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Latest comment: 7 months ago by CensoredScribe in topic When does history start or end?
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Anonymous quotes signed "A"

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Latest comment: 12 years ago4 comments4 people in discussion

There is no dispute that these quotes are accurate, are from the journal edited by Anthony, and they were signed "A". Thus they do not belong in the "Dipsuted" section, but under Section A. Any concern about the varying attributions is covered very succinctly in the attribution blurb, which does NOT attribute the words to a specific person, but rather accurately describes the source of the quotation and its varying implications. 69.138.131.88 18:34, 16 August 2012 (UTC)Reply

I have reorganized the article with these quotes in a section labeled "Anonymous" rather than "Disputed", along with other anonymousities. Is this an acceptable compromise? ~ Ningauble (talk) 17:36, 20 August 2012 (UTC)Reply
I support the move by Ningauble of all anonymous entries to their own section at the bottom. Certainly the 1869 essay signed "A" belongs there. Binksternet (talk) 20:02, 20 August 2012 (UTC)Reply
I agree also. Since we really can't know who said these things, or whether they were notable or knowledgeable figures, the quotes are of no value except to show that a random person of the time period in which they are reported would have said what was said. BD2412 T 21:33, 20 August 2012 (UTC)Reply

Scholarly conclusions about Susan B. Anthony

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Latest comment: 12 years ago4 comments2 people in discussion

Ann D. Gordon is the world's top scholar on Susan B. Anthony. She is the leader of the 30-year Elizabeth Cady Stanton & Susan B. Anthony Papers Project at Rutgers University. She has coordinated the effort to digitize, classify and interpret all of the 14,000 known documents pertaining to Anthony and her colleague Stanton. Gordon has determined that Anthony cannot be said to be the author of the 1869 essay marked "A" because of its preachy, religious tone (Anthony was not religious) and because Anthony never, ever signed "A" to her writings. Beyond that, Anthony never dedicated any of her speeches or essays to the subject of abortion—she considered it a political hot potato, a distraction from the more important goal of women's right to vote. See Susan B. Anthony abortion dispute.

The only connection that the essay has to Anthony is that Anthony was the owner of the newspaper which printed it. She was not the editor of the Revolution: that duty was shared by Parker Pillsbury and Elizabeth Cady Stanton. Anthony was not involved in day-to-day oversight of the newspaper; in July 1869 she was off to Saratoga for a women's rights convention and in August she was angering men in Philadelphia as she tried to get into a Labor convention. She was constantly riding trains to various US cities to give speeches and help the cause of suffrage; she was not sitting in the Revolution office going over typeset pages.

When scholars such as Ann D. Gordon and Laury Oaks agree with each other and with Anthony biographer Lynn Sherr that Anthony was not interested in speaking out or writing about abortion, we take their conclusions seriously. No topic scholar has spoken up in disagreement. On the other hand, the assertions of pro-life activists such as Cat Clark and Marjorie Dannenfelser are inherently suspect and wholly insufficient to counterbalance the weight of scholarship. Any pro-life activist saying Anthony was a pro-life activist cannot be given equal footing to a neutral scholar studying all of Anthony's writings. Binksternet (talk) 20:02, 20 August 2012 (UTC)Reply

This discussion would be well-suited to an article about Susan B. Anthony. The attribution on the wikiquote page should not include that discussion. Mention of the common attribution and a scholar's disputation of that attribution is appropriate. The quote has been moved and the dispute is included. 76.6.193.163 22:36, 22 August 2012 (UTC)Reply
Looking after our readers, we cannot let them take away the impression that Susan B. Anthony actually wrote those quotes when the leading scholars agree that she did not. Any changes that put some degree of uncertainty on the matter—any diminution of the scholarly assessment—should be resisted. The reader should know not to assign these quotes to SBA, no matter how much pro-life propaganda uses them. Binksternet (talk) 22:59, 22 August 2012 (UTC)Reply
Paternalistic edits are not needed at Wikiquote. —This unsigned comment is by 76.6.193.163 (talk • contribs) .
That's rich, coming from an IP editor who is promoting the anti-abortion position on Wikiquote rather than pushing for neutral representation. Th favoring of paternalism is also evident in this change you made to Ave Maria, Florida, taking out the well-cited word "controversial". Monaghan is nothing if not paternal. Binksternet (talk) 22:33, 24 August 2012 (UTC)Reply

Deleted quotes:

  • One of the most basic problems with abortion is this, you give the women a voice, but where's the man's voice?
  • What it really means is pro-human-life. Abortion clinic bombers are not known for their veganism, nor do Roman Catholics show any particular reluctance to have their suffering pets 'put to sleep'. In the minds of many confused people, a single-celled human zygote, which has no nerves and cannot suffer, is infinitely sacred, simply because it is 'human'. No other cells enjoy this exalted status. But such 'essentialism' is deeply un-evolutionary.
    • Richard Dawkins; as qtd. in James Randerson, “Richard Dawkins Chimpanzee Hybrid?”, The Guardian, Jan 2009.

Re: See also * Famine * Hunger * Scarcity

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Moved discussion to: https://en.wikiquote.org/wiki/Wikiquote:Village_pump#%22See_also%22_policy/guidelines?_UDScott,_Kalki_&_Ottawahitech —The preceding unsigned comment was added by Butwhatdoiknow (talk • contribs) 15:44, 16 January 2022 (UTC)

Article length

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Latest comment: 7 months ago2 comments2 people in discussion

The article is 729 thousand bytes long (latest revision as of 1 July 2022), and 724 thousand bytes long without pictures.

According to the English Wikipedia's article size rule states that articles going over 100 kilobytes in prose should almost certainly be divided. The articles on the English Wikipedia's long page list (archived URL) don't go over 550 kilobytes in size (including markup, I presume).

Should some of the quotes on this page be limited to 250 words or less, as the quotation guideline states, or what should be done to make prose navigation more comfortable? Should there be a Wikiquote guideline mirroring the English Wikipedia's WP:SIZERULE, that was mentioned above? - Victor P. (talk) 10:09, 1 July 2022 (UTC)Reply

Victor P. thank you for posting a link to the size rule, I am also concerned how this page should be divided as the abortion category on Wikipedia is a labyrinth of difficult to guess and seemingly random titles. For example why is it: Christian views on birth control and Christianity and abortion instead of the other way around, History of abortion law debate instead of Abortion law, Philosophical aspects of the abortion debate instead of Philosophical views of abortion, Socialist perspectives on abortion instead of Socialism and abortion, etc. It's an incredibly long list of atomized aspects, even excluding all the Abortion in X country pages, and normally I would say pages like Sexuality of X or Religious views of X are unnecessary and designed to hide information on a page no one will ever access, but in this case the size is a definite concern. We already have over a dozen other abortion pages, some of which do not correspond to any Wikipedia pages like, Abortion case law in the United States. I would be very interested in discussing this subject as it applies to the guidelines as no other topic seems to have so many pages for particular aspects of it as viewed through the lens of distinct academic disciplines, and I don't know if that's a good or a bad thing; these could all just as easily be the titles of different university classes being offered for different majors. This page got over two thousand views in a 30 day period, but the same is not true of the other pages concerning this subject. CensoredScribe (talk) 16:55, 1 May 2024 (UTC)Reply

Surplus

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A

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  • "The best scientific evidence published indicates that among adult women who have an unplanned pregnancy, the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion or deliver that pregnancy," said Brenda Major, PhD, chair of the task force. "The evidence regarding the relative mental health risks associated with multiple abortions is more uncertain."
    The task force found that some studies indicate that some women do experience sadness, grief and feelings of loss following an abortion, and some may experience "clinically significant disorders, including depression and anxiety." However, the task force found "no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors."
    The report noted that other co-occurring risk factors, including poverty, prior exposure to violence, a history of emotional problems, a history of drug or alcohol use, and prior unwanted births predispose women to experience both unwanted pregnancies and mental health problems after a pregnancy, irrespective of how the pregnancy is resolved. Failures to control for these co-occurring risk factors, the task force noted, may lead to reports of associations between abortion history and mental health problems that are misleading.
    The report noted that women have abortions for many different reasons and within different personal, social, economic and cultural circumstances, all of which could affect a woman's mental state following abortion. "Consequently," the task force wrote, "global statements about the psychological impact of abortion can be misleading."
    According to the report, women terminating a wanted pregnancy, who perceived pressure from others to terminate their pregnancy, or who perceived a need to keep their abortion secret from their family and friends because of stigma associated with abortion, were more likely to experience negative psychological reactions following abortion.
    The task force noted that despite the importance of understanding the mental health implications of abortion compared to its alternatives – motherhood or adoption—very few studies included appropriate comparison groups for addressing this issue. One of the task force's chief recommendations is for better-designed, rigorously conducted future research on the topic to "help disentangle confounding factors and establish relative risks of abortion compared to its alternatives."
    • "APA Task Force Finds Single Abortion Not a Threat to Women's Mental Health" (Press release). American Psychological Association. 12 August 2008. Archived from the original on 6 September 2011. Retrieved 7 September 2011.
  • The meta-analysis by Dr Saccone and colleagues concludes that surgical abortion “is an independent risk factor” for subsequent preterm birth. The authors found a weak association (odds ratios [OR], 1.44; 95% confidence interval, 1.09–1.90) between abortion and preterm birth, but we question whether this association is causal. We agree with the discussion of study limitations and will highlight several key points. First, the reported associations all had OR <2. Not only do bias and confounding often account for weak associations, but OR exaggerate true relative risk. Second, most studies included failed to adjust for important known confounders such as prior preterm birth, race, smoking, and short interpregnancy interval. Third, many studies had case-control designs, and recall bias has been shown to have a powerful impact in case-control studies of abortion, exaggerating negative outcomes of abortion.
    Even if some of the reported association is causal, the attributable risk of preterm birth following abortion is very small. When women continue unintended pregnancies, however, they may be at increased risk of preterm birth in that pregnancy. One systematic review found an association between unwanted pregnancies and preterm birth with an OR magnitude similar to the findings presented here (OR, 1.50; 95% confidence interval, 1.41–1.61). When women gained access to safe abortion in Oregon, a decrease in preterm birth and neonatal mortality were observed. Access to abortion also has clear social and economic benefits for women and families, likely affecting future pregnancy outcomes and preterm births.
    The data presented are insufficient to support counseling women that abortion is a risk factor for preterm birth or to warrant the large and expensive randomized trials to further evaluate this association as proposed by the authors. We suggest funding would be better spent on interventions known to prevent preterm birth: prenatal care, contraception, and smoking cessation, for example.

B

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  • Labor induction abortion provides a safe method of terminating pregnancies in the second trimester. With the introduction of new prostaglandin analogues and mifepristone, there have been major changes in efficacy, side effect profiles, and clinical practice. Procedures with prostaglandin E1 analogues have the shortest induction times. Prostaglandin E2 procedures may be slightly longer, but are accompanied by a higher rate of side effects. Prostaglandin F and non-prostaglandin methods have the longest induction times. The time to induction is influenced by parity, with nulliparous women having longer inductions, and by gestational age, with higher gestation associated with longer inductions.
    Complications of procedures with current methods include bleeding and the need for transfusion, which varies but is commonly reported around 0.5%. Infection is uncommon. A more serious concern is uterine rupture, which is documented by multiple case reports. It is unclear whether rupture is associated with a particular agent. Although rupture appears to be more common with a uterine scar, neither the absolute nor relative risk has been determined. Retained placenta or the use of operative procedure occurs in most series of 5–10% of women using mifepristone techniques and in some series of misoprostol abortion without mifepristone.
    • Borgatta, L (December 2014). "Labor Induction Termination of Pregnancy". Global Library of Women's Medicine. GLOWM.10444. doi:10.3843/GLOWM.10444. Archived from the original on 24 September 2015. Retrieved 25 September 2015.
  • In the past 12 years there have been 154 arson attacks, 39 bombings and 99 acid attacks against abortion providers. Seven have been killed in the last five years.
    • Borger, Julian (3 February 1999). "The bomber under siege". The Guardian. London. Archived from the original on 22 February 2017.
 
Precisely because murder, although a real social problem is horrible enough and sufficiently removed form everyday life to provide the excitement of the extreme and perverse, it makes a useful subject for fiction, whereas abortion raises problems which are too familiar, too troubling, too ambivalent, and not sufficiently exotic to afford the same satisfaction in reading. ~ John Boslik
  • A subtler analogue occurs in treatments of murder and abortion in twentieth-century fiction. Both are the objects of real and urgent moral, emotional, and legal concerns among American citizens. Yet murder is depicted vastly more often than abortion: it is the single most common plot device in whole genres of imaginative literature-novels, movies, and television. Abortion occurs much less often as a plot device even in novels, and almost never in movies or on television. Is this because murder is a familiar part of most Americans’ lives and abortion is not? Or because Americans are more likely to be affected by a murder than by an abortion? Or because murder is less horrible and disapproved than abortion?
    On the contrary: there are enormously more abortions in the United States than murders, and vastly more members of the reading public are affected by abortion than by homicide (unless, of course, one categorized abortions as “murders,” but it is still not the act on which the bulk of mystery or action plots turn). Moreover, although substantial elements of the population are categorically opposed to it, many Americans do not regard abortion as immoral. Precisely because murder, although a real social problem is horrible enough and sufficiently removed form everyday life to provide the excitement of the extreme and perverse, it makes a useful subject for fiction, whereas abortion raises problems which are too familiar, too troubling, too ambivalent, and not sufficiently exotic to afford the same satisfaction in reading.
 
In addition, the fact that abortion is so controversial makes it a risky subject for a medium designed to appeal to a general audience. Partisans of any point of view are likely to take exception to-possible even action against- a work that depicts abortion from a perspective they oppose, and it is safer for writers to avoid such topics in a culture in which commercial success affects artistic considerations. ~ John Boslik
  • Results: During 1988-1997, the overall death rate for women obtaining legally induced abortions was 0.7 per 100000 legal induced abortions. The risk of death increased exponentially by 38% for each additional week of gestation. Compared with women whose abortions were performed at or before 8 weeks of gestation, women whose abortions were performed in the second trimester were significantly more likely to die of abortion-related causes. The relative risk (unadjusted) of abortion-related mortality was 14.7 at 13-15 weeks of gestation (95% confidence interval [CI] 6.2, 34.7), 29.5 at 16-20 weeks (95% CI 12.9, 67.4), and 76.6 at or after 21 weeks (95% CI 32.5, 180.8). Up to 87% of deaths in women who chose to terminate their pregnancies after 8 weeks of gestation may have been avoidable if these women had accessed abortion services before 8 weeks of gestation.
    Conclusion: Although primary prevention of unintended pregnancy is optimal, among women who choose to terminate their pregnancies, increased access to surgical and nonsurgical abortion services may increase the proportion of abortions performed at lower-risk, early gestational ages and help further decrease deaths.
  • Voluntary abortion is the most controversial act in the entire field of medical practice, although today, it is a practice that, under different conditions, has been legalized in more than 100 countries, mostly in the developed world. The United Nations has agreed that in no case should abortion be promoted as a method of family planning and, therefore, it should be utilized only when contraception has failed. Overall, 61% of humanity lives in countries where abortion is legal and widely available; 14% in countries where termination is allowed to protect a woman’s health; physical, mental, or both; 21% in countries where it can be performed only to save the mother’s life and 4% in countries where abortion is not permitted at all. Restrictive legislation, per se, does not represent a valid deterrent to prevent abortion, while it may contribute to an increase in morbidity and mortality associated with pregnancy. In addition, because abortion is outlawed, nothing is done to actively reduce the reasons leading to it. Indeed, the countries with the lowest abortion rates are those where, on the one hand, pregnancy termination is legal and, on the other, sex education and contraceptive knowledge are widely spread.
  • Law & Order, Grey's Anatomy, Better Things, Station 19, Call the Midwife and Teen Mom: The Next Chapter are all TV shows that had depictions of abortion in 2022, according to the new Abortion Onscreen report. Among the annual study's findings this year:
    There's been an uptick in the number of shows and plotlines centered around abortion. Researchers found 60 abortion plotlines or mentions in 52 shows in 2022, versus 47 abortion plotlines in 42 shows in 2021.
    For the first time in ten years, a third of the TV plotlines portrayed barriers to abortion access versus only two such plotlines in 2021.
    Demographics on TV continue to misrepresent reality. In 2022, 58 percent of TV characters who obtained an abortion were white women when, in reality, it's mostly women of color.
    For about ten years now, researchers at the Abortion Onscreen project have scoured scripted and reality TV shows searching for any mention of abortion, but this year the work happened in a new context. "The overturn of Roe v Wade catalyzed a lot of people to really understand the importance of sharing abortion story lines on television," says Steph Herold, author of the report from the Advancing New Standards in Reproductive Health program at the University of California, San Francisco.
    Herold calls the increase in TV plot lines addressing the legal, financial and logistical barriers to access "significant."
    "Showrunners, writers, producers have really woken up to the abortion access crisis," she says.
  • Labor induction abortion is an alternative to surgical abortion in the second trimester, and provides access to abortion services when there are no providers trained in second trimester surgical abortion techniques. Induction of labor is also indicated in some cases of pregnancy termination for fetal abnormalities, such as when an intact fetus is important for diagnosis or for the patient's grieving process. However, an intact fetus is not necessary solely to confirm prenatal diagnosis of a genetic abnormality; accurate chromosomal analysis can be performed in almost every case after a dilation and evacuation (D&E) procedure.
    Although the majority of second trimester abortions performed in the United States are performed surgically, second trimester induction of labor is performed more frequently as gestational age increases. In the late second trimester and third trimester, labor induction is the primary method of elective termination in cases of lethal fetal abnormalities. When termination of a desired pregnancy is necessary for maternal indications, gestational age and the likelihood of fetal survival are factors in the choice of a treatment regimen.
    The incidence of induction abortion is higher in many other countries where D&E is not commonly practiced either as a matter of medical policy or because of the lack of facilities or providers.
    • Borgatta, L (December 2014). "Labor Induction Termination of Pregnancy". Global Library of Women's Medicine. GLOWM.10444. doi:10.3843/GLOWM.10444. Archived from the original on 24 September 2015. Retrieved 25 September 2015.

When does history start or end?

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Latest comment: 7 months ago1 comment1 person in discussion

I was wondering what time period History of abortion covers. Abortion (1500-1900) and Abortion (pre-Reformation) are not Wikipedia pages and it is unclear if those pages are for quotes from or quotes about those arbitrarily selected periods of time. Should there be a page for Abortion (1900-present)? Wikipedia has a lot of History of X pages, but further dividing those pages seems unnecessary unless we are discussing a country or a religion in the Yth century. CensoredScribe (talk) 16:55, 1 May 2024 (UTC)Reply

Surplus

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The lives and rights of women have not been advanced or enhanced, but rather destroyed, by abortion-on-demand. We are collecting affidavits from women who have been harmed by abortion, from women who are convinced that authentic feminism is pro-life, and from professionals who know that Roe has weakened the moral fabric of the legal and medical professions. ~ Norma McCorvey ("Jane Roe" in Roe v. Wade)
 
I am fond of saying that rubella vaccine has prevented thousands more abortions than have ever been prevented by Catholic religionists. ~ Stanley Plotkin
 
The pro-life case is rather simple. We believe that abortion should be outlawed because unborn humans are people and all people are endowed with inherent rights and dignities. ~ Matt Walsh
 
I do not believe that just because you're opposed to abortion, that that makes you pro-life. In fact, I think in many cases, your morality is deeply lacking if all you want is a child born but not a child fed, not a child educated, not a child housed. ~ Joan Chittister

A

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  • We all knew that we were flouting the law but doing it in the safest way from prosecution that we could. . . Before Roe v. Wade, I had no guilt feelings about what I was doing. I was proud of being able to help the women that I was taking care of.
    • Thomas Allen, discussing illegal abortions he performed, Voices of Choice, 2005 [1].
  • We try to use the physician for his technical skill and reduce the one-to-one relationship with the patient. We usually see the patient for the first time on the operation table and then not again. More contact is just not efficient.
    • Edward Allred, abortion doctor, quoted in The San Diego Union, October 12, 1980. Also quoted in Anthony Perry. Doctor's Abortion Business Is Lucrative ALL About Issues, December 1980, pages 10, 14, and 15.
  • A description of the partial-birth abortion is the single greatest argument against its continued existence... When a practitioner uses sharp scissors to stab a hole in the skull of a baby and vacuum out its brain contents and calls it a medical procedure, words have indeed lost their meaning... With regard to infanticide, no one looking at this procedure could disagree; it is one-fifth abortion, four-fifths infanticide. It kills a child when 80 percent of his or her body is out of the womb...
  • If partial-birth abortions remain legal, if Congress allows them to continue, what next? Killing a child who has emerged from the womb 3 or 4 more inches... Opponents of this bill keep asking whether it would be the first step in an effort to ban all abortions, but the real question is whether allowing this procedure is not a step toward legalized infanticide.
  • Every person has the right to have his life respected. This right shall be protected by law and, in general, from the moment of conception. No one shall be arbitrarily deprived of his life.
  • Of the various ways to perform abortion after the midpoint of pregnancy, there is only one that never, ever results in live births. It is D&E (dilation and evacuation) and not only is it foolproof, but many researchers consider it safer, cheaper, and less unpleasant for the patient. However, it is particularly stressful to medical personnel. This is because D&E requires literally cutting the fetus from the womb, and then reassembling the parts, or at least keeping them all in view, to assure that the abortion is complete...
    • American Journal of Obstetrics and Gynecology Sept 1, 1976, 126[1] 83-90.
  • O thou, whose eyes were closed in death’s pale night,
    Ere fate revealed thee to my aching sight;
    Ambiguous something, by no standard fixed,
    Frail span, of naught and of existence mixed;
    Embryo, imperfect as my tort’ring thought,
    Sad outcast of existence and of naught;
    Thou, who to guilty love first ow’st thy frame,
    Whom guilty honour kills to hide its shame;
    Dire offspring! formed by love’s too pleasing pow’r!
    Honour’s dire victim in a luckless hour!
    Soften the pangs that still revenge thy doom:
    Nor, from the dark abyss of nature’s womb,
    Where back I cast thee, let revolving time
    Call up past scenes to aggravate my crime.
      Two adverse tyrants ruled thy wayward fate,
    Thyself a helpless victim to their hate;
    Love, spite of honour’s dictates, gave thee breath;
    Honour, in spite of love, pronounced thy death.
  • BOSTON—There is no credible evidence that a single elective abortion of an unwanted pregnancy in and of itself causes mental health problems for adult women, according to a draft report released Tuesday by a task force of the American Psychological Association.
    The APA Task Force on Mental Health and Abortion reached its conclusions after evaluating all of the empirical studies published in English in peer-reviewed journals since 1989 that compared the mental health of women who had an induced abortion to comparison groups of women, or that examined factors that predict mental health among women who have had an elective abortion in the United States. The task force, formed in 2006, was charged with collecting, examining and summarizing the scientific research addressing mental health factors associated with abortion, including the psychological responses following abortion.
    • "APA Task Force Finds Single Abortion Not a Threat to Women's Mental Health" (Press release). American Psychological Association. 12 August 2008. Archived from the original on 6 September 2011. Retrieved 7 September 2011.
  • Supporters of [the Human Life Amendment] are often eloquent in their defense of the fertilized egg but are seldom willing to aid the woman whose body nourishes it.


  • The prosecutions on our courts for breach of promise, divorce, adultery, bigamy, seduction, rape; the newspaper reports every day of every year of scandals and outrages, of wife murders and paramour shooting, of abortions and infanticides, are perpetual reminders of men's incapacity to cope successfully with this monster evil of society [alcohol abuse].
    • Susan B. Anthony, women's suffrage movement leader in "Social Purity", a speech about social ills impacting women. [4][5]
  • I definitely do want to talk about the fact that when you are pregnant, there is a baby growing inside of you.
    • Judith Arcana, abortion activist, at a London seminar, October 1999 [6].
  • We – in the states – have dealt heavily, up to now, in euphemism. I think one of the reasons why the 'good guys' – the people in favor of abortion rights – lost a lot of ground is that we have been unwilling to talk to women about what it means to abort a baby. We don't ever talk about babies, we don't ever talk about what is being decided in abortion. We never talk about responsibility. The word 'choice' is the biggest euphemism. Some use the phrases 'products of conception' and ‘contents of the uterus,’ or exchange the word ‘pregnancy’ for the word ‘fetus.’ I think this is a mistake tactically and strategically, and I think it's wrong.. And indeed, it has not worked – we have lost the high ground we had when Roe was decided My objection here is not only that we have lost ground, but also that our tactics are not good ones; they may even constitute bad faith. It is morally and ethically wrong to do abortions without acknowledging what it means to do them. I performed abortions, I have had an abortion and I am in favor of women having abortions when we choose to do so. But we should never disregard the fact that being pregnant means there is a baby growing inside of a woman, a baby whose life is ended. We ought not to pretend this is not happening.

B

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  • The unborn are a convenient group of people to advocate for. They never make demands of you; they are morally uncomplicated, unlike the incarcerated, addicted, or the chronically poor; they don’t resent your condescension or complain that you are not politically correct...Prisoners? Immigrants? The sick? The poor? Widows? Orphans? All the groups that are specifically mentioned in the Bible? They all get thrown under the bus for the unborn.
  • Suffragists agreed with physicians about the moral status of abortion. Lumping abortion with infanticide, they referred to both as “child murder.”
    • Nicola Beisel and Tamara Kay, in Abortion, Race, and Gender in Nineteenth-Century America, AMERICAN SOCIOLOGICAL REVIEW, 2004, VOL. 69 (August:498–518).
  • I dare say any thinking sensitive individual can't not realize that he is ending life or potential life.
    • Dr. Charles Bender, abortionist, author Magda Denes, PhD. "In Necessity and Sorrow: Life and Death Inside an Abortion Hospital".
  • [I]n face of erroneous interpretations of freedom, [Pope John Paul II] emphasized in an unequivocal way the inviolability of the human being, the inviolability of human life from its conception until natural death. The freedom to kill is not true freedom, but a tyranny that reduces the human being to slavery.
  • This right of privacy...is broad enough to encompass a woman's decision whether or not to terminate her pregnancy....[T]he word 'person', as used in the 14th Amendment, does not include the unborn.
  • What about what Christians call "Right to Life"? There's plenty of Scripture that defends life and the family chaplain has to be able to explain that. Yes, we believe in freedom and individual choice. But if somebody killed a person you were close to and said, "Well, I had the right to choose to do that," your anger would bring you to the boiling point. What's the difference? Right to Life is primarily about babies. And, unbelievably, as I mentioned earlier, today we have states passing laws allowing babies to be euthanized after birth. Why doesn't everyone see that as murder? You still think that's a choice? If you can murder a baby a few hours old, why can't you murder one six months old? A year old? Because it has a deformity? Or because of some other perceived deficiency? As the chaplain, you'll need to be able to explain, both in logical and in biblical terms, why that kind of reasoning is just wrong. If you say, "Well, it is just common sense you cannot kill a baby after the child is born," you would be wrong. If it was common sense, we wouldn't have these laws on the books. Remember this- political correctness now trumps common sense.
    • William G. Boykin, Man to Man: Rediscovering Masculinity in a Challenging World (2020), p. 160-161
  • The heart of the abortion debate is often overlooked: Are the unborn human? Are the unborn full-fledged, living members of the human race who are just at the earliest stage of development? Or are they just blobs of cells? If the unborn aren’t human, no justification for abortion is necessary. If the unborn are human, no justification for abortion is adequate. Build a case for life. We meet pro-choice advocates on common ground, using a common source of authority: science. Here biology, specifically embryology (the study of embryos), are our friends. First, the Law of Biogenesis states that (1) life only comes from life, and (2) kinds produce like kinds. In other words, a human being outside of the womb must come from a living human being inside the womb. It doesn’t magically turn into a living human being at the point of birth. Human beings reproduce human beings.
    Second, those who study embryos have made it crystal clear: “The beginning of a single human life is from a biological point of view a simple and straightforward matter—the beginning is conception.” Science has spoken. The unborn are fully human beings. The only thing that separates the unborn from the born are their size, how developed they are, their environment (inside or outside the womb) and how dependent they are.
    • The Rev. Jason Braaten is pastor of Immanuel Lutheran Church, Tuscola, Ill. “Are the unborn Human”, The Lutheran Witness, Nov. 18, 2015
  • If one strikes a pregnant woman or gives her poison in order to procure an abortion, if the foetus is already formed or quickened, especially if it is quickened, he commits homicide.
    • Henry Bracton, 2 On The Laws and Customs of England, 341 (S.E. Thorne trans., George E. Woodbine ed. 1968) (ca. 1250 A.D.).
  • It's estimated that up to one in four pregnancies in Latin America end in illegal abortion, and that worldwide over 70,000 women die from illegal abortions every year.
  • Of the 56 million annual abortions performed around the world, nearly half, or 25 million, posed some threat to the health or life of the woman. The vast majority of unsafe abortions – 97 percent — were performed in developing countries in Africa, Asia and Latin America.
    And about half of those abortions in poor countries are unsafe, compared with just 12.5 percent in wealthy countries, according to a report in last week's issue of The Lancet, the British medical journal.
  • Manual evacuation abortion is a fairly simple procedure that midwives and other trained health care workers can perform. It doesn't take a sophisticated health care setting. It's not out of reach for low-resource countries. Medical abortions using drugs [mifepristone and misoprostol] are not very expensive and don't require special equipment.
  • All the religions have taken strong positions on abortion; they believe that the issue encompasses profound issues of life and death, right and wrong, human relationships and the nature of society, that make it a major religious concern.
    People involved in an abortion are usually affected very deeply not just emotionally, but often spiritually, as well. They often turn to their faith for advice and comfort, for explanation of their feelings, and to seek atonement and a way to deal with their feelings of guilt.
    Because abortion affects heart as well as mind, and because it involves life and death, many people find that purely intellectual argument about it is ultimately unsatisfying.
    For them it's not just a matter that concerns a human being and their conscience, but something that concerns a human being and their God.
  • I'm shunned by the gay community because I'm not the right kind of gay. I'm rejected by the feminist establishment for the same reasons. . . There is no room for dissent on the left. The moment you give into their framework, you surrender your individualism. . . Abortion is a failure of the feminist establishment. With every kind of birth control available in the world, abortion is not something to be proud of. If you need an abortion, you've failed.
    • Tammy Bruce, former member of NOW's national board of directors, to Columbia University students as quoted by Dan Healey in "Conservativism and Feminism Combined - Tammy Bruce, an Openly Gay, Pro-Choice, Pro-Clinton, Pro-Bush Conservative, Defies Labels", Columbia Spectator (April 6, 2005)[8]
  • The freedom that women were supposed to have found in the Sixties largely boiled down to easy contraception and abortion; things to make life easier for men, in fact.
    • Julie Burchill, British feminist and abortion advocate, in Damaged Gods, 1986.
  • Cherie Blair can call herself a feminist all she likes, but any feminist worth her salt would have made a point of having a termination - on the NHS, naturally - when she got knocked up the last time. . . Famous women would rather admit to having been sexually abused as children than to having had a termination. . . Myself, I'd as soon weep over my taken tonsils or my absent appendix as snivel over those [five] abortions. I had a choice, and I chose life - mine.
    • Julie Burchill, British feminist and abortion advocate, from "Abortion: still a dirty word" in The Guardian (May 25, 2005)[9].
  • [T]he vast majority of physicians observe the standards of their profession, and act only on the basis of carefully deliberated medical judgments relating to life and health. Plainly, the Court today rejects any claim that the Constitution requires abortions on demand.
    • Warren E. Burger, U.S. Supreme Court, incorrectly assessing the eventual legal interpretation of the ruling and development of abortion-on-demand, from his concurring opinion in Doe v. Bolton, (January 22, 1973)[10].
  • I wanted to take just a few brief moments to restate my firm support of our cause and to share with you my deep personal concern about our American tragedy of abortion on demand. We are concerned about abortion because it deals with the lives of two human beings, mother and child. I know there are people of good will who disagree, but after years of sober and serious reflection on the issue, this is what I think. I think the Supreme Court's decision in Roe versus Wade was wrong and should be overturned....[Y]ou and hundreds of thousands with you across the country have raised a voice of moral gravity about abortion, a voice of principle, a voice of faith, a full voice that properly asserts and affirms the basic dignity of human life. I'm confident that more and more Americans every year -- every day -- are hearing your message and taking it to heart. And, ladies and gentlemen -- and, yes, young people as well -- I promise you that the President hears you now and stands with you in a cause that must be won. God bless you all, and God bless life.
  • I think a noble goal for this country is that every child, born and unborn, ought to be protected in law and welcomed into life.
  • We must appreciate the dignity of life in all its seasons, even the path of the elderly in the twilight of their years, to work toward the day when every child, born and unborn, is welcomed to life and protected by law.
    • George W. Bush, to the Catholic Press Association Convention, (May 26, 2000).
  • Last year Cardinal O'Connor said, 'It is my very sincere prayer that if I live for a week, if I live for twenty years, my last breath will be in support for the sacredness of every human life.' As a country, we too, must keep our pledge to the first guarantee of the Declaration of Independence.
    • George W. Bush, to the Catholic Press Association Convention, (May 26, 2000).
  • Roe v. Wade was wrong because it 'usurped the power of the legislatures,' Bush said. 'I felt like it was a case where the court took the place of what legislatures should do in America,' he said. But Bush refused to say how he felt each state should act. Instead, he said that when it comes to legalizing abortion, 'it should be up to each legislature.'
  • Those of us who are pro-choice are also, passionately, pro-life. Most of us love babies, love children, and love our liberty—not to mention loving sex and our right to have it when, how, and with whomever we choose.
    • Rachel Kramer Bussel, "I'm Pro-Choice and I Fuck", Village Voice, (January 13, 2006).
  • I'm pro-choice because I couldn't fully enjoy sex were I consumed with worry about the potential consequences. I'm pro-choice for all my friends who've had abortions and gone on to do great things, who are better women for being childless (for now). I'm pro-choice for the new moms and dads I know who were able to actively choose to become parents. I'm pro-choice for all those babies... born knowing they're 100 percent loved and wanted.
    • Rachel Kramer Bussel, "I'm Pro-Choice and I Fuck", Village Voice, (January 13, 2006).

C

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  • [Freelance contributor Jack Hitt's] cover story on abortion in El Salvador in The New York Times Magazine on April 9 contained. . . a dramatic account of how Ms. Climaco received the [30-year jail] sentence [for homicide] after her pregnancy had been aborted after 18 weeks. It turns out, however, that trial testimony convinced a court in 2002 that Ms. Climaco's pregnancy had resulted in a full-term live birth, and that she had strangled the 'recently born'. . . One thing is clear to me, at this point, about the key example of Carmen Climaco. Accuracy and fairness were not pursued with the vigor Times readers have a right to expect.
    • Byron Calame, New York Times Public Editor (ombudsman), in his column Truth, Justice, Abortion and the Times Magazine [11] (December 31, 2006).
  • A fetus does not have a right to be in the womb of any woman, but is there by her permission. This permission may be revoked by the woman at any time, because her womb is part of her body. Permissions are not rights. There is no such thing as the right to live inside the body of another, i.e. there is no right to enslave. Contrary to the opinion of anti-abortion activists (falsely called “pro-lifers” as they are against the right to life of the actual human being involved) a woman is not a breeding pig owned by the state (or church). Even if a fetus were developed to the point of surviving as an independent being outside the pregnant woman's womb, the fetus would still not have the right to be inside the woman's womb.
  • 90% of illegal abortions are being done by physicians. Call them what you will, abortionists or anything else, they are still physicians, trained as such; . . . They must do a pretty good job if the death rate is as low as it is . . . Abortion, whether therapeutic or illegal, is in the main no longer dangerous, because it is being done well by physicians.
    • Mary Calderone, founder of SIECUS and medical director of the Planned Parenthood Federation of America, "Illegal abortion as a public health problem," American Journal of Public Health, (July 1960).
  • The traditional Western ethic has always placed great emphasis on the intrinsic worth and equal value of every human life regardless of its stage or condition. This ethic has had the blessing of the Judeo-Christian heritage and has been the basis for most of our laws and much of our social policy... This traditional ethic is still clearly dominant, but there is much to suggest that it is being eroded at its core and may eventually even be abandoned...
    The process of eroding the old ethic and substituting the new has already begun. It may be seen most clearly in changing attitudes toward human abortion. In defiance of the long held Western ethic of intrinsic and equal value for every human life regardless of its stage, condition, or status, abortion is becoming accepted by society as moral, right and even necessary. It is worth noting that this shift in public attitude has affected the churches, the laws, and public policy rather than the reverse. Since the old ethic has not yet been fully displaced it has been necessary to separate the idea of abortion from the idea of killing, which continues to be socially abhorrent. The result has been a curious avoidance of the scientific fact, which everyone really knows, that human life begins at conception and is continuous whether intra- or extra-uterine until death. The very considerable semantic gymnastics which are required to rationalize abortion as anything but taking a human life would be ludicrous if they were not often put forth under socially impeccable auspices. It is suggested that this schizophrenic sort of subterfuge is necessary because while a new ethic is being accepted the old one has not yet been rejected...
    Medicine's role with respect to changing attitudes toward abortion may well be a prototype of what is to occur...One may anticipate further development of these roles as the problems of birth control and birth selection are extended inevitably to death selection and death control whether by the individual or by society, and further public and professional determinations of when and when not to use scarce resources.
  • They can be born breathing and crying at 19 weeks' gestation. . . I am not anti-abortion, but as far as I am concerned this is sub-standard medicine. . . If viability is the basis on which they set the 24-week limit for abortion, then the simplest answer is to change the law and reduce the upper limit to 18 weeks.
    • Stuart Campbell, former professor of obstetrics and gynaecology at London's St. George's hospital commenting on the government's Confidential Enquiry into Maternal and Child Health (CEMACH) report that 50 babies a year are born alive in the UK after botched National Health Service abortions, as reported by London's The Sunday Times, November 27, 2005 [13].
  • I think the fear in the [abortion rights] movement is if we admit abortion is hard for some women, then we're admitting that it's wrong, which is totally not the case. I've heard from women who are having problems dealing with their abortion who are still ardently pro-choice.
    • Rosemary Candelario, director of Massachusetts Religious Coalition for Reproductive Choice, September 2001.
  • 300 Dollars that's the price of living what? / Mommy I don't like this clinic / Hopefully you'll make the right decision / And don't go through with the Knife incision
    • Nick Cannon, hip hop artist and comedian, describing his mother's choice not to abort him, in Can I Live?, (2005).
  • I know that the fetus is alive during the process most of the time because I can see fetal heartbeat on the ultrasound. . . I think brain death would occur because the suctioning to remove contents is only two or three seconds, so somewhere in that period of time, obviously not when you penetrate the skull, because people get shot in the head and they don't die immediately from that, if they are going to die at all, so that probably is not sufficient to kill the fetus, but I think removing the brain contents eventually will. . . My intent in every abortion I have ever done is to kill the fetus and terminate the pregnancy.
    • Leroy Carhart, testifying under oath in 1997 about what he does to facilitate abortion, Asheville Tribune.
  • I am LeRoy H. Carhart, and I am an abortionist. . . We're not asking for the right to suck the brains out of every child that walks down the street, we need to continue to offer safe abortions to women who need them to be done.
    • Leroy Carhart, addressing the Religious Coalition for Reproductive Choice, Omaha World-Herald (January 2001).
  • This act covers every D&E [dilation and evacuation] that I did. Everything that I do to cause an abortion is an overt act. . . The fetuses are alive at the time of delivery. [There is a heartbeat] very frequently.
    • Leroy Carhart, testifying under oath that language in the partial-birth abortion ban act bans more than just partial-birth abortion, Carhart v. Ashcroft (April 1, 2004).
  • Well, I was telling Ms. Smith at lunch today that, you know, we are talking about a fetus that's not only been dead for 48 hours, but we are talking about a fetus that has been dead for 48 hours in essentially a warming oven or crockpot. It has been kept at a hundred degrees for 48 hours, and if, you know, that's enough, that's enough temperature to cook meat, so we are not only dealing with a fetus that has been dead in my practice, we are dealing with a fetus that's both dead and soft, so it's much more pliable.
    • Leroy Carhart, testifying under oath on the safety of his abortion methods, in a deposition taken for Carhart v. Ashcroft, (April 1, 2004).
  • While it is certainly something we don’t like to do, the truth is that every Spring, the animal shelters, humane societies, and rescues are overloaded with kittens. The sad reality is that many have to be euthanized because there just aren’t enough homes for them all. Signs for Free Kittens will be posted all over the place, kittens will be given to anyone willing to take them, with little value being placed on their lives. Even worse, people get desperate and will dump kittens on the side of the road, left in dumpsters, drowned in creeks or just left to starve and die alone. We see it every Spring. We know it is happening.
    There is a safe, humane and proven solution to the feline overpopulation problem. TNR (Trap-Neuter-Return). And while it’s not a fun concept to digest, it is VITAL that we spay/abort a pregnant cat. While no one wants to abort kittens, unfortunately, it is necessary.
    • "Spaying Pregnant Females". Carol's Ferals. Archived from the original on 18 November 2012. Retrieved 17 December 2012.
  • We are here to help you help the cats in need, and while no one wants to think about aborting kittens, the alternative is far worse, killing bright eyed kittens because there just aren’t any homes left for them. By humanely aborting kittens in-utero, you are helping to find homes for kittens that already exist. It is imperative that we look at the big picture.
    • "Spaying Pregnant Females". Carol's Ferals. Archived from the original on 18 November 2012. Retrieved 17 December 2012.
  • Given the desire in developed countries to limit families to one or two children and the efficacy of contraception in general use, it is extremely likely that any normal couple will experience at least one unwanted pregnancy at some time during their reproductive years. In third world countries, desired family size is larger, but access to effective contraception is limited. As a result, abortion is common. Worldwide, about 46 million women have abortion each year, and about half of these procedures are illegal and considered “unsafe” by the World Health Organization definition: procedures carried out either by an unskilled person or in unsafe conditions, or both (255). “Where abortion is legal, it is generally reasonably sage; where it is illegal, complications are common, and about 78,000 women die every year from these complication (255). Societies cannot prevent abortion, buy they can determine whether it will be illegal and dangerous or legal and safe. Many countries in which abortion is completely illegal have very high rates of clandestine abortion.
    • Sacheen Carr-Ellis, Nathalie Kapp; "10. Family Planning". In Berek, Jonathan S. (ed.). “Novak's Gynecology” (14 ed.). (2007) Lippincott Williams & Wilkins. p.295
  • The overall annual risk of death with legal abortion has decreased markedly, from 4.1 per 100,000 in 1972 to 1.8 in 1976, and has remained less than 1 per 100,000 since 1987. Risk of death with vacuum curettage was 0.1 per 100,000 at or before 8 weeks in 1993 to 1997 and 0.2 per 100,000 at 9 to 10 weeks (262). Risk increases exponentially with gestational age, reaching 2.7 per 100m000 for dilation evacuation abortion at 16 to 20 weeks, and 7.2 per 100,000 at 21 weeks or more. “the maternal mortality rate in the United States is 7 to 9 per 100,000; hence abortion by dilation and evacuation (D&E) is safer than continuing pregnancy through 20 weeks. It has been estimate that 87% of the legal abortion deaths occurring after 8 weeks would have been prevented has the woman been able to get abortion services by 8 weeks (263).
    For individual women with high-risk conditions (e.g., cyanotic heart disease), even late abortion is a safer alternative to birth. Because of the availability of low-cost, our-of-hospital, first-trimester abortion, 88% of legal abortions are performed during the first trimester (before 13 weeks of amenorrhea), when abortion is the safest. The type of procedure is another determinant of risk. First-trimester abortions are virtually all performed by vacuum curettage, however, in the midtrimester, a variety of techniques can be used. The last published national review by both gestational age and type of procedure was for the period 1973 to 1987 (264) (Table 20.11). The date clearly show the greater safety of instrumental evacuation of the uterus (D&E) performed in the early midtrimester.
    • Sacheen Carr-Ellis, Nathalie Kapp; "10. Family Planning". In Berek, Jonathan S. (ed.). “Novak's Gynecology” (14 ed.). (2007) Lippincott Williams & Wilkins. p.297
  • Well, as you know, there are many things in life that are not fair, that wealthy people can afford and poor people can't. But I don't believe that the Federal Government should take action to try to make these opportunities exactly equal, particularly when there is a moral factor involved.
    • Jimmy Carter, when asked whether it is fair that women who can afford abortions can get them while women who cannot afford them are precluded, news conference, Washington, D.C. (July 12, 1977). Reported in Public Papers of the Presidents of the United States: Jimmy Carter, 1977, Book 2, p. 1237.
  • Prior to 1973 - just think about this for a minute - the laws of America reflected an overwhelming pro-life consensus that children before birth deserve the protection of the law. That consensus was a secular consensus. Those laws were not written by clerics, or in monasteries, or by the great organized religions of America. . . Not unique to our left or to the right, Democrats or Republicans, Liberals or conservatives, it represented the mainstream of America. My friends, it still is the mainstream of America, so don't be fooled. . . The American people have not accepted abortion on demand. . . We cannot become comfortable with it, because it's fundamentally contrary to what we believe as Americans. . . Every poll shows a vast and growing unease with the abortion license and the industry that serves it. I believe a pro-life consensus already exists in America. And it grows every time someone looks in a sonogram.
    • Robert Casey, prominent Democrat and former governor of Pennsylvania, addressing students at Notre Dame University, 1995.
  • Drugs to induce abortions may be used for pregnancies of less than 11 weeks or more than 15 weeks. For an abortion during early pregnancy (less than 10 weeks), a woman can begin taking the drugs at the doctor's office and continue taking the drugs in her home. For an abortion later in pregnancy, the woman has to be admitted to the hospital to take the drugs that will induce labor.
  • Complications from abortion are uncommon when it is done by a trained health care practitioner in a hospital or clinic. Also, complications occur much less often after an abortion than after delivery of a full-term baby. Serious complications occur in fewer than 1% of women who have an abortion. Death after an abortion is very rare. About 6 out of a million women who have an abortion die, compared with about 140 out of a million women who deliver a full-term baby.
  • Elective abortion probably does not increase risks for the fetus or woman during subsequent pregnancies.
    Most women do not have psychologic problems after an abortion. However, problems are more likely to occur in women who
    *Had psychologic symptoms before pregnancy
    *Were deeply attached to the fetus
    *Have limited social support or feel stigmatized by their support system
  • But what I find somewhat disturbing is that she (Mother Teresa) remained inactive when children were hurt or killed, or were at the risk of being orphaned ... this did not sit comfortably with her 'Child First' philosophy. But then, for her the unborn child was far more important than the actual child. Having gone through hundreds of her speeches I have wondered, when compared to the unborn child if the actual child mattered to her at all.
    • Aroup Chatterjee (1998), Mother Teresa: The Final Verdict
  • Plants and herbs have been used to induce abortions but there is very little published information describing the commonly used ones. The purpose of this report is to describe the herbal products used to induce abortions, and to enhance awareness and understanding of their toxic effects. A descriptive retrospective survey was conducted on the calls received by the Montevideo Poison Centre between 1986 and 1999 concerning the ingestion of herbal infusions with abortive intent. A total of 86 cases involving 30 different plant species were identified. The species most frequently involved were ruda (Ruta chalepensis/graveolens), cola de quirquincho (Lycopodium saururus), parsley (Petroselinum hortense), and an over-the-counter herbal product named Carachipita. The components of Carachipita are pennyroyal (Mentha pulegium), yerba de la perdiz (Margiricarpus pinnatus), oregano (Origanum vulgare), and guaycuri (Statice brasiliensis). Abortion occurred in 23 cases after the ingestion of parsley, ruda, Carachipita, celery, Cedron, francisco alvarez, floripon, espina colorada. Out of the 23 cases, 15 involved the only the ingestion of plants, 4 cases used injected drugs (presumably hormones), and in 4 cases there was associated self-inflicted instrumental manipulation. Multiple organ system failure occurred in those patients who had ingested ruda (alone or in combination with parsley or fennel), Carachipita, arnica, or bardana. Deaths occurred in one case of Carachipita ingestion and in 4 cases of ruda ingestion (2 cases of ruda alone, 2 cases of ruda with parsley and fennel). Self-inflicted instrumental manipulations were found in 4 of the patients with multiple organ system failure and in one of those who died. The results of this report are not conclusive, but it appears that the ingestion of plants to induce abortion involves the risk of severe morbidity and mortality.
  • Induced abortion is one of the commonest gynaecological procedures performed around the world. It has been estimated that there are about 53 million abortions performed each year (2). In the United Kingdom, approximately 186 000 abortions are performed in England and Wales per annum and around 11 500 procedures per annum are performed in Scotland (3). Sadly, a significant proportion of the 53 million abortions are still performed in unsafe conditions, especially in developing countries. It has been estimated that approximately 13% of all maternal deaths in the world are attributed to the procedure having been performed in places where there is poor access to safe practice or the service is not available legally. Furthermore, complications arising from abortion procedures can also lead to subsequent morbidity with loss of fertility and the sequelae of chronic pelvic pain.
    Since termination of pregnancy is such a common procedure, any attempt to reduce mortality and morbidity from this procedure can bring significant benefits to the quality of life for the women undergoing this procedure.
    • Chien P, Thomson M (15 December 2006). "Medical versus surgical methods for first trimester termination of pregnancy: RHL commentary". Reproductive Health Library. Geneva: World Health Organization. Archived from the original on 17 May 2010. Retrieved 1 June 2010.
  • There is evidence that it is beneficial to perform a routine ultrasound scan at the time when a patient is seen for the first time for a termination of pregnancy. The scan allows the determination of gestational age, which is important for advising the patient about the most appropriate method of termination. It also helps to diagnose multiple pregnancies, exclude/diagnose an ectopic pregnancy, diagnose a molar pregnancy and diagnose coincidental pelvic pathology, such as an ovarian cyst. The unavailability of this investigation may, however, be a limiting factor in a under-resourced setting.
    • Chien P, Thomson M (15 December 2006). "Medical versus surgical methods for first trimester termination of pregnancy: RHL commentary". Reproductive Health Library. Geneva: World Health Organization. Archived from the original on 17 May 2010. Retrieved 1 June 2010.
  • Abortion is the greatest deception that has plagued the black church since Lucifer himself.
    • Clenard Howard Childress, Jr., Life Education And Resource Network.
  • Between 1882 and 1968, 3,446 Blacks were lynched in the U.S. That number is surpassed in less than 3 days by abortion. 1,452 African-American children are killed each day by the heinous act of abortion. 3 out of 5 pregnant African-American women will abort their child. Since 1973 there has been over 13 million Black children killed and their precious mothers victimized by the U.S. abortion.
    • Clenard Howard Childress, Jr.
  • I do not believe that just because you're opposed to abortion, that that makes you pro-life. In fact, I think in many cases, your morality is deeply lacking if all you want is a child born but not a child fed, not a child educated, not a child housed. And why would I think that you don't? Because you don't want any tax money to go there. That's not pro-life. That's pro-birth. We need a much broader conversation on what the morality of pro-life is.
  • I am opposed to abortion and to government funding of abortions. We should not spend state funds on abortions because so many people believe abortion is wrong.
    • Bill Clinton, now in favor of legalized abortion, in a letter to Arkansas Right to Life, (September 26, 1986).
  • You might assume this would be an incendiary topic in the world of veterinary medicine. But it’s not. I’m sure there are plenty of vets unwilling to perform feline abortions but I don’t know any personally. Faced with the choice: terminate a pregnancy in the process of spaying a cat or add to the already huge unwanted kitten population…hmmm…let me think…
    • Coates, Jennifer (7 May 2007). "Feline abortion: often an unnerving necessity". petMD. Archived from the original on 21 January 2012. Retrieved 18 December 2012.
  • I’ve probably performed over a hundred abortions and so far my career as an abortionist has gone unmarred by near-term kitten stirrings or otherwise stress-provoking signs of life. By accident or divine intervention I’ve never had the opportunity to consider whether to abort or not based on the size of the kittens.
    I did hear about one vet who did a “peek and shriek,” meaning she opened the abdomen only to find that the kittens were so close to term she couldn’t go through with the procedure. She stitched her back up and let nature take its course.
    For the record, I’d never ever do this. This cat’s natural delivery was probably extra-painful and suture-poppingly perilous. Imagine trying to deliver a baby with a recent abdominal incision. I’ve never had an abdominal incision but, having delivered a baby the old-fashioned way, I’m not insensitive to this kitty’s predicament. I would have felt compelled to abort the kittens or attempt to deliver them by C-section.
    • Coates, Jennifer (7 May 2007). "Feline abortion: often an unnerving necessity". petMD. Archived from the original on 21 January 2012. Retrieved 18 December 2012.
  • I probably don’t have to explain to you, my Dolittler readers, why aborting kittens of a certain age is fraught with potential moral peril. But others don’t always see it that way. There are so many kittens on the street, they’d argue, how can you conscionably allow them to live when you’re in the ideal position to end their lives?
    Theoretically, that may make sense. But there’s something about recognizing the coloration of the kittens’ fur beneath the thin lining of the uterus that evokes the vision of kittens in a plastic bag. And drowning kittens in a bag seems antithetical to the values I pledged to when I took the veterinarian’s oath at graduation.
    Consequently, I always pause when I acknowledge a cat’s pregnancy pre-spay. I’ve taken to adding an X-ray to my protocol. If the kittens look full term I’ll send her home. Luckily that’s only happened a couple of times. I hate losing the opportunity to spay her when I have her in my sights but the alternative’s worse—for my conscience.
    • Coates, Jennifer (7 May 2007). "Feline abortion: often an unnerving necessity". petMD. Archived from the original on 21 January 2012. Retrieved 18 December 2012.
  • [A]nti-abortion activists are able to take advantage of the fact that the general public and most policy-makers do not know what constitutes “good science ... to defend their positions, these activists often cite studies that have serious methodological flaws or draw inappropriate conclusions from more rigorous studies”.
  • How is the person who considers abortion to be murder any different from the Pole who knew what was going to happen at Auschwitz? If the Pole was morally obligated to attempt to save lives, isn't the person who opposes abortion under the same obligation?
    • B.D. Colen, The Anti-Abortion High Ground. -- full source needed
  • The mortality rate associated with abortion is low (0.6 per 100,000 legal, induced abortions), and the risk of death associated with childbirth is approximately 14 times higher than that with abortion. Abortion-related mortality increases with each week of gestation, with a rate of 0.1 per 100,000 procedures at 8 weeks of gestation or less, and 8.9 per 100,000 procedures at 21 weeks of gestation or greater.
  • Women must be seen as having the moral authority to make their own abortion decisions not because they are victims who are suffering, but because doing so is integral to being able to chart one’s own destiny. When pregnancy is finally viewed as a voluntary gift of life to another, not a woman’s duty, the abortion debate will not turn on the question of when life begins. When women who refuse childbearing are understood to be responsible rather than reprehensible, there will be no incentive to place fetal viability or any other restrictions on their decision making. And when women are accorded a right to sexual, the sanctification of fetal innocence and the urge to punish with unwanted pregnancy or illegal abortion will abate.
  • The prevalence of economically influenced abortions and the sterilization campaigns against poor, minority, and disabled women show us that autonomy is impossible without eradication of discrimination and poverty. Racism, sexism, and poverty can make the difference between abortions that reflect choice and those reflecting bitter necessity.
  • The consequences of right-wing reproductive health policies are devastating not only to women, but also to children and families. If you rate every country in the world starting with whether each provides full access to family planning, emergency contraceptives, pays for abortions and provides comprehensive sex education, and compare those to rates for countries where these policies are opposed, you will see that those who provide full access to EC, abortion, family planning and sex education have the LOWEST abortion rates, lowest STD rates, lowest infant mortality rates, lowest teen pregnancy rates, lowest maternal death rates as well as the best indicators for EVERY measurement of women's health.
    On the other side of the spectrum where abortion and family planning are illegal, the worst indicators for women's health are found including the highest (and most dangerous) abortion rates in the world. Right now, today, as you are reading this, ½ the hospital beds in every large city hospital in Central and South America are taken by women suffering from illegal abortion attempts. And all these countries have the highest abortion rates in the world.
  • If Americans support abortion, let's vote. . . Just this past term, in Stenberg vs. Carhart, the court expanded the apocryphal abortion right to an all-new right to stick a fork in the head of a half-born baby.
    • Ann Coulter, lawyer and political commentator, syndicated column (December 28, 2000).
  • Taxes are like abortion, and not just because both are grotesque procedures supported by Democrats. You're for them or against them. Taxes go up or down; government raises taxes or lowers them. But Democrats will not let the words abortion or tax hikes pass their lips.
    • Ann Coulter, lawyer and political commentator, syndicated column, (February 21, 2002).
  • Liberals' only remaining big issue is abortion because of their beloved sexual revolution. That's their cause: Spreading anarchy and polymorphous perversity. Abortion permits that.
    • Ann Coulter, lawyer and political commentator, Slander: Liberal Lies About the American Right, 2002.
  • [T]he abortion patient has a right not only to be rid of the growth, called a fetus, in her body, but also has a right to a dead fetus. . . [I] never have any intention of trying to protect the fetus, if it can be saved. . . as a general principle [t]here should not be a live fetus.
    • Robert Crist, abortion doctor, testifying in federal court in 1980.
  • [The few doctors willing to replace those who are retiring are] mostly physicians who have had difficulty establishing regular ob-gyn practices. . . Out of [one abortion practitioner's] first six months of work, there are nine malpractice suits ... After it was apparent the guy was a klutz, they kept using him, and trying to cover for him, because they couldn't find another provider.
    • Robert Crist, abortion doctor, St. Petersburg Times, June 3, 1990.
  • In testimony Wednesday in St. Louis Circuit Court, Crist said that it is not uncommon for second-trimester fetuses to leave the womb feet-first, intact and with their hearts still beating. He sometimes crushes their skulls to get the fetuses out. Other times, he dismembers them.
    • Robert Crist, abortion doctor, paraphrased in the article "Abortion Doctor Gives Graphic Testimony Describing Abortion Procedure", St. Louis Post-Dispatch (May 25, 2000).
  • My friend, O' Lordy / Went to take care of her own body / She got shot down in the road / She looked up before she went / She said 'This isn't really what I meant' / And the daily news said '2 with 1 stone'
  • Therapeutic abortion refers to termination of pregnancy for medical indications. Inclusive medical and surgical disorders are diverse and discussed throughout this text. In cases of rape or incest, many consider termination. The most frequent indication currently is to prevent birth of a fetus with a significant anatomical, metabolic, or mental deformity. The term elective abortion or voluntary abortion describes the interruption of pregnancy before viability at the request of the woman, but not for medical reasons. Most abortions done today are elective, and thus, it is one of the most frequently performed medical procedures.
    • Cunningham F, Leveno KJ, Bloom SL, et al. Abortion. In: Cunningham F, Leveno KJ, Bloom SL, et al, eds. Williams Obstetrics. 25th ed. New York, NY: McGraw-Hill; 2018:346-370

