re-experiencing, and avoidance associated with posttraumatic stress disorder (PTSD). According to the study, 14.3% of American and 0.9% of Russian women met the full diagnostic criteria for PTSD. (Vincent Rue, Priscilla Coleman, James Rue, David Reardon (2004). Induced abortion and traumatic stress: A preliminary comparison of American and Russian women. Med Sci Monit, 2004; 10(10): SR5-16).

In keeping with the paper, it should however be noted that many day to day tasks cause problems for sufferers of PTSD, especially as a result of child abuse.

Postabortion physical issues

  • The exact risk and type of complications depend on the abortion method as well as the clinical and hygienic conditions. Studies found that in developed countries where abortion is legal the risk of serious physical complications of an abortion is less than 1%. In countries where abortion is illegal, this percentage is much higher, although the exact figure is unknown. This is due to the inherently dangerous nature of unregulated illegal surgery by doctors of dubious skill. Serious complications may include infections, bleeding, and even fatal injuries.
The Abortion-Breast Cancer (ABC) hypothesis is based on the fact that during early pregnancy hormone levels increase significantly. This initiates cellular differentiation (growth) in the breast preparing for lactation. The ABC hypothesis states that if the pregnancy is aborted prior to full differentiation in the third trimester this could leave more "vulnerable" cells than prior to the pregnancy; resulting in an elevated risk of breast cancer. The majority of interview based studies have indicated a link, some are statistically significant, but there is a debate as to how reliable they are given the controversial nature of abortion may create recall bias. The most recent meta-analysis published in the Lancet March 2004 of 53 epidemiological studies concluded there was no ABC link. Nevertheless gaps remain in the research while the "ABC link" is still a hot campaigning issue in anti-abortion circles.

Abortion law

Main Article: Abortion law

Abortion has been a controversial subject throughout history due to the moral and ethical issues that surround it. It has been regularly banned and otherwise limited, though abortions have continued to be commonplace in many areas where it is illegal. Almost 2/3 of the world’s women currently reside in countries where abortion may be obtained on request or for a broad range of social, economic or personal reasons. Abortion laws vary widely by country, with some countries allowing nearly total liberalization, and others banning abortion under any circumstances. There are also countries that do not have any laws restricting abortion, such as Canada.

Abortion as a political issue

Abortion has sometimes been a bitterly-fought battle in politics, especially in the United States. The real controversy here started in 1973, when 7 out of 9 Supreme court Justices ruled in favor of abortion in the case of Roe vs. Wade. Specifically, they ruled that states could not forbid a woman to terminate her pregnancy in the first three months (the first trimester) of her pregnancy.

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

In many other countries, the issue of abortion is less of a political issue. None of the main political parties in the UK, for instance, are challenging the basis of the currently permissive laws on abortion, and abortion is available free through the National Health Service. Abortion is no longer considered to be a mainstream political issue in the UK.

Abortion and Feminism

The cornerstone of the pro-choice feminist movement is reproductive rights, freedom from the interference of men, other women, the state or the church in the decision over whether to have an abortion.

It stresses heavily the right of a woman to choose an abortion for her own protection and life, as well as for her happiness, her career, her education, and her personal freedom. Most of the arguments tend to characterize abortion as a form of birth control, freeing women from the physical and emotional burden of sex. They charge that men are already free of pregnancy and do not have to carry children at all, so abortion is merely an equalizer in this regard. Further, the perspective tends to view any encroachment by male pro-life advocates as chauvinism.

Most feminist groups tend to be heavily pro-choice or pro-choice leaning. Groups like NOW and others have a definite bias toward the right of a woman to have an abortion, but similar pro-choice feminist views are defended and advanced by non-feminist groups ranging from the American Civil Liberties Union to Planned Parenthood. Abortion rights is often a measuring stick for support of feminism, and the two are used interchangeably by many on both sides of the debate.

The pro-life feminist movement connects abortion to war and characterizes it as a male-dominated institution of violence against both women and children. Early feminists took the view that abortion was a horrible tragedy, a disastrous crime, and a male-supported instrument to further power over women.

Elizabeth Cady Stanton termed abortion infanticide, while Emma Goldman bemoaned the high rate of abortion as "appalling" and "beyond belief" (although the latter firmly supported the right of women to have abortions). Mattie Brinkerhoff characterized abortion as destroying the life of an unborn child, and evidence that a woman "has been greatly wronged." Victoria Woodhull, the first female US presidential candidate, affirmed that "[t]he rights of children as individuals begin while yet they remain the foetus." Caroline Elizabeth Sarah Norton wrote of "infant butcheries" and "ante-natal child murder," describing abortion as interfering with "the right of the unborn to be born." Mary Wollstonecraft suggested outright that abortion violated the laws of nature and Matilda Joslyn Gage suggested it was one of the greatest wrongs against women and that it was committed by men. Alice Paul, author of the first Equal Rights Amendment in 1923, said simply "Abortion is the ultimate exploitation of women." Susan B. Anthony referred to it as "child murder" and said famously:

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

Today the pro-life feminist view is taken by few groups. Although some groups are neutral on abortion, the Feminists For Life are the primary group explicitly and aggressively advocating both for feminism and against abortion.

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