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  • Observe, O man, and see whether the dog goes after the bitch after she has conceived. Look at the cow or certainly at the mare, and notice whether the bulls or stallions bother them after they are with young. Obviously, they forego the pleasure of intercourse when they sense that they are unable to produce offspring. Therefore, since bulls and dogs and other kinds of animal show such regard for their young, it is men alone, whose teacher was born of the Virgin, who have no fear of destroying and killing their little ones, made in the image of God, just so that they can satisfy their lust. This is the reason why many women practice abortion before their term is complete, or certainly why they discover means of mutilating or damaging the tiny and still fragile limbs of these little ones. And thus, as they are impelled by their incentives to lust, they are first murderers before they become parents.
    • St.Peter Damian, letter 96, Letters 91-122, Fathers of the Church: Medieval Continuation, Owen J. Blum, O.F.M., 1998, Catholic University of America Press, pp. 62-63, ISBN 0813208165 ISBN 9780813208169. Editor's note: “Here we have one of the few references, perhaps the only explicit one, in Damian's letters, to the practices of abortion. And to the horror of post-modern feminists he puts the blame on ‘the many women who practice abortion,’ charging them ‘with being murderers before they became parents.’ This discussion and its context are important evidence from the Central Middle Ages, reflecting the constant opposition of the Church to abortion from the Council of Elvira (ca. 302) to the present.”
  • Despite the multitude of research on the history of abortion politics in the United States, no study has examined how large mainstream religious institutions engaged with the abortion debate. Research has mostly looked at activists and institutions on the extremes of the debate, generally overlooking how the large, moderate institutions were being torn apart in the middle. When religious institutions are mentioned, it is brief and their views are assumed to be static.
  • Many of today’s feminists see abortion as one of the touchstones of their movement. Yet many of the early leaders of the women’s suffrage movement in the U.S. believed that the rights of mother and child are inextricably linked and that the right to life and the right to vote are rooted in the inherent dignity of each human person.
    The public statements of many early champions of women’s rights in the U.S. make clear their opposition. Elizabeth Cady Stanton referred to abortion as “infanticide” and wrote that “when we consider that women are treated as property, it is degrading to women that we should treat our children as property to be disposed of as we see fit.” Victoria Woodhull, the first female candidate for president, wrote: “Every woman knows that if she were free, she would never bear an unwished-for child, nor think of murdering one before its birth.” And Elizabeth Blackwell, the first woman to receive a medical degree in the U.S., wrote: “The gross perversion and destruction of motherhood by the abortionist filled me with indignation, and awakened active antagonism.”
    Mrs. Pankhurst’s American counterpart, Susan B. Anthony, was a friend and heroine to many of these women. Along with Cady Stanton, she founded The Revolution newspaper, which served as a mouthpiece for the American women’s suffrage movement. Anthony funded the paper herself, refusing the capital that would have resulted from allowing advertisements for “restellism,” as abortion was then called. The Revolution published a piece, attributable to Anthony, that said abortion was a choice that would burden both a woman’s “conscience in life and soul in death” and also ultimately an exploitation of women.
    • Dannenfelser, Marjorie (4 November 2015). "The Suffragettes Would Not Agree With Feminists Today on Abortion". Time. Archived from the original on 6 November 2015. Retrieved 4 November 2015.
  • Mother Teresa of Calcutta actually said, in her speech accepting the Nobel Peace Prize, 'The greatest destroyer of peace is abortion.' What? How can a woman with such cock-eyed judgement be taken seriously on any topic, let alone be thought seriously worthy of a Nobel Prize?
    • Richard Dawkins, The God Delusion (2006), Ch. 8: "What's wrong with religion? Why be so hostile?"
  • Medical science is irrelevant to the question of when a fetus becomes a human being.
    • Shannon Dea, assistant professor of philosophy and co-president of Planned Parenthood Waterloo Region, 1/6/2012 [15].
  • If women must submit to abortion to preserve their lifestyle or career, their economic or social status they are pandering to a system devised and run by men for male convenience.
    • Daphne deJong, feminist author, in Feminism and Abortion: The Great Inconsistency, (January 7, 1978).
  • Until this century, the laws of both Britain and America made women a part of' their husbands. By marriage, the husband and wife are one person in law. . . our law in general considers man and wife one person. The one person was, of course, the husband, who exerted absolute power over his wife and her property. She had no existence and therefore no protection under the law. The only thing a husband could not do was kill her. The earliest feminist battles were fought against the legal chattel status of women. Many feminists were among those who overturned the U.S. Supreme Court decision of 1857, that a black slave was ‘property’ and not entitled to the protection of the Constitution. Feminism totally rejected the concept of ownership in regard to human beings. Yet when the Court ruled in 1973 that the fetus was the property of its mother, and not entitled to the protection of the Constitution, ‘liberated’ women danced in the streets.
    • Daphne deJong, feminist author, in Feminism and Abortion: The Great Inconsistency, (January 7, 1978).
  • The food situation in the world is serious enough, it seems to me, to justify an extension of birth control propaganda to include the practice of abortion. There must be a decreasing birth rate for some years to come and all means ought to be employed to bring it about if we are to avoid aggravation of all the evils of over population ... Let us frankly admit that birth control means just what it says and includes both prevention of conception and abortion.
    • Herman Dekker, letter to the Editor (Margaret Sanger, founder of Planned Parenthood), Birth Control Review (August, 1920).
  • I do think abortion is murder—of a very special and necessary sort. What else would one call the deliberate stilling of a life? And no physician involved with the procedure ever kids himself about that...legalistic distinctions among 'homicide,' 'justified homicide,' 'self-defense,' and 'murder' appear to me a semantic game. What difference does it make what we call it? Those who do it and those who witness its doing know that abortion is the stilling of a life.
    • Magda Denes, abortion advocate, clinical psychologist and psychoanalyst, "Performing Abortions," Commentary Magazine (October, 1976).
  • 'Forceps, please,' Mr. Smith slaps into his hand what look like oversized ice-cube tongs. Holtzman pushes it into the vagina and tugs. He pulls out something, which he slaps on the instrument table. 'There,' he says, 'A leg. You can always tell fetal size best by the extremities. Fifteen weeks is right in this case.' I turn to Mr. Smith. 'What did he say?' 'He pulled a leg off,' Mr. Smith says. 'Right here.' He points to the instrument table, where there is a perfectly formed, slightly bent leg, about three inches long. It consists of a ripped thigh, a knee, a lower leg, a foot, and five toes. I start to shake very badly, but otherwise I feel nothing. Total shock is painless. 'I have the rib cage now,' Holtzman says, as he slams down another piece of the fetus. 'That's one thing you don't want to leave behind because it acts like a ball valve and infects everything.... There, I've got the head now. Also a piece of the placenta.' I look at the instrument table where next to the leg, and next to a mess he calls the rib cage but that I cannot recognize, there lies a head. It is the smallest human head I have ever seen, but it is unmistakably part of a person.
    • Magda Denes, abortion advocate, clinical psychologist and psychoanalyst, In Necessity and Sorrow; Life and Death Inside an Abortion Clinic 1978.
  • There was not one [abortion practitioner] who at some point in the questioning did not say 'This is murder.'
    • Magda Denes, abortion advocate, clinical psychologist and psychoanalyst, discussing two years of research done for her 1978 book In Necessity and Sorrow; Life and Death Inside an Abortion Clinic.
  • There's still the shame thing, even among people who are pro-choice ... We are still seen as dirty, even among our own people.
    • Diane Derzis, abortion clinic administrator, Atlanta Journal Constitution (May 16, 1993)
  • now the profile of our country looks a little less hard nosed / but that picket line persisted and that clinic's since been closed / they keep pounding their fists on reality hoping it will break / but I don't think there's a one of us leads a life free of mistakes
  • The fascists are some heavy dudes / They don't really give a damn about life / They just don't want a woman to control her body or have the right to choose / But baby that ain't nothin / They just want a male finger on the button / Because if you say war they will send them to die by the score / Aborting mission should be your volition / But if souter and thomas have their way / You'll be standing in line unable to get welfare while they're out hunting and fishing / It has always been around it will always have a niche / But they'll make it a privilege not a right / Accessible only to the rich / Pro-lifers should dig themselves / Cause life doesn't stop after birth / And to a child born to the unprepared / It might even just get worse.
  • An estimated 26% of all pregnancies worldwide are terminated by induced abortion: 41% in developed regions and 23% in developing regions. Of the estimated 76 million unintended pregnancies that occur annually in developing countries, perhaps 34 million result in unplanned births. Among the rest, an estimated 10 million end in miscarriage and 32 million are interrupted by induced abortion. Reliable data from the developing world on the ratio of abortions to pregnancies are limited almost entirely to those Asian countries in which abortion is permitted on broad grounds, ranging from 10% in Uzbekistan to 40% in Armenia, Kazakhstan, and Viet Nam. For other regions, the estimated ratio of abortions to pregnancies is 15% in sub-Saharan Africa (of which 99% are probably illegal); 21% and 30%, respectively, in Central and South America (of which virtually 100% are illegal, except in Cuba); and 18% and 20%, respectively, for Central and Southern Asia and for Southeast and Eastern Asia (of which an estimated 78% and 60% are illegal)
  • Accurate statistics on the incidence of abortion and on related morbidity and mortality are notoriously difficult to collect, however, whether from institutional sources, indirect estimation techniques, or from women themselves. The exception is in countries where services are available on request and where most procedures are performed in the public health system or in private clinics—that is, in approved facilities by trained personnel—with good reporting systems. In these countries, one can calculate abortion ratios (per 100 pregnancies or, alternatively, live births) and abortion rates (per 1000 women of the relevant age group or marital status) as well as abortion mortality ratios, recognizing that there may still be some underreporting.
    In estimating the percentages of all abortions that are performed under unsafe conditions where data are scarce or unreliable, however, both the numerator and denominator are problematic. On the basis of complex assumptions and a variety of complete and incomplete country-specific data sources, the WHO estimates that 19 million of the approximately 45 million abortions performed annually worldwide are unsafe according to their definition, with 97% of all unsafe procedures being performed in developing countries. Perhaps 68 000 women die each year from the complications of unsafe abortions, including those that are self-induced, and untold numbers suffer from infections and other damage to the reproductive tract. Preventable deaths from improperly performed procedures constitute 13% of maternal mortality globally, and 25% or more in some countries where maternal mortality from other causes is relatively low (e.g., Eastern Europe and South America), making unsafe abortion the leading single cause of maternal mortality worldwide.
    In developed countries in which safe services are broadly accessible, abortion deaths average about 1 per 100 000 procedures compared with 6 to 25 deaths during pregnancy, delivery, or its aftermath per 100 000 live births. Risks are hundreds of times higher in countries where women turn to untrained providers, quacks, or self-induced methods. Abortion deaths average 330 per 100 000 procedures in all developing regions (excluding China) and as high as 680 per 100 000 in sub-Saharan Africa. Ensuring the safety of all voluntary pregnancy terminations and not just those that are acceptable on narrow legal grounds is clearly central to the reduction of maternal mortality as proposed in the MDGs. The persistence of restrictive policies in many countries should be a major cause for alarm, however. These policies impede women’s access to high-quality services, often with disastrous results, in addition to impeding the collection of reliable data for the global monitoring of maternal health.
  • One of the distinguishing features of the abortion conflict compared to other social debates of our times is the level of protest, harassment, and violence generated over this issue. Journalists, physicians, and activists on both sides of the debate have talked about the spectacle occurring outside of clinics across the nation. Media frequently cover the confrontational aspects of the abortion debate at the expense of the “less dramatic” (but important) policy developments surrounding abortion politics. Media pundits and pro-choice politicians discuss these tactics in terms o personal acts of harassment, completely devoid of any political implications.
  • Every year, of course, our opponents who are well-oiled, and very popular, and who have access to a lot of prestigious support, every year, they say this is over, and the pro-lifers are the extremists. It's becoming more and more clear that the real extremists are the pro-abortionists. They are the ones that will not allow any dialogue at all. They are the ones who will not allow absolutely any consideration of any restriction on the abortion license, even something as hideous and nauseating as partial-birth abortion. Absolutely not. We do not talk about it. We will not consider it. This is the kind of dug-in, close-minded extremist party, namely the pro-abortionists.
  • At the heart of the abortion debate are twin questions. The first of these is purely scientific: Are the unborn living persons, or are they not? Science has definitively settled this question, and even pro-abortionists have been forced to admit that the preborn are living beings, as described in Chapter 70.
    The second question is philosophical and moral: May these living beings be killed, and, if so, under what circumstances?
    • Donovan, Colin B, [www.ewtn.com/expert/answers/abortio2.htm] "Abortion - Exocommunication"], “The Two Questions”, ‘’Eternal Word Television Network’’, Retrieved 2007-06-24.
  • Pregnant women should be told that having an abortion is safer than having the baby, according to medical chiefs.
    The advice, which would be given to women considering terminations, has caused anger, with anti-abortion campaigners accusing doctors' leaders of forcing an "absurdly liberal agenda" on women in a vulnerable situation....
  • Sonography in connection with induced abortion may have psychological hazards. Seeing a blown-up, moving image of the embryo she is carrying can be distressing to a woman who is about to undergo an abortion, Dr. Sally Faith Dorfman noted. She stressed that the screen should be turned away from the patient.
    • Sally Faith Dorfman, paraphrased in Obstetrics and Gynecology News, editorial (February 15, 1986).
  • Dublin Declaration on Maternal Health (September 2012)
    “As experienced practitioners and researchers in obstetrics and gynaecology, we affirm that direct abortion – the purposeful destruction of the unborn child – is not medically necessary to save the life of a woman.
    We uphold that there is a fundamental difference between abortion, and necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child.
    We confirm that the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.”
    • "Translations". Dublin Declaration. Archived from the original on 28 October 2015. Retrieved 28 October 2015.
  • To discover that abortion was one of the greatest crime-lowering factors in American history is, needless to say, jarring. It feels less Darwinian than Swiftian; it calls to mind a long ago dart attributed to G. K. Chesterton: when there aren't enough hats to go around, the problem isn't solved by lopping off some heads. The crime drop was, in the language of economists, an 'unintended benefit' of legalized abortion. But one need not oppose abortion on moral or religious grounds to feel shaken by the notion of a private sadness being converted into a public good.
    • Stephen J. Dubner and Steven D. Levitt, from the essay Where Have All the Criminals Gone? Want to understand what made the crime rate drop in the 1990s? Look back to the Roe v. Wade decision in 1973.

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  • The one regret I have about my own abortions is that they cost money that might otherwise have been spent on something more pleasurable, like taking the kids to movies and theme parks.
    • Barbara Ehrenreich, "Their Dilemma and Mine" (1989), reprinted in The Worst Years of Our Lives (1991).
  • No doctor, for ethical, moral or honest reasons wants to do nothing but abortions...women don't like to do abortions over and over for moral reasons. Sometimes our women doctors become pregnant themselves, which upsets the patients. At the same time, if a woman is carrying a baby, she doesn't like to abort someone else's. We have much more trouble keeping women doctors on the staff than men.
    • Edward Eichner, director of medicine at a Cleveland abortion facility, quoted in Rachel Weeping and Other Essays About Abortion, p. 43, 1982.
  • A woman should be able to choose to have an abortion up to a certain point in pregnancy.
  • Much like the secular debate over abortion, the religious debate is one best captured in shades of gray rather than how it's usually depicted by both "pro" sides — in black and white.
    In fact, the religious arguments themselves haven't changed much over the past three decades. They've simply grown in volume and intensity.
    The basic religious position against abortion is that human life begins at conception, not at birth, and therefore aborting a pregnancy violates the commandment against murder.
  • In the point-counterpoint of the abortion debate, biblical arguments seem to have lost their zing, as partisans talk past each other and dispute the meaning of the few biblical passages that come even close to being relevant. When Psalm 139, for example, says, "You (God) knit me together in my mother's womb," is that biblical proof life begins at conception or simply symbolic language showing God's providence, based perhaps on an ancient Phoenician myth? Depends on whom you ask.
    When Jeremiah 1:5 has God saying, "Before I formed you in the womb, I knew you," is that God's definition of conception or the author's literary description of his call as a prophet? Again, it depends on one's interpretation.
  • America's religious communities show deep divisions and hardening positions on abortion. As happens when a political or cultural issue becomes a religious cause couched in absolutist language and claims of divine sanction, compromise seems unthinkable.
  • The three main diseases of reproduction in cows–contagious abortion (Brucella abortus), trichomoniasis, and vibrionic abortion–can have serious effects on calving percentages and accordingly they ought to be controlled through calf–hood vaccination of heifers against contagious abortion and by strict adherence to approved breeding procedures in the case of the other two diseases.
    • "Beef cattle and Beef production: Management and Husbandry of Beef Cattle". Encyclopaedia of New Zealand. 1966. Archived from the original on 1 January 2009.
  • If the Vice President [Quayle] thinks it's disgraceful for an unmarried woman to bear a child, and if he believes that a woman cannot adequately raise a child without a father, then he'd better make sure that abortion remains safe and legal.
    • Diane English, Murphy Brown Producer, cited in John Fiske, Media Matters:Race and Gender in U.S. Politics, 1996.
  • The estimated rate of miscarriage is 15% to 20% in women who know they are pregnant, but as many as half of all fertilized eggs may spontaneously abort, often before the women realize they are pregnant. Women who have had previous miscarriages are at a higher risk for miscarriage. The risk of miscarriage also increases with maternal age beginning at age 30 and becoming greater after age 35.

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  • The first trimester of pregnancy is from conception through 12 weeks. Approximately 88 percent of abortions occur in the first trimester, and almost 60 percent of these are performed before nine weeks of pregnancy. The second trimester extends from 12 weeks through the end of the twenty-seventh week. About 12 percent of abortions occur in the second trimester, and only 1.2 percent of abortions occur when the pregnancy is at 21 weeks or more. The third trimester is from 24 weeks through delivery. Only 0.01 percent of all abortions are performed at this stage of development. Such late-term abortions are performed only in extreme medical situations.
  • I remain pro-choice. I am not religious. I am an atheist and a rationalist. The findings did surprise me, but the results appear to be very robust because they persist across a series of disorders and a series of ages. . . . Abortion is a traumatic life event; that is, it involves loss, it involves grief, it involves difficulties. And the trauma may, in fact, predispose people to having mental illness.
    • Professor David M. Fergusson, Christchurch Health and Development Study, commenting on research he directed, interviewed on Australian Broadcasting Corporation (March 1, 2006).[16].
  • When you're a doctor who does these abortions and the leaders of your movement appear before Congress and go on network news and say these procedures are done in only the most tragic of circumstances, how do you think that makes you feel? You know they're primarily done on healthy women and healthy fetuses, and it makes you feel like a dirty little abortionist with a dirty little secret. I think we should tell them the truth, let them vote and move on. In the vast majority of cases, the procedure is performed on a healthy mother with a healthy fetus that is 20 weeks or more along. The abortion-rights folks know it, the anti-abortion folks know it, and so, probably, does everyone else.
    • Ron Fitzsimmons, Executive Director of the National Coalition of Abortion Providers, in "An Abortion Rights Advocate Says He Lied About Procedure", New York Times (February 26, 1997).
  • One of the facts of abortion is that women enter abortion clinics to kill their fetuses. It is a form of killing, you're ending a life.
    • Ron Fitzsimmons, Executive Director of the National Coalition of Abortion Providers, "An Abortion Rights Advocate Says He Lied About Procedure", New York Times, (February 26, 1997).
  • Among the vulnerable for whom the Church wishes to care with particular love and concern are unborn children, the most defenceless and innocent among us. Nowadays efforts are made to deny them their human dignity and to do with them whatever one pleases, taking their lives and passing laws preventing anyone from standing in the way of this. Frequently, as a way of ridiculing the Church's effort to defend their lives, attempts are made to present her position as ideological, obscurantist and conservative. Yet this defence of unborn life is closely linked to the defence of each and every other human right. It involves the conviction that a human being is always sacred and inviolable, in any situation and at every stage of development. Human beings are ends in themselves and never a means of resolving other problems. Once this conviction disappears, so do solid and lasting foundations for the defence of human rights, which would always be subject to the passing whims of the powers that be. Reason alone is sufficient to recognize the inviolable value of each single human life, but if we also look at the issue from the standpoint of faith, “every violation of the personal dignity of the human being cries out in vengeance to God and is an offence against the creator of the individual”.
    Precisely because this involves the internal consistency of our message about the value of the human person, the Church cannot be expected to change her position on this question. I want to be completely honest in this regard. This is not something subject to alleged reforms or “modernizations”. It is not “progressive” to try to resolve problems by eliminating a human life. On the other hand, it is also true that we have done little to adequately accompany women in very difficult situations, where abortion appears as a quick solution to their profound anguish, especially when the life developing within them is the result of rape or a situation of extreme poverty. Who can remain unmoved before such painful situations?
  • Lively activities [are] observed by ultrasound in the tenth week, when babies rarely pause for more than five minutes.
    • Geraldine Lux Flanagan, Beginning Life 62 (1996).
  • One of the most controversial issues of our time and one in which we share a keen interest is the question of abortion. I have grave concern over the serious moral questions raised by this issue. Each new life is a miracle of creation. To interfere with that creative process is a most serious act. In my view, the Government has a very special role in this regard. Specifically, the Government has a responsibility to protect life--and indeed to provide legal guarantees for the weak and unprotected. It is within this context that I have consistently opposed the 1973 decision of the Supreme Court. As President, I am sworn to uphold the laws of the land and I intend to carry out this responsibility. In my personal view, however, this court decision was unwise. I said then and I repeat today--abortion on demand is wrong.
  • Three-quarters [of post-abortive women surveyed] said that having a baby would interfere with work, school, or other responsibilities, about two-thirds said they could not afford to have a child and half said they did not want to be a single parent or had relationship problems.
    • Aida Torres and Jacqueline Darroch Forrest, "Why Do Women Have Abortions", Family Planning Perspectives, 20 (4) Jul/Aug 1988, pp 169-176 (The bimonthly research journal of The Alan Guttmacher Institute).
  • Victim of rape or incest: 1%
    • Aida Torres and Jacqueline Darroch Forrest, "Why Do Women Have Abortions", Family Planning Perspectives, 20 (4) Jul/Aug 1988, pp 169-176 (The bimonthly research journal of The Alan Guttmacher Institute).
  • Of women who had an abortion at 16 or more weeks' gestation, 71% attributed their delay to not having realized they were pregnant or not having known soon enough the actual gestation of their pregnancy. Almost half were delayed because of trouble in arranging the abortion, usually because they needed time to raise money. One-third did not have an abortion earlier because they were afraid to tell their partner or their parents that they were pregnant.
    • Aida Torres and Jacqueline Darroch Forrest, "Why Do Women Have Abortions", Family Planning Perspectives, 20 (4) Jul/Aug 1988, pp 169-176 (The bimonthly research journal of The Alan Guttmacher Institute).
  • No matter how it is worded or performed, abortion hurts women. This won't stop until women stand up in unison and say, ‘This is unacceptable. We deserve better.’ Lack of emotional and financial resources are the real undue burden and abortion will never lift that.

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  • (This) subject lies deeper down in woman's wrongs than any other...I hesitate not to assert that most of (the responsibility for) this crime lies at the door of the male sex.
    • Matilda Gage, early feminist, in The Revolution (April 9, 1868).
  • Of seven abortion restrictions tested in a July 15-17 Gallup poll, informing women of certain risks of an abortion in advance of performing it is the most widely favored, at 87%. Seven in 10 Americans favor requiring parental consent for minors and establishing a 24-hour waiting period for women seeking abortions. Nearly two-thirds favor making the specific procedure known as "partial birth abortion" illegal... 71% say [abortion] should be illegal in the second trimester and 86% in the third.
    • Gallup.com press release citing poll results on July 25, 2011. [17].
  • [I]t seems to me as clear as daylight that abortion would be a crime.
    • Mahatma Gandhi, All Men Are Brothers: The Life and Thoughts of Mahatma Gandhi As Told In His Own Words, 165 (1958).
  • For God...has conferred on men the surpassing ministry of safeguarding life...Therefore from the moment of its conception life must be guarded with the greatest care while abortion and infanticide are unspeakable crimes.
  • I will maintain the utmost respect for human life from the time of conception.
    • "Oath of Geneva", as originally adopted by the General Assembly of the World Medical Association at Geneva in 1948. Subsequent amendments removed "from the time of conception".
  • [E]ven at 16 or 17 years old I understood that abortion was killing an unborn baby. I mean it was simple and straightforward and indeed it is simple and straightforward. We try to make this complicated but it's simple and straightforward. You've got a new human life developing in the mother's womb and abortion is the business of killing that baby.
  • Life is the division of human cells, a process that begins with conception. The [Supreme Court's abortion] ruling was unjust, and it is incumbent on the Congress to correct the injustice. I have always been supportive of pro-life legislation. I intend to remain steadfast on this issue...I believe that the life of the unborn should be protected at all costs.
    • Richard "Dick" Gephardt, U.S. Representative and former Democratic House majority leader, now in favor of legalized abortion, 1984.
  • [H]e was sometimes surprised by the anger a late-term abortion can arouse in him. On the one hand, the physician said, he is angry at the woman. 'But paradoxically,' he added, 'I have angry feelings at myself for feeling good about grasping the calvaria [the top of the baby's head], for feeling good about doing a technically good procedure which destroys a fetus, kills a baby.'
    • D.M. Gianelli, quoting anonymous New Mexico abortion practitioner, in "Abortion providers share inner conflicts," American Medical News, July 12, 1993. [18].
  • Despite restricted access, abortion remains one of the most common surgical procedures in the U.S. for women and, according to the Guttmacher Institute, fewer than 0.3% of patients experience a complication serious enough to require hospitalization. First-trimester abortions in particular are considered extremely safe. After years of debate about breast cancer and abortion, the U.S. National Cancer Institute in February 2003 gathered the world's leading experts to review the data and assess the risk. They stated that their conclusion that "induced abortion is not associated with an increase in breast cancer risk was "well established," the institute's highest rating for research findings.
  • Half of women who obtain an abortion pay more than one-third of their monthly income for the procedure.
    Costs rise significantly the longer a woman must wait, either because state law requires it or she needs to save up the money – or both. Studies show that women who cannot access abortion are three times more likely to fall into poverty than women who obtained abortions.
    In addition to the financial burden, many states are enacting laws designed to limit abortion access. These laws hit low-income women particularly hard. From 2011 to 2015, 31 states have enacted 288 such laws, including waiting periods and mandatory counseling sessions.
    Moreover, 24 states have enacted so-called TRAP laws (targeted regulation of abortion providers), which medical experts say go far beyond what is needed for patient safety and impose needless requirements on doctors and abortion facilities, such as requiring facilities to have the same hallway dimensions as a hospital.
  • I think that abortion should not be legal, and I think that how you would implement that I'm not sure.
    • Newt Gingrich, former Speaker of the House, in The American View, 2005.
  • I think that Planned Parenthood should be defunded, and I think it's a very significant issue to say to people, Should your tax money go to pay the leading abortion provider in America?”
  • I stand with President Ronald Reagan in supporting “the unalienable personhood of every American, from the moment of conception until natural death,” and with the Republican Party platform in affirming that I “support a human life amendment to the Constitution, and endorse legislation to make clear that the 14th Amendment protections apply to unborn children.” I believe that in order to properly protect the right to life of the vulnerable among us, every human being at every stage of development must be recognized as a person possessing the right to life in federal and state laws without exception and without compromise. I recognize that in cases where a mother's life is at risk, every effort should be made to save the baby's life as well; leaving the death of an innocent child as an unintended tragedy rather than an intentional killing. I oppose assisted suicide, euthanasia, embryonic stem cell research, and procedures that intentionally destroy developing human beings. I pledge to the American people that I will defend all innocent human life. Abortion and the intentional killing of an innocent human being are always wrong and should be prohibited. If elected President, I will work to advance state and federal laws and amendments that recognize the unalienable right to life of all human beings as persons at every stage of development, and to the best of my knowledge, I will only appoint federal judges and relevant officials who will uphold and enforce state and federal laws recognizing that all human being at every stage of development are person with the unalienable right to life.
    • Newt Gingrich, presidential candidate, when he signed the Personhood USA Pledge in December 2011.
  • [T]here is a growing body of evidence which suggests that increasing use of emergency contraception does not have any effect on the rates of unintended pregnancy and abortion.
    • Anna Glasier, director of family planning and well woman services at Lothian Primary Care National Health Service Trust, in Edinburgh, Scotland, in the British Medical Journal, (September 16, 2006).
  • To earlier feminists who had fought for the vote and for fair treatment in the workplace, it had seemed obvious that the ready availability of abortion would facilitate the sexual exploitation of women. Women like Susan B. Anthony and Elizabeth Cady Stanton regarded free love, abortion, and easy divorce as disastrous for women and children. They would have regarded women who actively promoted those causes as foolish or deranged.
    • Mary Ann Glendon, Learned Hand Professor of Law at Harvard University and Vatican official, "The Women of 'Roe v. Wade'", First Things, June/July 2003.
  • Anti-choicers have declared war on women. Now it's up to us to fight back. If that means guarding the clinic doors with Uzis, then that's what will have to be done. Just once, I'd like to see someone blow up one of those churches. . . This week is anti-choice week at UB. If you see one of them showing their disgusting videos or playing with toy fetuses, do your part and spit at them. Kick them in the head. . . Their God is worth nothing compared to my body. Abortion is a bit bloody. So is a root canal. It's a fucking operation! If you think abortion is gruesome, you should see childbirth; an ordeal that is ten times more dangerous to a woman's health ... The anti-choice movement is like self-help for them. Too bad there's no 'Fanatics Anonymous' to give them the help they need.
    • Michelle Goldberg, "Rant for Choice", The Spectrum, student paper at the State University of New York at Buffalo (October, 1995).
  • The custom of procuring abortions has reached such appalling proportions in America as to be beyond belief...So great is the misery of the working classes that seventeen abortions are committed in every one hundred pregnancies.
  • Women on Waves was founded to contribute to the prevention of unwanted pregnancy and unsafe abortions throughout the world by direct action. Because national penal laws, including those governing abortion, generally extend only as far as territorial waters (12 miles), Women on Waves made plans to provide reproductive health services on a ship with a mobile clinic, including abortions, outside the territorial waters of countries where abortion is illegal. We went to Ireland first because it was nearby and there was a dedicated pro-choice community with immediate interest in and commitment to the project. Although we encountered problems that meant we could not do abortions, we were contacted by more than 300 women in five days and provided reproductive health information, contraception, workshops and information on where to obtain legal abortions in Europe. In many parts of the world an anti-abortion backlash is taking place. To safeguard our reproductive rights in the face of anti-abortion activities, it is crucial to recapture a pro-active, pro-choice role. Women on Waves helped to make visible the need for legal abortion services in Ireland, and the extensive class and other differences between women able to access abortions abroad and those who could not. We are currently attempting to resolve our status under Dutch law, but until women everywhere have the right to reproductive freedom, we will continue to make waves.
  • Non-aggression is an ongoing obligation: it is never optional for anyone, even pregnant women. If the non-aggression obligation did not apply, then earning money versus stealing it and consensual sex versus rape would be morally indifferent behaviors. The obligation not to aggress is pre-political and pre-legal. It does not arise out of contract, agreement, or the law; rather, such devices presuppose this obligation. The obligation would exist even in a state of nature. This is because the obligation comes with our human nature, and we acquire this nature at conception.
  • During my 11 years in congress, I have consistently opposed federal funding for abortions. In my opinion, it is wrong to spend federal funds for what is arguably taking of a human life. Let me assure you that I share your belief that innocent human life must be protected, and I am committed to furthering this goal.
  • Our investigation revealed that the criminal conduct of Gosnell and his workers extended beyond the drug violations to nearly every aspect of the clinic's operations. Gosnell routinely and deliberately killed babies born alive by severing their spinal cords with surgical scissors, and encouraged his employees to do the same. He performed illegal abortions after the 24th week of pregnancy, often falsifying gestational ages to disguise his criminal conduct.
    • GRAND JURY XXIII (Philadelphia County) presentment recommending prosecution of abortion doctor Kermit Gosnell for murder, infanticide, and unlawful late-term abortion [19].
  • Gosnell and his staff operated the clinic in a reckless and criminal manner. Karnamaya Mongar died as a result. She was overdosed with a narcotic illegally dispensed by Gosnell's unlicensed, untrained, and unsupervised employees, at his direction, in his absence. This dangerous and criminal practice was routine at Gosnell's clinic.
    • GRAND JURY XXIII (Philadelphia County) presentment recommending prosecution of abortion doctor Kermit Gosnell for murder, infanticide, and unlawful late-term abortion [20].
  • [Gosnell] employed unlicensed and unskilled workers, including bogus doctors, to treat unsuspecting patients. In this presentment we recommend that Gosnell and members of his staff be prosecuted for criminal offenses arising out of the death of Karnamaya Mongar, for offenses relating to the killing of babies and performance of illegal abortions, and for offenses related to the operation of the criminal enterprise that was the Womens Medical Society.
    • GRAND JURY XXIII (Philadelphia County) presentment recommending prosecution of abortion doctor Kermit Gosnell for murder, infanticide, and unlawful late-term abortion [21].
  • A lot of people say they're killing their baby. You get a lot of that. Some people afterwards get very upset and say 'I killed my baby.' Or even before, they say 'My circumstances are such that I can't keep it, but I'm killing my baby.' They wouldn't rather have the baby, and give it up for adoption either. If you go into that with them they will say that they could never do that...and yet they still consider it killing the baby...well, they are killing a baby. I mean, they are killing something that would develop into maturity...
  • So far it has been assumed that the only pregnancies which are aborted are accidental ones and the only foetuses destroyed those whose mothers could not bear the thought of their becoming children. In a just world this would be the case, but the world is far from just. Too many women are forced to abort by poverty, by their menfolk, by their parents. Poverty has many faces; it may be the poverty of the young, the unmarried, the student, the unemployed, the female or a combination of these.
  • [A]bortion is an integral part of family planning. Theoretically this means abortions at any stage of gestation. Therefore I favor the availability of abortion beyond 20 weeks.
    • David Grundmann, medical director for Planned Parenthood of Australia, in his 1994 academic paper, Abortion After Twenty Weeks in Clinical Practice: Practical, Ethical and Legal Issues.
  • Unintended pregnancy and abortion are experiences shared by people around the world. These reproductive health outcomes occur irrespective of country income level, region or the legal status of abortion.
    *Roughly 121 million unintended pregnancies occurred each year between 2015 and 2019.
    *Of these unintended pregnancies, 61% ended in abortion. This translates to 73 million abortions per year.
  • Of the world's 1.64 billion women of reproductive age, 6% live where abortion is banned outright, and 37% live where it is allowed without restriction as to reason. Most women live in countries with laws that fall between these two extremes.

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  • Less restrictive abortion laws do not appear to entail more abortions overall. The world’s lowest abortion rates are in Europe, where abortion is legal and widely available but contraceptive use is high; in Belgium, Germany, and the Netherlands, the rate is below 10 per 1000 women aged 15 to 44 years. In contrast, in Africa, Latin America, and the Caribbean, where abortion laws are the most restrictive and contraceptive use is lower, the rates range from the mid-20s to 39 per 1000 women.
    Less restrictive abortion laws also do not guarantee safe abortions for those in need; better education and access to health care are also required. In India, unsafe illegal abortions persist despite India’s passage of the Medical Termination of Pregnancy Act in the early 1970s. The act appeared to remove legal hindrances to terminating pregnancies in the underfunded (national) health care system, but women still turn to unqualified local providers for abortion. Clearly, the implications of the law never reached the population that most needed to rely on it.7 This example is also seen in Cambodia, where abortion is legally available on request and women often attempt to abort themselves before turning to hospital.
  • Evidence demonstrates that liberalizing abortion laws to allow services to be provided openly by skilled practitioners can reduce the rate of abortion-related morbidity and mortality. However, sociopolitical and religious obstacles have and will continue to play a role in passing abortion laws. The roles of research, grassroots organizations, health providers, activists, and media are vital in highlighting the importance of relaxing abortion laws. The emotional, physiologic, and financial cost on women and families, as well as the burden on the economic health system, should no longer be ignored.
  • Narrated Abu Huraira: Allah's Apostle gave his verdict about two ladies of the Hudhail tribe who had fought each other and one of them had hit the other with a stone. The stone hit her abdomen and as she was pregnant, the blow killed the child in her womb. They both filed their case with the Prophet and he judged that the blood money for what was in her womb. was a slave or a female slave. The guardian of the lady who was fined said, "O Allah's Apostle! Shall I be fined for a creature that has neither drunk nor eaten, neither spoke nor cried? A case like that should be nullified." On that the Prophet said, "This is one of the brothers of soothsayers.
    • HADITH Sahih Bukhari 7:71:654, See also Sahih Bukhari 7:71:655
  • Narrated Abu Huraira: Allah's Apostle gave the judgment that a male or female slave should be given in Qisas for an abortion case of a woman from the tribe of Bani Lihyan (as blood money for the fetus) but the lady on whom the penalty had been imposed died, so the Prophets ordered that her property be inherited by her offspring and her husband and that the penalty be paid by her Asaba.
    • Sahih Bukhari 8:80:732
  • For those who cannot be educated, sterilization or legalized abortion seems to be the only remedy, for we certainly do not want such stupid people to pollute the race with stupid offspring. The defective conditions of life call urgently for improvement.
    • Norman Haire, letter to the editor, Birth Control Review, (July, 1930).
  • [Talking to friend Veronica, Anita Blake worries she may be pregnant.]
    Ronnie: I could ask, who's the father, but that's just creepy. If you are, then it's this little tiny, microscopic lump of cells. It's not a baby. It's not a person, not yet.
    Anita: We'll have to disagree on that one.
    Ronnie: You're pro-choice.
    Anita: Yep, I am, but I also believe that abortion is taking a life. I agree women have the right to choose, but I also think that it's still taking a life.
    Ronnie: That's like saying you're pro-choice and pro-life. You can't be both.
    Anita: I'm pro-choice because I've never been a fourteen-year-old incest victim pregnant by her father, or a woman who's going to die if the pregnancy continues, or a rape victim, or even a teenager who made a mistake. I want women to have choices, but I also believe that it's a life, especially once it's big enough to live outside the womb.
  • It [abortion] goes against all things which are natural. It's a termination of a life, however you look at it.
    • Robert Harris, abortionist, From author Magda Denes, PhD. "In Necessity and Sorrow: Life and Death Inside an Abortion Hospital".
  • Only now are we beginning to consider ... the concept that the fetus is a patient, an individual.
    • M.R. Harrison, in his popular medical textbook The Unborn Patient: Pre-Natal Diagnosis and Treatment, 1991.
  • No one, neither the patient receiving an abortion, nor the person doing the abortion, is ever, at anytime, unaware that they are ending a life...
    • William F. Harrison, abortion doctor, from the essay Why I Provide Abortions 1996.
  • It's true that abortion providers are perceived as not very good doctors -- that they have no alternative so they do abortions, that they cannot earn a living any other way.
    • Richard Hausknecht, abortion doctor, in "Who Will Do Abortions Here?", New York Times Magazine, January 18, 1998.
  • An abortion rarely affects your ability to become pregnant in the future, so it is possible to become pregnant in the weeks right after the procedure. Avoid sexual intercourse until your body has fully recovered, usually for at least 1 week. Use birth control in the first weeks following the abortion, as well as condoms to prevent infection.
    Postpartum depression can be triggered by changing pregnancy hormones after an abortion. If you have more than 2 weeks of symptoms of postpartum depression, such as fatigue, sleep or appetite change, or feelings of sadness, emptiness, anxiety, or irritability, see your health professional about treatment.
    • Healthwise (2004). "Manual and vacuum aspiration for abortion". WebMD. Archived from the original on 11 February 2007. Retrieved 5 December 2008.
  • The early feminists found abortion to be the ultimate exploitation of women. [Women had to] become men to compete. We bought into that. We're smarter today. It's more empowering to go through with your pregnancy.
  • In the 1950s and '60s, there were still states that outlawed birth control, so I started funding court cases to challenge that. At the same time, I helped sponsor the lower-court cases that eventually led to Roe v. Wade. We were the amicus curiae in Roe v. Wade. I was a feminist before there was such a thing as feminism. That's a part of history very few people know.
  • [T]his is indeed another kind of holocaust, by another name. At last count, more than 40 million unborn children have been deliberately, intentionally destroyed. What word adequately defines the scope of such slaughter? [After 9/11] the American people responded with shock, sadness and a deep and righteous anger — and rightly so. Yet let us not forget that every passing day in our country, more than three thousand innocent Americans are killed [through abortion].
    • Jesse Helms, former U.S. Senator, in his autobiography Here's Where I Stand, 2005.
  • Nearly ten years ago I declared myself a pro-lifer. A Jewish, atheist, civil libertarian, left-wing pro-lifer. Immediately, three women editors at The Village Voice, my New York base, stopped speaking to me. Not long after, I was invited to speak on this startling heresy at Nazareth College in Rochester (long since a secular institution). Two weeks before the lecture, it was canceled. The women on the lecture committee, I was told by the embarrassed professor who had asked me to come, had decided that there was a limit to the kind of speech the students could safely hear, and I was outside that limit.
    • Nat Hentoff, Jewish atheist leftist pro-lifer, Pro-choice bigots: a view from the pro-life left (November 30, 1992).
  • In medical practice, there are few surgical procedures given so little attention and so underrated in its potential hazard as abortion.
    • Warren Hern, abortion practitioner and author of Abortion Practice (1990), the textbook most widely used in the United States to teach abortion to medical personnel.
  • The sensations of dismemberment flow through the forceps like an electric current.
    • Warren Hern, abortion doctor, at the Associations of Planned Parenthood Physicians meeting, San Diego, October 26, 1978.
  • Television interviews in particular should focus on the public issue involved (right to confidential and professional medical care, freedom of choice and so forth) and not on the specific details of the procedure.
    • Warren Hern, excerpted from his medical textbook Abortion Practice, J.B. Lippincott Company, 1984.
  • The procedure changes significantly at 21 weeks because fetal tissues become much more cohesive and difficult to dismember.
    • Warren Hern, excerpted from his medical textbook Abortion Practice, J.B. Lippincott Company, 1984.
  • A long curved Mayo scissors may be necessary to decapitate and dismember the fetus.
    • Warren Hern, excerpted from his medical textbook Abortion Practice, J.B. Lippincott Company, 1984.
  • The aggregate fetal tissue is weighed, then the following fetal parts are measured, foot length, knee to heel length, and biparietal diameter.
    • Warren Hern, excerpted from his medical textbook Abortion Practice, J.B. Lippincott Company, 1984.
  • Vital signs should be observed regularly, and a Doppler [for listening to the fetal heartbeat] inaudible to the patient should be used at intervals to determine the presence or absence of fetal heart tones. This [informed consent] is a controversial area, but most professionals in the field feel that it is not advisable for patients to view the products of conception, to be told the sex of the fetus, or to be informed of a multiple pregnancy.
    • Warren Hern, excerpted from his medical textbook Abortion Practice, J.B. Lippincott Company, 1984.
  • The physician will usually first notice a quantity of amniotic fluid, followed by placenta and fetal parts, which may be more or less identifiable.
    • Warren Hern, abortion provider, from Abortion Practice, 1984.
  • Most physicians regard abortion as a stigmatized operation done by people who are otherwise incompetent and can't do anything else.
    • Warren Hern, abortion practitioner, American Medical News, September 5, 1994.
  • [T]he partial birth procedure is a particularly awful form of abortion....Anyone reading about or seeing pictures of this procedure is confronted with the terrible reality of what is happening....partial birth abortion is one-fifth abortion and four-fifths infanticide.
  • I'm standing for a principal. I'm willing to die for the principal. I consider it a great honor to die, possibly die, for having defended innocent human beings. . . . What I did I believe was an inalienable right or duty. You don't have to ask the government (for) permission to defend your unborn child or your neighbor's unborn child. And if we want that duty to be recognized we have to assert it.
    • Paul Hill, September 3, 2003 (Hill was executed on September 3, 2003 for murdering an abortionist).
  • I will use treatment to help the sick according to my ability and judgment, but never with a view to injury and wrong-doing. Neither will I administer a poison to anybody when asked to do so, nor will I suggest such a course. Similarly I will not give to a woman a pessary to cause abortion. But I will keep pure and holy both my life and my art.
  • In the beginning they were calling it a baby. We were saying it was only blood and tissue. Let's agree this is a life form, a potential life; you're terminating it. You don't have to argue that abortion stops a beating heart. It does. I can't say it's just like an appendectomy. It isn't. It's a very powerful and loaded decision.
  • I wasn't immune to the physicality of abortion, the blood, tissue, and observable body parts. My political and moral judgments on the nature of abortion evolved throughout the years, but I quickly came to realize that those who deliver abortion services have not only the power to give women control over their bodies and lives, but also the power—and the responsibility—of taking life in order to do that.
  • All patients undergoing an abortion, regardless of method, should have a contraceptive plan. All forms of hormonal contraception, including oral contraceptive pills/patches/rings, injectables (Depo-Provera, Depo-SubQ), and implantable contraception (Implanon, Jadelle) may be initiated immediately after a completed abortion procedure. Waiting for commencement of menstruation is unnecessary and puts the patient at risk for an immediate repeat pregnancy. An IUD (Copper-T) or intrauterine system (Mirena IUS) can be inserted immediately after a first- or second-trimester procedure, although the expulsion rate is slightly higher than if it is inserted after complete uterine involution. Expulsion rates for IUDs inserted immediately following first-trimester procedures are not significantly different from expulsion rates following delayed insertion, while expulsion rates following second-trimester postprocedure insertions are increased. However, multiple studies comparing immediate versus delayed insertion of an IUD after abortion show a loss to follow-up rate among the delayed group as high as 42%.
  • Aristotle’s Compleat Master-piece, presented a largely male perspective and slighted women’s vernacular sexual culture, which centered on childbirth and efforts to control fertility rather than on sexual intercourse. Nevertheless, the book demonstrates to readers that seventeenth-century women and their doctors knew about medications to induce abortion, something confirmed by recent historical research.
  • The early medical literature on mental health outcomes following abortion is fraught with methodological flaws that can improperly influence clinical practice.
  • Rates of depression are not significantly different between women obtaining abortion and those denied abortion. Rates of anxiety are initially higher in women denied abortion care. Counseling on decision-making for women with unintended pregnancies should reflect these findings.
  • PIP: This review of abortion history considers sacred and secular practice and traces abortion in the US, the legacy of the 19th century, and the change that occurred in the 20th century. Abortion has been practiced since ancient times, but its legality and availability have been threatened continuously by forces that would denigrate women's fundamental rights. Currently, while efforts to decrease the need for abortion through contraception and education continue, access to abortion remains crucial for the well-being of millions of women. That access will never be secure until profound changes occur in the whole society. Laws that prohibit absolutely the practice of abortion are a relatively recent development. In the early Roman Catholic church, abortion was permitted for male fetuses in the first 40 days of pregnancy and for female fetuses in the first 80-90 days. Not until 1588 did Pope Sixtus V declare all abortion murder, with excommunication as the punishment. Only 3 years later a new pope found the absolute sanction unworkable and again allowed early abortions. 300 years would pass before the Catholic church under Pius IX again declared all abortion murder. This standard, declared in 1869, remains the official position of the church, reaffirmed by the current pope. In 1920 the Soviet Union became the 1st modern state formally to legalize abortion. In the early period after the 1917 revolution, abortion was readily available in state operated facilities. These facilities were closed and abortion made illegal when it became clear that the Soviet Union would have to defend itself against Nazi Germany. After World War II women were encouraged to enter the labor force, and abortion once again became legal. The cases of the Catholic church and the Soviet Union illustrate the same point. Abortion legislation has never been in the hands of women. In the 20th century, state policy has been determined by the rhythms of economic and military expansion, the desire for cheap labor, and greater consumerism. The legal history of abortion in the US illustrates dramatically that it was doctors, not women, who defined the morality surrounding abortion. Women continue to have to cope with the legacy of this fact. The seemingly benign 2-sphere family of the 19th century cut a deep wound in the human community. Men had public power and authority and were encouraged to be sexual. Women were offered the alternative of being powerful only as sexual beings who could thus enforce a domestic moral order. The legacy of the 2-sphere family continues, but much has changed. By 1973 pressure for reform had led 14 states to liberalize their existing abortin laws, and the US Supreme Court finally ruled that abortion is a private matter between a woman and her doctor. The current problem is that despite new laws and new attitudes toward women and abortion, male dominated and male defined institutions still determine what is possible. Women's right to abortion will never be safe and secure as long as this situation continues.

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  • The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.
  • I was once pro-choice and the thing that changed my mind was, I read my husband's biology books, medical books, and what I learned . . . At the moment of conception, a life starts. And this life has its own unique set of DNA, which contains a blueprint for the whole genetic make-up. The sex is determined. We know there is a life because it is growing and changing.
    • Kathy Ireland, supermodel, appearing on the television show Politically Incorrect, 5/1/1998.

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  • What happens to the mind of a person, and the moral fabric of a nation, that accepts the aborting of the life of a baby without a pang of conscience? What kind of a person and what kind of a society will we have 20 years hence if life can be taken so casually? It is that question, the question of our attitude, our value system, and our mind-set with regard to the nature and worth of life itself that is the central question confronting mankind. Failure to answer that question affirmatively may leave us with a hell right here on earth.
    • Jesse Jackson, U.S. civil rights activist, now in favor of legal abortion, in National Right to Life News, (January, 1977).
  • Another area that concerns me greatly, namely because I know how it has been used with regard to race, is the psycholinguistics involved in this whole issue of abortion. If something can be dehumanized through the rhetoric used to describe it, then the major battle has been won. . . That is why the Constitution called us three-fifths human and then whites further dehumanized us by calling us niggers. It was part of the dehumanizing process. The first step was to distort the image of us as human beings in order to justify that which they wanted to do. . . Those advocates of taking life prior to birth do not call it killing or murder; they call it abortion. They further never talk about aborting a baby because that would imply something human. Rather they talk about aborting the fetus. Fetus sounds less than human and therefore can be justified.
    • Jesse Jackson, U.S. civil rights activist, in National Right to Life News, (January, 1977).
  • The care of human life and not its destruction is the first and only legitimate object of good government.
  • If abortion is about women's rights, then what were mine?
    • Gianna Jessen, 2015, Congressional hearing about Planned Parenthood
  • “[T]here is every indication that abortion is an absolutely universal phenomenon, and that it is impossible even to construct an imaginary social system in which no woman would ever feel at least compelled to abort.” So concluded an anthropologist after an exhaustive review of materials from 350 ancient and preindustrial societies.
    Beyond the stark fact of its universality, abortion throughout history exhibits a number of other distinctive features. First is the willingness on the part of women seeking abortion and those aiding them to defy laws and social convention; in every society that has forbidden abortion, a culture of illegal provision has emerged. Second, to a far greater degree than is the case with most other medical procedures, the status of abortion has been inextricably bound up with larger social and political factors, such as changes in women’s political power or in the population objectives of a society. Finally, the mere fact of legality does not necessarily imply universal access to abortion services. Crucial factors in the availability of abortion include the structure of health care services, and especially the willingness of the medical profession to provide abortion.
  • America first proclaimed its independence on the basis of self-evident moral truths. America will remain a beacon of freedom for the world as long as it stands by those moral truths which are the very heart of its historical experience. And so America: If you want peace, work for justice. If you want justice, defend life.
 
Men to other men are explorers; to men, women are the moon, enigmatic frontier and flow, "virgin"/empty land to be owned and controlled and into which flags can be rammed. Men have made women their territory, abortion theirs to control, mystify, and sell back to women; abortion is not simply a medical procedure, it is a medicalized procedure, a procedure medicalized, like childbirth and Pap tests, and for the same reasons—control and profit. ~ Linnea Johnson
  • I suggest we not only demedicalize abortion but that women begin (again) to do abortions ourselves. Bring back safe, "illegal" abortions done by women for and because of women. Groups of women can certainly do our own safe abortions; women have always done our own safe abortions. The medicalization of health and the colonization of women's bodies have obscured what can and must be done. Going back again and again to the patriarchs whose right/rite it is to rape women, beat women, and to force impregnation and childbirth is not what women want to continue doing. Women need to practice disobedience (civil..if you like) to law: we must not obey laws which we did not write and which are written at our expense and which keep us oppressed and keep us asking permission.
  • Even though the WHO has identified safe abortion as a strategic global priority, abortion as such remains a deeply contentious and divisive issue. Of all the bioethical issues that command public attention today, perhaps none is more controversial than the ethics of abortion. Although abortion has been legal in many countries for several decades now, its moral permissibility continues to be the subject of heated public debate. Significantly, the polarity of values and views underpinning the abortion controversy has threatened to divide nations, has seen abortion clinics firebombed and abortion workers fatally shot by pro-life fanatics, and has even brought down governments (Hadley 1996).
    Despite the legislative and moral reforms of the past five decades, women’s so-called ‘reproductive rights’ (including the right to safe abortion) are still constantly being challenged (Cave 2004; Mereith 2005). And despite being ‘sensationally’ and bewilderingly public’, abortion for many women remains a deeply private, personal and even taboo subject (Hadley 1996: xi). Even in so-called ‘liberal’ democratic countries where individualism and a person’s right to make important life choices (including the right to choose death) is highly respected and even enshrined in law, women are often forces tom justify their need of an abortion in a way ‘that many find to be degrading and intrusive’ (Greenwood 2001: ii3). And while there is much rhetoric about women having ‘reproductive autonomy’, doctors and the courts that legitimate their authority, ultimately have the power to decide if, when, how and under what circumstances a woman’s reproductive rights will be exercised (Cave 2004: Greenwood 2001; Hadley 1996; Meredith 2005; see also Gillon 2001; Hewson 2001; Wyatt 2001; Pojman & Beckwith 1994).
  • Other developments prompting ‘new’ debate on the abortion issue is the growth of ‘wrongful life’ or wrongful birth’ lawsuits and, more recently, ‘wrongful abortion’ suits. ‘Wrongful birth’ suits are based broadly on the argument that a given infant ‘should never have been allowed to be born’ (Forrester & Griffiths 2005: 192). For example, a child may have been born with severe and irremediable disabilities in circumstances where, if appropriate medical advice and care had been provided, a decision not to continue the pregnancy would have been made (see, e.g. Forrester & Griffiths 2005: 192-4). In such cases, an infant’s mother generally seeks compensation on grounds that she was deprived of the opportunity to have an abortion within a relevant time because of a health worker’s (e.g., a doctor’s or a counsellor’s) negligence (e.g. failed abortion; misdiagnosis of fetal abnormality after screening; misdiagnosis of maternal illness which would have resulted in fetal abnormality) (Shapira 1998; Petersen 1997).
    ‘Wrongful abortion’ lawsuits, in contrast, concern situations in which a pregnant woman is ‘induced to undergo an abortion by a negligent conduct (usually a medical misrepresentation)’ (Perry & Adar 2005: 507). For example, a woman might decide to have an abortion based on advice received from her attending medical practitioner that her fetus is at risk of being born with severe birth defects because of a drug she has taken. After the abortion is performed, however, she learns that the medical advice that she was given about the risks to her fetus ‘was a negligent misrepresentation, and that the termination of the pregnancy was unnecessary’ (Petty & Adar 2005: 507). In such cases, the woman might sue for compensation for the catastrophic loss she was suffered.
    The above issues help to demonstrate the complexities of the abortion issue and the tensions involved. Just what the outcome of the ‘new ethics of abortion’ will be, remains an open question. What is clear, however, is that there is ‘no Olympian perspective from which these issues can be viewed in benign and omniscient neutrality’ (Wyatt 2001: ii19).
  • The public has a right to know whether abortion methods are being altered to obtain organs, whether live births sometimes occur during such procedures, and whether baby body parts are being sold for profit.
  • The law, moreover enjoins us to bring up all our offspring, and forbids women to cause abortion of what is begotten, or to destroy it afterward; and if any woman appears to have so done, she will be a murderer of her child, by destroying a living creature, and diminishing humankind.

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  • It is plain, therefore, that the primary force behind retention of the abortion laws is belief that it is immoral. One of the serious moral objections is based on the view that the unborn foetus, even in its early stages of development, has an independent claim to life equivalent to that of a developed human being. Even those holding this judgment, however, can scarcely ignore the hard fact that abortion laws do not work to stop abortion, except for those too poor and ignorant to avail themselves of black-market alternatives, and that the consequence of their retention is probably to sacrifice more lives of mothers than the total number of foetuses saved by the abortion laws.
    • Sanford Kadish, professor of law, University of California, Berkeley, in (November 1967)"The Crisis of Overcriminalization". Annals of the American Academy of Political and Social Science 374: 157-170.
  • An abortion, because it is about more than the simple medical procedure, has the potential for serious negative emotional consequences. A woman who is torn by her abortion decision may transfer her negative impression of the medical experience to her decision and to abortion itself. Fortunately, there are many fine abortion providers whose services respect women and recognize the significance of abortion in women’s lives. They have been able to temper their professional distancing and provide the kind of care women need at this critical time.
  • Results: Sixteen systematic reviews were identified and evaluated. The available evidence does not support the use of pre-abortion ultrasound to increase safety. Routine use of cervical preparation with osmotic dilators, mifepristone or misoprostol after 14 weeks gestation reduces complications; at early gestational ages, surgical abortions have very few complications. Prophylactic antibiotics result in lower rates of post-surgical abortion infection. Pain medication such as non-steroidal anti-inflammatories should be offered to women undergoing abortion procedures; acetaminophen, however, is not effective in reducing pain. Women who are eligible should be offered a choice between surgical (vacuum aspiration or dilation and evacuation) and medical methods (mifepristone and misoprostol) of abortion when possible. Modern methods of contraception can be safely initiated immediately following abortion procedures.
    Conclusions: Evidence-based guidelines assist health care providers and policymakers to utilize the best data available to provide safe abortion care and prevent the millions of deaths and disabilities that result from unsafe abortion.
  • We are referred to substantial medical authority that [partial-birth abortion] perverts the natural birth process to a greater degree than [D&E], commandeering the live birth process until the skull is pierced. Witnesses to the procedure relate that the fingers and feet of the fetus are moving prior to the piercing of the skull; when the scissors are inserted in the back of the head, the fetus' body, wholly outside the woman's body and alive, reacts as though startled and goes limp. [Partial-birth abortion]'s stronger resemblance to infanticide means Nebraska could conclude the procedure presents a greater risk of disrespect for life and a consequent greater risk to the profession and society, which depend for their sustenance upon reciprocal recognition of dignity and respect. The Court is without authority to second-guess this conclusion.
  • The American College of Obstetricians and Gynecologists (ACOG) 'could identify no circumstances under which [partial-birth abortion] would be the only option to save the life or preserve the health of the woman.' The American Medical Association agrees....
  • While the deep concern of a woman bearing an unwanted child merits consideration and sympathy, it is my personal feeling that the legalization of abortion on demand is not in accordance with the value which our civilization places on human life. Wanted or unwanted, I believe that human life, even at its earliest stages, has certain rights which must be recognized -- the right to be born, the right to love, the right to grow old.
    • Edward “Ted” Kennedy, U.S. Senator and former presidential candidate, now in favor of legalized abortion, in a letter to a constituent, 8/3/1971 [23].
  • I share the confidence of those who feel that America is working to care for its unwanted as well as wanted children, protecting particularly those who cannot protect themselves. I also share the opinions of those who do not accept abortion as a response to our society's problems -- an inadequate welfare system, unsatisfactory job training programs, and insufficient financial support for all its citizens.
  • When history looks back to this era it should recognize this generation as one which cared about human beings enough to halt the practice of war, to provide a decent living for every family and to fulfill its responsibility to its children from the very moment of conception.
  • Have you ever considered how really insulting it is to say to someone, "I think your mother should have been able to abort you."? It's like saying, "If I had my way, you'd be dead right now." And that is the reality with which I live every time someone says they are pro-choice or pro-life "except in cases of rape" because I absolutely would have been aborted if it had been legal in Michigan when I was an unborn child, and I can tell you that it hurts. But I know that most people don't put a face to this issue -- for them abortion is just a concept -- with a quick cliche, they sweep it under the rug and forget about it. I do hope that, as a child conceived in rape, I can help to put a face, a voice, and a story to this issue. In reply, some have said to me, "So does that mean you're pro-rape?" Though ludicrous, I'll address it because I understand that they aren't thinking things through. There is a huge moral difference because I did exist, and my life would have been ended because I would have been killed by a brutal abortion. You can only be killed and your life can only be devalued once you exist. Being thankful that my life was protected in no way makes me pro-rape. Thank you to my 100% pro-life heroes!
    • Rebecca Kiessling, abortion survivor, from her autobiographical DVD "Conceived in Rape: From Worthless to Priceless" [32]
  • The ingestion of Ponderosa pine needles by beef cattle in the western United States has induced premature parturition or abortion, resulting in large economic losses due to retention of the placenta, death of premature calves, and lowered subsequent fertility of the dam. The mechanism of action by the ingested pine needles seems to involve constriction of the maternal cotyledon arterial bed, which results in a profound decrease in uterine blood flow, fetal stress, and parturition. Feeding pine needles induces a premature rise in the levels of cortisol and 17β-estradiol (associated with parturition), as well as an abrupt rise in the progesterone concentration after feeding and a sharp decrease before parturition.
  • Forced copulation and induced abortion were investigated in a herd of feral horses inhabiting a coastal barrier island. Eight mares were diagnoses pregnant in August and October 1989 by means of urinary and fecal steroid metabolites, prior to documented changes in herd stallions. These mares were observed for harassment and forced copulation by the new stallions and for the presence of foals during the spring and summer of 1990. No incidents of harassment or attempts at forced copulation were witnessed and seven of the eight mares produced foals in 1990. These data indicate that forced copulation and induced abortion are not common events among all feral horse herds and suggest reinvestigation of this hypothesized phenomenon.
  • Forced copulation and/or induced abortion has been reported among a number of species (Hilton 1982), including acanthocephalan worms (Abele and Gilchrist 1977), scorpion flies (Thornhill 1980), mallard ducks (Barash 1977) and certain rodents (Bruce 1969; Mallory and Brooks 1978; Stehn and Richmond 1975). Among ungulates there is a paucity of data regarding this phenomenon and only a single report exists for induced abortion among horses (Berger 1983).
  • Three-dimensional ultrasound images of babies in utero began to grace the family fridge. Fetuses underwent surgery. More premature babies survived and were healthier. They commanded our attention, and the question of what we owe them, if anything, could not be dismissed.
  • These trends gave antiabortionists an advantage... they present a sophisticated philosophical and political challenge. Caring societies, they say, seek to expand inclusion into "the human community." Those once excluded, such as women and minorities, are now equal. Why not welcome the fetus (who, after all, is us) into our community?
  • Advocates of choice have had a hard time dealing with the increased visibility of the fetus. The preferred strategy is still to ignore it... this makes us appear insensitive... unaffected by the desire to save the whales and... end violence at all levels. Pope John Paul II got that, and coined the term "culture of life"... and the slogan, as much as it pains us to admit it, moved some hearts and minds. Supporting abortion is tough to fit into this package.
  • In recent years, the antiabortion movement successfully put the nitty-gritty details of abortion procedures on public display, increasing the belief that abortion is serious business and that some societal involvement is appropriate. Those who are pro-choice have not convinced America that we support a public discussion of the moral dimensions of abortion.
  • Research has found countries with more liberal abortion laws have lower abortion rates.
    How abortion restrictions affect abortion rates isn't completely clear. States with fewer abortion restrictions have tended to have higher abortion rates, in part because they include women traveling from out-of-state to terminate a pregnancy.
    That research, published in the Lancet, also found countries with more abortion restrictions to have higher rates of abortion-related deaths.

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  • 'If you won't stand up for your own child, somebody has to.' He believed it, and he was convinced it was God's view. It made sense to him. But he also knew she could reject it out of hand simply because he was a man. How could he understand? No one was suggesting what he could or could not do with his own body. He had wanted to tell her he understood that, but again, what if that unborn child was a female? Who was standing up for the rights of that woman's body?
  • It is beyond comprehension why a group of rabbis would support partial-birth abortion. . . The message of the Torah is one of life. Abortion on demand is simply intolerable in the Jewish tradition. To sanction something so heinous as partial-birth abortion is proof of a culture of death standing in marked opposition to the Torah's ethic of life. . . Rather than work against Judeo-Christian moral principles, as these rabbis are doing, it is incumbent upon Jews to ally with Christians in upholding the moral principles we have in common. . . Together, we must actively oppose partial birth abortion.
    • Daniel Lapin, in a press release issued by his organization, Toward Tradition, (September 18, 2000).
  • [O]ne of the greatest sages of Jewish Law of the late 20th century, Rabbi Moshe Feinstein, unequivocally described abortion as a form of murder, albeit a form that is exempt from capital punishment. But those of us faithful to our tradition have obviously failed to persuade our fellow Jews that abortion equals murder.
    • Daniel Lapin, Weeping About our Families, (February 24, 2001).
  • At two months of age, the human being is less than one thumb's length from the head to the rump. He would fit at ease in a nutshell, but everything is there: hands, feet, head, organs, brain, all are in place. His heart has been beating for a month already . . . . With a good magnifier the fingerprints could be detected.
    • Jerome Lejeune, Professor of Fundamental Genetics, University Rene Descartes, testimony on The Human Life Bill, S. 158: Hearings Before the Subcommittee on Separation of Powers of the Committee on the Judiciary, United States Senate, 97th Cong., 1st Sess. 7-10 (1981).
  • Atheism, Gay Marriage, Intermarriage, Non-Kosher Food, Partial-Birth Abortion - all of these are legitimate mainstream ideas within Reform 'Judaism.' Judaism has lost more Jews through the efforts of Reform than through Hitler's gas ovens.
  • Access to high quality abortion care is essential to women's health, as evidenced by the dramatic decrease in pregnancy-related morbidity and mortality since the legalization of abortion in the United States, and by high rates of maternal death and complications in those countries where abortion is still provided under unsafe conditions. The past two decades have brought important advances in abortion care as well as increasing cross-disciplinary use of abortion technologies in women's health care. Abortion is an important option for pregnant women who have serious medical conditions or fetal abnormalities, and fetal reduction techniques are now well-integrated into infertility treatment to reduce the risks of multiple pregnancies resulting from assisted reproductive technologies.
  • Given the National Organization for Women's membership and proclivities, it's no wonder that people now view the NOW gang as being obsessed with only two issues: abortion rights and lesbian rights.
  • I prefer to call the most obnoxious feminists what they really are: feminazis. The term describes any female who is intolerant of any point of view that challenges militant feminism. I often use it to describe women who are obsessed with perpetuating a modern-day holocaust: abortion.
  • A feminazi is a woman to whom the most important thing in life is seeing to it that as many abortions as possible are performed. Their unspoken reasoning is quite simple. Abortion is the single greatest avenue for militant women to exercise their quest for power and advance their belief that men aren't necessary. 'Nothing matters but me', says the feminazi...the fetus doesn't matter, it's an unviable tissue mass. Feminazis have adopted abortion as a kind of sacrament for their religion/politics of alienation and bitterness.
  • President Obama is an extremist on abortion. He has never supported any meaningful restriction on it, and never will.
  • The induced expulsion from the uterus of the product of conception before viability by medical or surgical means. N.B.: The preferred term for unintentional loss of the product of conception prior to 24 weeks' gestation is miscarriage.
  • Every year, millions of women around the world decide to end a pregnancy through abortion (defined as removal of a fetus or embryo from the uterus before the stage of viability). The global abortion rate is estimated at 28 per 1000 women of childbearing age but varies by and within regions. For example, western Europe has the lowest subregional rate at 12 abortions per 1000 women but eastern Europe has the highest at 43 per 1000. About 185 000 abortions are performed for residents of England and Wales annually—16.5 per 1000 women aged 15-44 years.
    Worldwide, just under half of all pregnancies are unintended and half of these end in abortion. The reasons women give for choosing abortion over adoption or parenthood are complex. Common themes include an understanding of the responsibilities of parenthood, financial constraints, and lack of partner support. Teenagers, economically disadvantaged women, and those who did not suspect they were pregnant or who face barriers to services are more likely to undergo abortion in the second trimester.
    • Lohr, PA; Fjerstad, M; Desilva, U; Lyus, R (2014). "Abortion". BMJ. 348: f7553. doi:10.1136/bmj.f7553. S2CID 220108457.
  • Until the mid-nineteenth century, what went on during pregnancy was in large part simply mysterious. In fact, until fifty years ago it was impossible even to diagnose pregnancy with any degree of reliability until “quickening,” the point at which the woman can feel the embryo move within her, an event that occurs during the fifth or sixth month of pregnancy. Until at least 1850, the act of inducing an abortion was itself a rather haphazard affair based primarily on herbal medicines. Because these medicines were difficult to prepare in accurate doses and were typically quite poisonous to the woman herself, abortion was unreliable, probably excruciatingly unpleasant and often fatal. The arrival of the curette on the gynecological scene in the 1880s probably made abortions more effective, but this technological “advance” brought with it new dangers of perforation and infection. Until the invention of antibiotics in the twentieth century, therefore, most abortions were ineffective or lethal.
  • SURPRISING AS it may seem, the view that abortion is murder is a relatively recent belief in American history. To be sure, there has always been a school of thought, extending back at least to the Pythagoreans of ancient Greece, that holds that abortion is wrong because the embryo is the moral equivalent of the child it will become. Equally ancient however is the belief articulated by the Stoics: that although embryos have some of the rights of already-born children (and these rights may increase over the course of the pregnancy), embryos are of a different moral order, and thus to end their existence by an abortion is not tantamount to murder.
    Perhaps the most interesting thing about these two perspectives (which have coexisted over the last two thousand years) is the fact that modern-day subscribers to the first point of view-that abortion is always murder-have been remarkably successful in America at persuading even opponents that their view is the more ancient and the more prevalent one. Their success in this effort is the product of an unusual set of events that occurred in the nineteenth century, events I call the first “right-to-life: movement.
  • Having a baby and giving it up for adoption, as pro-life people advocate, is not seen by most pro-choice people as a moral solution to the abortion problem. To transform a fetus into a baby and then send it out into a world where the parents can have no assurance that it will be well-loved and cared for is, for pro-choice people, the height of moral irresponsibility.
  • A group of women who valued motherhood, but valued it on their own timetable, began to make a new claim, one that had never surfaced in the abortion debate before this, that abortion was a woman's right. Most significantly, they argued that this right to abortion was essential to their right to equality -- the right to be treated as individuals rather than as potential mothers.
  • Reasonable people who are located in very different parts of the social world find themselves differentially exposed to diverse realities, and this differential exposure leads each of them to come up with different -- but often equally reasonable -- constructions of the world. Similarly, even deeply devout religious people, because they too are located in different parts of the social world and, furthermore, come from different religious and cultural traditions, can disagree about what God's will is in any particular situation. When combined with the fact that attitudes toward abortion rest on these deep, rarely examined notions about the world, it is unambiguously clear why the abortion debate is so heated and why the chances for rational discussion, reasoned arguments, and mutual accommodation are so slim.
  • Pro-choice and pro-life activists live in different worlds, and the scope of their lives, as both adults and children, fortifies them in their belief that their own views on abortion are the more correct, the more moral, and more reasonable. When added to this is the fact that should 'the other side' win, one group of women will see they very real devaluation of their lives and life resources, it is not surprising that the abortion debate has generated so much heat and so little light.
  • ...The fact that only poor women are denied reproductive freedom when abortions are illegal is unpersuasive to those who oppose abortion on moral grounds.
  • In short, there are no empirical grounds for assuming that women have an à priori preference for contraception over abortion.
    • Kristin Luker, Taking Chances: Abortion and the Decision Not to Contracept (1975).

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  • There are plenty of movements that have activists that are counter-productive, including both sides in the abortion debate. In the case of the pro-choice movement, many of the self-styled "clinic defenders" are brought in by the clinic, but it's also not uncommon for clinics to want them to go away. They aren't always willing to go away. They're more interested in their own philosophies and they don't take orders from the clinic. The following comes from the Bay Area Committee Against Operation "Rescue" (BACAOR) Manual for Clinic Defense. It illustrates this point, along with belligerency, a little screening out, and some remarkably interesting logic. "We do not call police ourselves during a hit. Our best work is done before police arrive, or when there are not enough police there to prevent us from doing what we have to do. Get in place before cops can mess with it; establish balance of power early, do key acts requiring physical contact with OR as much as possible before cops have enough people to intervene. Even if the sidewalk is 'public,' we've had success at putting enough of us out, early enough, to basically bully the ORs into staying across the street." Another section says: "Even if the scuffle gets to a heated point, they are going to stop eventually, either from fear, demoralization or from realization that they are blowing the image they have tried to convey to media and others." The idea that prolifers really mean it when they say they are using nonviolence as with Gandhi and King, of course, is not an option. The term "OR" is short for a protester working with Operation Rescue. The manual goes on to talk about psychological tactics, including that, "while male loose cannons are more capable of hurting defenders than are female loose cannons, it is also true that the men have such a disdain/disregard for women that they are less likely to physically beat people up." Read this sentence over again: men failing to beat people up follows naturally from having disdain and disregard for women. "Chivalry is not dead with these people (just convoluted), and that means they have an inordinate sense of modesty and 'honor' about being accused of touching women. There are innumerable instances of clinic defenders neutralizing male ORs by shouting 'get your hands off me, don't you dare touch me' all the while they are tugging or pushing OR out of the line." It doesn't take an abortion opponent to point out that these attitudes aren't helpful in defending the clinics. Clinic personnel have been known to be of that opinion as well. Not all support is supportive.
  • Native American cultures commonly believe that one cannot respect Mother Earth without family planning. Because of the strong matriarchal traditions, issues of family planning, such as contraception and abortion, are considered women's business, not men's. As one Lakota woman put it, "Anything that has to do with our bodies ... is really our business as women, and as Lakota women, it is part of our cultures to make our own decisions about abortion."
  • It is especially noteworthy in the Chinese religions that sex and sexual pleasure are esteemed and celebrated along with the need for moderation. Moderation is also considered a virtue in reproduction. Thus, there is minimal resistance in these religions to contraception, and abortion is allowed as a backup if needed.
  • The most plausible explanation for the association that some studies find between abortion and mental health is that it reflects preexisting differences between women who continue a pregnancy and those who end one.
    A substantial amount of research shows that women who deliver babies are, on average, more likely to have planned and wanted their pregnancies and to feel emotionally and financially capable of becoming a mother. In contrast, women who seek abortions are, on average, less likely to be married or involved in an intimate relationship, more likely to be poor, and more likely to have suffered physical or psychological abuse. All of these latter qualities are risk factors for poor mental health.
  • My research, based on clinic interviews in the 1990s with more than 400 women who obtained a first-trimester abortion, shows that women who terminate an unplanned pregnancy report a range of feelings, including sadness and loss as well as relief. Nonetheless, two years after their abortion, most women say they would make the same decision if they had it to do over again under the same circumstances. Because of the stigma attached to abortion in our society, however, most women feel they can't talk about their abortions - unless they repent.
    Women who think they made the right decision in having an abortion must be able to say so without fear of condemnation and without feeling that something is wrong with them. And women who feel sadness and regret should feel free to share their feelings as well. But their words should not be used to deceive women or to limit their choices.
  • The best scientific evidence published indicates that among adult women who have an unplanned pregnancy the relative risk of mental health problems is no greater if they have a single elective first-trimester abortion than if they deliver that pregnancy. The evidence regarding the relative mental health risks associated with multiple abortions is more equivocal. Positive associations observed between multiple abortions and poorer mental health may be linked to co-occurring risks that predispose a woman to both multiple unwanted pregnancies and mental health problems.
    The few published studies that examined women’s responses following an induced abortion due to fetal abnormality suggest that terminating a wanted pregnancy late in pregnancy due to fetal abnormality appears to be associated with negative psychological reactions equivalent to those experienced by women who miscarry a wanted pregnancy or who experience a stillbirth or death of a newborn, but less than those who deliver a child with life-threatening abnormalities.
    The differing patterns of psychological experiences observed among women who terminate an unplanned pregnancy versus those who terminate a planned and wanted pregnancy highlight the importance of taking pregnancy intendedness and wantedness into account when seeking to understand psychological reactions to abortion.
    None of the literature reviewed adequately addressed the prevalence of mental health problems among women in the United States who have had an abortion. In general, however, the prevalence of mental health problems observed among women in the United States who had a single, legal, first-trimester abortion for nontherapeutic reasons was consistent with normative rates of comparable mental health problems in the general population of women in the United States.
    Nonetheless, it is clear that some women do experience sadness, grief, and feelings of loss following termination of a pregnancy, and some experience clinically significant disorders, including depression and anxiety. However, the TFMHA reviewed no evidence sufficient to support the claim that an observed association between abortion history and mental health was caused by the abortion per se, as opposed to other factors.
    • Brenda Major, Mark Appelbaum, Linda Beckman, Mary Ann Dutton, Nancy Felipe Russo, Carolyn West; "Mental Health and Abortion". American Psychological Association. 2008. Archived from the original on 19 April 2012.
  • People may believe the soul doesn't appear till six months, or departs at 42 years, or takes alternate Tuesdays off. It's fine for people to believe whatever they want, but they can't use these beliefs to write laws that justify killing. Being unique, alive, and human is qualification enough to be part of our human family.
  • I have some bad news: the abortion debate is over. I have some good news: it's reemerging transformed. This moment of silence may have been necessary for hardened hearts to hear the whisper of conscience. Pro-choice leaders mourn that disapproval of abortion is rising, while their own troops are graying. The average member of the National Abortion and Reproductive Rights Action League (NARAL) is 55, while college freshmen have dropped their support for legalized abortion from 65% to 51% since 1990. A 1996 poll found those most likely to agree that 'abortion is the same thing as murdering a child'--a stunning 56%-- are between the ages of 18 and 29. No wonder young people oppose abortion. Anyone under the age of 27 could have been killed this way. A third of their generation was.
  • We have treated the loss of our fetuses as a theoretical loss, a sad-but-necessary loss, as of civilians in wartime. We have not yet realized that the offspring lost are not the enemy's, nor our neighbor's, but our own. And it is not a loss of inert, amorphous tissue, but of a growing being unique in history.
  • No one wants an abortion as she wants an ice cream cone or a Porsche. She wants an abortion as an animal, caught in a trap, wants to gnaw off its own leg.
  • It was my pseudonym, Jane Roe, which had been used to create the 'right' to abortion out of legal thin air. But Sarah Weddington and Linda Coffey never told me that what I was signing would allow women to come up to me 15, 20 years later and say, 'Thank you for allowing me to have my five or six abortions. Without you, it wouldn't have been possible.' Sarah never mentioned women using abortions as a form of birth control. We talked about truly desperate and needy women, not women already wearing maternity clothes.
    • Norma McCorvey, testimony to the Senate Subcommittee on the Constitution, Federalism and Property Rights (January 21, 1998).
  • One of my most important activities is that I am involved, together with Sandra Cano of Doe vs. Bolton, in the efforts of the Texas Justice Foundation (and other groups) to work for the reversal of the Roe vs. Wade and Doe vs. Bolton decisions. The approach we are taking is to show that the lives and rights of women have not been advanced or enhanced, but rather destroyed, by abortion-on-demand. We are collecting affidavits from women who have been harmed by abortion, from women who are convinced that authentic feminism is pro-life, and from professionals who know that Roe has weakened the moral fabric of the legal and medical professions.
  • Most of the patients come to our abortion clinic as a result of failure of a birth control method, or a failure of our system to provide birth control.
    • Clayton H. McCracken, director of Inter Mountain Planned Parenthood, Fall 2000.
  • Once you decide the uterus must be emptied, you then have to have 100% allegiance to maternal risk. There's no justification to doing a more dangerous procedure because somehow this doesn't offend your sensibilities as much.
    • James T. McMahon, American Medical News (U.S. Congressional Record, 1996, p. H10634).
  • If I see a case...after 20 weeks, where it frankly is a child to me, I really agonize over it because the potential is so imminently there. I think, 'Gee, it's too bad that this child couldn't be adopted.' On the other hand, I have another position, which I think is superior in the hierarchy of questions, and that is: 'Who owns the child?' It's got to be the mother.
    • James T. McMahon, American Medical News (July 5, 1993).
  • We think abortion is a bad thing. No woman wants to have an abortion.
    • Kate Michelman, then Executive Director of National Abortion and Reproductive Rights Action League, in a taped Philadelphia Inquirer interview 1993.
  • The fact is that late term abortions are exceedingly rare. They are performed only when necessary to preserve a woman's health or life, or when a woman is carrying a fetus with lethal anomalies, many of which would die soon after birth. Again, the fact is that these abortions, these terminations are compelled by life and, life and health reasons and grave fetal abnormalities.
    • Kate Michelman, President, National Abortion and Reproductive Rights Action League [NARAL], at a news conference, (November 7, 1995).
  • [Late-term abortions] are rare terminations, Tony [Snow]. They occur very rarely. They occur under the most difficult of circumstances, as I said...these are pregnancies that have gone awry.
    • Kate Michelman, NARAL President, on FOX News Sunday, (June 2, 1996).
  • But late-term abortions are only used under the most compelling of circumstances--to protect a woman's health or life or because of grave fetal abnormality.
    • Kate Michelman, NARAL President, the Washington Times (June 16, 1996).
  • And, by the way, my belief is that if men were the ones getting pregnant, abortions would be easier to get than food poisoning in Moscow.
  • Therefore, we argue that, when circumstances occur after birth such that they would have justified abortion, what we call after-birth abortion should be permissible. In spite of the oxymoron in the expression, we propose to call this practice ‘after-birth abortion’, rather than ‘infanticide’, to emphasize that the moral status of the individual killed is comparable with that of a fetus (on which ‘abortions’ in the traditional sense are performed) rather than to that of a child. Therefore, we claim that killing a newborn could be ethically permissible in all the circumstances where abortion would be. Such circumstances include cases where the newborn has the potential to have an (at least) acceptable life, but the well-being of the family is at risk. Accordingly, a second terminological specification is that we call such a practice ‘after-birth abortion’ rather than ‘euthanasia’ because the best interest of the one who dies is not necessarily the primary criterion for the choice, contrary to what happens in the case of euthanasia... The moral status of an infant is equivalent to that of a fetus in the sense that both lack those properties that justify the attribution of a right to life to an individual. Both a fetus and a newborn certainly are human beings and potential persons, but neither is a ‘person’ in the sense of ‘subject of a moral right to life’
    • Francesca Minerva, PhD, ethics professor, in "After-birth abortion: why should the baby live?", Journal of Medical Ethics (February 23, 2012).
  • If criteria such as the costs (social, psychological, economic) for the potential parents are good enough reasons for having an abortion even when the fetus is healthy, if the moral status of the newborn is the same as that of the infant and if neither has any moral value by virtue of being a potential person, then the same reasons which justify abortion should also justify the killing of the potential person when it is at the stage of a newborn.
    • Francesca Minerva, PhD, ethics professor, in "After-birth abortion: why should the baby live?", Journal of Medical Ethics (February 23, 2012).
  • The net result is that slightly fewer than a third of all conceptions lead to a fetus that has a chance of developing. In other words, if you were to choose a zygote at random and follow it through the first week of development, the chances are less than one in three that it would still be there at full term, even though there has been no human intervention. Nature, it seems, performs abortions at a much higher rate than any human society. It is simply not true that most zygotes, if undisturbed, will produce a human being.
  • In the end, the abortion controversy comes down to one question: Will this particular pregnancy be terminated or not? There are only two possible choices, neither good. One is to abort the fetus. The other is to demand that the pregnancy be brought to term and, in effect, to compel the birth of an unwanted child. The second choice is repugnant to me. Not only does it entail real and immediate risks for the mother, but it may create a lifetime of misery for the child – misery that will, in all likelihood, persist for generations. Frankly, I can imagine fewer human acts more deeply evil than bringing an unwanted child into the world.
  • Abortion may be sinful or immoral, but it is not the function of the law to enforce the whole of morality. It is difficult to understand what religious or moral principle, what divine or human purpose, is served by compelling underprivileged women to undergo pregnancy for the full term and to bear unsought and frequently unwanted children or to risk sickness or death at the hands of incompetent and frequently lecherous and importunate abortionists. No doubt the fact that the price of maintaining this principle is paid almost exclusively by the poor has delayed its critical examination.
    • Norval Morris and Gordon Hawkins, The Honest Politician's Guide to Crime Control, 1970.
  • The sanctity of life is often also taken to refer to the life of "the unborn child." Yet the use of this expression is as if we referred to the reader as "an adult fetus." To say that a fertilized ovum or an embryo is a human being and therefore entitled to the full protection of the law is a prejudicial abuse of language. Nor do those who take this position ever maintain it consistently, for they never embrace the logical corollary which is that all abortive operations are murders and should be so treated in law.
    • Norval Morris and Gordon Hawkins, The Honest Politician's Guide to Crime Control, 1970.
  • Conception is life- let's say that, finally, take that approach- and yes, you're taking it away. And then we have to develop the rationale for the taking of it, as we develop the rationale for taking life elsewhere- in war, in capital punishment.[asked if he had any regrets] Regrets? About our stand on abortion? No, no, no. Only for the ones we didn't get to help- and for them, our work is in front of us.
  • I tell brides and grooms to have many children. To bear many children and raise them is God's blessing. It is unthinkable the human beings apply their own standard of judgement and arbitrarily abort precious lives given to them by God. All life born into this world embodies God's will. All life is noble and precious, so it must be card for and protected.
  • Pine Needle Abortion (PNA) is a problem for cattle ranchers who raise cattle in areas where ponderosa pine trees grow. Abortions caused by pine needles are most common on grazing lands throughout the western United States (James et al., 1977). Pine needles have been known to cause abortions in cattle since 1920 (James et al., 1989). PNA can cause severe financial losses to the cattle industry. Abortion rates can range from 0% to 100% (James et al., 1989).
    Abortions are caused when cows eat green pine needles off trees, from windfalls, and dead needles off the ground around pine trees (James et al., 1977). Cows in feedlots have been seen eating pine needles due to boredom (James et al., 1977). Weather influences consumption of pine needles by cows, due to the availability of feed, snow cover, and grazing time (Pfister et al., 1993).
    Calves aborted due to PNA are born weak but viable, meaning pine needles cause a premature parturition (Ford et al., 1992). Abortions may occur as early as twenty-four hours to as long as three weeks following ingestion of pine needles (Pfister et al., 1993). Cows usually retain the placenta after abortions caused by PNA (Stuart et al.1989). There are also other problems associated with PNA such as metritis, peritonitis, and death to the cow (Stuart et al., 1989).
    • Myers, Brandon; Beckett, Jonathon (2001). "Pine needle abortion" (PDF). Animal Health Care and Maintenance. Tucson: Arizona Cooperative Extension, University of Arizona. p.47. Archived from the original (PDF) on 28 July 2015. Retrieved 10 April 2013.

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  • I don't think government has the proper role in forcing a woman to have a child or forcing a woman not to have a child. And we've seen that around the world. This is something that should be privately decided with the family, woman, all the other private factors of it, but we should work toward preventing the necessity of abortion.
  • As we walked through the door, so accusing their eyes, like they have any right at all to criticize; hypocrites we're all here for the very same reason
  • Fewer women would have abortions if wombs had windows.
    • Bernard Nathanson, co-founder of NARAL and former abortion doctor turned pro-life, in his book Aborting America, 1979.
  • The practice of abortion was revolutionized at virtually the same moment that the laws were revolutionized, through the widespread introduction of suction curettage in 1970. Even without a suction machine, a simple combination of catheter and syringe can produce enough suction to carry out a safe early abortion. As for the self-induced abortion, by thrusting a coat hanger or other dangerous object into the womb, this will also be a thing of the past.
    • Bernard Nathanson, co-founder of NARAL and former abortion doctor turned pro-life, Aborting America (Doubleday, 1979).
  • [W]e simply fabricated the results of fictional polls. We announced to the media that we had taken polls and that 60 percent of Americans were in favor of permissive abortion... We aroused enough sympathy to sell our program of permissive abortion by fabricating the number of illegal abortions done annually in the U.S... Repeating the big lie often enough convinces the public. The number of women dying from illegal abortions was around 200-250 annually. The figure we constantly fed to the media was 10,000. These false figures took root in the consciousness of Americans, convincing many that we needed to crack the abortion laws... [A]bortion is now being used as a primary method of birth control in the U.S. and the annual number of abortions has increased by 1,500 percent since legalization.
  • How many [maternal] deaths were we talking about when abortion was illegal? In N.A.R.A.L. we generally emphasized the drama of the individual case, not the mass statistics, but when we spoke of the latter it was always '5,000 to 10,000 deaths a year.' I confess that I knew the figures were totally false, and I suppose the others did too if they stopped to think of it. In 1967, the federal government listed only 160 deaths from illegal abortion. In the last year before the Blackmun era began, 1972, the total was only 39 deaths. [T]he actual total was probably closer to 500."
  • According to the best medical evidence, abortion is extremely safe in terms of a person’s ability to get pregnant again in the future. In fact, fertility often returns quickly after an abortion. If a person wants to delay pregnancy, they should use a reliable method of birth control starting immediately after an abortion.
  • Abortion is safer than having a child, so having more than one abortion is definitely safer than having more than one child. There is no “maximum” number of times that a person can have an abortion in her lifetime.
  • No one plans to have an abortion until they need one and when they do, it's unlikely they have money set aside for the procedure, much less the additional costs that they will need to cover in order to obtain care. The National Abortion Federation runs the largest national, toll-free Hotline to help people find quality abortion providers and help them raise the funds to pay for their care and the associated costs:
  • Abortion providers have kept the costs of abortion care as low as they can and many of our members help patients raise money, arrange travel, and access other community support. However, since many people don’t have insurance that will cover their procedure, it can be hard for them to afford this essential health care service. The average cost of a first-trimester aspiration abortion is $508, while a medication abortion averages $535. A second-trimester abortion can cost more than $2,000.
  • The history of the relationship between the medical profession and abortion is an unusual saga of a seeming rediscovery, from the eighteenth century onward, of the main elements of abortion practice which, in fact, were known to medical practitioners in antiquity. Although dilators, curettes, and even a rudimentary suction apparatus existed in the ancient world, "modern" abortion techniques - especially dilation and curettage - did not come into prominence until developments within the larger field of gynecology occurred during the mid nineteenth century.
  • The mission of the National Abortion Federation (NAF) is to ensure safe, legal, and accessible abortion care, which promotes health and justice for women. An important part of this work is to develop and maintain evidence-based guidelines and standards as well as to educate providers in the latest technologies and techniques. NAF’s programs make it possible for women to receive the highest quality abortion care.
    • "2015 Clinical Policy Guidelines" (PDF). National Abortion Federation. 2015. Archived (PDF) from the original on 12 August 2015. Retrieved 30 October 2015. “Introduction”, iii
  • Policy Statement: Abortion by dilation and evacuation (D&E) after 14 weeks from LMP is a safe outpatient surgical procedure when performed by appropriately trained clinicians in medical offices, freestanding clinics, ambulatory surgery centers, and hospitals.
    • "2015 Clinical Policy Guidelines" (PDF). National Abortion Federation. 2015. Archived (PDF) from the original on 12 August 2015. Retrieved 30 October 2015. p.23
  • Policy Statement: Medical induction abortion is a safe and effective method for termination of pregnancies beyond the first trimester when performed by trained clinicians in medical offices, freestanding clinics, ambulatory surgery centers, and hospitals. Feticidal agents may be particularly important when issues of viability arise.
    • "2015 Clinical Policy Guidelines" (PDF). National Abortion Federation. 2015. Archived (PDF) from the original on 12 August 2015. Retrieved 30 October 2015. p.27
  • RU-486 is properly called an 'abortifacient.' Because it is a drug that can induce a menstrual period after the implantation of a fertilized egg in the uterus, it can terminate a woman's pregnancy in its earliest stages.
  • The article calls her “Clara Taylor” but we know her by her true name, Nicola Louise Moore. Moore works as an independent contractor for Planned Parenthood of the Heartland, doing surgical and medical abortions at their recently opened abortion clinic in Omaha, Nebraska, and at the main office on Army Post Road in Des Moines, Iowa... The focus of her practice has always been on abortion... Moore continues to stay with her mother, Sally Falk Moore, Professor of Anthropology, Emerita at Harvard University, at her home in Cambridge, Massachsetts.
  • An ambulance responded to an emergency call from Planned Parenthood of the Heartland in Sioux City, Iowa... and transported a patient to a local hospital. Sidewalk counselors recalled seeing the same woman earlier in the day as she entered the clinic for an abortion. Her condition is unknown at this time... Abortionist Nicola Moore, a Massachusetts abortionist who flies to the mid-west to do abortions for Planned Parenthood of the Heartland, was believed to be the abortionist on duty at the time of the incident.
  • The right to life, inherent in each of the inhabitants of the nation and the world, is the principal axis of human rights and, therefore, merits the determined attention of the government.
  • Managing pain associated with abortion procedures is an essential goal in the care of patients requesting pregnancy termination. Effective methods range from local cervical anesthesia with or without supplemental oral or intravenous (IV) medications, to general anesthesia (GA). A number of factors influence the options available to patients, including local regulations, safety considerations, facility infrastructure and resources, cost, and insurance coverage. In the USA, where most abortions occur in freestanding clinics, cervical anesthesia with or without IV conscious sedation represents the most common method used. On the other hand, in countries where abortions occur primarily in hospital operating rooms, general anesthesia predominates.
  • Pain management remains an important challenge in abortion practice, although studies suggest that progress in pain control has been achieved over time in the USA. In a survey in the late 1970s, 2,299 women having abortions with cervical anesthesia were asked to rate their pain as ”mild, moderate, or severe.” Forty-six per cent called the pain moderate, and 32% called it severe. A survey conducted two decades later of more than 2,000patients at 12 abortion facilities in the USA found that 30% of patients felt no pain, 25% mild pain, 29% moderate pain, and 14% severe pain. About 80% of patients said the pain was less than or similar to what they expected.
  • Numerous patient-related variables are known to influence pain perception. Factors associated with increased pain include younger age of the patient, fewer prior pregnancies, history of dysmenorrhea, preprocedure anxiety, and depression. History of prior pelvic examination and gestational age of the pregnancy are not related to an increase in pain. Regarding the procedure itself, both shorter procedure time and provider experience correlate with less pain; the amount of cervical dilation and cannula size are not associated with an increase in pain.
    As these numerous factors suggest, perception of pain is a complex and multidimensional phenomenon. Recognized components of pain include physical (sensory), physiological (affective, motivational, and interpretive), and social (context and support) features and their constant interplay. As Melzack noted, “The quality of pain experiences must not be confused with the physical event.”
  • At eight weeks, the danger of a miscarriage . . . diminishes sharply.
  • Child murderers practice their profession without let or hindrance, and open infant butcheries unquestioned...Is there no remedy for all this ante-natal child murder?...Perhaps there will come a time when...an unmarried mother will not be despised because of her motherhood...and when the right of the unborn to be born will not be denied or interfered with.

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  • As I understand it, this puts the burden on the attending physician who has determined, since they were performing this procedure, that, in fact, this is a nonviable fetus; that if that [w:fetus|fetus], or child - however way you want to describe it - is now outside the mother's womb and the doctor continues to think that its nonviable but there's, lets say, movement or some indication that, in fact, they're not just out limp and dead, they would then have to call a second physician to monitor and check off and make sure that this is not a live child that could be saved...If these children are being born alive, I, at least, have confidence that a doctor who is in that room is going to make sure that they're looked after.
    • Barack Obama, on the floor of the Illinois state senate in 2002, explaining his opposition to a bill that would protect infants born alive during a botched abortion (Source: Weekly Standard, 8/23/2012 - video clip at [38]).
  • If abortion is homicide or murder, it is impossible to see why the woman who solicits the abortion is absolved of all culpability. If she solicited the murder of her husband, she would be as guilty of murder as the one who pulled the trigger. Nor is the penalty for the abortionist commensurate with the anti-abortion claims. A fine or ten years in prison are significant penalties and would certainly heck the abortion provider, but those are not penalties commensurate with intentional homicide.
    In an article on criminal penalties for abortion, Richard Doerflinger attempted to counter these presumed discrepancies. Why no penalty for the woman? He points out that in the past when there were penalties for the woman and the abortionist, women were seldom prosecuted. The reason was that the woman was usually the only witness who could testify that an abortion had been performed. In order to obtain a criminal conviction of the abortionist, her testimony was crucial. The woman was given immunity from prosecution in exchange for her testimony. Over and above prosecutorial necessity, juries tended to be sympathetic to women, judging that, in one way or another, they were coerced into having an abortion. Doerflinger cited a study by James Burtcchaell, Rachel Weeping, which argues that, all too frequently, the woman’s choice is coerced by parents, partners, or her own anxieties.
  • No law will actually prevent women seeking and obtaining abortions. Everyone agrees that if abortion is illegal, abortions will still be performed. Many years ago Daniel Callahan undertook a worldwide survey of abortion laws and practices. He concluded that, no matter how stringent the law, women sought and obtained abortions.
    The fact that law will not actually eliminate abortions should give pause to policymakers and the bishops because many of the other social goals can be completely and definitively effected by law. The death penalty can be abolished with the stroke of a pen. When Mario Cuomo was governor of New York, he simply vetoed every death penalty bill that came to his desk. There were no executions in New York, and no lynch mobs sprang up to practice “back alley executions.” One either goes to war or one does not. Universal health care legislation may be difficult to draft and pass, but it is eminently the work of policy. It may be crass realism, but it makes sense to concentrate political attention on goals that can actually be attained by law and policy, rather than promoting laws that express a moral concern but fail in their practical effect.
  • I was aborted, and my body discarded... like I didn't exist. But a nurse heard me crying... and cared enough to save my life. Many children, more than you might think, actually survive failed abortions and are born alive. I know because I'm one of them... There's something else you may not know...when he was in the Illinois State Senate, Barack Obama voted to deny basic constitutional protections for babies born alive from a failed abortion. Not once, but four times. I know it's by the grace of God I'm alive today, if only to ask America this question: is this the kind of leadership that will move us forward, that will discard the weakest among us? How will you answer?
    • Melissa Ohden, abortion survivor, in a political campaign commercial [39] [40].
  • The poor cry out for justice and equality, and we respond with legalized abortion. I believe that in a society that permits the life of even one individual to be dependent on whether that life is ‘wanted’ or not, all its citizens stand in danger...We do not have equal opportunities. Abortion is a cruel way out.
    • Graciela Olivarez, Chicana civil rights and anti-poverty activist, 1972.
  • I am in no position to judge other women, you know. But I mean, why did she get pregnant? It's not good for women to go through the procedure [abortion] and have something living sucked out of their bodies. It belittles women. Even though some women say, 'Oh, I don't mind to have one,' every time a woman has an abortion, it just crushes her self-esteem smaller and smaller and smaller.

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  • You hold that women should be free to choose what they think is right regarding abortion: if a woman's conscience tells her that abortion is in her case permissible, then she should be free to choose to have an abortion. This position has plausibility, because it seems to show respect for the woman's conscience. But I wonder whether this is just an appearance. What do you think about cases where the woman's conscience tells her that abortion is not a good thing--because she thinks she is killing her baby--but she wants an abortion anyway. Why should these abortions be allowed? You may object that these cases are rare, but in fact they are very common. Various polls have repeatedly shown that about 50% of Americans think that abortion is tantamount to murder, and this figure holds for women as for men; so we might expect that about half of the women seeking an abortion believe it is tantamount to murder.
    • Michael Pakaluk, philosopher, to an audience at Columbia University on February 1, 1995.
  • Suppose we bracket for the moment the idea that the unborn child is a human being with human rights. Let's suppose that these things are uncertain, which in fact they are not. Even so: wouldn't legal abortion be contrary to responsible principles of decision under uncertainty? If it were true that we "don't know when human life begins," it would follow, of course, that we don't know that the fetus is not a living human being; that is, we don't know that abortion is not morally equivalent to murder. But isn't that precisely what we ought to know, before allowing abortion?
    • Michael Pakaluk, philosopher, to an audience at Columbia University on February 1, 1995.
  • People are interested in having babies; they're just not interested in having 15 babies. The average American woman spends 23 years of her life preventing pregnancy. No one's going 23 years not having sex.
    • Cristina Page, author of How the Pro-Choice Movement Saved America: Freedom, Politics and the War on Sex, as quoted in "I'm Pro-Choice and I Fuck", Rachel Kramer Bussel, Village Voice January 13, 2006.
  • A late termination is actually not very nice and there is no way of getting away from it, I don't feel I am doing it for any other reason than for the best of both the mother and the baby.
    • John Parsons, M.D., abortionist, ABC.net: Religion and Ethics: 12-28-2005.
  • Responsible parenthood involves decades devoted to the child's proper nurture. To sentence a woman to bear a child against her will is an unspeakable violation of her rights: her right to liberty (to the functions of her body), her right to the pursuit of happiness, and, sometimes, her right to life itself, even as a serf. Such a sentence represents the sacrifice of the actual to the potential, of a real human being to a piece of protoplasm, which has no life in the human sense of the term. It is sheer perversion of language for people who demand this sacrifice to call themselves 'right-to-lifers.'
  • Is [birth control] an abortion? Definitely not. An abortion requires an operation. It kills the life of a baby after it has begun.
  • Other Reasons for Having an Abortion Past 12 Weeks
    Exposure to intimate partner violence.
    Absence of partner due to estrangement or death.
    Lack of financial and/or emotional support from partner.
    Lack of pregnancy symptoms, seeming continuation of “periods,” irregular menses.
    Psychological denial of pregnancy, as may occur in cases of rape or incest (Jones and Finer, 2012; Ingram et al., 2007; Paul et al., 2009).
  • Pelvic infection complicates up to 12% of induced abortions and has an adverse effect on future reproductive outcome. The presence in the lower genital tract of Neisseria gonorrhoeae, Chlamydia trachomatis or the anaerobic organisms characterizing bacterial vaginosis is associated with an increased risk of post-abortion infective morbidity. Meta-analysis of randomized trials has shown that prophylaxis with antibiotics effective against either C. trachomatis or bacterial vaginosis reduces the risk of post-abortion infective morbidity by around a half. Other strategies which have been advocated for minimizing the risk of infective morbidity are screening for lower genital tract infections, with treatment of positive cases only, and a combined strategy where women are screened for sexually transmitted infections as well as receiving prophylaxis. These strategies provide the opportunity for appropriate follow-up and partner notification of those women found to have sexually transmitted infections. A multicentre study designed to determine the prevalence of genital tract infections among Scottish women seeking induced abortion, and to compare strategies of 'universal prophylaxis' and 'screen and treat' for minimizing infective morbidity in such women has been undertaken. A total of 1672 women were recruited. Prevalence rates of lower genital tract gonorrhoea, chlamydia and bacterial vaginosis were found to be similar to those reported in other UK studies. Women managed by the 'screen and treat' strategy (particularly those whose genital tract swabs were reported negative) had slightly higher rates of infective morbidity in the 8 weeks after abortion than those managed by 'prophylaxis'. Using currently available screening tests and genitourinary medicine services, 'prophylaxis' appears to be the more cost effective of the two strategies studied.
  • Do you think abortion is tragic and terrible and wrong, that Roe v. Wade went too far and that the prochoice movement is elitist, unfeeling, overbearing, overreaching and quite possibly dead? In the current debate over abortion, that makes you a prochoicer. As the nation passes the thirty-third anniversary of Roe, it is hard to find anyone who will say a good word in public for abortion rights, let alone for abortion itself. Abortion has become a bit like flag-burning -- something that offends all right-thinking people but needs to be legal for reasons of abstract principle ('choice'). Unwanted pregnancy has become like, I don't know, smoking crack: the mark of a weak, undisciplined person of the lower orders. On the New York Times op-ed page, William Saletan argues that prochoicers should concede that 'abortion is bad, and the ideal number of abortions is zero,' and calls for 'an explicit pro-choice war on the abortion rate.' Sounding a "clear anti-abortion message,' prochoicers should promote a basket of 'solutions' to unintended pregnancy: the Prevention First Act, which calls for federal funding for family planning programs; expanded access to health insurance and emergency contraception; comprehensive sex education. 'Some pro-choice activists' are even 'pushing for more contraceptive diligence in the abortion counseling process, especially on the part of those women who come back for a second abortion.' Give those sluts the lecture they deserve. . . .[T]here's another problem. Inevitably, attacking abortion as a great evil means attacking providers and patients. If abortion is so bad, why not stigmatize the doctors who perform them? Deny the clinic a permit in your town? Make women feel guilty and ashamed for choosing it and make them sweat so they won't screw up again? Ironically, improvements in contraception have made unwanted pregnancy look more like a personal failing. 'Why was I so careful? Because I never wanted to have an abortion,' wrote 32-year-old Laurie Gigliotti in response to Saletan's op-ed, describing her super-vigilant approach to safe sex. You can just see how unwanted pregnancy will join obesity and smoking as unacceptable behavior in polite society. But how is all this censoriousness supposed to help women control their fertility? If half of all pregnancies are unplanned, it doesn't make sense to treat them as individual sins.
    • Katha Pollitt, "Subject to Debate" column in The Nation (February 5, 2006).
  • We are always told that violent anti-choicers are a mere fringe. Obviously, few anti-choicers commit murder or arson. But, as the Matthew Shepard case reminds us, extreme vocabulary creates a climate of moral permission for extreme acts. This is a movement whose main spokespeople, many of them mantled in clerical or political authority, regularly use words like 'baby killers', 'murder', 'holocaust', and 'Nazis', thus legitimizing just about anything. After all, the conspirators who tried to assassinate Hitler are heroes.
    • Katha Pollitt, "Subject to Debate" column in The Nation (November 16, 1998), reprinted in 2001.
  • Young women need to know that abortion rights and abortion access are not presents bestowed or retracted by powerful men (or women) -- Presidents, Supreme Court justices, legislators, lobbyists -- but freedoms won, as freedom always is, by people struggling on their own behalf.
    • Katha Pollitt, "Subject to Debate" column in The Nation (May 1, 2000)reprinted in 2001.
  • What would the alternative be? Abortion by prayer? By edict? Upon seeking consensus? After groveling? Women have thought long and hard about this decision before they ever get to my clinic. In fact, most of them have been agonizing for days or even weeks, some to the extent of rescheduling their appointments several times.
    • Suzanne T. Poppema, discussing the phrase "abortion on demand", in Why I Am An Abortion Doctor (1996).
  • After her [the patient's] counseling session, she's taken into one of our operating areas; a simple ten foot square room where she reclines and places her feet in stirrups. The hard cold steel is softened and warmed by lamb's wool padding. The lighting is muted except for the illumination I'll need for the procedure. Music is an option. To the extent It doesn't affect my ability to perform the procedure, ritual involving friends and symbols can even be part of the abortion. Some women set up small alter-like areas of cloth and crystals, other women play special music; many burn candles.
    • Suzanne T. Poppema, abortion provider, Why I Am An Abortion Doctor (1996).
  • Abortion induced by physical trauma has a long history. This article describes bas-relief sculptures in Angkor Wat, Cambodia dating from the 9th to the 12th centuries, and compares them to contemporary observations of massage abortion. The Cambodian carvings, along with two similar representations in Indonesia, are the earliest known illustrations of an abortion in progress. The bas-reliefs prove that abortion techniques were well understood at the time, although their cultural interpretation is uncertain.
  • Massage abortion is widely practised in present day Southeast Asia, from Myanmar, through Thailand, down to Malaysia, and across to Indonesia and the Philippines. In Malaysia it is called bomo. In the Philippines a hilot, or traditional birth attendant (TBA), is the person who usually conducts the procedure. Narkavonnakit interviewed 81 abortion practitioners in Thailand and found almost half of all abortions were by massage. She estimated that several hundred thousand massage abortions were being performed in rural Thailand each year.
    In Southern Nigeria, traditional abdominal massage techniques are used for a variety of obstetric conditions, such as cephalopelvic disproportion. In approximately 20% of cases it is practised early in pregnancy, and possibly perceived as an abortion technique.
    The crude application of force to induce abortion has been observed in many preliterate societies. Massage abortion does not involve any vaginal manipulation and the pregnancy must be sufficiently advanced for the fundus uteri to be palpable from above the symphysis. The TBA attempts to stabilise the uterus (Figure 1) and then begins to put increasing pressure on the abdominal wall. She may use her fingers, her elbows, her feet, or even the pestle many village women own to pound rice. The pressure is continued until vaginal bleeding is observed.
    Some abortions occur within minutes, but sometimes the procedure is continued for much longer and occasionally leads to internal haemorrhage. Surgeons report admitting women with board-like abdominal rigidity, a low fever and rebound tenderness. On opening the abdomen expecting to find an inflamed appendix, they observe instead a bruised uterus. Sometimes hysterectomy is necessary.
  • Think outside the box, or perhaps more accurately, inside the pouch. Let us suppose that the big-brained, technically competent mammal ruling the globe was not a hairless primate bit a marsupial. No laws on abortion would exist. The female who wanted to end an early pregnancy would look into her pouch and simply remove an unintended early embryo. Alternatively, perhaps more plausibly, suppose that rhubarb were a totally effective abortifacient without side effects. Then every farm since the dawn of civilization and every contemporary window box would grow the plant, and women would make an appropriate brew whenever they decided against continuing an early pregnancy.
    Worldwide women do attempt to terminate their own pregnancies with mechanical or chemical means, but commonly at greater danger of perforation and infection. In part the laws, guidelines, attitudes, and controversy that surround abortion derive from the fact that a woman who wished to end a pregnancy must seek the assistance of a second party, a health professional who is appropriately trained in safe abortion techniques. Although there is still a long way to go, technology is moving closer to putting the abortion decision where it belongs-in the hands of the woman.
  • Manual vacuum aspiration continues to be an exceptionally safe and simple way of performing a first-trimester abortion. Ten years ago, medical abortion was still a novelty; but as this book documents, a large and compelling evidence base now exists on the effectiveness and safety of mifepristone and misoprostol for inducing an early abortion, and on the use of misoprostol alone for treating incomplete abortion or fetal demise. Both mifepristone and misoprostol are now off patent, making high-quality generic products increasingly available in many developing countries. In low resource settings, misoprostol also has a life-saving potential in the treatment and prevention of postpartum hemorrhage and its availability is bound to increase. An effective abortifacient may not be growing in every window box, but it is becoming closer to reality.
    Do technological simplifications trump all ethical considerations surrounding abortion? Personally, I do not think so. As a physician who has provided abortions, but also as a onetime research embryologist, I am awed by the development of the early embryo yet impressed by the frequency of developmental errors. If, as is pharmacologically plausible, someone invented a pill to prevent spontaneous abortion, then 15 to 30% of all term deliveries would involve severe and often fatal anomalies. In many such cases, spontaneous abortion is a natural healing process. In a similar way, the option of a safe induced abortion can change the future life course of a 17-year old student in Chicago with an unintended pregnancy, or ameliorate a social inequity when a family in Addis Ababa, Ethiopia, who can just afford to keep two children in school, would have collapsed into poverty if they had had a third child.
  • Women who seek services from abortion care providers present with varying needs. Many patients are sure about their decision to have an abortion, and they primarily want information about the abortion methods available and what to expect. Other women may wish to explore their pregnancy options more fully and obtain help in making a decision. For some women, having an abortion may be as much an emotional experience as it is a physical because of personal circumstances, ambivalence, or intense and perhaps conflicting feelings the decision evokes.
  • In the case of an unwanted pregnancy, the existential choice for a woman is not abortion vs. no abortion, but, as [Garrett Hardin] has pointed out, abortion vs. compulsory childbearing. If others can force her to be a mother... then she is coerced into putting her body at the disposal of the fetus as if she were an unclaimed natural resource or a chattel slave.... Thus, the woman's most fundamental right of choice, the right to control her own body and happiness, is being abrogated.
    • Sharon Presley and Robert Cooke, The Right to Abortion: A Libertarian Defense, Association of Libertarian Feminists.

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  • No significant differences were observed in self-rated health or chronic pain after first-trimester versus second-trimester abortion. At 5 years, 27% (95% CI, 21% to 34%) of women who gave birth reported fair or poor health compared with 20% (CI, 16% to 24%) of women who had first-trimester abortion and 21% (CI, 18% to 25%) who had second-trimester abortion. Women who gave birth also reported more chronic headaches or migraines and joint pain, but experienced similar levels of other types of chronic pain and obesity. Gestational hypertension was reported by 9.4% of participants who gave birth. Eight of 1132 participants died during follow-up, 2 in the postpartum period. Maternal mortality did not differ statistically by group.
  • In the first decade of the 2000s about 1.2 million abortions were being performed annually in the United States, the lowest figures since 1974. The all-time high figure occurred in 1990 with 1.6 million abortions. The effectiveness of contraceptives is cited for the declining rate of abortion. Of all abortions performed worldwide, 4 percent occur in North America. According to a summer 2008 poll conducted by the Pew Research Center 54 percent of Americans believe abortion should remain legal, while 41 percent believe it should be outlawed. Of the two major political parties, 63 percent of Democrats in comparison to 41 41 percent of Republicans believe abortion should remain legal. In that same poll, 62 percent of white evangelicals and 47 percent of Catholics thought abortion should be illegal. Abortion opponents, who designate their cause “prolife,” believe that aborting an embryo or fetus is the murder of an unborn human being. Proponents of abortion rights, who take up the banner “pro choice,” believe that abortion is about a woman controlling her own body and fertility. For this treason, the argument over abortion has been characterized as the “clash of absolutes.”
  • The most radical arguments on both sides of the abortion issue have obscured certain beliefs shared by both sides. For example, few contend that abortion is an absolute good, and most people favor reducing the number of abortion by preventing unwanted pregnancies. Where the two sides differ is on the specific means used to achieve this end. Conservatives tend to regard the issue in moral or religious terms and concentrate on discouraging sexual relations before marriage. Many liberals concentrate on providing better sex education and offering young unmarried people various birth control methods to prevent conception. Many programs in recent years emphasized both approaches.
  • Make no mistake, abortion-on-demand is not a right granted by the Constitution. No serious scholar, including one disposed to agree with the Court's result, has argued that the framers of the Constitution intended to create such a right.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • [T]he decision by the seven-man majority in Roe v. Wade has so far been made to stick. But the Court's decision has by no means settled the debate. Instead, Roe v. Wade has become a continuing prod to the conscience of the nation.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • As a nation today, we have not rejected the sanctity of human life. The American people have not had an opportunity to express their view on the sanctity of human life in the unborn. I am convinced that Americans do not want to play God with the value of human life. It is not for us to decide who is worthy to live and who is not. Even the Supreme Court's opinion in Roe v. Wade did not explicitly reject the traditional American idea of intrinsic worth and value in all human life; it simply dodged this issue.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • We must all educate ourselves to the reality of the horrors taking place. Doctors today know that unborn children can feel a touch within the womb and that they respond to pain.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • Late-term abortions, especially when the baby survives, but is then killed by starvation, neglect, or suffocation, show once again the link between abortion and infanticide. The time to stop both is now.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • It is possible that the Supreme Court itself may overturn its abortion rulings. We need only recall that in Brown v. Board of Education the court reversed its own earlier 'separate-but-equal' decision.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • As we continue to work to overturn Roe v. Wade, we must also continue to lay the groundwork for a society in which abortion is not the accepted answer to unwanted pregnancy. Pro-life people have already taken heroic steps, often at great personal sacrifice, to provide for unwed mothers.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • We will never recognize the true value of our own lives until we affirm the value in the life of others.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • [W]e cannot survive as a free nation when some men decide that others are not fit to live and should be abandoned to abortion or infanticide. My Administration is dedicated to the preservation of America as a free land, and there is no cause more important for preserving that freedom than affirming the transcendent right to life of all human beings, the right without which no other rights have any meaning.
    • Ronald Reagan, "Abortion and the Conscience of a Nation", Human Life Review, Spring 1984.
  • The fact that a majority of the States reflecting, after all, the majority sentiment in those States, have had restrictions on abortions for at least a century is a strong indication, it seems to me, that the asserted right to an abortion is not ‘so rooted in the traditions and conscience of our people as to be ranked as fundamental...’
    • William H. Rehnquist, U.S. Supreme Court, one of two dissenters against the majority opinion in the landmark abortion case, Roe v. Wade (January 22, 1973).
  • People hold diverse beliefs concerning the ethics of abortion in general and the right of individual women to choose to have an abortion for themselves. Public opinion pollsters and many commentators attempt to squeeze beliefs into only two categories: pro-life and pro-choice.
  • The legal status and availability of abortion is often determined by government interest in population control. The People’s Republic of China’s one-child policy, which is not evenly enforced across the country, has been implemented in part through mandatory abortions; Ceausescu’s regime in Romania, on the other hand, attempted to raise population growth by banning abortion and contraception. Under state socialism , reproduction has figures as a form of production subject to government regulation. The Soviet Union provided workers with medical abortion as routine birth control; in impoverished 1990s Russia, abortions, having been routinized, outnumbered live births by two to one.
    Japan legalized abortion in 1948, when families and government shared interests in reducing family size. Women in Japan and southeastern Europe turned to abortion during World War II to cope with wartime poverty. Initially used by mothers to limit family size but now practiced by women of all ages, abortion in countries like Japan and Greece is not regarded as posing a symbolic threat to motherhood. Where abortion is medicalized as routine birth control, a backup to nonmedical contraceptive methods, it is medical contraception rather than abortion that symbolized women’s reproductive rights. Elsewhere, legalization restricts women’s access to abortion. Turkey’s 1983 Population Planning Law allows elective abortion through ten weeks of pregnancy, but a married woman’s husband must consent. Germany requires counseling before medically approved abortion.
  • Planned Parenthood is outraged by this law and the subsequent court ruling. [F]orcing doctors to use an ultrasound... is the very definition of government intrusion... [T]his decision sets an abhorrent precedent... This law has no basis in medicine...
    • Cecile Richards, president and CEO of Planned Parenthood Federation of America, responding to a court ruling that upheld a Texas law that requires doctors to show every pregnant woman a medical sonogram of the fetus and imposing a 24-hour waiting period thereafter prior to aborting it [44].
  • Plants will react quite sharply to an abortion. The fetus, however, will also react to the death of an animal in the family, and will be acquainted with the unconscious psychic relationships within the family long before it reaches the sixth month. The plants in a house are also quite aware of the growing fetus; the plants will also pick up the fact that a member of the family is ill, often in advance of physical symptoms. They are that sensitive to the consciousness within cellular structure. Plants will also know whether a fetus is male or female.
  • You mentioned a most painful problem of today's life — the question of the legality of abortion. Of course, there are no two opinions on this subject: abortion is most definitely murder. Therefore, only in cases where the mother's life is in danger should it take place. But it is wrong to think that a woman who is guilty of abortion always attracts low spirits. The karma of the whole family should be taken into consideration. Often we can notice that in a family where one of the children is worthless the other children are not bad. Karma ties groups of people for long, long thousands of years. And often, even a high spirit has not unimpeachable, irreproachable parents. And it is significant that the dark forces are especially against the reincarnation of highly developed spirits, and they try their best to prevent the reincarnations that are dangerous for them. And, once more, it is not the purgatory of the Subtle World that prevents spirits from reincarnating, but only the crime of the parents. There is not a more powerful purgatory than the earthly life, if all the potentialities of the individuality are intensified. It is said in the Teaching, "As the one who hungers longs for food, even so, the spirit that is ready to incarnate longs for the new incarnation." Therefore, one can imagine what suffering the spirit undergoes by reason of artificial prevention. The spirit is connected with the embryo at the moment of conception, and gradually enters the body in the fourth month when the nerve and brain channels are being formed. Therefore, abortion is permissible only in exceptional cases.
  • When I talk about my abortion, people assume I'm straight. When I talk about being queer, people don't imagine that I've had an abortion before. It's been hard to live with both identities in a way that I feel other people can understand. I'm not disqualified from being queer because I've had an abortion.
  • I believe that abortion should be safe and legal in this country. I have since the time that my Mom took that position when she ran in 1970 as a U.S. Senate candidate. I believe that since Roe v. Wade has been the law for 20 years we should sustain and support it.
  • Global advocacy efforts must focus on changing laws and formulating national policies that respect reproductive freedom and a woman’s right to choose as a matter of basic human rights. In rural areas where access to services is scarce and few obstetricians are available, training community health workers in manual vacuum aspiration and early medical abortion is critical. Even in the case of India, where abortion services are generally legal, the lack of trained personnel remains a critical public health challenge.
  • Chairs and residency program directors in obstetrics and gynecology and family medicine, as well as other leaders in the field, are increasingly recognizing the need to increase the training of residents in family planning and abortion care. Moreover, where the law allows, efforts are under way to enhance training and utilization of nonphysician clinicians in early abortion provision.

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  • If the abortion is well done, we don't have to watch the baby die. So we inject a salt solution. The result is like putting salt on a slug, but we don't have to watch it.
    • Pro-Life Dr. Russell Sacco quoting what an abortion doctor told him, "Infants Aborted Alive: Officials Wink at Laws" The Oregon Journal (March 14, 1982).
  • Background: Preterm birth (PTB) is the number one cause of perinatal mortality. Prior surgery on the cervix is associated with an increased risk of PTB. History of uterine evacuation, by either induced termination of pregnancy (I-TOP) or spontaneous abortion (SAB), which involve mechanical and/or osmotic dilatation of the cervix, has been associated with an increased risk of PTB in some studies but not in others.
  • An effective postabortion care plan ensures that women receive care that is complete, appropriate, and prompt ("CAP").
    *Complete. Many women treated for abortion complications want to avoid pregnancy. Yet fewer than one-third of women receiving care for abortion complications have ever used effective contraception. Family planning services and counseling can best be provided at the same place where women receive emergency postabortion care, yet few facilities provide family planning services and even fewer provide counseling. At two hospitals, for example, fewer than 3% of women received postabortion family planning counseling. Because postabortion care is often a medical and emotional crisis, empathic family planning counseling is especially important to enable women to avoid future unwanted pregnancies—and unsafe abortions.
    *Appropriate. Most women seeking emergency care are suffering from incomplete abortion, which, if left untreated, can lead to hemorrhage, infection, and death. Uterine evacuation can be done safely and effectively with manual vacuum aspiration (MVA) using local anesthesia. MVA under local anesthesia is safer and usually less expensive than sharp curettage with general anesthesia, the treatment commonly used in many countries. For example, at one Kenyan hospital the cost of postabortion treatment fell by 66% after MVA replaced sharp curettage, mainly because of dramatically reduced hospital stays.
    *Prompt. Often, women do not receive medical treatment soon enough. Delays put their lives at risk. Decentralizing emergency care and establishing a formal referral system can reduce delays by offering some degree of postabortion care at every level of the health system and by helping each woman reach the level of care that she needs in time.
    A planned postabortion care strategy provides more effective care—and often at little or no additional cost—than the crisis atmosphere that currently characterizes most postabortion care.
  • Several of these sperm cells start, but only one enters the ovum and is absorbed into it. This process is called fertilization, conception or impregnation. If no children are desired, the meeting of the male sperm and the ovum must be prevented. When scientific means are employed to prevent this meeting, one is said to practice birth control. The means used is known as a contraceptive. If, however, a contraceptive is not used and the sperm meets the ovule and development begins, any attempt at removing it or stopping its further growth is called abortion. There is no doubt that women are apt to look upon abortion as of little consequence and to treat it accordingly. An abortion is as important a matter as a confinement and requires as much attention as the birth of a child at its full term.
    • Margaret Sanger, founder of Planned Parenthood, Woman and the New Race, Chapter X (1920).
  • It is a noteworthy fact that not one of the women to whom I have spoken so far believes in abortion as a practice; but it is principle for which they are standing. They also believe that the complete abolition of the abortion law will shortly do away with abortions, as nothing else will.
    • Margaret Sanger, founder of Planned Parenthood, "Women in Germany", Birth Control Review (December, 1920).
  • [It is] the most barbaric method [of family planning], the killing of babies — infanticide — abortion.
    • Margaret Sanger, founder of Planned Parenthood, in My Fight for Birth Control, 1931.
  • ...we explained simply what contraception was; that abortion was the wrong way — no matter how early it was performed it was taking a life; that contraception was the better way, the safer way — it took a little time, a little trouble, but was well worth while in the long run, because life had not yet begun.
  • Always to me any aroused group was a good group, and therefore I accepted an invitation to talk to the women's branch of the Ku Klux Klan at Silver Lake, New Jersey, one of the weirdest experiences I had in lecturing. . . Never before had I looked into a sea of faces like these. I was sure that if I uttered one word, such as abortion, outside the usual vocabulary of these women they would go off into hysteria. And so my address that night had to be in the most elementary terms, as though I were trying to make children understand. In the end, through simple illustrations I believed I had accomplished my purpose. A dozen invitations to speak to similar groups were proffered. The conversation went on and on, and when we were finally through it was too late to return to New York.
  • Usually this desire [for family limitation] has been laid to economic pressure... It has asserted itself among the rich and among the poor, among the intelligent and the unintelligent. It has been manifested in such horrors as infanticide, child abandonment and abortion.
    • Margaret Sanger, founder of Planned Parenthood, Woman and the New Race, Chapter 2.
  • It is apparent that nothing short of contraceptives can put an end to the horrors of abortion and infanticide.
    • Margaret Sanger, founder of Planned Parenthood, Woman and the New Race, Chapter 2.
  • While there are cases where even the law recognizes an abortion as justifiable if recommended by a physician, I assert that the hundreds of thousands of abortions performed in America each year are a disgrace to civilization.
    • Margaret Sanger, founder of Planned Parenthood, Woman and the New Race, Chapter 10.
  • When motherhood becomes the fruit of a deep yearning, not the result of ignorance or accident, its children will become the foundation of a new race. There will be no killing of babies in the womb by abortion, nor through neglect in foundling homes, nor will there be infanticide.
    • Margaret Sanger, founder of Planned Parenthood, Woman and the New Race (1920).
  • But unlike abortion today, in most states even the slaveholder did not have the unlimited right to kill his slave.
  • Tabulation, integration, and results: Data were extracted independently by two reviewers, one of whom was blinded to journal, year of publication, authors, and institution. Data from 12 studies were combined using meta-analytic techniques based on a fixed-effects model. The overall summary relative risk (RR) estimate for developing postabortal upper genital tract infection in women receiving antibiotic therapy compared with those receiving placebo was 0.58 (95% confidence interval [CI] 0.47-0.71). Of high-risk women, those with a history of PID had a summary RR estimate of 0.56 (95% CI 0.37-0.84); women with a positive chlamydia culture at abortion had a summary RR estimate of 0.38 (95% CI 0.15-0.92). Of low-risk women, those with no reported history of PID had a summary RR estimate of 0.65 (95% CI 0.47-0.90); in women with a negative chlamydia culture, the summary RR estimate was 0.63 (95% CI 0.42-0.97). The lowest summary RR estimate was among women drawn from populations with a low incidence (5-6%) of postabortal infection (summary RR estimate 0.22, 95% CI 0.11-0.42). The overall 42% decreased risk of infection in women given periabortal antibiotics is similar to the risk reduction demonstrable when only studies published before 1985 are combined (summary RR estimate 0.63, 95% CI 0.44-0.89).
    Conclusion: Our meta-analysis revealed a substantial protective effect of antibiotics in all subgroups of women undergoing therapeutic abortion, even women in low-risk groups. No more placebo-controlled trials should be performed, because women assigned to placebo are exposed to preventable risk. Routine use of periabortal antibiotics in the United States may prevent up to half of all cases of postabortal infections.
  • I will become a believer in the ingenuousness, though never the propriety, of the Court's newfound respect for the wisdom of foreign minds when it applies that wisdom in the abortion cases.
    • Antonin Scalia, in a speech delivered to Mississippi College School of Law, as quoted in "Scalia Defends Gay, Abortion, Gun Rulings at First Baptist" by the Jackson Free Press (January 5, 2010).
  • It thus appears the mansion of constitutionalized abortion law, constructed overnight in Roe v. Wade, must be disassembled doorjamb by doorjamb.
    • Antonin Scalia, as quoted in Scalia Dissents: Writings of the Supreme Court's Wittiest, Most Outspoken Justice, edited by Kevin A. Ring, 2004.
  • I am optimistic enough to believe that, one day, Stenberg v. Carhart will be assigned its rightful place in the history of this Court's jurisprudence beside Korematsu and Dred Scott.
    • Antonin Scalia, in his dissenting opinion in Stenberg v. Carhart, 2000.
  • The state could have been concerned about rendering society callous to infanticide ... the horror of seeing a live human creature outside the womb dismembered. Can't that be a valid societal interest?
    • Antonin Scalia, questioning attorneys during oral arguments in US Supreme Court case Stenberg vs. Carhart (April 25, 2000).
  • The method of killing a human child, one cannot even accurately say an entirely unborn human child, proscribed by this statute is so horrible that the most clinical description of it evokes a shudder of revulsion... the notion that the constitution of the United States, designed, among other things, 'to establish justice, insure domestic tranquillity, ... and secure the blessings of liberty to ourselves and our posterity,' prohibits the states from simply banning this visibly brutal means of eliminating our half-born posterity is quite simply absurd.
    • Antonin Scalia, in his dissenting opinion in Stenberg v. Carhart, 2000.
  • If only for the sake of its own preservation, the Court should return this matter to the people – where the Constitution, by its silence on the subject, left it – and let them decide, State by State, whether this practice should be allowed.
    • Antonin Scalia, in his dissenting opinion in Stenberg v. Carhart, 2000.
  • Susan B. Anthony Pro-Life America, an organization dedicated to abolishing abortion, said big technology companies had routinely limited its and other groups’ pro-life speech, suspending accounts and blocking ads with little explanation.
    “Transparency is the main point,” said Jane Eklund, a fellow at the human rights group Amnesty International USA, which released a report on Tuesday calling on tech giants to clearly outline and explain their rules around abortion-related content. “Without clear guidelines, it’s difficult to hold them accountable for their actions that could be impacting users or to identify and address any content moderation that affects what people can find online.”
    Concerns that some of the tech platforms are suppressing posts about abortion have led to changes in how women and organizations talk about it online. They intentionally misspell the term as “aborshun” or “ab0rti0n,” or replace the “bor” with a boar emoji in hopes of reaching more people.
    But that can also make it harder for people to find information, and coded language risks adding stigma to the procedure, experts and content creators say.
  • Bruce (1959; 1960a) reported that the exposure of a recently inseminated female laboratory mouse to a male other than her mate commonly results in blockage of pregnancy. The regular 5-day cycle of the female is not interrupted in such cases; she returns to estrus 4-5 days after the original mating, and fertile mating with the second male typically occurs. All offspring born after the successive matings are sired by the second male. The reaction appears to result from a reduction in prolactin secretion following contact with the odor of an unfamiliar male (Parkes and Bruce 1961). Subsequent investigations of the generality of the so-called Bruce effect have revealed that it is also exhibited under laboratory conditions in wild “Mus musculus” (Chipman and Fox 1966b) and is suspected or known to occur in several other species of mice and voles: “Microtus agrestis” (Clulow and Clarke 1968), “Microtus pennsylvanicus” ((Clulow and Langford 1971), “Clethrionymus glareoglus” (Clarke et al. 1970), and “Microtus ochrogaster (Stehn and Richmond 1975). Mallory and Clulow (1977) have recently suggested that pregnancy blockage may also occur in wild populations of “Microtus pennsylvanicus”.
    There are everal hypothesis concerning the functional significance of the Bruce effect; three which propose means by which selection operating at the level of the individual could account for the evolution and maintainence of the mechanism are reviewed below and evaluated in light of the results of both laboratory and field observations. Perhaps the most popular of these hypotheses is that the Bruce effect may be a produce of male-male competition (Bronson 1968l Trivers 1972; Wilson 1975): An adaptive advantage would be conferred upon a male capable of annulling the effects of a competitor’s insemination and subsequently restoring the female’s sexual receptivity. In keeping with this perspective, pregnancy blockage has been considered (Rogers and Beauchamp 1976) to function in much the same fashion as male infanticide in langurs and chimpanzees, phenomena which have frequently been interpreted as mechanisms of post copulatory male-male competition (Trivers 1972: Alexander 1974; Hrdy 1977). A second hypothesis as to the functional significance of pregnancy blockage has been offered by Dawkins (1976), who suggested that the effects mutually advantageous to the female and her new mate. Dawkins viewed the situation in the context of the possible courses of action available to an impregnated female deserted by her mate, and assumed that “deception” of the new male as to the paternity of the unborn offspring is impossible. Under those circumstances the male, by inducing pregnancy blockage, avoids investment in another male’s offspring and gains a mating, while the female, tough foreiting her initial expenditures, benefits from remating as quickly as possible with a male who will presumably provide parental care. The third hypothesis is that of Bruce and Parrot (1960) who suggested that the Bruce effect functions to promote exogamy.
  • The global abortion rate was stable between 2003 and 2008, with rates of 29 and 28 abortions per 1000 women aged 15–44 years, respectively, following a period of decline from 35 abortions per 1000 women in 1995. The average annual percent change in the rate was nearly 2•4% between 1995 and 2003 and 0•3% between 2003 and 2008. Worldwide, 49% of abortions were unsafe in 2008, compared to 44% in 1995. About one in five pregnancies ended in abortion in 2008. The abortion rate was lower in subregions where more women live under liberal abortion laws (p<0•05).
  • Because few of the abortion estimates were based on studies of random samples of women, and because we did not use a model-based approach to estimate abortion incidence, it was not possible to compute confidence intervals based on standard errors around the estimates. Drawing on the information available on the accuracy and precision of abortion estimates that were used to develop the subregional, regional, and worldwide rates, we computed intervals of certainty around these rates (webappendix). We computed wider intervals for unsafe abortion rates than for safe abortion rates. The basis for these intervals included published and unpublished assessments of abortion reporting in countries with liberal laws, recently published studies of national unsafe abortion, and high and low estimates of the numbers of unsafe abortion developed by WHO.
  • Abortion rates have declined significantly since 1990 in the developed world but not in the developing world. Ensuring access to sexual and reproductive health care could help millions of women avoid unintended pregnancies and ensure access to safe abortion.
  • Dr Gilda Sedgh, ScD, Jonathan Bearak, PhD , Susheela Singh, PhD , Akinrinola Bankole, PhD , Anna Popinchalk, MPH , Bela Ganatra, MD , et al.; “Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends”, (May 11, 2016)
  • We found in a paper we did last year that the abortion rate is no different in countries with restrictive laws than in countries with liberal laws. Abortions are going to happen regardless of what the law is. And the majority of abortions, 73 percent, are obtained by married women. So what are you going to do? Tell married women not to have sex?
  • [22] And if two men strive and strike a woman with child, and her child be born imperfectly formed, he shall be forced to pay a penalty: as the woman's husband may lay upon him, he shall pay with a valuation. [23] But if it be perfectly formed, he shall give life for life, [24] eye for eye, tooth for tooth, hand for hand, foot for foot, [25] burning for burning, wound for wound, stripe for stripe."
    • Septuagint Text of the Old Testament, Chapter 21 of Exodus.
  • A person's a person, no matter how small.
    • Horton Hears a Who, the 1954 Dr. Seuss childrens' book about an elephant who tries to protect tiny creatures on a speck of dust, but makes no mention of abortion. This is a common pro-life slogan because of their choice to protect unborn babies.
  • If President Clinton had been standing were I was standing at that moment he would not veto this bill. . . A mother was six months pregnant. A doctor told her that the baby had Downs Syndrome and she decided to have an abortion. She came in the first two days to have the laminaria inserted and changed, and she cried the whole time. . . On the third day Dr. [Martin] Haskell brought the ultrasound in and hooked it up so that he could see the baby. . . On the ultrasound screen I could see the heart beating. . . Dr. Haskell went in with forceps and grabbed the baby's legs and pulled them down into the birth canal. Then he delivered the baby's body and the arms--everything but the head. The doctor kept the baby's head just inside the uterus. The baby's little fingers were clasping and unclasping, and his feet were kicking. Then the doctor stuck the scissors through the back of his head, and the baby's arms jerked out in a flinch, a startled reaction, like a baby does when he thinks that he might fall. The doctor opened up the scissors, stuck a high-powered suction tube into the opening and sucked the baby's brains out. Now the baby was completely limp. . . I was really completely unprepared for what I was seeing. I almost threw up as I watched the doctor do these things. . . After that, the doctor delivered the baby's head, cut his umbilical cord and threw him into a pan, along with the placenta and the instruments he had used. I saw the baby move in the pan. . . I asked another nurse and she said it was just 'reflexes.'. . . The woman wanted to see her baby, so they cleaned him up, put him in a blanket and handed him to her. . . She cried the whole time, and she kept saying, 'I'm so sorry, please forgive me!'
    • Brenda Pratt Shafer, registered nurse for late-term abortion doctor Martin Haskell at Women's Medical Center in Dayton, Ohio, describing the procedure in sworn testimony to the U.S. House Judiciary Committee, 1995.
  • It is to be deeply regretted that the American people have been denied the deliberative role in shaping public policy on this issue that has been played by the citizens of other developed democracies. The American people are capable of rising above partisanship on a matter of this gravity. Their voice can and must be heard, through the normal procedures of democracy. For like the practice of slavery, and like Jim Crow laws of the not-so-distant past, the abortion issue raises the most fundamental questions of justice - questions that cannot be avoided, and that cannot be resolved by judicial fiat.
    • Eunice Kennedy Shriver (founder of the Special Olympics) and Sargent Shriver (1972 Democratic Vice-Presidential Nominee and first director of the Peace Corps), et al., A New American Compact: Caring About Women, Caring for the Unborn, New York Times, July 14, 1992 at A23.
  • I have never denied that human life begins at conception. If I have a complaint about our society, it's that we don't deal with death and dying. Do we believe human beings have a right to make decisions about death and dying? Yes we do, and those decisions are made every day in every hospital.
    • Tim Shuck, clinic worker, Peter Korn. Lovejoy: A Year in the Life of an Abortion Clinic (The Atlantic Monthly Press: New York) 1996 p 94.
  • Some light might also be shed on the abortion debate by distinguishing between actual personhood and anticipatory or attributed personhood. To put it another way, there is both an objective and a subjective side to regarding the fetus as a person. Objectively, for instance, the fetus is not a person because it has not acquired the capacities or characteristics that define an entity as a person. Subjectively, however, the pregnant woman or the couple may regard the fetus as a person and provide it all the respect and protection a person should be accorded. Couples who want a child and plan a family may and should regard the conceptus as a person. The pregnant woman may joyfully welcome the news that she has a baby on the way. By talking to the fetus, stroking the bulging abdomen, and celebrating the pregnancy, the woman or the couple brings the child into the circle of the human family. It is not yet a person, but it is already regarded as—it is named and accepted as—a person. The essential difference between actual and attributed personhood is in the value of the fetus to those involved in the pregnancy. It is not vitality but the acceptance, affirmation, recognition, and love of the fetus that grants it personhood and ensures that it will become a person. The experience of the fetus as a person—as an entity of personal worth—is the basis for symbiotic bonding between mother and child. A woman who wants a child and values her pregnancy will be convinced that she is carrying a baby, a person. No other designation conveys the reality of this experience of one who is “other” than the mother. She recognizes it as another self, it is not a “thing,” not simply part of her body. This important human phenomenon of attributed personhood is often overlooked by those who oppose the legal availability of abortion because they believe that elective abortions are never morally justifiable. The search for objective criteria of personhood seems cold and calculating to those who have experienced only the joyous, celebratory side of pregnancy. They often react with fear, horror, and anger to people they believe to be unappreciative of the values of gestating life.
  • The pro-life groups were right about one thing, the location of the baby inside or outside the womb cannot make much of a moral difference. We cannot coherently hold it is alright to kill a fetus a week before birth, but as soon as the baby is born everything must be done to keep it alive. The solution, however, is not to accept the pro-life view that the fetus is a human being with the same moral status as yours or mine. The solution is the very opposite, to abandon the idea that all human life is of equal worth.
    • Peter Singer, Princeton ethicist, "Bioethics: The Case of the Fetus", in the New York Review of Books (August 5, 1976).
  • Suppose that a newborn baby is diagnosed as a haemophiliac. The parents, daunted by the prospect of bringing up a child with this condition, are not anxious for him to live. Could euthanasia be defended here?. . . When the death of a disabled infant will lead to the birth of another infant with better prospects of a happy life, the total amount of happiness will be greater if the disabled infant is killed. The loss of happy life for the first infant is outweighed by the gain of a happier life for the second. Therefore, if killing the haemophiliac infact has no adverse effect on others, it would, according to the total view, be right to kill him... It may still be objected that to replace either a fetus or a newborn infant is wrong because it suggests to disabled people living today that their lives are less worth living than the lives of people who are not disabled. Yet, it is surely flying in the face of reality to deny that, on average, this is so.
    • Peter Singer, Princeton ethicist, Practical Ethics, pp. 185-8, 1993.
  • [M]y ethical position is a form of preference-utilitarianism. . . I apply this ethic to such issues as. . . abortion, euthanasia and infanticide. . . [This] approach to these issues leads to striking conclusions. It offers a clear-cut account of why abortion is ethically justifiable. . . Some of my conclusions have been found shocking. . . In Germany, my advocacy of active euthanasia for severely disabled newborn infants has generated heated controversy.
    • Peter Singer, Princeton ethicist, "A Philosophical Self-Portrait", The Penguin Dictionary of Philosophy, 1997.
  • As of 2010–2014, an estimated 36 abortions occur each year per 1,000 women aged 15–44 in developing regions, compared with 27 in developed regions. The abortion rate declined significantly in developed regions since 1990–1994; however, no significant change occurred in developing regions.
    *By far, the steepest decline in abortion rates occurred in Eastern Europe, where use of effective contraceptives increased dramatically; the abortion rate also declined significantly in the developing subregion of Central Asia. Both subregions are made up of former Soviet Bloc states where the availability of modern contraceptives increased sharply after political independence—exemplifying how abortion goes down when use of effective contraceptives goes up.
  • As of 2017, 42% of women of reproductive age live in the 125 countries where abortion is highly restricted (prohibited altogether, or allowed only to save a woman’s life or protect her health).
  • ..if a woman with a serious illness- heart disease, say, or diabetes- gets pregnant, the abortion procedure may be as dangerous for her as going through pregnancy - with diseases like lupus, multiple sclerosis, even breast cancer, the chance that pregnancy will make the disease worse is no greater that the chance that the disease will either stay the same or improve. And medical technology has advanced to a point where even women with diabetes and kidney disease can be seen through a pregnancy safely by a doctor who knows what he's doing. We've come a long way since my mother's time - The idea of abortion to save the mothers' life is something that people cling to because it sounds noble and pure- but medically speaking, it probably doesn't exist. It's a real stretch of our thinking.
    • Don Sloan, abortion provider, "Choice: A Doctor's Experience with the Abortion Dilemma" Don Sloan, M.D. and Paula Hartz New York: International Publishers. 2002 pgs 45-46.
  • Is abortion murder? All killing isn't murder. A cop shoots a teenager who appeared to be going for a gun, and we call it justifiable homicide - a tragedy for all concerned, but not murder. And then there's war...
    • Don Sloan, abortion provider, Tamara L. Roleff. Abortion: Opposing Viewpoints (Greenhaven Press: San Diego) 1997 p 25.
  • Violence against abortionists has largely been confined to the United States and Canada. An attempt by a North American pro-life group to establish a branch in Britain in 1993 was thwarted when the government had the group's representative deported for being "a threat to the public good". In 1988, the Supreme Court of Canada struck down the law restricting the legal availability of abortions in Canada. Since then, the number of abortions sought by Canadian women has grown significantly and the vehemence of pro-life protestors has increased. Many pro-choice activists say they fear an escalation of violence such as the United States has experienced.
    • Smith, G. Davidson (1998). "Single Issue Terrorism Commentary". Canadian Security Intelligence Service. Archived from the original on 15 October 2007. Retrieved 1 September 2011.
  • American sociologist Dallas Blanchard has observed that some members of the Canadian pro-life movement whom he has encountered are as capable of violence as US extremists and that the pattern of activity in Canada is similar to that in the United States. An article in the May 1996 edition of Chatelaine magazine depicts the current status of the abortion debate in Canada as a battlefield where the fear of violence rules. The atmosphere in clinics resembles a state of siege, with steel bars, security cameras, intercom systems, bomb threats and workers trained in life-saving techniques as well.
    The issue will not go away. The potential for continued violence exists. Indeed, the number of abortions sought by Canadian women has grown significantly since the Supreme Court decision of 1988. The vehemence of pro-life protestors has increased and so may their potential for violence if their level of frustration continues to grow, which it may do in the event of unfavourable legislation or legal judgements or the introduction of abortion drugs. In Canada, changes to government funding of abortions may encourage pro-life activists to indulge in more militant activity.
    • Smith, G. Davidson (1998). "Single Issue Terrorism Commentary". Canadian Security Intelligence Service. Archived from the original on 15 October 2007. Retrieved 1 September 2011.
  • Violence against abortion clinics and other activities directed toward patients and staff of abortion facilities have been termed terrorism by the pro‐choice movement. However, the Federal Bureau of Investigation denies that these actions are terrorism. Instances of abortion clinic violence for 1982–1987 were examined in order to determine whether there is a correspondence between these incidents and definitions or models of terrorism. It appears that these incidents do fit the classification of “limited political” or ‘subrevolutionary” terrorism. Reasons why the FBI has made the decision not to include these acts as forms of terrorism are entertained. One is that current international tensions have resulted in a preoccupation with only certain types of events which for administrative, i.e., juris‐dictional, reasons have come to essentialize terrorism. Another explanation, posited by pro‐choice activists, is that the FBI's decision is a consequence of political influence: the current administration is openly anti‐choice.
    • Smith, G. Davidson (1998). "Single Issue Terrorism Commentary". Canadian Security Intelligence Service. Archived from the original on 15 October 2007. Retrieved 1 September 2011.
  • Although researchers and practitioners alike have long been aware of the existence and dangers of self-induced abortions, virtually no research exists on this topic. This article describes methods of self-induced abortion from current and historical literature. A case study of an adolescent using quinine is discussed to highlight both the reasons some adolescents choose to self-abort and the possible dangers of using such methods. Serious risks to the adolescent are associated with any self-induced abortion attempt. Nurse practitioners are in a key position to assess an adolescent's risk factors for self-induced abortion attempts and to educate about the dangers of such attempts.
    PIP: The introduction to this article on the existence and dangers of self-abortion attempts among adolescents in the US notes that in 1992 more than 134,000 US adolescents sought legal abortions, while an unknown number attempted illegal or self-induced abortions. The article goes on to describe a case in which a 19-year-old almost died after ingesting 1.5 g of quinine in a self-abortion attempt. Next, the article reviews the literature on methods used to attempt self-induced abortion and points out that 70 cases of attempted quinine induced abortion resulted in three abortions and 11 maternal deaths. A table lists other methods of self-induced abortion, including use of drugs, instrumentation, cervical dilation, and trauma. After noting that adolescents may be particularly susceptible to such attempts because of their limited resources and limited access to legal abortions, the article describes reasons for self-induced abortion attempts. Next, recommendations are made to help nurse-practitioners recognize the symptoms of self-induced abortion attempts and prevent the occurrence of self-induced abortion by accessing risks and providing adolescents with the education and support needed to prevent such attempts.
  • Abortion may be caused in different ways. Injuries sustained by crowding through doors, hooks from cattle, or chasing by dogs have caused many a ewe to give birth to an immature lamb, usually dead. Ergotized grain or hay, smutty grain or its straw, frozen turnip or beet tops and impure water are other sources of this trouble. Careful management, clean, sound food and pure water are the best preventatives of sporadic abortion. Some of the symptoms are a loss of appetite, dullness and desire on the part of the ewe to isolate herself from the flock. Generally abortion takes place before any symptoms are noticed, but it is occasionally necessary to remove the foetus and placenta lest blood poisoning set in. Both foetus and afterbirth should in all cases be burned, and the uterus flushed out twice a day for several days with a three per cent solution of creolin in warm water.
    Epizootic abortion is caused by a germ allied in the common moulds. It is contagious and spreads rapidly through a flock unless proper precautions are taken. An animal which has aborted should be at once removed from the flock, and the uterus injected with the creolin solution mentioned above. Foetus, afterbirth, etc. should be burned, and the place where the main flock are kept should be thoroughly cleaned. All bedding should be burned and the floors covered with sawdust containing ten percent be weight of crude carbolic acid. The walls and ceilings should be whitewashed with lime and carbolic acid in the proportion of one pound of commercial carbolic acid to each give gallons of lime wash. Rams that have served affected ewes should be disinfected by syringing into the sheath a five per cent solution of creolin, or a 1 to 1,000 solution of bi-chloride of mercury. For this purpose a fountain syringe is the most convenient instrument. Such rams should not be used again for breeding until a considerable time has elapsed.
  • The murder of children, either before or after birth, has become so frightfully prevalent that physicians... have declared that were it not for immigration the white population of the United States would actually fall off! In a populous quarter of a certain large Western city it is asserted, on medical authority, that not a single Anglo-Saxon child has been born alive for the past three years... it is plain enough that the murder of infants is a common thing among American women.
  • Infanticide is on the increase to an extent inconceivable. Nor is it confined to the cities by any means. Androscoggin County in Maine is largely a rural district, but a recent Medical Convention there unfolded a fearful condition of society in relation to this subject. Dr. Oaks made the remark that, according to the best estimate he could make, there were four hundred murders annually produced by abortion in that county alone....There must be a remedy for such a crying evil as this. But where shall it be found, at least where begin, if not in the complete enfranchisement and elevation of woman? Forced maternity, not out of legal marriage but within it, must lie at the bottom of a vast proportion of such revolting outrages against the laws of nature and our common humanity.
    • Unsigned editorial in 1 The Revolution 10, 146-7 (March 12, 1868). Its co-editors were Elizabeth Cady Stanton and Parker Pillsbury.
  • Results
    Eleven quantitative studies that compared the mental health of women having later abortions (for reasons of fetal anomaly) with other groups were evaluated. Findings differed depending on the comparison group. No studies considered the role of prepregnancy mental health, and one study considered whether factors common among women having later abortions and mental health problems drove the association between later abortion and mental health.
    Conclusion
    Policies based on the notion that later abortions (because of fetal anomaly) harm women's mental health are unwarranted. Because research suggests that most women who have later abortions do so for reasons other than fetal anomaly, future investigations should examine women’s psychological experiences around later abortions.
  • It was 1957 and I was living in London, working as a waitress. I had no money and no friends and was trying to figure out what to do. There was no way I could give birth to someone and also give birth to myself. At the time, to get an abortion in England you needed two doctors to write a letter stating that it was [medically] necessary. I could not make myself feel guilty for a moment. It was the first time I took responsibility for my life. You know, when you are desperate, it's easy to make the decision to abort. Ambivalence seems to be a function of legality.
    • Gloria Steinem, appearing in the documentary film Speak Out: I Had An Abortion, 2005.
  • THIS is an article about a medical syndrome that does not exist. A so-called abortion trauma syndrome has been described in written material and on television and radio programs. For example, leaflets warning of deleterious physical and emotional consequences of abortion have been distributed on the streets of cities in the United States. Women who have undergone induced abortion are said to suffer an "abortion trauma syndrome or "postabortion trauma" that will cause long-term damage to their health.
  • The subject of abortion is fraught with politics, emotions, and misinformation. A widespread practice reaching far back in history, abortion is again in the news. Psychiatry sits at the intersection of the religious, ethical, psychological, sociological, medical, and legal facets of the abortion issue. Although the religions that forbid abortion are more prominent in the media, many religions have more liberal approaches. While the basic right to abortion has been upheld by the U.S. Supreme Court, several limitations have been permitted, including parental notification or consent (with the possibility of judicial bypass) for minors, waiting periods, and mandatory provision of certain, sometimes biased, information. Before the Roe v. Wade decision legalizing abortion in 1973, many women were maimed or killed by illegal abortions, and psychiatrists were sometimes asked to certify that abortions were justified on psychiatric grounds. Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae. The psychiatric outcome of abortion is best when patients are able to make autonomous, supported decisions. Psychiatrists need to know the medical and psychiatric facts about abortion. Psychiatrists can then help patients prevent unwanted pregnancies, make informed decisions consonant with their own values and circumstances when they become pregnant, and find appropriate social and medical resources whatever their decisions may be.
  • PENNYROYAL oil has been used in folklore medicine for many years as an abortifacient and as a means to induce menstruation. Herbal medicine books currently in health food stores mention its use as an abortifacient and recommend its use for various minor ailments. We report two recent cases of pennyroyal oil ingestion for the purpose of abortion. One of these cases resulted in shock, disseminated intravascular coagulation (DIC), massive hepatic nercrosis, and death.
  • In light of the recent national discussion over abortion, it's important Americans know the President's best-kept secret: his extreme record on abortion. Melissa Ohden's powerful story draws a stark contrast to his unbending support of abortion and the abortion industry and reveals the human face to this debate... President Obama's appalling record on abortion is not just limited to his four votes to deny rights to abortion survivors but spans to his recent heartless refusal to support bans on sex-selection and late-term abortions. These actions fly in the face of mainstream American views and run counter to the President's first term pre-election talk of finding common ground. Recent polling reveals the majority of Americans support bans on these horrific practices.
    • Author unknown, Susan B. Anthony List, announcing the launch of a television ad campaign, 2012, as reported by Human Events [46]
  • Of course I'm following the Supreme Court nominations - I have a uterus! I'm stocking up - I got three abortions on the way here. . . I'm pro-choice. . .
    • Commedienne Wanda Sykes, discussing the Senate confirmation hearings of nominee John G. Roberts on The Tonight Show (September 14, 2005).

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  • One doctor said, 'In France, we think that abortion is more moral earlier.' And I thought to myself, we think so too in the United States, but we don't dare say it.
    • Charlotte Taft, abortion counselor and consultant, "When abortions come late in a pregnancy; Though rare, most aren't for medical reasons", US News & World Report (January 19, 1998).
  • Infanticide and infant neglect exist in inverse ratio to the accessibility of abortion services.
  • I am sure that deep down in your heart, you know that the unborn child is a human being loved by God, like you and me. How can anyone knowing that, deliberately destroy that life? It frightens me to think of all the people who kill their conscience so that they can perform an abortion. When we die, we will come face to face with God, the Author of Life. Who will give an account to God for the millions and millions of babies who were not allowed a chance to live, to experience loving and being loved?
    • Mother Teresa, message to the Cairo International Conference on Population and Development on September 9, 1994.
  • My prayer for each one of you is that you may always have the faith to see and love God in each person including the unborn. God bless you.
    • Mother Teresa, message to the Cairo International Conference on Population and Development on September 9, 1994.
  • If there is a child that you don't want or can't feed or educate, give that child to me. I will not refuse any child. I will give a home, or find loving parents for him or for her. We are fighting abortion by adoption and have given thousands of children to caring families. And it is so beautiful to see the love and unity that a child brings to a family.
    • Mother Teresa, message to the Cairo International Conference on Population and Development on September 9, 1994.
  • But I feel that the greatest destroyer of peace today is abortion, because it is a war against the child, a direct killing of the innocent child, murder by the mother herself. And if we accept that a mother can kill even her own child, how can we tell other people not to kill one another? How do we persuade a woman not to have an abortion? As always, we must persuade her with love and we remind ourselves that love means to be willing to give until it hurts. . . So, the mother who is thinking of abortion, should be helped to love, that is, to give until it hurts her plans, or her free time, to respect the life of her child. The father of that child, whoever he is, must also give until it hurts...
  • Many people are very, very concerned with the children of India, with the children of Africa where quite a few die of hunger, and so on. Many people are also concerned about all the violence in this great country of the United States. These concerns are very good. But often these same people are not concerned with the millions who are being killed by the deliberate decision of their own mothers. And this is what is the greatest destroyer of peace today — abortion which brings people to such blindness.
  • By abortion, the mother does not learn to love, but kills even her own child to solve her problems. And, by abortion, the father is told that he does not have any responsibility for the child he has brought into the world. That father is likely to put other women into the same trouble. So abortion leads to more abortion. Any country that accepts abortion is not teaching its people to love, but to use any violence to get what they want. This is why the greatest destroyer of love and peace is abortion.
  • Human rights are not a privilege conferred by government. They are every human being's entitlement by virtue of his humanity. The right to life does not depend, and must not be contingent, on the pleasure of anyone else, not even a parent or sovereign... you must weep that your own government, at present, seems blind to this truth.
    • Mother Teresa, in her amicus brief filed before the U.S. Supreme Court in the cases of Loce v. New Jersey and Krail et al. v. New Jersey in February 1994.
  • America needs no words from me to see how your decision in Roe v. Wade has deformed a great nation. The so-called right to abortion has pitted mothers against their children and women against men. It has sown violence and discord at the heart of the most intimate human relationships. It has aggravated the derogation of the father's role in an increasingly fatherless society. It has portrayed the greatest of gifts—a child—as a competitor, an intrusion, and an inconvenience.
    • Mother Teresa, in her amicus brief filed before the U.S. Supreme Court in the cases of Loce v. New Jersey and Krail et al. v. New Jersey in February 1994.
  • We speak of peace. These are the things that threaten peace. I think that today peace is threatened by abortion, too, which is a true war, the direct killing of a child by its own mother. In the Bible we read that God clearly said: “Even though a mother did forget her infant, I will not forget him.”Today, abortion is the worst evil, and the greatest enemy of peace. We who are here today were wanted by our parents. We would not be here if our parents had not wanted us.We want children, and we love them. But what about the other millions? Many are concerned about the children, like those in Africa, who die in great numbers either from hunger or for other reasons. But millions of children die intentionally, by the will of their mothers. Because if a mother can kill her own child, what will prevent us from killing ourselves, or one another? Nothing.
    • Mother Theresa, when receiving the Nobel peace price in 1979. As quoted from Hitchens, C. (2012). The missionary position: Mother Theresa in theory and practice.
  • When I or people like me are running the country, you'd better flee because we will find you, we will try you and we'll execute you. I mean every word of it. I will make it part of my mission to see to it that you are tried and executed.
    • Randall Terry, leader of Operation Rescue, Addressing doctors who perform abortions, in a speech to the U.S. Taxpayers Alliance, from The Hotline, May 9, 2000.
  • Women have been having abortions, legal or illegal, since time immemorial mostly for social and economic reasons. Unsafe abortion is a common finding in underdeveloped countries where women are denied reproductive rights. However, in a developed country, where facilities for safe abortion are readily available, unsafe and self induced methods are rarely seen and reported.
  • What does come as more of a surprise, if the evidence and statistics are to be believed, is the extent to which abortion under most adverse conditions, has been accepted by women (and men) throughout the world as a means of birth control and preferable to continuing with pregnancy. This in itself suggests, and our more limited experience in this country tends to support the view, that abortion is not liable to be followed by psychiatric illness. A psychiatrist, Dr. Kummer, in Part II of the book concludes-"that abortion, far from being a precipitator of psychiatric illness, quite to the contrary is actually a defence against such an occurrence in women who are susceptible to mental illness".
  • Too little has been known of the extent to which illegal abortion is wide spread and practiced un-officially, not only in countries which are traditionally regarded as undeveloped, but also in those which are comparatively civilized. One would not expect statistics on a subject such as this to be either plentiful or reliable and most of the contributors felt obliged to make this point. Never the-less, one could hardly fail to be impressed with the theme of speaker after speaker as to the distress caused universally by excess fertility and only now coming to be accepted as worthy of attention. There is evidence of a decline in criminal abortion in countries which have adopted a more liberal code of practice with a consequent fall in death and morbidity association with abortion, though the number of legal terminations which have to be performed to achieve these improvements is rather frightening.
  • You wake up in the morning and find yourself back to back in bed with an unconscious violinist. A famous unconscious violinist. He has been found to have a fatal kidney ailment, and the Society of Music Lovers has canvassed all the available medical records and found that you alone have the right blood type to help. They have therefore kidnapped you, and last night the violinist's circulatory system was plugged into yours, so that your kidneys can be used to extract poisons from his blood as well as your own. [If he is unplugged from you now, he will die; but] in nine months he will have recovered from his ailment, and can safely be unplugged from you.
  • Suppose you find yourself trapped in a tiny house with a growing child. I mean a very tiny house, and a rapidly growing child—you are already up against the wall of the house and in a few minutes you'll be crushed to death. The child on the other hand won't be crushed to death; if nothing is done to stop him from growing he'll be hurt, but in the end he'll simply burst open the house and walk out a free man.
    • Judith Jarvis Thomson, A Defense of Abortion 1971: 52.
  • For what we have to keep in mind is that the mother and the unborn child are not like two tenants in a small house, which has, by unfortunate mistake, been rented to both: the mother owns the house. The fact that she does adds to the offensiveness of deducing that the mother can do nothing from the supposition that third parties can do nothing. But it does more than this: it casts a bright light on the supposition that third parties can do nothing.
    • Judith Jarvis Thomson, A Defense of Abortion 1971: 53.
  • Again, suppose it were like this: people-seeds drift about in the air like pollen, and if you open your windows, one may drift in and take root in your carpets or upholstery. You don't want children, so you fix up your windows with fine mesh screens, the very best you can buy. As can happen, however, and on very, very rare occasions does happen, one of the screens is defective; and a seed drifts in and takes root.
    • Judith Jarvis Thomson, A Defense of Abortion 1971: 58.
  • A high correlation between abortion experience and contraceptive experience can be expected in populations to which both contraception and abortion are available ... Women who have practiced contraception are more likely to have had abortions than those who have not practiced contraception, and women who have had abortions are more likely to have been contraceptors than women without a history of abortion.
  • Abortion is not a cerebral or reproductive issue. Abortion is a matter of the heart. For until one understands the heart of a woman, nothing else about abortion makes any sense at all.
  • This baby looks pretty good, I'm sorry that the baby had a lot of problems. But it did.
    • George Tiller, handing a photo of a dead late-term fetus he had aborted to pro-choice legislator Ruby Gilbert during a tour of his late-term abortion clinic, "Tours provide insight into abortion", The Wichita Eagle, October 7, 1997.
  • We have some experience with late terminations; about 10,000 patients between 24 and 36 weeks and something like 800 fetal anomalies between 26 and 36 weeks in the past 5 years.
    • George Tiller, declaring his pro-choice credentials in a speech to the National Abortion Federation, April 2-4, 1995, New Orleans, LA. Click to listen.
  • Whether in the name of traditional sex roles or in the name of a traditional sexual morality, much opposition to abortion seems really to be about the control of women.
  • Those who give drugs for procuring abortion, and those who receive poisons to kill the foetus, are subjected to the penalty of murder.
    • Council of Trullo, canon XCI, 692.

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  • In no case should abortion be promoted as a method of family planning. . . Any measures or changes related to abortion within the health system can only be determined at the national or local level according to the national legislative process. In circumstances where abortion is not against the law, such abortion should be safe.
  • Abortion and euthanasia have become preeminent threats to human dignity because they directly attack life itself, the most fundamental human good and the condition for all others. They are committed against those who are weakest and most defenseless, those who are genuinely 'the poorest of the poor.' They are endorsed increasingly without the veil of euphemism, as supporters of abortion and euthanasia freely concede these are killings even as they promote them. Sadly, they are practiced in those communities which ordinarily provide a safe haven for the weak -- the family and the healing professions. Such direct attacks on human life, once crimes, are today legitimized by governments sworn to protect the weak and marginalized.
  • Having an abortion does not increase the risk of mental health problems, but having a baby does, one of the largest studies to compare the aftermath of both decisions suggests.
    The research by Danish scientists further debunks the notion that terminating a pregnancy can trigger mental illness and shows postpartum depression to be much more of a factor.
    Abortion in Denmark has been legal since 1973 — the same year the U.S. Supreme Court ruled on Roe v. Wade, which established a right to abortion.
    The Danish study included 365,550 teenagers and women who had an abortion or first-time delivery between 1995 and 2007. None had a history of psychiatric problems that required hospitalization. Through various national registries, researchers were able to track mental health counseling at a hospital or outpatient facility before and after an abortion or delivery.
    During the study period, 84,620 had an abortion while 280,930 gave birth.
    Researchers compared the rate of mental health treatment among women before and after a first abortion. Within the first year after an abortion, 15 per 1,000 women needed psychiatric counseling — similar to the rate seeking help nine months before an abortion.
    Researchers say women who seek abortions come from a demographic group more likely to have emotional problems to begin with. Statistics show that a large percentage struggle economically and they have above-average rates of unintended pregnancies.
  • While first-time mothers had a lower rate of mental problems overall, the proportion of those seeking help after giving birth was dramatically higher. About 7 per 1,000 women got mental health help within a year of giving birth compared with 4 per 1,000 women pre-delivery.
    The most common problems among women in both the abortion and the delivery groups were debilitating anxiety, severe stress and depression.
    "A woman should know that her risk of having a psychiatric episode is not increased" after an abortion, said Trine Munk-Olsen of Aarhus University, who led the study.

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  • The pro-life case is rather simple. We believe that abortion should be outlawed because unborn humans are people and all people are endowed with inherent rights and dignities.
    • Matt Walsh, WALSH: Three Reasons Why The ‘Rape And Incest’ Argument For Abortion Is Misleading, Disingenuous, And Wrong, 15 May 2019, The Daily Wire
  • My whole professional training was to prolong life, to nurture and protect it. Abortion is clearly at odds with that ethos...[yet] I have never refused to perform an abortion because of any personal conflict...
    • Dr. Bertram Wainer, abortionist, From Magda Denes, PhD. In Necessity and Sorrow: Life and Death Inside an Abortion Hospital.
  • Conversations around reproductive health and justice have historically left out people who identify as LGBTQ. I think the conversations have been very heteronormative. This is a population that does need access to these types of services and has a hard time in accessing these services in a way that is affirming to their gender and sexual orientation.
  • Women are not stupid ... women have always known that there was a life there.
    • Faye Wattleton, then president of Planned Parenthood, to NBC television, May 15, 1989.
  • I am fully aware of that. I am fully aware [that it's not a frog or a ferret that's being killed, that it's a baby].
    • Faye Wattleton, then president of Planned Parenthood on the Phil Donahue Show, September 6, 1991.
  • I think we have deluded ourselves into believing that people don't know that abortion is killing. So any pretense that abortion is not killing is a signal of our ambivalence, a signal that we cannot say 'yes, it kills a fetus, but it is the women's body, and therefore ultimately her choice.'
    • Faye Wattleton, former president of Planned Parenthood, as quoted in Salon Magazine, (June 27, 1997).
  • If you refuse to eat an embryonic life form on the grounds that it ends the life of an animal then you might as well join the loonies who gather on N. Charles street to compare abortion to the Holocaust.
    • Simon Waxman, referring to the practice by some vegetarians of eating chicken eggs in the Johns Hopkins News-Letter (February 10, 2006)[48].
  • I was co-counsel in Roe v. Wade, have sired zero children and one fetus, the abortion of which was recently recounted by my ex-wife [lead Roe attorney, Sarah Weddington] in her book, A Question of Choice. I had a vasectomy in 1969 and have never had one mement of regret.
    • James R. (Ron) Weddington, co-counsel in Roe v. Wade, in letter to then President-elect Clinton, encouraging him to step up abortion and other birth control for the poor source: Clinton Library, page 60.
  • The word 'privacy' does not appear in the Constitution. Then again, neither does 'travel.' But if you were to ask any American, 'Do you have the right to travel where and when you like?' they'd say 'yes.' And the Supreme Court has upheld this right.
    • Sarah Weddington, the lawyer who argued Roe v. Wade, "A Delicate Decision", Westchester County Weekly, (January 22, 1998).
  • It never should have been filed. Those who filed it got publicity, but the publicity actually has been very helpful for those of us who believe the government should not be involved.
    • Sarah Weddington, the lawyer who argued Roe v. Wade, referring to the lawsuit filed by her former client "Jane Roe" to overturn the landmark ruling, Court Says 'No' To Roe, Associated Press (June 20, 2003).
  • At the heart of the controversy in these cases are those recurring pregnancies that pose no danger whatsoever to the life or health of the mother but are, nevertheless, unwanted for any one or more of a variety of reasons -- convenience, family planning, economics, dislike of children, the embarrassment of illegitimacy, etc.
    • Byron White, U.S. Supreme Court, one of two dissenters in Roe v. Wade, (January 22, 1973).
  • I find nothing in the language or history of the Constitution to support the court's judgment. The court simply fashions and announces a new constitutional right for pregnant mothers and, with scarcely any reason or authority for its action, invests that right with sufficient substance to override most existing state abortion statutes.
    • Byron White, U.S. Supreme Court, one of two dissenters in Roe v. Wade, (January 22, 1973).
  • Aware that in Roe it essentially created something out of nothing and that there are many in this country who hold that decision to be basically illegitimate, the Court responds defensively.... I do not share the warped point of view of the majority, nor can I follow the tortuous path the majority treads in proceeding to strike down the statute before us. I dissent.
  • The goal of the right is not to stop abortion but to demonize it, punish it and make it as difficult and traumatic as possible. All this it has accomplished fairly well, even without overturning Roe v. Wade.
    • Ellen Willis, "Escape from Freedom," Situations: Project of the Radical Imagination, Vol 1, No 2 (2006).
  • With consistency, beautiful and undeviating, human life, from its commencement to its close, is protected by the common law. In the contemplation of law, life begins when the infant is first able to stir in the womb. By the law, life is protected not only from immediate destruction, but from every degree of actual violence, and, in some cases, from every degree of danger.
    • James Wilson, "Of the Natural Rights of Individuals" (1790-1792). Wilson was a leading framer of the U.S. Constitution.
  • Abortion is not the emancipation of women. Abortion is the ultimate exploitation of women. When they ask us, 'What about the woman,' we will not say, 'What about the baby?' We will give them a good answer. We will say, 'We refuse to choose between women and their children. We will fight for you who deserve better than abortion.'
    • Sally Winn, vice president of Feminists for Life, at the annual March For Life, January 2003.
  • So what will it be: Wanted fetuses are charming, complex, REM-dreaming little beings whose profile on the sonogram looks just like Daddy, but unwanted ones are mere 'uterine material'? How can we charge that it is vile and repulsive for pro-lifers to brandish vile and repulsive images if the images are real? To insist that the truth is in poor taste is the very height of hypocrisy. Besides, if these images are often the facts of the matter, and if we then claim that it is offensive for pro-choice women to be confronted by them, then we are making the judgment that women are too inherently weak to face a truth about which they have to make a grave decision. This view of women is unworthy of feminism. Free women must be strong women, too; and strong women, presumably, do not seek to cloak their most important decisions in euphemism.
    • Naomi Wolf, feminist author and advocate of legal abortion, in "Our Bodies, Our Souls", The New Republic (October 15, 1995).
  • I wish to say my word on the theme of the day — Abortion and the Abortionists. . . Abortion [is]one of the fixed institutions of the country, one of the marked characteristics of the age, one of the indicative symptoms of the ripening and the rottening of our prevalent state of society! Who proposes to disturb Madame Restel [underground abortion practitioner]? Who really wants that there should be no opportunity to secure an abortion under peculiarly trying circumstances? . . . But the great revenue of these practitioners is from the married women among the wealthy. They have become unfit to have children, and abortion is the sewerage for this wretched stagnation of feminine life. . . . Abortion before marriage and especially after marriage are the rule rather than the exception—in the wealthy and fashionable classes, and to a great extent among workingwomen who say they 'can't afford to have children'. . . Abortion is only a symptom of a more deep-seated disorder of the social state. It cannot be put down by law. Normally the mother of ten children is as healthy, and may be as youthful and beautiful, as a healthy maiden. Child-bearing is not a disease, but a beautiful office of nature. But to our faded-out, sickly, exhausted type of women, it is a fearful ordeal. Nearly every child born is an unwelcome guest. Abortion is the choice of evils for such women.
    • Victoria Woodhull, first woman to run for U.S. President, member of the Equal Rights Party, in Woodhull's and Claffin's Weekly (September 23, 1871).
  • We are aware that many women attempt to excuse themselves for procuring abortions, upon the ground that it is not murder. But the fact of resort to so weak an argument only shows the more palpably that they fully realize the enormity of the crime. Is it not equally destroying the would-be future oak to crush the sprout before it pushes its head above the sod, as to cut down the sapling, or cut down the tree? Is it not equally to destroy life, to crush it in the very germ, and to take it when the germ has evolved to any given point in its line of development?
    • Victoria Woodhull and Tennessee Claflin, Woodhull and Claflin's Weekly (June 20, 1874).
  • Men must no longer insult all womanhood by saying that freedom means the degradation of woman. Every woman knows if she were free, she would never bear an unwished-for child, nor think of murdering one before its birth.
    • Victoria Woodhull, first woman to run for U.S. President, member of the Equal Rights Party, in The Evening Standard (Wheeling, WV) (November 17, 1875).
  • The rights of children as individuals begin while yet they remain the foetus.
    • Victoria Woodhull, first woman to run for U.S. President, member of the Equal Rights Party, in Woodhull's and Claffin's Weekly (December 24, 1870).
  • Abortion is also a practice which spreads damnation world-wide. . . When a woman becomes conscious that she is pregnant, and a desire comes up in her heart to shirk the duties it involves, that moment the fetal life is the unloved, the unwished child. Is it to be wondered at that there are so many undutiful children--so many who instinctively feel that they are "encumbrances" rather than the beautiful necessities of the home? What true mother's heart but bounds with pride and joy when she sees the beauteous results of her constructive work? Why should she not also feel happiness when she realizes that she is performing that constructive process? Is it to be wondered at that so many children lacking all confidence in themselves and so foolishly diffident that it follows them through life, when we consider the conduct of women during pregnancy? It should be the pride of every woman to be the willing, the anxious, the contented mother, and if she be so under the guidance of the knowledge we deem essential, she will never have cause to regret that she fulfilled the duties of maternity. All practices which degenerate the character of children should be discountenanced by every humanitarian, and women encouraged to wisely and perfectly mold and fashion the life which they shall give to the world.
    • Victoria Woodhull, first woman to run for U.S. President, member of the Equal Rights Party, in a speech to the American Association of Spiritualists (September 13, 1871).
  • Whoever has read the WEEKLY knows I hold abortion (except to save the life of the mother) to be just as much murder as the killing of a person after birth is murder.
    • Victoria Woodhull, first woman to run for U.S. President, member of the Equal Rights Party, in Woodhull's and Claffin's Weekly (December 2, 1871).
  • The [Roe v. Wade] opinion's author, Justice Harry A. Blackmun, said in one internal court memo that he was drawing 'arbitrary' lines about the times during pregnancy when a woman could legally receive an abortion. In another memo, Justice Potter Stewart, who joined the Blackmun opinion, said the determination in the opinion about these lines was 'legislative.'
    • Bob Woodward, The Abortion Papers, Washington Post, January 22, 1989 at D1.
  • The use of antibiotics in emergency abortion care has been an area of uncertainty for many providers. This confusion has resulted in misuse and overuse of antibiotics in many settings. The development of a scoring system to determine who should be given or not given antibiotics would give concrete guidance to providers in making these clinical decisions.
    Concerns about the interactions of hormonal contraceptives and other drugs, specifically antibiotics, have been widely discussed. The Technical Working Group concurred that systematic evidence shows little or no effect of antibiotics on serum levels of hormones. Although research could be helpful in dispelling the concern of reduced efficacy, it was the consensus that other research needs are more compelling given the strength of existing research.
    • "The Prevention and Management of Unsafe Abortion" (PDF). World Health Organization. April 1992. Archived (PDF) from the original on 30 May 2010. Retrieved 18 October 2017. p.9
  • Research is needed on the attitudes of staff toward abortion and toward the women who seek care for complications of unsafe abortion. Identification of these attitudes and strategies to change punitive attitudes are essential to improving the care women receive for abortion complications.
    The speed with which women receive treatment after arriving at a health facility is also affected by staff attitudes. Currently, women seeking care for abortion complications are often the last to receive treatment, only after all other patients have been treated. Research into the staff’s perceptions of the seriousness of abortion complications and the women’s need for care will highlight mechanisms to improve the speed of the care delivered.
    • "The Prevention and Management of Unsafe Abortion" (PDF). World Health Organization. April 1992. Archived (PDF) from the original on 30 May 2010. Retrieved 18 October 2017. p.11
  • Every woman with an unwanted pregnancy who is contemplating abortion should receive counselling from a trained health-care professional with comprehensive knowledge and experience of different methods of abortion. Information must be provided to each woman, regardless of her age or circumstances, in a way that she can understand, to allow her to make her own decisions about whether to have an abortion and what method to choose.
    Both counselling and abortion procedures should be provided as promptly as possible without undue delay. Nevertheless, clinicians should be sensitive in recognizing that some women require additional time and support in reaching their decision.
    Abortion counselling can take place in any health-care setting; ideally, it should be given where the abortion procedure can be initiated. Private interview facilities are essential and each woman should be free to choose to be interviewed alone or with the support of a partner, parent, or friend.
    Health-care professionals providing abortion counselling must be familiar with their local legal framework regarding consent by women below the legal age of consent. Each woman should reach her own decision and should not be coerced into involving her parents or partner where there is no legal requirement to do so.
  • There is little, if any, difference between medical and surgical abortion in terms of safety and efficacy. Thus, both methods are similar from a medical point of view and there are only very few situations where a recommendation for one or the other method for medical reasons can be given.
  • When abortions are performed in accordance with WHO guidelines and standards, the risk of severe complications or death is negligible. Approximately 55% of all abortions from 2010 to 2014 were conducted safely, which means they were performed by a trained health worker using a WHO-recommended method appropriate to the pregnancy duration.
    Almost one-third (31%) of abortions were “less safe,” meaning they were either performed by a trained provider using an unsafe or outdated method such as “sharp curettage”, or by an untrained person albeit using a safe method like misoprostol, a drug that can be used for many medical purposes, including to induce an abortion.
    About 14% were “least safe” abortions provided by untrained persons using dangerous methods, such as introduction of foreign objects and use of herbal concoctions. Deaths from complications of unsafe abortion were high in regions where most abortions happened in the least safe circumstances. Complications from “least-safe” abortions can include incomplete abortion (failure to remove all of the pregnancy tissue from the uterus), haemorrhage, vaginal, cervical and uterine injury, and infections.
  • Adopted by the 24th World Medical Assembly, Oslo, Norway, August 1970
    and amended by the 35th World Medical Assembly, Venice, Italy, October 1983
    and the 57th WMA General Assembly, Pilanesberg, South Africa, October 2006
    1. The WMA requires the physician to maintain respect for human life.
    2. Circumstances bringing the interests of a mother into conflict with the interests of her unborn child create a dilemma and raise the question as to whether or not the pregnancy should be deliberately terminated.
    3. Diversity of responses to such situations is due in part to the diversity of attitudes towards the life of the unborn child. This is a matter of individual conviction and conscience that must be respected.
    4. It is not the role of the medical profession to determine the attitudes and rules of any particular state or community in this matter, but it is our duty to attempt both to ensure the protection of our patients and to safeguard the rights of the physician within society.
    5. Therefore, where the law allows therapeutic abortion to be performed, the procedure should be performed by a physician competent to do so in premises approved by the appropriate authority.
    6. If the physician's convictions do not allow him or her to advise or perform an abortion, he or she may withdraw while ensuring the continuity of medical care by a qualified colleague.
  • [W]e are concerned that, in a world in which abortion could be made illegal, Google’s current practice of collecting and retaining extensive records of cell phone location data will allow it to become a tool for far-right extremists looking to crack down on people seeking reproductive health care. That’s because Google stores historical location information about hundreds of millions of smartphone users, which it routinely shares with government agencies.
    • Ron Wyden, Anna Eshoo, Alex Padilla, Sara Jacobs, Martin Heinrich, Ted W. Lieu, John Hickenlooper, Lori Trahan, Elizabeth Warren, Jackie Speier, Jeffrey A. Merklley, Rashida Tlaib, Bernard Sanders, Yvette D. Clarke, Edward J. Markey, Katie Porter, Cory A. Booker, Veronica Escobar, Mazie K. Hirono, Jimmy Gomez, Tina Smith, Judy Chu, Tammy Duckworth, Andy Levin, Suzan K. DelBene, Mary Gay Scanlon, Earl Blumeauer, Jake Auchincloss, Suzanne Bonamici, Ayanna Pressley, Pramila Jayapal, Nanette Diaz Barragan, Rosa L. DeLauro, Mark Takano, Debbie Wasserman Shultz, Lauren Underwood, Lizzie Fletcher, Ro Khanna, Barbara Lee, Alexandria Ocasio-Cortez, Lisa Blunt Rochester, Madeleine Dean; Congress of the United States, "Letter to Sundar Pichai", (May 24, 2022), p.1

X

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Y

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Z

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  • According to the Center on Reproductive Rights and Justice (CRRJ), at least 17 women have already been arrested for allegedly trying to perform their own abortion or helping someone do so. (In one well-known case, a Pennsylvania mother, Jennifer Whalen, was sent to jail after buying pills online for her daughter.) Some experts say that's just wrong. CRRJ is working to decriminalize home abortions, and others argue that taking misoprostol at home is actually a practical solution for women with little access to care, a position shared by the World Health Organization.

Dialogue

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  • Q: Consider the case of a mature woman, 48 years of age and aware both of her biological clock and her church's teachings, who still decides on an abortion. Whose decision is that — under God? Who has the final call?
    Bush: You know, I would hope that the person would make a decision to put the child up for adoption.
    Q: So you think banning abortion would work. Would not those women with the means simply head for Canada for the procedure? How can you stop women from getting an abortion if they want one?
    Bush: You can't. You can't...You're asking me, as the president, would I understand reality? I do. I think the key is to change the culture. The role of the president is to set a tone and to appreciate life. I want the goal for America to be that born and unborn children be protected in law and welcomed to life. That's a goal. That's the ideal world. And that's exactly where I intend to lead.
  • Q: Are you currently a member of the Board of Directors for Physicians for Choice, Physicians for Reproductive Health and Choice?
    Carhart: Exactly. I am.
    Q: And are you also on the National Board of Directors of the Religious Coalition of Reproductive Choice?
    Carhart: Yes, ma'am. I am.
    Q: Doctor, are you board certified?
    Carhart: No, ma'am. I'm not.
    • Leroy Carhart, confirming his pro-choice credentials under oath, Carhart v. Ashcroft, (4/1/2004).
  • Reporter: What led you to develop D & X [dilation and extraction or "partial-birth abortion"]?
    Haskell: D & E's [dilation and evacuation], the procedure typically used for later abortions, have always been somewhat problematic because of the toughness and development of the fetal tissues. . . I just kept doing D & Es because that was what I was comfortable with, up until 24 weeks. But they were very tough. Sometimes it was a 45-minute operation. I noticed that some of the later D & Es were very, very easy. . . You see the easy ones would have a foot length presentation, you'd reach up and grab the foot of the fetus, pull the fetus down and the head would hang up and then you would collapse the head and take it out. It was easy. . . Then I said, `Well gee, if I just put the ultrasound up there I could see it all and I wouldn't have to feel around for it.' I did that and sure enough, I found it 99 percent of the time. Kind of serendipity.
    • Martin Haskell, discussing the invention of his late-term abortion method, Cincinnati Medicine, Fall 1993 (U.S. Congressional Record, 1996, p. H10614).
  • Reporter: [Is] the fetus . . . dead beforehand...?
    Haskell: No, it's really not. . . in my case, I would think probably about a third of those are definitely. . . dead before I actually start to remove the fetus. And probably the other two-thirds are not.
    Reporter: Is the skull procedure also done to make sure that the fetus is dead so you're not going to have the problem of a live birth?
    Haskell: It's immaterial. If you can't get it out, you can't get it out. . . The point here is to effect a safe legal abortion. I mean, you could say the same thing about the D&E [dilation and evacuation] procedure. You know, why do you do the D&E procedure? Why do you crush the fetus up inside the womb? To kill it before you take it out? Well, that happens, yes. But that's not why you do it. You do it to get it out. I could do the same thing with a D&E procedure...But that's not really the point. The point here is you're attempting to do an abortion. And that's the goal of your work, is to complete an abortion. . .
    Reporter: I wanted to make sure I have both you and (Dr.) McMahon saying 'No' then. That this is misinformation, these letters to the editor saying it's only done when the baby's already dead, in case of fetal demise and you have to do an autopsy. But some of them are saying they're getting that information from NAF [National Abortion Federation]. Have you talked to Barbara Radford or anyone over there?
    Haskell: Well, I had heard that they were giving that information, somebody over there might be giving information like that out. The people that staff the NAF office are not medical people. And many of them when I gave my paper, many of them came in, I learned later, to watch my paper because many of them have never seen an abortion performed of any kind.
    Reporter: Did you also show a video when you did that?
    Haskell: Yeah. I taped a procedure a couple of years ago, a very brief video, that simply showed the technique. The old story about a picture's worth a thousand words.
    Reporter: As National Right to Life will tell you.
    Haskell: Afterwards they were just amazed. They just had no idea. And here they're rabid supporters of abortion. They work in the office there. And...some of them have never seen one performed...And I'll be quite frank: most of my abortions are elective in that 20-24 week range...In my particular case, probably 20% are for genetic reasons. And the other 80% are purely elective...
    • Martin Haskell, explaining how his late-term abortion method is used to effect safe abortions, to American Medical News (U.S. Congressional Record, 1996, p. H2919).
  • Kathy Ireland: Show me some evidence it's not a human being.
    Bill Maher: Let me reverse that. Tell me the evidence it is a human.
    Kathy Ireland: A moment after conception the genetic blueprint is complete. We have our blood type, our fingerprints, the sex is determined at the moment of conception. We know it is life. What kind of life is it? According to the laws of biogenesis, all life comes from preexisting life. Each species reproduces after its own kind. So human beings can only reproduce other human beings.
    • Kathy Ireland, supermodel, appearing on Bill Maher's television show Politically Incorrect, 2/28/2000.
  • McCain: Do you believe in the exemption, in the case of abortion, for rape, incest, and life of the mother?
    Bush: Yeah, I do.
    McCain: [But you] support the pro-life plank [in the Republican Party platform]?
    Bush: I do.
    McCain: So, in other words, your position is that you believe there's an exemption for rape, incest and the life of the mother, but you want the platform that you're supposed to be leading to have no exemption. Help me out there, will you?
    Bush: I will. The platform doesn't talk about what specifically should be in the constitutional amendment. The platform speaks about a constitutional amendment. It doesn't refer to how that constitutional amendment ought to be defined.
    McCain: If you read the platform, it has no exceptions.
    Bush: John, I think we need to keep the platform the way it is. This is a pro-life party.
    McCain: Then you are contradicting your platform.
    • U.S. Republican Party debate on the Larry King Live show (February 15, 2000).
  • Obama: I am pro-choice.
  • Reporter: In all situations including the late term thing?
  • Obama: I am pro-choice. I believe that women make responsible choices and they know better than anybody the tragedy of a difficult pregnancy and I don't think that it's the government's role to meddle in that choice.
    • Barack Obama, while campaigning for the U.S. Senate in 2003, explaining why he opposed restrictions even on late-term abortions (Source: Weekly Standard, 8/22/2012 - video clip at [52])
  • Glendon: Why did you and so many other constitutional lawyers stop criticizing the Court's abortion decisions after most of you had been highly critical of Roe v. Wade?
    Sacks: I suppose it was because we had been made to understand that the abortion issue was so important to the women in our lives, and it just did not seem that important to most of us.
    • Al Sacks, as Dean of Harvard Law School circa 1985, quoted by Harvard law professor Mary Ann Glendon, First Things, June/July 2003.
  • Q: What about parents conceiving and giving birth to a child specifically to kill him, take his organs, and transplant them into their ill older children?
    Singer: It's difficult to warm to parents who can take such a detached view, [but] they're not doing something really wrong in itself.
    Q: Is there anything wrong with a society in which children are bred for spare parts on a massive scale?
    Singer: No.
    Q: Would it be ethically OK to kill 1-year-olds with physical or mental disabilities?
    Singer: [This question] should be raised as soon as possible after birth.
    Q: What about Roe v. Wade?
    Singer: [Abortion] should have been left to legislatures...[Roe v. Wade was] a piece of judicial legislation...[it is] undemocratic to take major decisions like this out of the hands of people.
    • Peter Singer, Princeton ethicist, discussing his support of euthanasia, infanticide and abortion of the disabled, "Blue-state philosopher", World Magazine, (November 27, 2004).
  • Q: Would you kill a disabled baby?
    Singer: Yes, if that was in the best interests of the baby and of the family as a whole. Many people find this shocking, yet they support a woman's right to have an abortion. One point on which I agree with opponents of abortion is that, from the point of view of ethics rather than the law, there is no sharp distinction between the foetus and the newborn baby.
  • Susan Stamberg: Do you all at the National Women's Political Caucus (NWPC) make room for pro-life women?
    Woods: We do not support candidates who are not pro-choice.
    • Harriet Woods, chair of NWPC, in an interview broadcast on National Public Radio, July 10, 1993.

Anonymous

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  • [Doing abortions] can make you feel bad ... No matter how pro-choice you are, it makes you feel low.
  • [Abortion is] the dirty work of our field. The sad truth is that the people who moonlight at the clinics are grade-B doctors. They're not the cream of the crop.
  • Nobody wants to perform abortions after ten weeks because by then you see the features of the baby, hands, feet. It's really barbaric. Abortions are very draining, exhausting, and heartrending. There are a lot of tears. Sometimes patients turn on you. They say, "Let's get out of here," after the abortion, as if you're some dirty person. It's vicious. Then you get these teenyboppers in the office who laugh their way through it. It doesn't mean a thing to them. That bothers me...I do them because I take the attitude that women are going to terminate babies and deserve the same kind of treatment as women who carry babies...I've done a couple thousand, and it turned into a significant financial boon, but I also feel I've provided an important service. The only way I can do an abortion is to consider only the woman as my patient and block out the baby....
    • Anonymous abortionist, in M.D.: Doctors Talk About Themselves John Pekkanen, Delcorte Press: New York, 1988. Pgs 90-91.
  • It [the fetus] is a form of life...This has to be killing...The question then becomes, 'Is this kind of killing justifiable?' In my own mind, it is justifiable, but only with the informed consent of the mother.
    • Anonymous abortion provider, Democrat & Chronicle 7/5/92.
  • I have angry feelings at myself for feeling good about grasping the calvaria [head], for feeling good about doing a technically good procedure that destroys a fetus, kills a baby.
    • Anonymous abortion provider, "Abortion Providers Share Inner Conflicts" Diane M. Gianelli, American Medical News, July 12, 1993.
  • The later ones though, they're bad- you see little arms and feet...little, but you know what they are and you know what's really being done.
    • Anonymous abortion doctor, The Abortionist Mary Ellen Mark, GQ Magazine, Feb. 1994.
  • So when I went back to doing abortions and saw the fetus on the ultrasound, I recalled the early days of my pregnancies, when I found out I was pregnant and saw the baby on the ultrasound, and it really felt like this is a baby, a very real and potential being. Now, I do feel that this is a potential person and it does not have a life of its own outside of the mother, but I also am really aware that when you're ready to embrace a pregnancy, you can embrace it from the very moment you conceive or are aware that you are pregnant....You look at the ultrasounds and there's a fetus with a heartbeat and then after the procedure, there's the fetus, usually in pieces, in a dish. It was alive one moment and it's not the next... I don't believe, as some anti-abortion people would have you believe, that there's a "silent scream." But it's very clear to me that it's killing a potential life. And I found that hard at first.
    • Anonymous abortion provider, Birth Mother, Doctor, Abortionist Salon Magazine, Camille Peri.
  • It was disturbing for me to see recognizable body parts in the removed tissue, usually an arm or a leg. My intent is not to be gruesome, but there is a reality behind all the political jargon that I believe I allowed myself to ignore until this experience. I have images now that accompany phrases such as, “Potential for life” and I understand the emotions that drive pro-life forces...
    • Anonymous medical student working at Planned Parenthood, Abortion Action Guide Medical Students for Choice, National Abortion Federation, Sept. 1993.
  • You're going from dealing with people to dealing with what most people here at the Center consider a real hurdle, to do sterile room, because you have to deal with the actual abortion tissue. And for some people that's really hard. They can be abstractly in favor of abortion rights, but they sure don't want to see what an eighteen-week abortion looks like.
    • Anonymous clinic worker Abortion at Work: Ideology and Practice in a Feminist Clinic Wendy Simonds (Rutgers University Press: New Brunswick) 1996 p 69.
  • So by it looking like a baby, you're associating it with yourself because you used to be a baby, you used to be a fetus.
    • Anonymous clinic worker Abortion at Work: Ideology and Practice in a Feminist Clinic Wendy Simonds, p 83.
  • When I can identify the four chambers of the heart, I start feeling miserable. And when I put my hands on somebody to feel how big they are and I get kicked, I am barely able to talk at that moment.
    • Anonymous abortion doctor, Diane M. Gianelli, Abortion Providers Share Inner Conflicts American Medical News, July 12, 1993.
  • It's hard to be in a profession where you have a hard time answering the questions that other people ask you about what you do.
    • Anonymous abortion provider, Diane M. Gianelli, Abortion Providers Share Inner Conflicts American Medical News, July 12, 1993.

In fiction

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  • Metatron: I am to charge you with a holy crusade.
Bethany: For the record, I work in an abortion clinic.
Metatron: Noah was a drunk, look what he accomplished. And no one's even asking you to build an ark.

"Prevention of infection after induced abortion" (April 2011)

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Achilles, Sharon L.; Reeves, Matthew F. (April 2011). "Prevention of infection after induced abortion". Contraception. 83 (4): 295–309. doi:10.1016/j.contraception.2010.11.006. PMID 21397086.

  • One known complication of induced abortion is upper genital tract infection, which is relatively uncommon in the current era of safe, legal abortion. Currently, rates of upper genital tract infection in the setting of legal induced abortion in the United States are generally less than 1%. Randomized controlled trials support the use of prophylactic antibiotics for surgical abortion in the first trimester. For medical abortion, treatment-dose antibiotics may lower the risk of serious infection. However, the number-needed-to-treat is high. Consequently, the balance of risk and benefits warrants further investigation. Perioperative oral doxycycline given up to 12 h before a surgical abortion appears to effectively reduce infectious risk. Antibiotics that are continued after the procedure for extended durations meet the definition for a treatment regimen rather than a prophylactic regimen. Prophylactic efficacy of antibiotics begun after abortion has not been demonstrated in controlled trials. Thus, the current evidence supports pre-procedure but not post-procedure antibiotics for the purpose of prophylaxis. No controlled studies have examined the efficacy of antibiotic prophylaxis for induced surgical abortion beyond 15 weeks of gestation. The risk of infection is not altered when an intrauterine device is inserted immediately post-procedure. The presence of Chlamydia trachomatis, Neisseria gonorrhoeae or acute cervicitis carries a significant risk of upper genital tract infection; this risk is significantly reduced with antibiotic prophylaxis. Women with bacterial vaginosis (BV) also have an elevated risk of post-procedural infection as compared with women without BV; however, additional prophylactic antibiotics for women with known BV has not been shown to reduce their risk further than with use of typical pre-procedure antibiotic prophylaxis. Accordingly, evidence to support pre-procedure screening for BV is lacking. Neither povidone-iodine nor chlorhexidine have been shown to alter the risk of infection when used as cervicovaginal preparation. However, chlorhexidine appears to be more effective than povidone iodine at reducing bacteria within the vagina. The Society of Family Planning recommends the routine use of antibiotic prophylaxis, preferably with doxycycline, before surgical abortion. Use of treatment doses of antibiotics with medical abortion may decrease the rare risk of serious infection but universal requirement for such treatment has not been established.
  • These guidelines examine the risk of infection, identifiable risk factors, and prophylactic measures for infection with the most common methods of induced abortion: suction dilation and curettage (D&C), dilation and evacuation (D&E), and early medical abortion. The microbiology and epidemiology are similar for this group of procedures, as the vagina and cervix are the portals through which all are performed. However, the majority of data come from studies of suction D&C procedures since first trimester surgical abortions are the most common method of induced abortion.
    Induced abortion is one of the most common surgical procedures in the United States with over 1.3 million performed in 2003. In the United States, the annual abortion rate is 16–21 per 1000 women. Nearly half of all women have faced an unintended pregnancy and approximately one-third of women have had an induced abortion.
    The rate of upper genital tract infection after induced abortion, regardless of method, is generally very low, less than 1% in most clinical settings in the United States. Nevertheless, because abortion is so common, small improvements in post-procedural infection rates can have profound impacts on the absolute number of post-procedure infections. Although death associated with legally induced abortion is also rare (overall 0.7 per 100,000 procedures), approximately 30% of abortion-related deaths are attributable to infection.
    In procedures that access the endometrial cavity through the cervix, some bacterial contamination is inevitable. Clinically important infection, however, is relatively uncommon. The availability of legal abortion services in which safe aseptic surgical technique is utilized has dramatically decreased the number of septic abortions. Routine antibiotic prophylaxis has further reduced infectious risk.
  • The reported infection rate following first trimester surgical abortion ranges widely due to various clinical practices and degrees of ascertainment and diagnostic biases, often resulting in overdiagnosis of infection (Table 1). When objective measures are used, such as temperature ≥38°C, the infection rate ranges from 0.01% to 2.44%. However, when the diagnosis is based only on physician concern, the rate increases and widens considerably. Post-abortal infection rates are uniformly higher in Scandinavia than North America for a combination of reasons that likely stem from issues of definition, clinical triggers for antibiotic treatment, and larger numbers of providers, each of whom perform fewer procedures than US providers. In randomized trials of antibiotic prophylaxis, the infection rates in placebo groups reveal this variability (Table 2).
  • The overall risk of infection is low after D&E. In the United States, prior to the routine use of prophylactic antibiotics, the rate of postabortal fever following D&E was 0.8% (95% CI 0.6–1.0%) in one large case series and 1.6% in a teaching hospital (95% CI 1.0–2.4%).
    Infection rates for labor induction are more difficult to document because there is a higher incidence of medication-induced pyrexia, a common side-effect with prostaglandin use. When examining the available literature for infection rates rather than simple pyrexia, a post-induction infection rate of 1–3% is reported.
    Infection rates for labor induction are more difficult to document because there is a higher incidence of medication-induced pyrexia, a common side-effect with prostaglandin use. When examining the available literature for infection rates rather than simple pyrexia, a post-induction infection rate of 1–3% is reported. This infection rate, though still relatively low, is higher than infection rates for D&E. Prophylactic antibiotics are not typically given for labor induction abortions in the United States and no studies could be identified on this topic. In general, infection prevention and treatment during labor induction abortion is most analogous to infection prevention and treatment in labor.
  • Most D&E procedures are performed after cervical preparation with prostaglandin analogues (misoprostol or gemeprost) or osmotic dilators, most commonly laminaria (a natural osmotic dilator made from the stalks of Laminaria species, a common type of seaweed) or Dilapan (a synthetic osmotic dilator). None of the three types of osmotic dilators has been shown to increase the risk of infection when left in place for up to 24 h before a D&E. In randomized comparisons of laminaria before first-trimester abortion, the use of laminaria decreased the risk of infection compared to rigid dilation. The risk of infection associated with osmotic dilators is not well studied with use for more than 24 h or with use of more than one set of osmotic dilators prior to D&E. No studies have been performed that address whether antibiotic administration at the time of dilator insertion would confer additional benefit. With use of misoprostol for cervical preparation prior to D&E, the risk of infection appears to be low. Two studies report no or few complications with misoprostol for cervical preparation but do not specifically report the number of observed infections.
  • Despite multiple studies showing a benefit, the issue of antibiotic prophylaxis for surgical abortion was controversial until a meta-analysis was published by Sawaya et al. in 1996. The meta-analysis showed that a variety of antibiotics and regimens are effective for women of all risk strata with an overall RR of developing upper genital tract infection for women receiving antibiotics vs. placebo of 0.58 (95% CI 0.47–0.71). Furthermore, based on the studies included in the meta-analysis, the protective effect of antibiotics was easily demonstrable regardless of what subgroup was analyzed: women with a history of PID (RR 0.56, 95% CI 0.37–0.84), women with Chlamydia at the time of the procedure (RR 0.38, 95% CI 0.15–0.92), low risk women (RR 0.65, 95% CI 0.47–0.90), and women without Chlamydia at the time of the procedure (RR 0.63, 95% CI 0.42–0.97). Therefore, the authors concluded that no further placebo-controlled trials should ethically be performed given that there are a variety of regimens known to be effective for prophylaxis.
  • Since suction curettage for early pregnancy failure, including incomplete and missed abortion, is the same procedure as that for induced abortion, the infection risk attributable to uterine aspiration should be the same and the benefits similar. The benefits may actually be greater since pre-existing infection may be the cause of, or result from early pregnancy failure. However, few studies have been conducted in this population, and a meta-analysis found insufficient data to make conclusions about the use of antibiotic prophylaxis with suction curettage for treatment of incomplete or missed abortion. No evidence to date supports the routine use of prophylactic antibiotics for either expectant or medical management of early pregnancy failure.
    In the absence of any studies establishing the inflection point where infection risk is lower than the risk of using prophylactic antibiotics, the Society of Family Planning recommends that all women undergoing surgical abortion procedures receive antibiotic prophylaxis. The use of prophylactic antibiotics prior to surgical management of early pregnancy failure is reasonable but not proven to be beneficial.
  • Randomized trials of antibiotic prophylaxis for medical abortion have not been conducted. A retrospective cohort study from the Planned Parenthood Federation of America found a significant association between the risk of serious infection and two interventions: (1) switching from vaginal to buccal administration of misoprostol and (2) giving doxycycline for one week starting on the day of mifepristone administration. In this study, serious infection was defined by the receipt of parenteral antibiotics in an emergency department or inpatient unit. Infections treated solely with oral agents were omitted. These authors showed that the baseline risk of serious infection with medical abortion of 0.093% was reduced to 0.025% when the misoprostol route was changed from vaginal to buccal, and was further reduced to 0.006% when routine provision of antibiotic prophylaxis was initiated. Hence, the provision of oral doxycycline 100 mg twice daily for 1 week at the time of medical abortion gave a RR reduction of 76% and an attributable risk reduction (ARR) of 0.019%. With this low ARR, the number needed to treat (NNT) with a week of doxycycline is more than 5000 women to prevent one serious infection requiring intravenous antibiotics. The study did not evaluate compliance. Moreover, because the study used historical controls, the addition of a treatment course of antibiotics cannot be separated from the effect of the switch in the route of misoprostol administration. Adverse effects of giving this large number of women a treatment course of oral antibiotics for the purpose of prevention in the absence of a diagnosed infection also need to be considered. Although individual practitioners may decide to use antibiotics with provision of medical abortion, the Society of Family Planning does not believe universal antibiotics is required for all women having a medical abortion.
  • Both nitroimidazoles (metronidazole and tinidazole) and tetracyclines are effective. Although multiple regimens for several different antibiotics have been compared to placebo, few studies have compared different antibiotics directly or different regimens of the same antibiotic. Hence, the optimal prophylactic regimen remains unclear.
  • In general, the use of systemic antibiotic prophylaxis is based on the premise that the presence of antibiotics in host tissues at the time of initial exposure to bacteria can augment natural host defenses by reducing the titers of endogenous and clinically introduced bacteria before they multiply and become pathogenic. Studies of prophylaxis for surgical site infections that involve skin incisions suggest that only a narrow window exists for prophylaxis; giving the prophylaxis too early does not benefit the patient and only increases risks of adverse effects, whereas delaying the prophylaxis even 3 h after the surgical exposure can result in ineffective prophylaxis. Well-conducted animal studies also show that antibiotics given more than 3 h after direct bacterial inoculation of surgical incisions have virtually no effect on reducing the incidence of infection. In comparison, when animals were given prophylactic antibiotics either 1-hour prior or at the time of incision, the animals had the same rate of infection as control animals that were either not inoculated with bacteria or were inoculated with killed bacteria. Furthermore, when antibiotics were administered between 1 and 3 h after surgical incision and bacterial inoculation, they had intermediate levels of infection.
    Several randomized controlled trials that evaluate timing of antibiotic prophylaxis at the time of Cesarean section have demonstrated a significant reduction in post-surgical infections, including endometritis, when the prophylactic antibiotics are administered prior to skin incision as compared to after cord clamping. A meta-analysis that further evaluated the timing of prophylactic antibiotics at the time of cesarean section specifically found that preoperative administration as compared to administration following cord clamping reduced post-partum endometritis by more than 50% (RR 0.47; 95% CI, 0.26–0.85).
  • No studies have directly compared treatment length when antibiotics are started pre-operatively. A placebo-controlled study of doxycycline found that 100 mg preoperative followed by 200 mg immediately postoperatively lowered the risk of infection by 87%. This study, with excellent follow-up, suggests that antibiotics do not need to be extended beyond the immediate postoperative period.
    Data from major surgery provide useful insight into the timing and duration of antibiotic prophylaxis. In general, major abdominal and vaginal surgeries have higher risk of post-procedure infection than induced abortion procedures. For instance, the rate of endometritis following cesarean section is 1–5% as compared to <1% following surgically induced abortion. For major abdominal and gynecologic surgery, multiple studies have demonstrated that post-procedural continuation of antibiotics has no effect on the risk of infection. For colorectal surgery, a single preoperative dose of antibiotics is recommended based on 182 randomized trials. No benefit of postoperative antibiotics could be demonstrated in 24 randomized trials comparing single pre-operative to multiple pre- and postoperative doses. Similarly, a Cochrane review of antibiotic prophylaxis at cesarean delivery found that multiple-dose regimens increase significantly the risk of urinary tract infection but do not reduce the incidence of postoperative fever, endometritis, or wound infection compared to a single perioperative dose. Since surgically induced abortions and cesarean sections are similarly classified as clean contaminated procedures, it is likely that presurgical prophylaxis alone is sufficient for surgically induced abortion as it is for cesarean section.
  • Currently, many institutions providing abortions begin routine antibiotics only post-procedurally for the purpose of prophylaxis. Because single-dose post-abortion prophylaxis has never been examined in placebo-controlled clinical trials, these institutions have largely been giving a full treatment course of doxycycline rather than a single prophylactic dose. Two studies suggest that a maximum of 3 days of doxycycline is needed with similar outcomes for 3- and 7-day antibiotic courses.
  • Any considerations of disadvantages of antibiotic prophylaxis for abortion stem from the fact that the risk of infection after induced abortion is relatively low. For every 1000 induced abortions, it would be uncommon to have more than 20 infections (2%). Therefore, at least 980 women would not benefit from antibiotic prophylaxis yet would incur all of the risks of side effects and adverse reactions. Even with effective strategies, like prophylactic antibiotics, the NNT becomes very large as the risk that the adverse event (postabortal infection) becomes small (Table 5). In most settings in the United States, with a low postabortal infection rate, the number of women who must be treated to prevent one infection is over 100.
  • Immediate insertion of an IUD after surgical abortion is a safe way to provide effective contraception. Despite concerns about leaving a foreign body within the uterine cavity after abortion, there is no evidence that post-abortion IUD insertion increases the risk of infection. In a study of prophylactic doxycycline before abortion by Darj et al., one third of subjects elected to receive an IUD after their abortion; doxycycline reduced the risk of infection with concurrent IUD placement by approximately 50%. Furthermore, there was no significant increase in the risk of post-procedure infection in the patients who elected IUD placement. Nulliparous adolescents seeking abortion are among those with the highest risk for infection after abortion. In a 1979 report from Israel, Goldman et al., randomized 162 nulliparous adolescents to one of three plastic or copper IUDs and found only three cases of “mild pelvic inflammation” (1.8%).

"Report of the APA Task Force on Mental Health and Abortion" (13 August 2008)

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"Report of the APA Task Force on Mental Health and Abortion" (PDF). Washington, DC: American Psychological Association. 13 August 2008. Archived (PDF) from the original on 15 June 2010.

  • ”Does abortion cause harm to women’s mental health? Although this is the question that is posed most often in public debates, this question is not scientifically testable as stated. An adequate answer to this question requires a randomized experimental design that would rigorously define the experimental, control, and outcome variables and specify any limitations in generalizing the results. Unlike many other areas if research, however, the study of abortion is not open to the methodologies or randomized clinical trials. For obvious reasons, it is neither desirable nor ethical to randomly assign women who have unwanted pregnancies to an abortion versus delivery versus adoption group. Thus, although people have frequently used the existing literature to make causal statements, inferences of cause from this literature are inappropriate.
    • pp.7-8
  • Are negative feelings that may accompany abortion of an unwanted pregnancy more severe than alternative solutions, such as giving up a child for adoption or raising a child a woman does not want or feels emotionally, physically, or financially unable to care for? Only research designs that include a comparison group that is clearly defined and otherwise equivalent to women who have an elective abortion are appropriate for answering this primary question. Otherwise, any previously existing group differences associated with the outcome variable may bias conclusions. As will be discussed below, few studies examining the mental health implications of abortion include appropriate comparison groups for answering this question.
    • p.8
  • What predicts individual variation in women’s psychological experiences following abortion? This last question addresses the substantial individual variation observed in women’s psychological experiences following abortion. Rather than focusing on how the “typical” woman responds following a “typical” abortion, this question asks why some women experience abortion more or less favorably than do others. This question is important to address because the proportion of women who have negative mental health issues after having an abortion will vary depending on the characteristics of each woman as well as the characteristics of her circumstances-there is no one answer that applies to all women. Because this question focuses on within-group variability rather than on differences between the abortion group and another group, research designed to answer this question does not require a comparison group of women who do not have, abortions, or a nationally representative sample. Research designed to answer this question, however, should at minimum be prospective and longitudinal an use reliable and valid measures of mental health.
    • pp.8-9
  • In summary, women’s psychological experience of abortion is not uniform, but rather varies as a function of characteristics and events that led up to the pregnancy; the circumstances of women’s lives and relationships at the time that a decision to terminate the pregnancy was made; the reasons for, type, and timing of the abortion; events and conditions that occur in women’s lives subsequent to an abortion; and the larger social-political context in which abortion takes place. This variability is an important factor in understanding women’s psychological experiences following abortion.
    • p.10
  • One frequently used framework for understanding women’s psychological experience of abortion is derived from psychological theories of stress and coping. This perspective views abortion as a potentially stressful life event within the range of other normal life stressors. Because abortion occurs in the context of a second stressful life event-a pregnancy that is unwanted, unintended, or associated with problems in some way-a stress and coping perspective emphasizes that it can be difficult to separate out psychological experiences associated with abortion from psychological experiences associated with other aspects f the unintended pregnancy. Abortion can be a way of resolving stress associated with an unwanted pregnancy, and, hence, can lead to relief. However, abortion can also engender additional stress of its own.
    A hallmark principle of psychological theories of stress and coping is variability. From this perspective, although unwanted pregnancy and abortion can pose challenges and difficulties for an individual woman, these events will not inevitably or necessarily lead to negative psychological experiences for women. Stress emerges from an interaction between the person and the environment in situations that the person appraises as taxing or exceeding his or her resources to cope. A woman’s psychological experience of abortion will be mediated by her appraisals of the pregnancy and abortion and their significance for her life, her perceived ability to cope with those events, and the ways in which she copes with emotions subsequent to the abortion. These are shaped by conditions of the woman’s environment (e.g., age, material resources, presence or absence of a supportive partner) as well as by characteristics of the woman herself (e.g., her personality, attitudes, and values). Thus, for example, a woman who regards abortion as conflicting with her own and her family’s deeply held religious, spiritual, or cultural beliefs but who nonetheless decides to terminate an unplanned or unwanted pregnancy may appraise that experience as more stressful than would a woman who does not regard an abortion as in conflict with her own values or those of others in her social network.
    • pp.10-11
  • [A]n alternative perspective views abortion as a uniquely traumatic experience. This perspective argues that abortion is traumatic because it involves a human death experience, specifically, the intentional destruction of one’s unborn child and the witnessing of a violent death, as well as a violation of parental instinct and responsibility, the severing of maternal attachments to the unborn child, and unacknowledged grief. The view of abortion as inherently traumatic is illustrated by the statement that “once a young woman is pregnant….it is a choice between having a baby or having a traumatic experience”. The belief that women who terminate a pregnancy typically will feel grief, guilt, remore, loss, and depression also is evident in early studies of the psychological immplications of abortion, many of which were influenced by psychoanalytic theory and based on clinical case studies of patients presenting to psychiatrists for psychological problems after an abortion.
    • p.11
  • Speckhard and Rue posited that the traumatic experience of abortion can lead to serious mental health problems for which they coined the term “postabortion syndrome” (PAS). They conceptualized PAS as a specific form of posttraumatic stress disorder (PTSD) comparable to the symptoms experienced by Vietnam veterans, including symptoms of trauma, such as flashbacks and denial, and symptoms such as depression, grief, anger, shame, survivor guilt, and substance abuse. Speckhard (1985, 1987) developed the rationale for PASS in her doctoral dissertation in which she interviewed 30 women specifically recruited because they deemed a prior abortion experience (occurring from 1 to 25 years previously) to have been “highly stressful.” Forty-six percent of the women in her sample had second-trimester abortions, and 4% had third-trimester abortions; some had abortions when it was illegal. As noted above, this self-selected sample is not typical of U.S. women who obtain abortions. PAS is not recognized as a diagnosis in the “Diagnostic and Statistical Manual of the American Psychiatric Association (American Psychiatric Association, 2002).
    • p.11
  • Whether or not a particular behavior or attribute is stigmatized often varies across cultures and time. Actions that once were viewed benignly can become stigmatized (e.g., smoking), and others that once were highly stigmatized (e.g., sex out of wedlock, divorce, cohabitation) can become less so. As society’s views of a behavior change, so too will the appraisals and responses of those who engage in that behavior. Hence, the socio-cultural context can shape a woman’s appraisal of abortion not only at the time that she undergoes the procedure, but also long after the abortion. Social messages that encourage women to think about (reappraise) a prior abortion in more negative ways (as a sin, as killing a child) may increase women’s feelings of guilt, internalized stigma, and emotional distress about an abortion they had long ago. In contrast, social messages and support groups that encourage women to cognitively reappraise an abortion in a more positive or benign way may lead to improved emotional responses.
    • p.12
  • Poverty is a systemic risk factor for unplanned pregnancy and for abortion. Women at particularly high risk for unintentional pregnancy and women who obtain abortions tend to be young, unmarried, poor, and women of color. In 2000, women with resources below the federal poverty level represented 57% of all abortions (Jones, Darroch, & Henshaw, 2002b). Exposure to sexual or physical abuse during childhood and exposure to intimate partner violence including rape also are associated with greater likelihood for both unintended pregnancy and abortion.
    • p.13
  • Many scholars have noted that research on the mental health implications of abortion is plagued by numerous methodological problems. These problems continued to be reflected in most of the studies reviewed by the current task force and limited conclusions that could be drawn from this literature. In the following discussion, we highlight the problems that we encountered most often in our review of the post-1989 literature. We do not recapitulate all of the details presented in previous methodological discussions. The primary issues we address are those of comparison and contrast groups, co-occurrence of risk factors, sampling, measurement of reproductive history and underreporting, attrition, statistical treatment of data, outcome measurement, and clinical relevance. These issues are not independent of each other. Indeed, the complex interactions among these factors can make it difficult to sort out their separate and combined effects.
    • p.15
  • In order for empirical research to address the relative risk of elective abortion compared to alternative courses of action that a pregnant woman facing an unwanted pregnancy might take, clearly defined and otherwise equivalent comparison groups are essential. Otherwise, any previously existing group differences associated with the outcome variable may badly bias conclusions. One appropriate comparison group would be women who are denied or unable to obtain an abortion and who, hence, must carry to term an unwanted pregnancy. Other appropriate comparison groups would be women who deliver an unwanted pregnancy and either give the child up for adoption or raise it. By at least partly controlling for the “wanted-ness” of the pregnancy, such comparisons provide assurance that the women being compared face a similar situation. Unfortunately, very few studies used appropriate comparison groups.
    • p.15
  • Unfortunately, very few studies encountered in our review of the literature adequately assessed and controlled for co-occurring risks. As discussed above, there are naturally occurring interrelations among many of the phenomena associated with elective abortion that make it difficult to tease apart the causal chains that might be operating. Elective abortion commonly co-occurs with unwanted or unintended pregnancy, and unwanted/unintended pregnancy is often associated with adverse circumstances and characteristics that may be associated with mental health problems. Because few studies adequately controlled for these co-occurring risks, it is almost impossible from the available literature to distinguish outcomes that flow from abortion per se from outcomes that might appear to be associated with abortion, but in actuality have their origins in the unwanted/unintended pregnancy (or some other co-occurring risk), which is more highly represented in the abortion group than in the comparison group. It was particularly difficult to detect these co-occurring conditions and their consequences from secondary data analyses of data sets collected for other purposes because potential confounds that were not of interest in the initial data collection were unlikely to have been adequately assessed.
    • p.16
  • Abortion, like other stigmatized conditions, is typically underreported. It has long been recognized that individuals are unlikely to frankly answer questions that have the potential to be embarrassing, overly self-disclosing, or in other ways reflect negatively on them. One of the earliest applications of a statistical model designed for reducing bias in obtaining answers to sensitive questions—the so-called randomized response methodology—was for estimating the mean number of abortions in an urban population of women. The percentage of women reporting an abortion on surveys is consistently lower than the number expected based on estimates made from national provider data, sometimes markedly so. Absent the use of techniques such as randomized response methodology or the selection of highly disclosing samples, one is likely to obtain biased estimates of prevalence rates. Generally, there are two types of underreporting: failure to acknowledge having had any abortions and having had multiple abortions but reporting only some of them.
    • p.17
  • Finally, assessing the clinical significance of abortion, as with any other medical procedure, requires asking “what is the benefit?” as well as “what is the harm?” of the procedure. Many of the abortion studies reviewed focused only on negative outcomes. Focusing solely on adverse effects can create a distorted picture of the information needed to provide complete and accurate informed consent. It is akin to focusing on the risks of chemotherapy without addressing its potential benefits for curing cancer. For example, in separate reports based on the same sample, one research team reported a negative association between abortion and mental health and a positive association between abortion and other life outcomes (e.g., education, employment). The authors concluded that there is a “need for further research into the risks and benefits associated with abortion as a means of addressing the issues raised by unwanted or mistimed pregnancies”.
    • p.19
  • As applied to the case of abortion, one example of the interventionist fallacy would be the belief that if abortion and depression are related, then reducing access to abortion would reduce the prevalence of depression. A change in the availability of elective abortion, however, would have many consequences. It would mean that women who want to terminate an unwanted pregnancy would now be forced to deliver. As a consequence, the characteristics of the population of women who delivered children would change. Characteristics previously prevalent among women who had an abortion (e.g., greater poverty, exposure to violence) would now be prevalent among the delivery group. The portrait of the mental health of mothers might reasonably be expected to be worse. This potential change in the profile of women giving birth does not include any new mental health problems that might develop from stresses associated with raising a child a woman feels unable to care for, or may not want, or from relinquishing a child for adoption. Thus, reducing access to abortion would be likely to result in poorer mental health among women who deliver. Hence, rather than reducing the prevalence of depression among women, this intervention could potentially increase it.
    • p.20
  • Based on our comprehensive review and evaluation of the empirical literature published in peer-reviewed journals since 1989, this Task Force on Mental Health and Abortion concludes that the most methodologically sound research indicates that among women who have a single, legal, first-trimester abortion of an unplanned pregnancy for nontherapeutic reasons, the relative risks of mental health problems are no greater than the risks among women who deliver an unplanned pregnancy. This conclusion is generally consistent with that reached by the first APA task force (Adler et al., 1990).
    This report has highlighted the methodological failings that are pervasive in the literature on abortion and mental health. This focus on methodological limitations raises the question of whether empirical science is capable of informing understanding of the mental health implications of and public policy related to abortion. Some policy questions cannot be definitively answered through empirical research because they are not pragmatically or ethically possible.
    • p.92
  • [T]here is unlikely to be a single definitive research study that will determine the mental health implications of abortion “once and for all” as there is no “all,” given the diversity and complexity of women and their circumstances. Important agendas for future research are to further understand and alleviate the conditions that lead to unwanted pregnancy and abortion and to understand the conditions that shape how women respond to these life events, with the ultimate goal of improving women’s lives and well-being.
    • p.93

"Reasons Why Women Have Induced Abortions: Evidence from 27 Countries" (1998)

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Bankole; et al. (1998). "Reasons Why Women Have Induced Abortions: Evidence from 27 Countries". International Family Planning Perspectives. 24 (3): 117–27, 152. doi:10.2307/3038208. JSTOR 3038208. Archived from the original on 17 January 2006.

  • Context: The immediate explanation that women often give for seeking induced abortion is that the pregnancy was unplanned or unwanted. However, the myriad social, economic and health circumstances that underlie such explanations have not yet been fully explored.
  • Results: Worldwide, the most commonly reported reason women cite for having an abortion is to postpone or stop childbearing. The second most common reason—socioeconomic concerns—includes disruption of education or employment; lack of support from the father; desire to provide schooling for existing children; and poverty, unemployment or inability to afford additional children. In addition, relationship problems with a husband or partner and a woman's perception that she is too young constitute other important categories of reasons. Women's characteristics are associated with their reasons for having an abortion: With few exceptions, older women and married women are the most likely to identify limiting childbearing as their main reason for abortion.
    Conclusions: Reasons women give for why they seek abortion are often far more complex than simply not intending to become pregnant; the decision to have an abortion is usually motivated by more than one factor. While improved contraceptive use can help reduce unintended pregnancy and abortion, some abortions will remain difficult to prevent, because of limits to women's ability to determine and control all circumstances of their lives.
  • Although abortion occurs in every society, and a substantial proportion of pregnancies are resolved by abortion worldwide, there is little empirical research on why women obtain abortions. This lack of information is part of an overall scarcity of data on abortion. Legal, moral and ethical issues surrounding abortion make research on all aspects of abortion difficult to undertake, and also affect the quality of the information obtained. Collecting good information on reasons for abortion may be especially difficult, because it requires asking women to articulate the often complex and sensitive process that led to the decision.
  • In countries where safe abortion services are scarce, only affluent women who can afford the fees of a private doctor will obtain an abortion, along with poorer women who are so determined they are willing to risk their health and life in seeking out unsafe clandestine services.
  • Evidence abounds that a high proportion of women become pregnant unintentionally, in both developed and developing countries. In the United States and in some Eastern European countries for which data are available, about one-half to three-fifths of all pregnancies are unintended, and a large proportion of these are resolved through abortion. And in many developing countries, the proportion of recent births that are unintended exceeds 40%; even in regions where most couples still want large families, 10-20% of births are unplanned.
  • Official government statistics on abortion patients. These studies are relatively rare, and are available only in countries where abortion is legal under broad conditions. The data quality is affected by the completeness of coverage and by the type of data collection approach used. For example, if women are required to report their reasons for having the procedure on an official form or if they must answer questions posed by medical personnel, they may be less forthcoming than if they are surveyed less formally.
  • Contraceptive use does not necessarily provide complete protection against pregnancy; each method can fail, even when it is used perfectly. U.S. data from the late 1980s, for example, show that the estimated first-year failure rate for the pill is 8%, while that for the condom is 15%.11 (Failure rates for less effective methods, such as periodic abstinence, are even higher—e.g., 26%.) The DHS data indicate that in 16 of the 18 developing countries for which data are available, more than 10% of contraceptive-use discontinuations in the five preceding years were precipitated by a method failure, and this proportion surpassed 20% in seven of these countries.
  • Timing births and controlling family size. The desire to postpone a birth or to stop childbearing is a very common reason given by women seeking abortion. In almost half of the 23 studies (in 20 countries) with this information, about 50% or more of women gave the birth-timing and family-size control cluster of reasons as their most important reason.
  • Poverty and economic reasons. Economic reasons or women saying that they could not afford to properly care for a child come second overall in importance. The proportion who gave this reason was more than 20% in six of the 19 studies with relevant information (Table 2). The importance of women's economic situation as the main reason for their seeking an abortion was evident in developed as well as developing countries. (U.S. women, for example, tended to explain this reason with a more specific one, such as a baby would disrupt employment or schooling, that the woman or her partner was unemployed and that she lacked support from her partner.13) When women were allowed more than one response (Table 3), 30-68% cited poverty as contributing to their decision in four of the seven countries with available data.
  • Relationship problems. Relationship problems, including the partner's objection to carrying the pregnancy to term, are moderately important in explaining why women have abortions. The proportion of women citing such problems as their overriding reason for the abortion reached 25-42% in four studies (Chile, Honduras, Mexico and Nigeria). It was the main reason for fewer than 10% of respondents in nine studies, and for 10-20% in seven studies.
  • Young and unmarried. Being too young or fearing that parents or others would object to the pregnancy is a fairly common reason for having an abortion. In 10 countries, more than 10% of women gave this as their main reason, and 20-37% did so in five of them (three in Latin America and two in Sub-Saharan Africa).
    This reason was an especially common primary reason in Honduras and Mexico, where it was cited by about one-third of women. It also was a prominent contributing factor in Australia: One-quarter of Australian women mentioned that being "too young" was a factor in their decision to have an abortion and 15% cited not wanting their parents or others to know about the pregnancy. In the Netherlands, 13% mentioned as a contributing reason for their decision that they were too young, and in the United States, at least 30% cited either being too young or fearing their parents' objections as contributing reasons for their abortion.
  • Risk to maternal health. This reason was somewhat important overall, having been cited as the main reason by 5-10% in seven countries and by 20-38% in three (Kenya, Bangladesh and India). This factor is apparently less important in Latin America and in the developed countries included here.
    The category of maternal health risk may include risks to either physical or mental health; another area of uncertainty is whether the potential health problem has been identified by a doctor or by only the woman herself. Because a threat to maternal health is often an exception to the law in countries where abortion is illegal, many women may cite this reason because it is socially acceptable and provides a legal or moral justification for abortion.
  • Fetal defect. Women rarely report that fetal defects or potential problems for the baby motivated their decision to have an abortion. This probably stems from one or more factors, including the low actual incidence of birth defects, the fact that most women obtain abortions before such defects could be known, and fetal defects are generally not detected in developing countries (where advanced testing and modern medical care are not widely available). Furthermore, in many surveys, this reason may not have had its own separate category, but may have been grouped into an "other" catch-all category. Finally, the reason may have been omitted altogether in some studies.
  • "Other" reasons. Almost all studies have a residual category of "other reasons." However, fewer than 10% of women cited them as primary in most studies, although the proportion doing so reached 14-16% in the Czech and Sri Lankan studies. In most studies conducted with women who have abortions, the factors that fell into the "other" category were usually unspecified, especially since the studies mostly gave little attention to why women seek abortion in general.
  • How closely are a woman's reasons for abortion related to her socioeconomic and demographic characteristics? We address this question by examining how the reasons vary by three characteristics—the woman's age, marital status and level of education—in 10 countries. (For two of these countries, Australia and the Philippines, the data are based on the number of responses to an item that allowed women to specify multiple reasons.)
    *Age. A woman's age is only moderately associated with why she seeks an abortion (Table 4). In four of the five countries for which data are available on postponing childbirth as a reason for abortion, women younger than age 25 were more likely than those aged 25 and older to say the reason for their abortion was to postpone childbearing. The exception was Zambia, where only 29% of younger women said they sought their abortion for timing purposes, compared with 71% of older women.
  • Marital status. A desire to stop childbearing and socioeconomic circumstances appear to be the most prominent reasons why married women have abortions,*† while socioeconomic factors and young age or parental objections are the two most important ones among unmarried women. Marital status makes no difference in the likelihood of citing a desire to postpone childbearing as the main reason for having an abortion. However, in five of the seven countries with available data, unmarried women were at least as likely as married women to cite socioeconomic reasons as most important; as expected, the proportion citing being underage and parents' objections as their main reason was consistently higher among unmarried women than married women.
    Unmarried women were more likely than married women to say their abortion was mainly motivated by relationship problems (for example, 22% vs. 5% in the Czech Republic, and 30% vs. 4% in the Philippines). In all seven countries, but especially in Colombia, the Czech Republic and the United States, reasons of maternal or fetal health tended to be more important among married than unmarried women.
    •Education. No clear association emerged between women's educational attainment and their main reasons for seeking an abortion. Studies conducted in five countries show that the profile of reasons why women have abortion is very similar among both more and less educated women.
  • The universality of the phenomenon of unintended pregnancy illustrates that, worldwide, women and couples have great difficulty in successfully planning births. In the majority of the 49 developing countries for which we examined fertility survey data, a high proportion of women would like to postpone having a child or to stop altogether, but are not using an effective contraceptive method. Even where effective use is quite high, women continue to experience unplanned pregnancy, because of either contraceptive failure or unanticipated changes in their life circumstances, or sometimes as a result of their own ambivalence.
    The analysis of the reasons women give for why they had an abortion shows that the most commonly reported ones are postponing childbearing to a more suitable time or stopping altogether to focus energies and resources on existing children. The fact that these two reasons were less important in Latin America and the United States than in Asia and some of the other developed countries may partly be explained by the high prevalence of sterilization at relatively young ages in these first two regions, which reduces the need for abortion to limit family size. The desire to delay or stop childbearing probably reflects a number of underlying, more specific reasons for not wanting to have a child at that time.
  • The second most commonly reported reason consists of socioeconomic factors, such as being unable to afford a child—either in terms of the direct costs of raising a child or the opportunity costs to a woman who, to care for a child, must interrupt her education or work. This set of reasons is particularly prominent in Sub-Saharan Africa, where the majority of women who seek abortion tend to be young and unmarried, and where pregnancies that end in abortion are likely to occur in unstable relationships.*‡
    In the Latin American countries for which we have information, relationship problems are among the most important reasons why women seek abortion; in these societies, where many women are in consensual unions, the issue of being able to support the child should the relationship end is probably a major concern. Being unable to afford a child is also an important reason why women obtain an abortion in the United States.
    While at least a small proportion of women in most countries mentioned the risk to their health as their primary motivation for the abortion, this reason was relatively more prevalent in Sub-Saharan Africa and South Asia than in other regions. This finding is not surprising, since we expect abortions for maternal health reasons to be related to large family size and close birth spacing, factors that are much more common in these two regions than in the others.
  • The patterns in the relationships between women's characteristics and their reasons for obtaining abortions suggest that these reasons are not random, but relate closely to the woman's current situation and aspirations. For example, older women who have had as many children as they want typically report that their abortion was motivated by a desire to prevent adding to an already large family. In many cases, these women also mention other related reasons, such as being unable to afford another child. On the other hand, unmarried women are more likely than married women to say they chose an abortion because they are too young to have a child, because a baby would have a negative impact on their education or work, or because they fear the reactions of parents or others if they carry to term.
    The scarcity of research on why women have abortions points to the need for more work in this area. A comparison of results from studies that obtained only the most important reason for abortion and from others that allowed women to give multiple responses shows that the decision is likely to be motivated by more than one factor.
  • Evidence from one U.S. study shows that the reasons why women do not want a child at the moment are remarkably similar to the reasons women give for obtaining an abortion.21 Studies of all women who have an unplanned pregnancy that examine the reasons why it was unplanned and why women opt for either of the available alternatives—birth or abortion—would greatly enhance our understanding of the personal and structural factors that shape women's decisions about whether and when to have a child. Such cohort studies following women who choose different paths are rarely undertaken and should be encouraged.
    Despite the scarcity of studies on reasons why women obtain abortions and the limitations of the existing research, the evidence presented here points to the usefulness of such exploratory research. More investigations and improved research approaches are crucial to better understand the complex situations and processes that lead to unintended pregnancies and to women's decision to end them through abortion. Such an understanding would increase the chance that policymakers and providers respond humanely and effectively to the varied situations and needs that lead to the decision to resolve unwanted pregnancy through abortion.
  • The research reviewed here supports the conclusion that improved contraceptive practice is an important means of reducing abortion. However, it also suggests that some unplanned pregnancies and abortions are difficult to prevent, because of limits to individuals' ability to determine and control the circumstances of their lives.

"Doctors or mid-level providers for abortion" (27 July 2015)

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Barnard, S; Kim, C; Park, MH; Ngo, TD (27 July 2015). "Doctors or mid-level providers for abortion" (PDF). The Cochrane Database of Systematic Reviews (7): CD011242. doi:10.1002/14651858.CD011242.pub2. PMID 26214844.

  • The World Health Organization recommends that abortion can be provided at the lowest level of the healthcare system. Training mid-level providers, such as midwives, nurses and other non-physician providers, to conduct first trimester aspiration abortions and manage medical abortions has been proposed as a way to increase women’s access to safe abortion procedures.
    • p.1
  • There was no statistically significant difference in the risk of failure for medical abortions performed by mid-level providers compare with doctors. Observational data indicate that there may be a higher risk of abortion failure for surgical abortion procedures administered by mid-level providers, but the number of studies is small and more robust data from controlled trials are needed. There were no statistically significant differences in the risk of complications for first trimester surgical abortions performed by mid-level providers compared with doctors.
    • p.2
  • Unsafe abortion remains a major public health concern in developing countries. Despite the existence of safe and effective surgical methods (Kulier 2009), and medical methods to induce abortion (Kulier 2011), an estimated 22 million unsafe abortions are performed each year, resulting in the deaths of 47,000 women and disabilities for an additional five million women (Sedgh 2012). Most of these deaths and disabilities could be prevented through the provision of safe and legal induced abortion by qualified providers. To ensure that women living in developing countries can readily access safe termination procedures, the World Health Organization (WHO) recommends that abortion can be provided at the lowest level of the healthcare system (WHO 2008). However, in many developing countries, even in settings where abortion is legal, access to abortion remains limited due to a shortage of trained physicians.
    • p.6
  • Authorising and training mid-level providers to provide abortion could reduce the number of unsafe procedures and alleviate the burden on healthcare systems. A review of medical abortion service delivery has suggested that the provision and management of medical abortion by mid-level providers is cost-effective in resource-limited settings due to salary costs and the scarcity of physicians (Berer 2009). However, not all countries across the world adopt this practice. In many developed country settings, including France and the UK (Jones 2000), nurses and midwives are not permitted to manage and administer abortion procedures independently. Only a handful of countries in the developing world permit midwives to perform aspiration abortion (Cambodia (Long 2001) and South Africa) or paramedics to carry out ’menstrual regulation’ procedures (Bangladesh). In many countries, national policies limit access to medical abortion by restricting its prescription and provision to certified physicians (Yarnall 2009).
    • p.6
  • There is some evidence of an increase in the risk of failure or incomplete abortion for surgical abortion procedures provided by mid-level providers (pooled risk ratio (RR) 2.25, 95% confidence interval CI 1.38 to 3.68), however the absolute risk is small and the data come from only three cohort studies. We rated the quality of the body of evidence as very low. There is no evidence of a statistically significant difference in the risk of total complications (which includes abortion failure, complications alone, immediate complications or delayed complications) when surgical abortion is provided by mid-level providers. There is no statistically significant evidence of a difference in the risk of failure of medical abortion between mid-level providers and physicians. Our results suggest that medical abortion can be carried out safely and effectively by mid-level providers.
    • p.18
  • The training of mid-level providers to provide abortion procedures aims to address shortages of trained physicians, particularly in rural areas (Berer 2009). As rural settings may pose different challenges for mid-level providers carrying out abortion procedures, such as a lack of access to primary care facilities for the management of complications, we recommend that future studies investigate the safety and effectiveness of the provision of surgical abortion procedures by mid-level providers and doctors in rural developing country settings.
    • p.18
  • Due to the shortage of physicians, mid-level providers are often the only health professionals available in many settings. Given the potential to expand women’s access to safe abortion in underserved areas, mid-level provision has been widely advocated (Chong 2006; IPAS 2002; Samora 2007). Training mid-level providers to provide first-trimester medical abortion and surgical abortion up to 12 weeks could facilitate widened access to safe termination, with the potential to reduce the number of unsafe abortions and related deaths and disabilities.
    • p.18
  • There is a significant difference in the risk of failure/incomplete abortion(P value = 0.002) between mid-level providers and physicians for surgical abortion, but the effect is small. The results suggest that for every 1000 procedures administered by a mid-level provider, an additional four women (95% confidence interval (CI) 1 to 9) will experience abortion failure or incomplete abortion. However, in the context of settings with a shortage of physicians and a high incidence of unsafe abortion procedures, the potential health gains associated with mid-level provision of abortion are substantial. The current WHO unsafe abortion statistics estimate that 22 million unsafe abortions take place every year, resulting in five million complications (a 23% complication rate) and 47,000 deaths (Sedgh 2012). Even based on the assumption (from surgical abortion randomised controlled trials (RCTs)) that the total complication rate for procedures carried out by mid-level providers is as high as 22/1000, if all unsafe abortions were carried out by mid-level providers, there could be a 90% reduction in complications and far fewer deaths (Chong 2006). A change in policy that allows mid-level providers to carry out abortion procedures may not achieve the theoretical reduction of 90% of complications, but it will contribute to a reduction in the number of complications and deaths caused by a lack of access to safe abortion. Compared to the other potential complications that can occur, abortion failure is not life-threatening in the majority of cases and its treatment and management falls within the scope of the same providers.
    • p.18-19
  • Implications for practice
    Our findings suggest that mid-level providers can provide medical abortion safely and effectively. Based on a small number of studies, there may be some difference in the effectiveness of surgical abortion procedures performed by mid-level providers compared with physicians, however we cannot be sure. Observational data indicate that there may be a higher risk of abortion failure for surgical abortion procedures administered by mid-level providers, but the number of studies is small and more robust data from controlled trials are needed. There is no significant difference in the risk of complications when surgical abortions are provided by mid-level providers. If these findings are confirmed in further studies, in settings with a shortage of trained providers coupled with a high incidence of unsafe abortion, mid-level provision of terminations could potentially reduce complications and death related to unsafe abortion.
    Implications for research
    Further studies are required to establish the minimum level of provider training and experience required for safe and effective abortion procedures in both low and high-resource settings.
    • p.20


"Is There a Post-Abortion Syndrome?" (January 21, 2007)

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Bazelon, Emily (January 21, 2007). "Is There a Post-Abortion Syndrome?". The New York Times. Archived from the original on April 24, 2009

  • Soon after Koop’s refusal in 1987 to report on the health effects of abortion, the American Psychological Association appointed a panel to review the relevant medical literature. It dismissed research like Reardon’s, instead concluding that “well-designed studies” showed 76 percent of women reporting feelings of relief after abortion and 17 percent reporting guilt. “The weight of the evidence,” the panel wrote in a 1990 article in Science, indicates that a first-trimester abortion of an unwanted pregnancy “does not pose a psychological hazard for most women.” Two years later, Nada Stotland, a psychiatry professor at Rush Medical College in Chicago and now vice-president of the American Psychiatric Association, was even more emphatic. “There is no evidence of an abortion-trauma syndrome,” she concluded in an article for The Journal of the American Medical Association.
    Academic experts continue to stress that the psychological risks posed by abortion are no greater than the risks of carrying an unwanted pregnancy to term. A study of 13,000 women, conducted in Britain over 11 years, compared those who chose to end an unwanted pregnancy with those who chose to give birth, controlling for psychological history, age, marital status and education level. In 1995, the researchers reported their results: equivalent rates of psychological disorders among the two groups.
  • Brenda Major, a psychology professor at the University of California, Santa Barbara, followed 440 women for two years in the 1990s from the day each had her abortion. One percent of them met the criteria for post-traumatic stress and attributed that stress to their abortions. The rate of clinical depression among post-abortive women was 20 percent, the same as the national rate for all women ages 15 to 35, Major says. Another researcher, Nancy Adler, found that up to 10 percent of women have symptoms of depression or other psychological distress after an abortion — the same rates experienced by women after childbirth.
    Researchers say that when women who have abortions experience lasting grief, or more rarely, depression, it is often because they were emotionally fragile beforehand, or were responding to the circumstances surrounding the abortion — a disappointing relationship, precarious finances, the stress of an unwanted pregnancy.
  • Nancy Russo, a psychology professor at Arizona State University and a veteran abortion researcher, spends much of her professional time refuting Reardon and Coleman’s results by retracing their steps through the vast data sets. Russo examined the analysis in the 2002 and 2005 articles and turned up methodological flaws in both. When she corrected for the errors, the higher rates of mental illness among women who had abortions disappeared. Russo published her findings on depression in The British Medical Journal last year; her article on anxiety disorders is under review. “Science eventually corrects itself, but it takes a while,” she says. “And you can feel people’s eyes glaze over when you talk about coding errors and omitted data sets.” Priscilla Coleman, for her part, says that research that concludes that abortion has negative effects is more scrutinized because it’s “so politically incorrect.” When researchers attack his findings, Reardon writes to the journals’ letters pages. “Even if pro-abortionists got five paragraphs explaining that abortion is safe and we got only one line saying it’s dangerous, the seed of doubt is planted,” he wrote in his book.
  • Even if no solid evidence provides a causal link to increased rates of depression or other emotional problems, abortion is often a grim event. And for a minority of women, it is linked to lasting pain. You don’t have to be an anti-abortion advocate to feel sorrow over an abortion, or to be haunted about whether you did the right thing.
  • While it seems that some anti-abortion advocates exaggerate the mental-health risks of abortion, some abortion advocates play down the emotional aftereffects. Materials distributed at abortion clinics and on abortion-rights Web sites stress that most women feel relief after an abortion, and that the minority who don’t tend to have pre-existing problems. Both claims are supported by research. But the idea that “abortion is a distraction from underlying dynamics,” as Nancy Russo put it to me, can discourage the airing of sadness and grief. “The last thing pro-choice people, myself included, want to do is to give people who want to make abortions harder to get or illegal one iota of help,” says Ava Torre-Bueno, a social worker who was the head of counseling for 10 years at Planned Parenthood in San Diego. “But then what you hear in the movement is ‘Let’s not make noise about this’ and ‘Most women are fine, I’m sure you will be too.’ And that is unfair.”
    Initially, Torre-Bueno’s encounters with grieving patients surprised her, because sadness wasn’t an issue in the first years after Roe. “In 1975, I’d say, ‘I wonder how you’re feeling,’ and women would answer, ‘Thank God it’s legal!’ ” she says. But by the early 1980s, Torre-Bueno and a handful of other counselors who favor abortion rights say, the emotional tide began to turn along with the political one. Congress cut off Medicaid money for abortion. The Supreme Court retrenched. Protesters picketed clinics and made bomb threats. Some clinic directors decided it was not enough to treat abortion as a straightforward medical procedure. Charlotte Taft, who founded an abortion clinic in Dallas in 1978, later began practicing what she calls “emotional triage” to identify women at risk of adverse reactions. She would ask prospective patients: Are you against abortion but feel you have no choice? Do you believe that abortion is murder? Do you think God will never forgive you? Is someone pressuring you? Do you have a history of depression? “Some women are clearly fine,” Taft told me. “Others are torn apart, and they need more process.” When women answered Taft’s questions by saying things like “I’m going to hell, but I have to do this,” Taft sent them home with exercises to help them work through their emotions.

"Making abortions safe: a matter of good public health policy and practice" (2000)

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Berer M (2000). "Making abortions safe: a matter of good public health policy and practice". Bulletin of the World Health Organization. 78 (5): 580–92. PMC 2560758. PMID 10859852.

  • Good laws and policies on abortion, in addition to being legal instruments, are a sign of public acceptance of fertility control and of women’s need for abortion. They signify an acceptance of the limitations of contraception and contraceptive use, and of women’s right to decide the number and spacing of their children. Further, they mark respect for and acknowledgement of women’s responsibility as mothers. Not least, they indicate a public health awareness of the costs of dangerous abortions, not only to women but also to their existing children, partners and families, and to health services and society as well.
    • p.582
  • Different laws permit different combinations of individual choice and state commitment versus state control over abortion. Sweden has been described as having an “enabling” law, in that the state grants freedom of choice and provides the means to implement it. Ireland’s law is “restrictive”, in that the state both denies private discretion and discourages or forbids implementation; thus, Irish women often travel to the United Kingdom for abortions, while in most countries with such laws, abortions are performed clandestinely. The USA is described as having a “hindering” law, in that the state grants individual choice on abortion but provides no services. Israel, on the other hand, is said to have an “intrusive” law, wherein the state limits individual discretion by requiring approval for all abortions, but provides all abortions that have been approved.
    Abortion mortality and morbidity tend to be highest in countries where abortion laws are most restrictive. Many such laws originate from colonial times and are no longer operative in the countries that drew them up. Restrictive laws allow abortion only when a woman can be seen as a victim of circumstances, i.e., in a medical emergency or cases of fetal abnormality or following rape or incest. Yet the great majority of women need abortions for family planning reasons and on economic and social grounds.
    • p.583
  • The earlier in pregnancy that an abortion takes place, the safer it is for the woman’s health and the less complicated for the provider. Hence, on public health grounds, regulations that tend to delay the procedure should be avoided. Such regulations include putting the abortion decision into the hands of people other than the woman herself, weighting “conscientious objection” clauses in favour of providers who want to opt out requiring a waiting period between obtaining permission for and having an abortion.
    • p.583
  • Young women are required to have parental consent for abortion in 27 countries, most commonly in eastern and western European countries, but also in China, India and some states of the USA. Again, consent may be waived with a court’s authority, but this is very burdensome.
    • p.583
  • Women who need abortions after the first trimester of pregnancy include the following; those who are not aware that they are pregnant or who deny the pregnancy until it begins to show (most often young women); those who think they are too old to get pregnant; those whose personal circumstances change dramatically during the pregnancy (e.g. the husband leaves or dies); those who develop medical reasons for abortion; and those who find out that the fetus is seriously damaged. Where abortion has previously been illegal and clandestine, women needing second trimester abortions also include those who are unaware that the law has changes, those living far from facilities, those who need more time to find out where to obtain a safe abortion, and those who have attempted self-induced abortion unsuccessfully aand who have a continuing pregnancy.
    • p.584
  • A medical board and individual medical practitioners can be either supportive or restrictive. However, by putting the decision into the hands of anyone except the woman who is seeking an abortion, countries risk perpetuating the need to seek unregistered providers and unsafe procedures, thus maintaining the public health problem they hoped to reduce. The examples of Sweden and Canada show that criminal law and complicated restrictions on abortion are not necessary. They offer unambiguous models, worth emulating.
    • p.584
  • Abortion services that are openly available have the opportunity to offer family planning and sexual health information and services, to give women the means to protect themselves. In developed countries, experience has shown that few women who seek an abortion actually need “counseling” as regards the abortion decision, but they do need information. This includes information on the choice of abortion method before the abortion and on what happens during the procedure, information on possible complications and seeking help for these afterwards, information about resuming sexual intercourse, prevention of HIV infection and other sexually transmitted infections, and the offer of a choice of contraceptive methods. The involvement of partners should be possible, but only at the woman’s request, so as to protect her right to privacy.
    • p.585
  • Much can be done despite the difficulties of changing national abortion laws. Women’s health groups and other advocates, parliamentarians and health professionals, can work together to support the right of women not to die from unsafe abortions and to ensure that they receive treatment for complications. They can urge hospitals not to report women and legitimate service providers to the police, as well as advocate for the decriminalization of abortion. In countries where the letter of the law is not a primary obstacle, they can also campaign for a choice of safe abortion methods, improvements in regulations governing the registration of providers and facilities, and for better training for providers. Additionally, they can monitor accessibility, affordability, and quality of care in these services.
    • p.587

"Need Abortion, Will Travel" (25 February 2008)

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Bloom, Marcy (25 February 2008). "Need Abortion, Will Travel". RH Reality Check. Archived from the original on 30 November 2008. Retrieved 15 June 2009.

  • There has always been abortion tourism. The term refers to travel undertaken in order to access to safe abortion care -- which is a long-standing crisis in the US as well as internationally.
    In her May 2003 on abortion beyond borders, the Guttmacher Institute's Susan Cohen provided some relevant history: "New York legalized abortion, without a residency requirement, in 1970, which immediately put New York City on the map as an option for those women who could afford to travel. Before that it was an open secret that affluent American women would travel to London to obtain safe, legal procedure."
  • In October 2007, the Global Safe Abortion Conference in London discussed this issue in the context of "abortion journeys" -- the long, distressing, often expensive journeys that women are forced to undertake in order to access safe abortion due to restrictive legislation in their home countries. Writing about the discussion at the conference, Grace Davies noted, "These journeys -- abortion tourism -- are a tragic reality for women around the world, from Kenya to Poland. In fact, the term ‘abortion tourism' highlights one of the central characteristic of the phenomenon. In highly restrictive situations, class and socio-economic status play a huge role in whether or not a woman can access safe abortion."
  • According to the Irish Family Planning Association and the Safe and Legal Abortion Rights Campaign in Ireland, "approximately 200 women per week travel to the United Kingdom from Ireland and Northern Ireland," where abortion is greatly restricted and virtually illegal. "Economics play a part...abortion remains a class issue," emphasized Goretti Horgan of Alliance for Choice Northern Ireland.
  • At a 1996 workshop on reproductive freedom held at a conference at the University of Connecticut School of Law, Ursula Nowakowska of Poland reported on the effects of her country's 1993 anti-abortion law. The law, "permitting abortions only if the life of the mother was seriously threatened or if there was severe deformation of the fetus," is essentially a farce, an insult, and a danger to women's lives and dignity, as are the restrictive anti-abortion laws in other countries. "...Women have gone to Western Europe or further east to obtain abortions" -- Poland's version of abortion tourism. "Most Polish women go to Poland's East and South neighboring countries: Ukraine, Lithuania, Russia, Bielorus, Czech Republic, and Slovakia... Fewer women can afford to seek abortion care in Western countries, as the abortion services there are more expensive, but the care is of much higher quality." For the Polish women who have the financial resources, they go to "Germany, Belgium, and Austria." A February 2008 report posted in the ASTRA bulletin on sexual and reproductive rights indicated that at least 31,000 Polish women underwent abortions in the United Kingdom in 2007, a 30% growth in the number of Polish women from recent years.
  • Portugal decriminalized first-trimester abortion last year, "leading to the easing of one of Europe's most restrictive abortion laws." It is estimated that "perhaps 20,000 or more illegal abortions a year take place and thousands of women end up in hospitals with complications...Many thousands each year, unsurprisingly, choose instead to cross the border" to more liberal Spain-abortion tourism for Portuguese women. Figures for the number of women who left the country in recent years to access safe abortion care aren't available, although in 2006, "about 4,000 Portuguese women went for abortions to...one clinic in Spain...near the Portuguese border."
  • In the United States, despite the legalization of abortion 35 years ago and where restrictions on abortion are nothing short of a war against women's lives, "access to abortion has been severely eroded" -- leading to the current US version of abortion tourism. According to the National Abortion Federation, "88% of all US counties have no identifiable abortion provider. In non-metropolitan areas, the figure rises to 97%. As a result, among many other barriers to safe abortion care, nearly a quarter of US women wanting abortions have to travel 50 miles or more to reach the nearest abortion provider." During my 18 years as the executive director of Aradia Women's Health Center in Seattle, Washington, our clinic consistently saw women from throughout the state, as well as Alaska, Idaho, Wyoming, Montana, Iowa, Texas, California, Oregon, and Mexico.
  • So who dies from lack of abortion access? Who suffers? Who is forced to continue an unwanted pregnancy, or desperately turns to underground, unscrupulous, and deceptive clinics? Who cannot become an "abortion tourist" and travel within or outside of one's country for safe abortion care? The universal theme is clear -- it is disproportionately women or girls who are young and/or poor, indigenous, of color, an immigrant, a refugee, and/or geographically isolated. It is only women with fiscal resources who are able to travel the long distances to another state or country for safe abortion care.

"Developments in Laws on Induced Abortion: 1998–2007" (2008)

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Boland, R.; Katzive, L. (2008). "Developments in Laws on Induced Abortion: 1998–2007". International Family Planning Perspectives. 34 (3): 110–20. doi:10.1363/3411008. PMID 18957353. Archived from the original on 7 October 2011.

  • Although abortion is a medical procedure, its legal status in many countries has been incorporated in penal codes, which have historically characterized abortion as a crime. Over time, the majority of these criminal bans have been amended to specify circumstances in which abortion carries no legal penalty, such as when a woman's life or health is in danger. Today, most countries, even those with relatively liberal laws on abortion, still have penal code provisions outlining the circumstances in which abortion is a crime. Increasingly, these penal code provisions have been supplemented or replaced by public health statutes, court decisions, and other laws and regulations that address the provision of reproductive health care. Characterizing a country's abortion law, therefore, may require reference to multiple legal sources.
  • The last 10 years have seen a clear trend toward liberalization of abortion laws. This means that more countries have broadened the grounds on which abortion may be performed legally or have adopted measures to make the procedure more accessible. Only a handful of countries have increased restrictions on access to abortion since 1998. Although liberalization of abortion laws and regulations has taken place all over the world, restrictions have increased in the Americas and in East and Central Europe.
  • The negative impact of abortion restrictions on women's survival, health and well-being is a growing concern for human rights bodies, as well as nongovernmental human rights advocates. Abortion law reform has occurred against a backdrop of human rights advocacy at the United Nations and in other international, regional and national human rights venues. In some countries, such as Nepal and Swaziland, government reforms of abortion laws have been explicitly motivated by a desire to uphold women's rights. In Colombia, the Constitutional Court was guided by human rights norms in holding that the country's abortion ban was unconstitutional. In Sub-Saharan Africa, abortion law reform has come in the form of reproductive health laws that codify the reproductive rights standards upheld in the 1994 ICPD in Cairo.98 For the first time, a regional human rights body, the African Union, has approved a protocol that guarantees the right to abortion under certain circumstances, and two human rights tribunals have directed countries, Peru and Poland, to ensure access to abortion when it is legal under national law.
  • An important factor in access to abortion is the regulation of facilities that are authorized to provide abortions and the types of medical providers who are allowed to perform the procedure. Even in countries recognizing multiple grounds for abortion, restrictions on facilities and personnel have placed obstacles in the path of women seeking legal abortions. Some countries, including India and South Africa, have decentralized regulatory control over facilities to allow local officials to approve such facilities. Other countries, such as Ethiopia and Vietnam, have used regulations to make clear that midlevel providers can perform abortion or that medication abortion can be provided in public facilities.
    Regulations relating to medical technologies may also affect abortion access. Many governments have now approved medications for nonsurgical abortion, thereby broadening the range of abortion methods from which women can choose. At least 39 countries have registered mifepristone, 35 in the last 10 years.49 Although Western European countries were among the first to register mifepristone, in recent years, such countries as Tunisia, India, Hungary and Guyana have approved the drug.
  • In many countries, access is hampered not by restrictive regulatory procedures, but by the absence of any procedures for obtaining the service. Where laws are restrictive, the lack of regulations makes physicians reluctant to perform any abortions, even those authorized by law, for fear of being subject to prosecution. Most of these laws are contained in penal codes dating from the last century; at the time they were enacted, legislators in all probability thought little about implementation. In Latin America, however, several countries, including Ecuador and Uruguay, have adopted measures that clarify procedures for having an abortion.
    Finally, in some countries, such as Thailand, regulations have provided an opportunity to expand previously accepted interpretations of existing laws. By interpreting terms such as "health" to include mental health, these regulations increase the number of women who are eligible for safe abortion in public and private facilities.
  • The findings of this article and its 1998 predecessor suggest that the trend toward liberalization of abortion laws should be hard to reverse. In a 22-year period, 36 countries have significantly liberalized their abortion laws. An important impetus for many of these changes, particularly over the last 10 years, has been the expansion of the use of human rights principles to support a woman's right to abortion. This basis for reform can only assume greater importance as courts and human rights bodies increasingly hold governments accountable for their duties under human rights law. Women's right to dignity and health entitle them not only to make decisions about abortion, but also entitle them to information, support and access to services. Thus, advocates can call upon governments to expand grounds for legal abortion and to take steps to ensure access to the procedure where it is legal. For governments seeking to meet their obligations under human rights laws, recent progressive developments in abortion laws worldwide may help point the way toward reform.

“Dictionary of Ethics, Theology and Society” (1996)

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Lisa Sowle Cahill, Abortion; [https://books.google.com/books?id=5ar7AQAAQBAJ “Dictionary of Ethics, Theology and Society”,(1996) by Paul A. B. Clarke, Andrew Linzey

  • Abortion demonstrates perhaps better than any other moral issue the impossibility of segregating ’personal’ from ‘social’ ethics, morality from law, or religious from secular moral argument.
    In ethical discourse, abortion is understood as the deliberate choice to terminate a pregnancy through an action which either directly destroys the foetus or causes its expulsion from the uterus before viability. Such a choice is obviously a highly personal moral action. In abortion a person or persons cause the death of another individual member of the species (although whether the foetus is likewise a ‘person’ is a hotly contested and crucial point in the abortion debate).
    • p.1
  • The comparative legal scholar Mary Ann Glendon (1987) notes that twentieth-century abortion laws have developed in most European countries as a result of public debate contributing to a revised consensus.. Religious groups were not necessarily excluded from the process, even given highly pluralistic cultures (e.g. consultations of British government commissions with the churches in order to offer recommendations prior to policy changes) Of twenty countries studied, only two (Ireland and Belgium) retained blanket prohibitions against abortion. Eleven countries, including Great Britain (England, Scotland and Wales), allowed abortion ‘with cause’ and after review, although the actual accessibility of abortion varied. Six countries, among them the USA, allowed elective abortion, at least in the first trimester of pregnancy. Gloendon argues that the process toward moderate change which occurred in the UK and elsewhere from the late 1960s onward was short-circuited in the USA by the 1973 Supreme Court decision, ‘’Roe v. Wade’’. ‘’Roe’’ allowed the woman virtually absolute freedom in terminating a first or second trimester pregnancy, but also isolated her as an individual from the social and economic supports which encourage childbirth (e.g. through healthcare and family policies). Although the compromise statutes likely to have emerged through American legislatures might have been permissive in the first trimester, it might also have used moderate restraints on later abortions to affirm a moral ethos which values childbearing and seeks alternatives to problem pregnancies.
    In the USA in particular, the churches are engaged in a struggle either to sustain abortion rights’ or to redefine abortion policy more narrowly (with the Roman Catholic Church as perhaps the most visible institutional advocate of the latter course).
    • p.3
  • Key to abortion law is the moral status of the foetus, a conundrum perhaps in principle not definitively resolvable. Although an individual life may begin with conception, even official Catholic teaching acknowledges that the status of such a life as a ’person’ is finally unclear and not empirically demonstrable (Vatican 1987). In the absence of conclusive scientific or philosophical evidence which could settle the issue, the task is to shape a reasonable social consensus about the status of foetal life and about its protectability in the face of the mother’s conflicting interests. If the foetus has significant value independently of the mother, than its protection may well fall within the proper scope of the law.
    • p.3
  • Criteria of a just and viable law would include that it be non-discriminatory not create greater evils than it avoids and command enough respect to be enforceable. In a heterogenous SOCIETY, no individual or group should be excluded from the development of a consensus about law, provided that arguments are articulated in publicly accessible language, which, while non-sectarian, need not be ‘neutral’. Even ostensibly secular philosophical or humanist positions necessarily owe their identity to particular moral and political traditions, as is certainly true of the liberal democratic positions which have created the very framework for the modern Western abortion debate.
    • pp.3-4

"Surgical versus medical methods for second-trimester induced abortion" (1 November 2008)

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Cheng L. (1 November 2008). "Surgical versus medical methods for second-trimester induced abortion". The WHO Reproductive Health Library. World Health Organization. Archived from the original on 1 August 2010. Retrieved 17 June 2011.

  • 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. A vast majority (90%) of these abortions take place during the first trimester of pregnancy. The second trimester of pregnancy (also called mid-trimester) is the period from 13 to 28 weeks of gestation. It is subdivided into an "early period" (between 13 and 20 weeks) and a "late period" (between 20 and 28 weeks). Worldwide, 10%–15% of all induced abortions occur during the second trimester. Overall, two thirds of all major complications of abortions are attributable to those performed in the second trimester.
    Over the past 30 years, there have been continuing efforts to improve abortion technology in terms of effectiveness, safety (lower complication risk), technical ease of performance and acceptability. The optimal method for second-trimester abortion continues to be debated. It is important to determine which is the best method because abortions performed in the second trimester account for a disproportionate amount of abortion-related morbidity and mortality. The overall risk of death is 10 times higher with D&E; abortion than with first trimester suction curettage, and the risk of mortality increases progressively with advancing gestational age. Any attempt to reduce mortality and morbidity from this procedure can bring significant benefits to the quality of life for the women undergoing this procedure.
  • In this review, D&E; was found to be superior to the two medical methods studied (intra-amniotic instillation of prostaglandin F2α and a combination of mifepristone and misoprostol). It should be noted, however, that to perform D&E; safely, health-care providers need specialized training and an adequate caseload to maintain their skills. Guidelines issued by the United Kingdom Royal College of Obstetricians and Gynaecologists recommend that inexperienced providers use medical methods. In China, for second-trimester abortions, facilities and equipment required for the surgical method are often lacking. In such settings medical abortion may be easier to perform. Also, medical abortions can be performed by mid-level health-care providers rather than experienced surgeons. Hence, the findings of this review are likely to be less applicable in under-resourced settings.
    Use of D&E; and medical methods varies in different parts of the world. For example, D&E; is used for 96% of abortions performed at ≥13 weeks' gestation in the USA and 75% of those in England and Wales. In contrast, in China, Finland and Sweden, virtually all abortions in the second trimester are performed using medical methods. Induction with mifepristone and misoprostol for termination of pregnancies of 10–16 weeks’ gestation, and intra-amniotic administration of ethacridine lactate (Rivanol) for termination of >16 week’s gestation are routine methods in clinical practice in China. Intra-amniotic instillation techniques of prostaglandin F2α for termination of second trimester pregnancy is not used in modern abortion care.
  • In many parts of the world D&E; is the standard method for termination of pregnancies of over 13 weeks of gestation. The conventional suction method is regarded as being appropriate for pregnancies of between 12 and 15 weeks of gestation, whereas D&E; is considered to be a safe and an effective option for gestations above 15 weeks when undertaken by specialist practitioners with appropriate experience. Cervical injury is more frequent with D&E; in the second trimester. Hence, preoperative cervical priming is used to reduce cervix-related complications. Even though the safety and efficacy of D&E; for termination of second-trimester pregnancy has been found to be superior to medical methods in this review, some practitioners find it very distressing to perform this procedure at an advanced stage of gestation.
    The Royal College of Obstetricians and Gynaecologists recommends medical abortion with mifepristone followed by a prostaglandin as a safe and effective method for second-trimester abortion. It has been established that pretreatment with the mifepristone 36–48 hours before the administration of the prostaglandin can increase the success rate, shorten the induction-to-abortion interval and reduce the amount of prostaglandin required in second-trimester abortion. Recently, it has been shown that misoprostol administered by the vaginal or sublingual route is more effective than oral misoprostol after pretreatment with mifepristone, although more women preferred the oral route. In areas where mifepristone is not available, sublingual or vaginal misoprostol without mifepristone pretreatment could be used as an alternative regimen. Routine surgical evacuation of the uterus is not required following second-trimester medical abortion. It should only be undertaken if there is clinical evidence that the abortion is incomplete. Gastrointestinal side-effects (nausea, vomiting and diarrhoea), painful uterine contractions and fever (> 38º C) are common but not serious with medical abortion. Uterine rupture occurs rarely in second-trimester medical terminations of pregnancy, but providers should be aware of this risk.

"Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009" (September 2011)

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Coleman, PK (September 2011). "Abortion and mental health: quantitative synthesis and analysis of research published 1995–2009". The British Journal of Psychiatry. 199 (3): 180–86. doi:10.1192/bjp.bp.110.077230. PMID 21881096.

  • Results
    Women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be attributable to abortion. The strongest subgroup estimates of increased risk occurred when abortion was compared with term pregnancy and when the outcomes pertained to substance use and suicidal behaviour.
    Conclusions
    This review offers the largest quantitative estimate of mental health risks associated with abortion available in the world literature. Calling into question the conclusions from traditional reviews, the results revealed a moderate to highly increased risk of mental health problems after abortion. Consistent with the tenets of evidence-based medicine, this information should inform the delivery of abortion services.
  • Despite federal legalisation of abortion in the USA in 1973, women’s right to choose abortion has been hotly debated, factoring heavily into the broader political landscape. Paralleling political division at the societal level, there has been considerable debate among academics regarding the extent to which abortion poses serious mental health risks to women. Over the past several decades, hundreds of studies have been published indicating statistically significant associations between induced abortion and adverse psychological outcomes of various forms. However, the authors of the three most recent qualitative literature reviews arrived at the conclusion that abortion does not pose serious risks above those associated with unintended pregnancy carried to term. This conclusion is problematic for several reasons, the most salient of which are described briefly below.
    First, only a handful of studies have actually included unintended pregnancy carried to term as a control group. Pregnancy intendedness is not well defined in the literature and basic conceptualisation and measurement issues challenge the validity of the intendedness variable as used in the available studies. Specifically, pregnancies that are terminated are sometimes initially intended by one or both partners and pregnancies that are initially unintended may become wanted as the pregnancy progresses, rendering assessment of intendedness subject to considerable change over time. In addition, pregnancy intendedness is typically measured dichotomously (intended/unintended) when true responses may actually fall on a continuum from fully intended and planned for years to entirely unintended, with a great deal of variation likely between these two extremes. At least half of all pregnancies in the USA are classified as unintended and among adolescents and women over 40 years old the percentage is over 75%, meaning the majority of women in the control groups in studies comparing abortion with term pregnancy actually delivered unintended pregnancies even if the variable was not directly assessed.
  • In this highly politicised area of research it is imperative for researchers to apply scientifically based evaluation standards in a systematic, unbiased manner when synthesising and critiquing research findings. If not, authors open themselves up to accusations of shifting standards based on conclusions aligned with a particular political viewpoint. Moreover, the results may be dangerously misleading and result in misinformation guiding the practice of abortion. Through a process of systematically combining the quantitative results from numerous studies addressing the same basic question (e.g. ‘is there an association between abortion and mental health?’) far more reliable results are produced than from particular studies that are limited in size and scope. Moreover, as a methodology wherein studies are weighted based on objective scientific criteria, meta-analysis offers a logical, more objective alternative to qualitative reviews when the area of study is embedded in political controversy.
  • Based on data extracted from 22 studies, the results of this meta-analytic review of the abortion and mental health literature indicate quite consistently that abortion is associated with moderate to highly increased risks of psychological problems subsequent to the procedure. The magnitude of effects derived varied based on the comparison group (no abortion, pregnancy delivered, unintended pregnancy delivered) and the type of problem examined (alcohol use/misuse, marijuana use, anxiety, depression, suicidal behaviours). Overall, the results revealed that women who had undergone an abortion experienced an 81% increased risk of mental health problems, and nearly 10% of the incidence of mental health problems was shown to be directly attributable to abortion. The strongest effects were observed when women who had had an abortion were compared with women who had carried to term and when the outcomes measured related to substance use and suicidal behaviour. Great care was taken to assess accurately the risks from the most methodologically sophisticated studies, and the quantitatively based conclusions reflect data gathered on over three-quarters of a million women. Of particular significance is the fact that all effects entered into the analyses were adjusted odds ratios with controls for numerous third variables.
    The finding that abortion is associated with significantly higher risks of mental health problems compared with carrying a pregnancy to term is consistent with literature demonstrating protective effects of pregnancy delivered relative to particular mental health outcomes. For example, with regard to suicide, Gissler et al reported the annual suicide rate for women of reproductive age to be 11.3 per 100 000, whereas the rate was only 5.9 per 100 000 in association with birth. Several other studies conducted in different countries have revealed even lower rates of suicide following birth when compared with women in the general population. More research is needed to examine systematically the specific nature of this protective effect against suicide, to determine the extent to which the protective effect holds for unintended pregnancies delivered, and to examine possible protective effects of childbirth relative to other mental health variables.
    When the abortion group was compared with the no pregnancy group and with the unintended pregnancy delivered group, the magnitude of the effects was very close. This finding challenges the generally accepted belief that unintended pregnancy delivered represents the only or most appropriate control group for studies designed to explore the impact of abortion on mental health.
  • Future studies should explore possible process mechanisms linking abortion to substance misuse and suicidal behaviour, since the strongest effects were detected for these variables. For example, substance misuse and suicidal behaviour may result from efforts to block or avoid any psychological pain associated with the procedure and may be construed as faster, easier remedies for personal suffering than seeking professional help. Women could find it particularly difficult to reach out to others if they experience shame or guilt associated with the abortion. Consistent with the contemporary ethos of evidence-based medicine wherein effective use is made of the best available data from systematic research, firm standards should be articulated for accessing and synthesising information from the published literature for the purpose of training healthcare personnel. The results of this systematic, quantitative review cast serious doubt on the conclusions derived from the recently published traditional reviews described earlier, and suggest that there are in fact some real risks associated with abortion that should be shared with women as they are counselled prior to an abortion decision.
  • Procedure benefits of abortion have not been empirically established and the results of the substantial review by Thorp et al described earlier in conjunction with the results of the present quantitative synthesis indicate considerable evidence documenting mental health risks. Without more research pertaining to possible benefits, the above guidelines are difficult to apply. In one study by Major et al, the average response of the study respondents reflecting their positive post-abortion emotional reactions (defined as ‘happy’, ‘pleased’ or ‘satisfied’) was 2.24 on a scale of 1 to 5, with 1 corresponding to ‘not at all’ and a 5 representing ‘a great deal’. The passage of time apparently did not result in more positive emotions, because 2 years after abortion the average rating dropped by a statistically significantly amount to 2.06. A few additional studies have addressed associations between abortion and educational attainment, income and other outcomes of this nature, which may be construed as indirect indicators of mental health; however, mental health benefits have received scant direct attention in the literature.
  • This review was undertaken in an effort to produce an unbiased, quantitative analysis of the best available evidence addressing abortion as one risk factor among many others that may increase the likelihood of mental health problems. The composite results reported herein indicate that abortion is a statistically validated risk factor for the development of various psychological disorders. However, when the independent variable cannot be ethically manipulated, as is the case with abortion history, definitive causal conclusions are precluded from both individual studies and from a quantitative synthesis such as this one. Although an answer to the causal question is not readily discerned based on the data available, as more prospective studies with numerous controls are being published, indirect evidence for a causal connection is beginning to emerge.
  • Although decisions on whether to proceed with induced abortion are made on the basis of clinical assessments of the extent to which abortion poses a risk to maternal mental health, these clinical assessments are not currently supported by population-level evidence showing the provision of abortion reduces mental health risks for women having unwanted pregnancy.

“A Decade of International Change in Abortion Law:1967-1977” (July, 1978)

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REBECCA J. COOK, BERNARD M. DICKENS; “A Decade of International Change in Abortion Law:1967-1977”, AJPH July, 1978, Vol. 68, No. 7

  • The argument in favor of ensuring high standards is compelling, especially since adverse reactions to routine procedures may in principle arise from any individual case. Nevertheless, the argument can be overstated, and its emphasis upon excellence has been found both to condemn the merely good and to disregard the governing realities. If medical procedures were to require performance by only the most highly skilled, many fewer could be undertaken than in fact are, and skills would be more difficult if not impossible to develop. Childbirth itself, which in countries with liberalized abortion laws presents a greater hazard to female health than early pregnancy termination, is not generally surrounded by special legal requirements of qualifications of medical attendants. Leading physicians delegate many procedures, for which they remain medically responsible, to their staffs. They advise, supervise, and are at hand, of course, for instance in the event of emergency, but do not attend in person.
    • p.639
  • In both developed and developing regions of the world, properly trained midwives, public health nurses, and comparable health and auxiliary personnel can conduct procedures early in pregnancy under adequate supervision. An advantage of their involvement may be their ability to provide a higher quality of pre- and post-abortion care and counseling than a busy physician can offer, thereby securing better and perhaps more confidential overall patient management. They already play an important role in fertility control, including menstrual regulation to which the earliest abortion is analogous. Further, as research produces non-surgical abortifacients with controllable side-effects, a physician's proximity to their employment can be reduced, and effective management can be projected along more extended lines of delegation. Legally restricting medical services to the most scarce and costly personnel may prejudice community services.
    • p.639
  • The reason abortion legislation requires an approval procedure is to authenticate that abortion is performed only on a legal indication; the fact that the particular indication approved is usually not required to be agreed between the two or more opinions suggests that the procedure is not really aimed at improving health care. This is supported by the concentration of second opinions upon legal indications, and their disregard of the techniques proposed to be used; these can affect female health considerably, and selection of a suitable technique is a matter that physicians with responsibility for a patient's welfare might need to discuss. The second opinion may be given as a matter of routine, moreover, based upon reading existing records and reports, and the woman's condition may not really be independently assessed.
    Further problems arise with a committee system, the abolition of which in Singapore after five years' experience may be instructive. Committee references reduce privacy, and can be unduly humiliating and degrading in a field where many women are routinely shy, not just because of embarrassing origins of their pregnancy. Committee approval, in common with other second opinion provisions, may also increase the cost of medical termination; few laws govern the fees which may be charged for that opinion. The incentive to earn fees may be medically distorting, it has been noted, in that a doctor requested to offer a second opinion to a physician favoring abortion, and therefore seeking the second opinion, may favor abortion to encourage the referring doctor to seek subsequent opinions from him in other cases.
    Members of a hospital's therapeutic abortion committee may see their role as fastidiously to screen applicants on medical, psychiatric, and legal grounds, in order to safe-guard the hospital, its medical and auxiliary staff, and them-selves from the risk of liability to up to life imprisonment (for instance in Canada) for participating in an illegal abortion. As against this, however, some committees rarely meet together, but approve applications by telephone and correspondence as a matter of course, subject only to keeping within their facility's periodic quota of surgical time and hospital beds that can be devoted to the procedure.
    • p.640
  • It is uniformly recognized that the earliest abortion is the safest, and the Badgley Committee favored making abortion available at the earliest stage possible. It was found, however, that on average, women take 2.8 weeks after first suspecting pregnancy (not just after actually becoming pregnant) to visit a physician, and that after this the average interval is eight weeks until the abortion is induced. The eight-week average is ominous in light of some committees' "rubber stamp" approach. The delay results from the manner in which physicians, hospitals, and therapeutic abortion committees often interact among themselves to evaluate their increasingly desperate and frustrated applicants. The Badgley Committee found that:
    ... many patients get the medical 'merry-go-round' treatment. This sequence of events is costly to the public purse, heightens the level of stress among patients, and extends the length of their pregnancies for many women." 7(p. 19).
    • p.640
  • General patterns of legal development show steady decriminalization of the practice of abortion. More broadly expressed indications for lawful procedures emphasize this trend, but even in jurisdictions where legal change has not occurred, criminal enforcement of prohibitive law is infrequent and selective (k). The unqualified practitioner may very occasionally suffer prosecution, but the charge is likely to be manslaughter rather than just illegal abortion, or furnishing means to procure miscarriage. Awareness of the cost to female life and health of unqualified interference in pregnancy, and of the cost to public hospital, health, and welfare resources of its consequences, is on occasion a strong contributory cause of legal reform.
    • p.641
  • Legal reform may deceive, however, since jurisdictions persuaded to change their laws do not necessarily undertake provision of services from public funds. The struggle in the United States over federal funding of services brings home a dichotomy between permission and support not uncommonly experienced. Legislative change often presents only a move from public prohibition unenforced by judicial proceedings, to public permission not supported by administrative resources.
    • p.642

"Abortion in the Middle East and North Africa" (2008)

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Dabash, Rasha; Roudi-Fahimi, Farzaneh (2008). "Abortion in the Middle East and North Africa" (PDF). Population Research Bureau. Archived (PDF) from the original on 6 October 2011.

  • Abortion is one of the oldest medical practices, evidence of which dates back to ancient Egypt, Greece, and Rome. Abortion techniques used by Egyptian pharaohs were documented in the ancient Ebers Papyrus (1550 B.C.). It is believed that during the Middle Ages, abortion techniques were adopted and accepted by Western Europe and later diffused across the globe.
    • p.1
  • Ideally, unwanted pregnancies and abortions would be rare or nonexistent. In reality, however, millions of women around the world experience unintended pregnancies each year and many seek abortions. According to a recent WHO study, an estimated one-fifth of pregnancies—42 million out of 210 million—each year are voluntarily aborted (see Figure 1). Of these, 22 million occur within a formal health care system and 20 million outside of the legal system.
    • p.1
  • The majority of women in MENA face legal barriers to abortion. Nearly 80 percent live in countries where abortion laws are restricted: 55 percent live in countries where abortion is prohibited except to save the mother’s life and 24 percent live in countries where abortion is permitted only to preserve women’s physical or mental health (see Figure 2). About 20 percent of MENA’s population lives in Turkey and Tunisia, the only two countries in the MENA region where abortion is legal on request during the first trimester of pregnancy.
    Data from Tunisia and Turkey suggest that abortions haven’t only become safer as a result of legalization but that abortion rates have also declined as their family planning programs have expanded. In Turkey, the rate of abortion dropped from 18 percent of pregnancies in 1993 to 11 percent in 2003. Also during that period, the percent-age of married women using modern contraception increased from 34 percent to 42 percent.
    • p.2
  • Despite the expansion of family planning programs and increased use of modern contraception, unmet need for family planning persists globally and in the MENA region to varying degrees (see Figure 3, page 4). Unmet need for family planning is defined as the proportion of married women who prefer to avoid a pregnancy but are not using contraception. Unmet need ranges from around 50 percent in Yemen to 6 percent in Turkey. Yemen has a relatively weak health system and contraceptive use is the lowest in the region. As a result, Yemeni women still give birth to around six children, on average, and have a 1-in-39 lifetime chance of dying due to pregnancy-related causes—the highest in the region.
    • p.3
  • Around the world, with a few exceptions, governments are moving toward liberalizing their abortion laws. Where abortion laws have become more liberal, unsafe abortion and related maternal deaths have generally declined. Following the legalization of abortion in South Africa, for example, deaths due to unsafe abortion decreased by 90 percent from 1994 to 2001.
    • p.5
  • Restrictive laws make it difficult for researchers to collect data or study the incidence, circumstances, and impact of abortion on women and societies in the region. Lack of data is a major challenge in developing post-abortion services. In countries where abortion is restricted, no one knows whether abortion rates are increasing or declining, or where the need is greatest for post-abortion care. We do know that in all these countries, women resort to clandestine abortions when they need to. In the 2006 Syrian survey, more than half of the respondents who reported having an abortion said that they would be willing to have another abortion if they needed to.
    • p.7

“Abortion and the Culture Wars: Competing Moral Geographies and Their Implications for Bioethics, “Morality, bioethics and the interminability of bioethical controversies” (2006)

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H. Tristram Engelhardt, Jr., in Caplan, Arthur; et al. (2006). “The Fulbright Brainstorms on Bioethics - Bioethics: Frontiers and New Challenges”. Principia. ISBN 9789728818616. “Abortion and the Culture Wars: Competing Moral Geographies and Their Implications for Bioethics, “Morality, bioethics and the interminability of bioethical controversies”

  • Opponents to abortion rights however continue to try to influence the public opinion negatively: by humanizing the fetus; vilifying and imposing shame on women who seek abortions and by producing false scientific research that “proves” abortion harms women. Abortion opponents worldwide also try to restrict access to abortion services by seeing political and legal ways to restrict women’s right to end their pregnancy.
    In the 1980s ultrasound was introduced and became widely available for prenatal diagnostics. Ultrasound images of pregnancies and fetuses were quickly introduced into the mass media and the pictures were used immediately by the anti-abortion rights movement. The Vatican was very interested in the way the ability to visualize the fetus could change our perception of it. The Pope Paul VI Institute has produced several videotapes of 3-D ultrasound title “Living Proof in 3-D: Putting a Face on the Unborn Human Person”.
    • 3. Tactics of Opponents to Abortion Rights, p.39
  • Opponents to abortion also attempt to restrict access to abortion services by imposing unnecessary regulations (waiting periods ,special licenses). The argument used to justify these restrictions is that it will improve the quality of care and protect women’s health. However, these regulations never apply to similar small medical procedures other than abortion. A first trimester abortion is a very simple and one of the safest medical procedures, which can easily be done by a trained general physician or even nurse and midwife and does not require any extra regulations and laws. Still, South Africa is one of the only countries to allow nurses and midwifes to do abortions. Therefore laws restricting the provision of abortion to gynecologists, as in Germany and France, or requirements for special licenses and regulations for abortion clinics (almost everywhere) have no medical ground. Such laws are motivated by political reasons and can even undermine the quality and availability of health care services. These extra regulations can be so strict that the clinics have to expend vast amounts of money to meet the requirements, unnecessarily increasing the cost of the procedure. Such costs may make the procedure unnecessary expensive for women themselves in countries where abortion is not covered by health insurance such as the United States, or may force clinics to close down. Unfortunately also hospitals and medical professionals sometimes refuse to provide or even refer for abortion services, denying women this most basic healthcare. Often medical students are not even trained in performing abortions. In most countries where abortion is illegal, doctors sometimes have a financial incentive to support the restrictive laws because they provide expensive illegal abortions to women with means.
    • pp.40-41
  • Most countries that legalized abortion did so through legislation or court cases. However, anti-abortion groups started calling for referenda on the abortion issue. Historically, referenda have been a popular way to solve tricky political issues and to attempt to affirm the right of the majority already in power.
    Even the question of whether to extend the right of suffrage to women has been decided by referenda. In Canada (1916) and the US (1919),an all-male referendum was conducted to determine voting rights for women. This however was only possible after a long and highly visible campaign of the women’s movement and now it would be considered immoral to decide such an issue by a referendum. Arguments against women’s right to vote were that women were emotionally weal and therefore not able to come to an objective judgment. Women were said to be intellectually inferior and in need of a man to handle their affairs. Some of the same ways of negatively characterizing women are now used to deny women’s decisions about abortion.
    In the past few years abortion referenda have been held in Portugal, Ireland and Switzerland. Interestingly enough it is usually the anti-abortion groups that have the political power to set the agenda for these referenda. In 2001, after the Swiss government finally agreed to liberalize the abortion law, anti-abortion groups succeeded to force a referendum to prevent the law from taking effect. Because the Swiss government strongly supported and campaigned for the legalization of abortion, the referendum was won with a comfortable majority. In 1998 the Portuguese Parliament approved proposal for legal abortion on request up to 19 weeks of pregnancy, but later a national referendum was proposed to sole the matter. Tis was the first referendum in the history of Portugal and the Government did not fully support the referendum, but the Catholic Church mobilized all its forced for “no” vote.
    • p.43
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Faúndes, Anibal; Shah, Iqbal H. (1 October 2015). "Evidence supporting broader access to safe legal abortion". International Journal of Gynecology & Obstetrics. World Report on Women's Health 2015: The unfinished agenda of women's reproductive health. 131: S56–S59. doi:10.1016/j.ijgo.2015.03.018. ISSN 0020-7292. PMID 26433508.

  • The FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health also states that: “Abortion is very widely considered to be ethically justified when undertaken for medical reasons to protect the life and health of the mother…” and, when referring to abortion for non-medical reasons, the Committee concludes that “a woman’s right to autonomy, combined with the need to prevent unsafe abortion, justifies the provision of safe abortion”
    In contrast, only 40% of Brazilian obstetricians/gynecologists were willing to help a patient requesting a safe abortion and only 2% were willing to provide the abortion themselves. In Gabon, health providers, mostly residents in obstetrics and gynecology, grossly delayed the care of severely ill abortion patients in contrast to much faster care provided to women with nonabortion-related conditions.
    The contradiction between what many of our colleagues believe and practice and what the FIGO Committee for the Ethical Aspects of Human Reproduction and Women’s Health supports, is the result of our failure to communicate the evidence supporting the greatest possible access to safe abortion, while maintaining the position of promoting the reduction in the number of induced abortions worldwide.
  • The effect of criminalization of abortion on abortion-related mortality was dramatically demonstrated in Romania after the abrupt decision to prohibit abortion in November 1965. Criminalization of abortion was followed by a rapid increase in the abortion-related mortality ratio from approximately 15 per 100 000 live births to over 140 per 100 000 in a few years. Although maternal mortality for other causes decreased during that period, the overall maternal mortality ratio increased from approximately 80 at the time of the change in the abortion law, to 170 at the peak of abortion mortality. Mortality declined dramatically when abortion restrictions were removed.
  • While criminalization of abortion has been shown to be efficient in increasing maternal mortality, it has not been efficient in producing the effect expected by the legislators who voted to make abortion a crime: to prevent women voluntarily terminating their pregnancies.
    The lowest abortion rates are observed in countries where abortion laws are broadly permissive and access to safe abortion is easy, such as in western European countries; for example, Netherlands, Belgium, Germany, and Switzerland where abortion rates in 2008 ranged from 7–9 per 1000 women aged 15–44 years. Countries where abortion is highly restricted have three- to five-fold higher abortion rates. For example, the abortion rate was 29 in Pakistan, 27 in the Philippines, and 46 per 1000 women of reproductive age in Kenya. It is true that the highest abortion rates were found in Eastern Europe, where abortion laws are liberal and access is easy, but in this region access to modern contraception was limited until recently, and when methods became accessible, the abortion rate dropped by 50%—from 90 in 1995 to 43 per 1000 women in 2008.
  • The third reason that prompted FIGO to promote access to safe abortion in the framework of more permissive laws is that decriminalization rapidly reduces abortion-related mortality and, consequently, maternal mortality.
    This was dramatically demonstrated in Romania when, after the fall of President Nicolae Ceausescu, abortion law was again liberalized and access to safe abortion became easy. There was an immediate and dramatic fall in abortion-related mortality, resulting in a decline in total maternal mortality from 170 in 1989 to 75 in 1991.
    More recently, studies of abortion-related deaths in public hospitals in South Africa showed that the number of deaths fell from 425 in 1994, before the promulgation of the Choice on Termination of Pregnancy Act, to an average of 40 per year—a 91% reduction after the law reform. Portugal had low abortion-related mortality as shown by 14 deaths resulting from abortion over a seven-year period (2001–2007) prior to liberalization of the abortion law. This was reduced to only one death in the six years (2008–2013) following liberalization.
  • There is no direct cause − effect relationship between legalization and improved access to safe abortion and a decline in the abortion rate. A reduction in the frequency of unintended pregnancies that lead to abortion is usually the result of improved information and access to effective contraception. A possible explanation is that where abortion is a crime and carried out clandestinely, the abortion providers are primarily commercially motivated and, consequently, not interested in reducing repeat abortion. When abortion is legal and accessible within the health system, there is a motivation to prevent the repetition of abortion and postabortion counseling and provision of contraceptive methods improves, leading to a reduced incidence of repeat abortion. As repeat abortion constitutes at least 40% or more of all induced abortions, its reduction can at least partially explain a drop in the total abortion rate, recalling that women who have an induced abortion are demonstrating that they do not want a baby (or another baby) and will take any risk to avoid an unwanted birth. As such, they are at high risk of aborting again if they get pregnant.
    It is not that decriminalization alone will reduce the frequency of abortion, but rather facilitate the opportunities for its prevention. More importantly, it does not automatically increase abortion rates, which is the reason often argued for opposing decriminalization and better access to safe termination of pregnancy.
    The sudden and dramatic reduction in abortion rates in Eastern Europe between 1995 and 2008, coinciding with improved access to safe and effective modern contraceptives, is a good demonstration that women prefer to prevent a pregnancy than to abort it, even if termination of pregnancy services are legal and accessible. By making legal and safe abortion care accessible and providing contraceptive information and services, abortion rates can be drastically reduced. In Zimbabwe, women receiving counseling and services had significantly fewer unintended pregnancies and repeat abortion during the 12-month follow-up period than the control group that received no counseling or services. A recent review of evidence indicates that most women initiate contraception following abortion or treatment of abortion complications if contraceptive information and services are provided.
  • Analysis of the reasons that FIGO is in favor of greater access to safe abortion should make it clear that it is not “in favor of abortion” or an increased incidence of induced abortion, but on the contrary, it strives to reduce the number of abortions to the minimum possible. FIGO recognizes that the aim of reducing the number of induced abortions will be achieved by not criminalizing its practice or denying care when requested within the limits of the law, as is currently the case in many countries. The number of induced abortions will be reduced through education and access to effective contraception. To criminalize abortion only causes suffering and deaths, particularly in less privileged countries and among the most marginalized sectors of society—exactly the group of women whose health and well-being FIGO has the duty to protect with all its capacity. Making safe termination of pregnancy broadly available is, paradoxically, one of the means that will help reduce the number of abortions.

“Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model” (November 25, 2017)

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Dr Bela Ganatra, MD , Caitlin Gerdts, PhD , Clémentine Rossier, PhD , Brooke Ronald Johnson Jr, PhD , Özge Tunçalp, MD , Anisa Assifi, MPH , et al.; “Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model”, Volume 390, ISSUE 10110, P2372-2381, (November 25, 2017)

  • Of the 55• 7 million abortions that occurred worldwide each year between 2010–14, we estimated that 30•6 million (54•9%, 90% uncertainty interval 49•9–59•4) were safe, 17•1 million (30•7%, 25•5–35•6) were less safe, and 8•0 million (14•4%, 11•5–18•1) were least safe. Thus, 25•1 million (45•1%, 40•6–50•1) abortions each year between 2010 and 2014 were unsafe, with 24•3 million (97%) of these in developing countries. The proportion of unsafe abortions was significantly higher in developing countries than developed countries (49•5% vs 12•5%). When grouped by the legal status of abortion, the proportion of unsafe abortions was significantly higher in countries with highly restrictive abortion laws than in those with less restrictive laws.
  • WHO defines unsafe abortion as a procedure for termination of a pregnancy done by an individual who does not have the necessary training or in an environment not conforming to minimal medical standards. However, abortions done in accordance with these standards are considered safe and the risk of severe complications or death is minimal. The people, skills, and environment needed to meet medical standards are outlined in WHO guidelines, which are updated periodically. In the 25 years since unsafe abortion was defined, evidence has evolved and simple technologies, such as manual vacuum aspiration and medical abortion (with mifepristone and misoprostol, or misoprostol alone if mifepristone is unavailable), have made the provision of safe abortions possible at the primary care level and by health workers other than doctors. The conditions leading to a safe abortion are in turn affected by numerous factors, including the laws and policies on abortion (ie, legal context), the socioeconomic conditions, the availability of safe abortion services, and the stigma surrounding abortion. Stigma related to seeking or provision of abortion is increasingly being recognised as having an effect on how and where women access care and who provides care.
  • The results showed a disparity in abortion safety between developed and developing regions. In 2010–14, almost all abortions in developed countries were safe, although a small proportion of less-safe abortions was also seen—notably in eastern Europe—probably due to the persistence of outdated medical practices such as sharp curettage. In eastern Europe, as in many parts of Asia, development of evidence-based national standards and guidelines and training of providers could result in substantial improvements in the safety and quality of abortion care.
    The subregions with the highest proportions of safe abortions (northern Europe and northern America) also showed the lowest incidence of abortion. Most countries in these two subregions have less restrictive laws on abortion, high contraceptive use, high economic development, high levels of gender equality, and well developed health infrastructures, suggesting that achievement of both low incidence of abortion and high safety in such contexts is possible.
    Although eastern Asia was similar to developed regions, fewer than one in two abortions in south-central Asia and about one in four abortions in Africa were safe. Most abortions in Africa were characterised as least safe, suggesting that use of dangerous invasive methods by untrained individuals is common. Although the estimates of case fatality rates should be interpreted with caution because they were calculated with information from several different estimates and various time periods, our results suggested that the subregions with the highest proportions of least-safe abortions also had the highest case fatality rates. This finding might be due to the more serious complications arising from least-safe abortions and the poor health infrastructure to treat complications when they occur. Multifaceted interventions addressing legal, policy, and health system barriers; health-worker shortages; provider attitudes; gender inequality; and abortion stigma are needed.
    Only about one in four abortions in Latin America were safe, although most unsafe abortions were categorised as less safe, reflecting the transition of use of dangerous methods to use of misoprostol outside formal health systems in this region. Such abortions might result in fewer complications than abortions done using dangerous methods, as shown by the lower case fatality rates in regions with a high proportion of less-safe abortions than in regions with a high proportion of least-safe abortions. However, these regions also have better functioning health systems and better access to care to treat complications when they occur. Self-management of medical abortion in early pregnancy is an evidence-based option in WHO guidelines, however the use of misoprostol outside of the formal health system, often without access to appropriate information and a trained health-care worker if needed, does not represent a standard of care, but rather an absence of safe options. Thus, despite lower case fatality rates, these abortions are considered less safe and structured health systems interventions that address access to information, medications, and support to women are needed.
  • The analysis showed a positive association between safe abortions and less restrictive laws. Such laws might promote an enabling environment for trained providers and improve access to safe methods. The highest proportions of safe abortion were seen in developed countries with less restrictive laws, suggesting that both the legal grounds and overall development of a country have a part in abortion safety.

“The Moral Property of Women” (2002)

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Gordon, Linda (2002). “The Moral Property of Women”. University of Illinois Press. ISBN 0-252-02764-7.

  • Abortion has always been far more prevalent than infanticide. One antiabortion argument is that abortion violates some age-old and God-given “natural law,” but the historical evidence dissolves that illusion. Almost all preindustrial societies accepted abortion. The ancient Jewish metaphor calls the fetus part of the mother as the fruit is a part of the tree till it ripens and falls; the Islamic metaphor holds that the welfare of the trunk is more vital than that of the branches. One anthropological collection of tribal studies, the Human relations Area Files, found that 62 percent, or 125 of 200 groups, used abortion. Considering that anthropologists often didn’ task, or could find out, about abortion, that is almost certainly an underestimate.
    The high incidence of abortions did not means that they were easy. Women accepted the pain and danger of abortion in the same manner that they accepted the pain and danger of childbirth, with the assumption that both were necessary for their own and their communities health and welfare. Over the centuries there developed a varied technology of abortion-magical and mechanical, external and internal. When abortions became illegal, these techniques merely went underground. In fact, there is striking continuity between abortion techniques used in ancient societies and those used in modern “home remedy” abortions. These methods remain prevalent among the poor throughout the world; in communities deprived of access to professional medical care, dependence on folk medicine continues.
    • pp.15-16
  • One standard method of attempting to induce abortion, ancient and modern, was the potion, or abortifacient. In modern usage, only 7 to 14 percent of reportedly successful abortions resulted from internal medicine (before RU-486). With few exceptions these recipes were part of a folk culture of herbal medicine. Recipes ranged from teas made of common herbs-such as marjoram, thyme, parsley, rosemary, ginger, and lavender0to exotic ad elaborate concoctions such as a paste of mashed ants, foam from camel’s mouths, and tail hairs of the black-tailed deer dissolved in bear fat. The basic principle behind these various brews is that, to the degree they are effective at all, they are indirectly effective. None of them specifically aims at the fetus or its uterine support system. Rather, they so irritate or poison the body or the digestive system that they cause rejection of the fetus as a side effect. Some of the herbs commonly used may in fact be mild emmenagogues, stimulating the onset of menstruation and thus appearing to cause abortion. Hence the following description of the properties of basil from a seventeenth-century English herbal: “To conclude. It expelleth both birth and afterbirth; and as it helps the deficiency of Venus in one kind, so it spoils all her actions in another.”
    Abortion performed by inserting an object into the uterus were more effective. These procedures were done frequently, and with great success, in preindustrial societies. For example, this instruction the Persian physician Abu Bekr Muhammad ibn Zakariya Al-Razi in the tenth century: “If these methods [contraceptives he has prescribed] do not succeed . . . there is not help for it but that she insert into her womb a probe or a stick cut into the shape of a probe, especially good being the root of the mallow One end of the probe should be made fast to the thigh with a thread that it may go in no further. Leave it there. . . until the menses do appear and the woman is cleansed.”
    • pp.16-17
  • Certain Eskimo tribes use a thinly cared rib of walrus which is sharpened as a knife on one end, while the opposite end is made dull and rounded the sharp end is covered with a rolled cover made of walrus skin, which is opened on both ends, and the length of which corresponds to the cutting part of the piece of bone. A long thread made of the sinews of reindeer is fastened to the upper as well as lower end of the cover. When this probe is being placed in the vagina, the sharp part is covered with the leather covering. After it has been inserted far enough the thread fastened on the lower end of the covering is gently tugged. The sharp end thus being bared, a half turn is given the probe together with a thrust upwards and inwards, which punctures the uterus. Before withdrawing the instrument, the upper thread of the covering is pulled in order to cover the sharp end, thus preventing further injury to the genital organs.”
    In modern times this operation is performed with knitting needles, crochet hooks, nail files, nutcrackers, knives, hatpins, umbrella ribs, and pieces of wire; or with a catheter (a rubber tube), when more –professional equipment is available The physiological event, the irritation of the uterus causing it to reject embryo and placenta, can also be created by the injection of a chemical into the uterus, such as potassium soap. Ancient prescriptions of this type called for the use of tar, cinnamon on a tampon of linen, or even pepper.
    Other abortion experts sought to destroy the fetus by external means, instructing women to engage in rigorous exercise: lifting heavy objects, climbing trees, taking hot baths, jumping from high places, shaking. Early twentieth-century Jewish women on the Lower East Side of New York city attempted to abort themselves by sitting over a pot of steam, preferably from hot stewed onions-a technique identical with one prescribed in an eighth-century Sanskrit source. Some ancient techniques are significantly more dangerous We have reports of abortions performed by pouring hot water or hot ashes on the belly of the pregnant woman, having her bitten by large ants, grasping the uterus through the abdominal wall and twisting it until the fetus is detached.
    • p.17
  • Despite the great pain involved, some women successfully aborted themselves, though most enlisted an experienced helper, typically a specialist. Some times the providers were exclusively or mainly abortionists, as in ancient Rome, where they were called “sagae” (probably the root word for the French “sagefemme” or midwife). In the harem of the sultan or Turkey the official abortionist, called the “bloody midwife,” was one of the sultan’s own wives. Frequently, too, the providers were not only abortionists but general medical providers for women-we might call them folk gynecologists.
    • pp. 17-18

"Induced abortion: an overview for internists" (2004)

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Grimes, DA; Creinin, MD (2004). "Induced abortion: an overview for internists". Annals of Internal Medicine. 140 (8): 620–26. doi:10.7326/0003-4819-140-8-200404200-00009. PMID 15096333.

  • Internists care for many women who have had abortions and many who will seek abortions in the future. Each year, about 2% of all women of reproductive age have an abortion. Women having abortions tend to be young, white, unmarried, and early in pregnancy. Most abortions are done by suction curettage under local anesthesia in a freestanding clinic. However, medical abortion is growing in popularity as a nonsurgical alternative. The regimen approved by the U.S. Food and Drug Administration specifies mifepristone, 600 mg orally, followed 2 days later by misoprostol, 400 microg orally (within 49 days from last menses). Recent studies have recommended alternative approaches, such as mifepristone, 200 mg orally, followed in 1 to 3 days by misoprostol, 800 microg vaginally (up to 63 days). Medical abortion can be provided by a broader variety of physicians than can surgical abortion. The overall case-fatality rate for abortion is less than 1 death per 100,000 procedures. Infection, hemorrhage, acute hematometra, and retained tissue are among the more common complications. Referral back to the original abortion provider for management is advisable. Overall, induced abortion does not lead to late sequelae, either medical or psychiatric. Of importance, no link exists between induced abortion and later breast cancer. For physicians who are asked to help with a referral, the National Abortion Federation and Planned Parenthood Federation of America have helpful Web sites and networks of high-quality clinics. The cost of abortion (currently about 372 dollars at 10 weeks) has decreased in recent decades. Provision of ongoing contraception and encouragement of emergency contraception can reduce unintended pregnancies and the need for abortion.
  • Abortion is the removal of a fetus or embryo from the uterus before the stage of viability, further defined as “20 weeks' gestation or fetal weight < 500 g”. The latter descriptors are misleading, however, because fetal viability has not been reported at 20 weeks and weight alone is a poor predictor of viability. The terminology of timing is also confusing. The notion of pregnancy “trimesters” was adopted by the U.S. Supreme Court in the Roe v. Wade decision of 1973, which legalized abortion nationwide. Regrettably, this obstetrical convention has no basis in biology, and the distinction between first- and second-trimester abortion remains blurred after 3 decades. The practical importance is that states may regulate second-trimester abortions, for example, specifying that abortions must take place in a hospital. However, pregnancy should be considered a continuum, with no clear demarcations once embryogenesis is complete.
  • When women inquire about abortion, physicians should review all the options for the pregnancy as part of informed consent. These include carrying the pregnancy to delivery and keeping the baby, delivering the baby and giving it up for adoption, or abortion. If abortion is chosen, counseling can then focus on the procedures available; this discussion needs to include the efficacy, benefits, risks, and side effects of surgical abortion and, for women at 9 or fewer weeks of gestation, the alternative of medical abortion.
  • Accurate determination of the duration of the pregnancy is an important prerequisite to abortion; as is often the case in surgery, surprises are unwelcome. Therefore, most National Abortion Federation clinics surveyed (66%) use ultrasonography to confirm gestational age before surgical abortion.
  • Local anesthesia is the most common approach to pain control. In a recent survey of providers, 58% used paracervical block with or without oral premedication, 32% combined paracervical block with intravenous sedation, and 10% used general anesthesia. Local anesthesia is both safer and less expensive than general anesthesia, although pain relief is not complete. With local anesthesia, most women have discomfort similar to bad menstrual cramps during the operation; this resolves soon after the operation is finished. Most women are comfortable at the time of discharge.
  • A follow-up visit is usually scheduled in 2 or 3 weeks, but evidence supporting the benefit of this visit is lacking. Moreover, only about half of women opt to return. The principal use of the follow-up visit may be management of contraception. If an internist sees an asymptomatic woman for follow-up after abortion, a pelvic examination is typically performed but is unnecessary. Likewise, no laboratory tests are indicated. Most important, the patient should be asked how she is doing with her chosen contraceptive.
  • Follow-up sooner than 2 weeks can accurately predict successful abortion when vaginal ultrasonography is routinely used to confirm expulsion. Without ultrasonography, whether the patient or physician can accurately assess outcome in these situations is unknown. The main goal of the ultrasonography is to determine the presence or absence of the gestational sac. Harwood and colleagues demonstrated that clot and debris are normally seen in the uterus when transvaginal ultrasonography is used after medical abortion; the thickness of the endometrial lining does not predict abortion success.
  • Abortion is one of the safest procedures in contemporary practice. However, in some developing countries where safe, legal abortion is not available, 50 000 to 70 000 women die of unsafe abortion each year. Refinements in abortion technology, improvements in prevention and management of complications, and earlier abortions have all contributed to the impressive safety record. The case-fatality rate from abortion today is less than 1 death per 100 000 abortions. By comparison, the risk for death from anaphylaxis after parenteral administration of penicillin is about 2 per 100 000 events. The risk for complications is also low. In a recent large case series report, the risk for a complication requiring hospitalization was 0.7 per 1000 abortions; less serious complications occurred in 8 per 1000 abortions.
  • Both gestational age and abortion method influence abortion safety; in general, the earlier the abortion, the safer. In terms of mortality risk, suction curettage early in pregnancy is the safest method that has been widely used. Delays in obtaining services, regardless of the cause, tend to increase both the risk and cost of abortions. Suction curettage is safer than sharp curettage; medical abortion also has low complication rates.
  • Extensive literature has documented the long-term safety of abortion. Induced abortion does not harm a woman's reproductive capacity. Premature birth, infertility, ectopic pregnancy, spontaneous abortion, and adverse pregnancy outcomes are not increased in frequency after abortion. The question of placenta previa is unsettled; some reports have found an increased risk for this abnormal placental attachment in later pregnancies, whereas others have not.
    Induced abortion does not harm women's emotional health; for most women, it allows an overall improvement in quality of life. Indeed, the most common reaction to abortion is a profound sense of relief. In some studies, abortion has been linked with improved psychological health because the abortion resolved an intense crisis in the woman's life. The alleged “postabortion trauma syndrome” does not exist.
    Abortion does not increase a woman's risk for cancer. Flawed epidemiologic studies led to claims that abortion elevates a woman's risk for breast cancer in later life. However, recall bias among controls in case–control studies accounts for this association; large cohort studies from Scandinavia have found either no association or a protective effect of abortion. After review of the evidence, both the World Health Organization and the National Cancer Institute have concurred that no credible evidence supports a link between abortion and breast cancer.

“Unsafe abortion: the global public health challenge” (April 27, 2009)

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Iqbal H. Shah & Elisabeth Ahman, Chapter 2 “Unsafe abortion: the global public health challenge”, in Paul M, Lichtenberg ES, Borgatta L, Grimes DA, Stubblefield PG, Creinin MD (eds.). “Management of unintended and abnormal pregnancy: comprehensive abortion care”. (April 27, 2009). Oxford: Wiley-Blackwell. ISBN 978-1-4051-7696-5.

  • Each year throughout the world, approximately 205 million women become pregnant and some 133 million of them deliver live-born infants. Among the remaining 72 million pregnancies, 30 million end in stillbirth or spontaneous abortion and 42 million end in induced abortion. An estimated 22 million induced abortions occur within the national legal systems; another 20 million take place outside this context and by unsafe methods or in suboptimal or unsafe circumstances.
    When faced with unwanted or unintended pregnancies, women resort to induced abortion irrespective of legal restrictions. In contrast to other medical conditions, ideologies and laws restrict access to safe abortion services, especially in developing countries and among the poorest of poor countries. Information on the incidence of induced abortion, whether legal and safe or illegal and unsafe, is crucial for identifying policy and programmatic needs aimed at reducing unintended pregnancy and addressing its consequences. Understanding the magnitude of unsafe abortion and related mortality and morbidity is critical to addressing this major yet much neglected public health problem.
  • Contrary to the commonly held view, most women seeking abortion are married or live in stable unions and already have several children. Some have an induced abortion to limit family size and some to space births. Where abortion is highly restricted, educated affluent women can often successfully obtain an abortion from a qualified provider, whereas poor women or those who have little or no education lack this option. Policy makers and program managers often need to know if certain groups require particular attention for prevention of unplanned pregnancy and unsafe abortion. Because of the limited data, however, socioeconomic and demographic differentials in unsafe abortion by marital status, education, income, work participation, type of occupation, urban-rural place of residence, ethnicity, and parity are difficult to document.
  • Legal restrictions do not eliminate abortion; instead, they make abortions clandestine and unsafe. Unsafe abortion carries high risk of death and disability. Unsafe abortion and related mortality are consistently higher in countries with increasing restrictions on legal abortion.
    Abortion is permitted on several grounds in most countries. However, in five countries (Holy See, Chile, El Salvador, Malta, and Nicaragua) induced abortion is not permitted even to save the life of the woman. While 67% of developed countries permit abortion on request, the corresponding figure is 15% for developing countries. Abortion is permitted solely to save the woman’s life in 22 countries in Africa, 15 in Asia, 3 in Europe, 11 in Latin America, and 7 in Oceania.
  • Abortion laws and policies should reflect our current commitment to women’s health and well-being rather than criminal codes and punitive measures left over from past centuries.

“Management of unintended and abnormal pregnancy: comprehensive abortion care” (April 27, 2009)

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Bonnie Scott Jones, Jennifer Dalven, “Abortion law and policy in the USA” Ch.4 in Paul M, Lichtenberg ES Borgatta L Grimes DA Stubblefield P Creinin (eds) “Management of unintended and abnormal pregnancy: comprehensive abortion care”. (April 27, 2009). Oxford: Wiley-Blackwell. ISBN 978-1-4051-7696-5.

  • Both opposition and emotional support from a patient’s partner, parents, or close friend can affect her emotional state on the day of the abortion and her adjustment afterwards. Research shows that a woman’s belief in her ability to cope and her well-being are enhanced when she perceives that she has social support for her abortion, and they are diminished when she does not.
    If a woman has a male partner, his reactions can affect her emotional response to the abortion experience positively or negatively. A male partner’s low expectation for postabortion coping affects the patient negatively if her own expectation is also low. A patient’s strong expectation for coping effectively mitigates a partner’s negative expectation.
  • Although some studies suggest that adolescence is a potential risk factor for negative emotional sequelae after abortion, longitudinal research shows that adolescents do not have a higher incidence of negative reactions, such as long-term depression. In the short term, teens may be more likely to engage in avoidant coping methods such as denial and mental disengagement and have lower expectations for coping ability.
    For adolescents, the reactions of parents can significantly increase or reduce emotional distress. Research has found that negative, antagonistic, or conditional support from parents is more detrimental to a young woman’s postabortion psychological adjustment than the absence of disclosure. When someone other than the adolescent herself discloses the pregnancy to her parents, the likelihood of negative outcome increases. Furthermore, the patient who chooses not to tell her parents but “believes” they would be supportive of her decision copes better after abortion than the patient who tells her parents but receives less than full support.
  • When the abortion process takes more than one day, as in some second-trimester procedures or medical abortions it is important to find out if the patient is being abused by her supposed “support” person. The risk of medical noncompliance is potentially increased for the patient whose abuser will be with her during the abortion process. If trust has been established in the patient-provider relationship, then she is more likely to reveal the truth when asked, “Have you ever been hit, or forced to have sex, or mentally abused by the person who will be with you overnight (if second trimester) or who will be with you during the medical abortion?” If a minor reveals abuse, then the provider must follow the laws for mandated reporting of child abuse. Providing referrals for domestic violence and/or rape crises counseling would be appropriate for these patients.
  • Some patients (who may or may not be abuse or rape survivors) express a strong preference for female clinicians/ attendants. Other patients are not affected by the provider’s gender, or they silently submit to whomever is in attendance. Providing abortion care for the patient whose pregnancy resulted from rape or who has suffered sexual violation in the past can present additional challenges for the clinician, especially if male. If a patient has been violated by a male perpetrator, then she may reject (verbally or nonverbally) being touched by a male clinician, ultrasound technician, or nurse. The key is to find out if gender is an issue for her and to offer choices and ways in which she can feel more in control, such as offering a female presence in the room.
  • Understanding the reasons that a woman may seek an abortion after the first trimester can help the clinician offer compassionate care. Most women who present for second trimester abortion care would have preferred to have the procedure earlier in gestation. Recent studies of women having second-trimester abortions in US facilities found that the most common reasons for delay were:
    *delays in detecting pregnancy;
    (indecision about the abortion; and
    * difficulties making financial or logistical arrangements for the abortion.
    Less common reasons included relationship problems, fears about telling parents (particularly for minors) or others; and/or time restraints because of work, school, or family obligations. In addition, because of the typical timing of prenatal diagnostic testing, a woman may not learn that she is carrying a fetus with serious or fatal congenital anomalies until the second trimester; moreover, some women develop medical or pregnancy complications as the gestation advances, and abortion is advised to preserve their health or lives.
  • In those rare instances when a woman expresses troubled feelings months or years after an abortion, the following issues often underlie the distress:
    *relationship dissatisfaction with her partner;
    *conflicts with one or both parents;
    *significant losses subsequent to the abortion;
    * failed outcome of a wanted pregnancy;
    * preexisting disorders, such as depression, obsessive compulsive, bipolar, panic, or personality disorders, and/or previous trauma that may be undiagnosed or untreated;
    *prone to shame and sensitive to stigma, and thining abortion is killing a baby;
    * events that trigger troubled memory of the abortion;
    *perception of insensitive treatment by the abortion provider;
    *joining a church that condemns abortion and emphasizes judgment;
    *exposure to antiabortion messages that foster feelings of victimization and shame;
    * isolation, lack of social support; and/or
    *loneliness, feeling unloved.
    The resolution of some of these issues requires professional counseling and possibly medical treatment. Other sources of distress can be relieved by trained secular or pastoral postabortion counselors or self-help resources and social support.
  • Obtaining informed consent, addressing the contraceptive needs of women, and attending to any emotional needs that may arise are essential to providing high-quality abortion care. The use of effective communication skills and needs assessment to discern patients’ concern provides important benefits to both the patient and the abortion care provider.

"Abortion laws reform may reduce maternal mortality: an ecological study in 162 countries" (5 January 2019)

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Latt, Su Mon; Milner, Allison; Kavanagh, Anne (5 January 2019). "Abortion laws reform may reduce maternal mortality: an ecological study in 162 countries". BMC Women's Health. 19 (1): 1. doi:10.1186/s12905-018-0705-y. ISSN 1472-6874. PMC 6321671. PMID 30611257.

  • There is little or no research about abortion laws and their impact on maternal mortality. Most studies have assessed change in trends of maternal mortality within countries after legalization without accounting for the other factors, such as levels of female education, which also change with time. For example, Handerson et.al conducted a retrospective medical chart review in Nepal after abortion law was reformed to legally permit abortion for rape or incest, physical or mental health reasons. They found that the reformation of abortion laws in Nepal appeared to be associated with a significant decline in the rate of abortion-related morbidities, such as serious infections and systematic complication. This study did not address possible impacts on maternal mortality. Of those studies that have been conducted, most have found a significant decrease in maternal mortality when abortion laws became less restrictive. However, one study conducted in Chile found that maternal mortality was decreased after abortion became completely illegal in Chile. Only one study was conducted in more than one country, where changes in abortion laws and maternal mortality were assessed in Romania, South Africa, and Bangladesh. This study found a downward trend in maternal mortality after the liberalization of abortion laws.
    While existing studies provide weak evidence of an association between more flexible abortion laws and reduced maternal mortality, all but one have been conducted within one country and none of the studies take account of confounding variables that change over time such as economic conditions and female education. In order to fill this gap in research, we conducted an ecological analysis using data from 162 countries on abortion laws and maternal mortality between 1985 and 2013 to estimate the association between the flexibility of abortion laws and maternal mortality at a country level.
  • There are a number of explanations for the association between the flexibility of abortion laws and maternal mortality. First, when abortion is legal and accessible within the health system, the quality of abortion services is improved, and thus reducing the incidence of unsafe abortions. Second, it is possible that change in total fertility rates (TFR) may play a role in influencing maternity mortality. Although the exact mechanism of the association between TFR and maternal mortality is still unknown, countries with higher TFR have higher maternal mortality. In a national household survey in Romania, TFR reduced after the restrictive abortion law was abolished in 1989. This is supported by a recent study in Mexico, which examined the effect of elective abortion program in Mexico city in 2007. Third, some effects can be mediated through the changes in the health-seeking behaviors of women. Women with an unwanted pregnancy will seek safe abortion services if they can request abortions legally.
    Our findings suggest that the liberalization of abortion laws will reduce maternal mortality. In our sample of 162 countries, 48 countries had flexibility score less than three in 2013; it is possible that maternal mortality would reduce in these countries if legal, safe abortion was more readily available. However, it is important to acknowledge that it may take years for abortion law reform to impact on maternal mortality. In fact, the change of the abortion laws itself may not be sufficient to reduce maternal mortality. Abortion law reform must also be accompanied with improved access to safe abortion services, as well as improvement in community attitudes (e.g., reduction in stigma) towards these services.
  • In conclusion, our study demonstrates that maternal mortality is lower when abortion laws are less restrictive. Our results suggest that there is a need to reform abortion laws in the countries with the most restrictive abortion laws, and to provide safe abortion services to protect women from unsafe and illegal abortions. To improve our understanding of the associations between abortion law and maternal mortality and other women’s health issues we recommend that key country-level variables such as contraceptive prevalence, female education and gender equity are systematically recorded.

“How TV lied about abortion” (Oct 14, 2021)

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Tanya Melendez, “How TV lied about abortion”, Vox, (Oct 14, 2021)

 
For decades, abortion on television was largely depicted as a debate in narrative form, one that pitted melodramatic anti- and pro-abortion rights stances against each other through characters audiences knew and loved.
 
Throughout the 1980s and ’90s, many television shows endorsed a position on a variety of social issues through their characters, making it clear they considered one side “right.” Topics such as race, gender equality, rape, HIV/AIDS, sexuality, addiction, mental illness, and more were all explored in primetime, typically in progressive fashion, and eventually, society moved toward those beliefs.
Whether it was Tom Hanks playing Elyse Keaton’s alcoholic brother on Family Ties, Ellen DeGeneres coming out in “The Puppy Episode” on her eponymous sitcom, Denzel Washington navigating racism as a doctor on St. Elsewhere, Chad Lowe playing an HIV-positive character on Life Goes On, or the late, great Dixie Carter’s Julia Sugarbaker delivering a stinging monologue about workplace sexual harassment on Designing Women, shows were not shy in writing strong, clear messages about where they stood on the biggest social debates of our time.
Except abortion. Those stories went out of their way to show “both sides” in the best possible light.
  • For decades, abortion on television was largely depicted as a debate in narrative form, one that pitted melodramatic anti- and pro-abortion rights stances against each other through characters audiences knew and loved. Gretchen Sisson and Katrina Kimport, researchers at the University of California San Francisco, argued in 2014 that, over time, these narratives collectively created “common cultural ideas about what pregnancy, abortion, and women seeking abortion are like.” The result, according to Sisson and Kimport, was an inaccurate picture of who seeks abortions, and why.
    Fictional abortions were also overdramatized. From the origins of television all the way through the past decade, overwhelmingly male TV writers created plot lines that framed abortion as a moral issue, amping up conflict for maximum emotional journeys. It isn’t hyperbolic to say that television significantly changed the way America understood abortion and, as a result, deeply influenced public policy.
  • From the first broadcast in 1928 through 1980, only two abortions seem to have happened in all of primetime television. The Defenders was the first series to mention abortion, although the procedure did not include a main character. Then, in 1972, came Maude.
    Writers for the Bea Arthur show only included the plot because they wanted to win a $10,000 contest prize for storytelling from an organization called Zero Population Growth. Original drafts focused on vasectomies, but showrunner Norman Lear wanted his main character to carry the humor, so writers switched to the now-legendary tale. An estimated 65 million people, or nearly one-third of the American population at the time, watched as 47-year-old married grandmother Maude discovered she was unexpectedly expecting and debated whether to keep the pregnancy. In the end, Maude had an abortion. Off camera, yes. Never mentioned on the show again? Also yes — but it happened. A main character wouldn’t make that choice again for a very long time.
  • The 1980s saw an increase in television that embraced more realistic storytelling, bolstered by eager audiences and more relaxed social mores. Issues like breast cancer, domestic violence, single motherhood, rape, working life, dating, and abortion were all explored from 8 to 11 pm. But the business of television relied on advertiser support, and programs couldn’t upset their sponsors or their conservative viewers any more in 1982 than they could in 1962. After all, Catholics buy cars, too.
    Since narratives are driven by conflict, in an abortion plot line writers typically used the choice itself to drive the story. This approach created high-stakes, emotionally driven drama around making the decision and framed having an abortion as the worst possible outcome of pregnancy.
    It also established an inaccurate profile of a typical abortion seeker by linking the procedure to a particular archetype: typically young, white, and middle-class or affluent women who had no other children and who rarely struggled to find an abortion provider. The real story is vastly different. Many abortion seekers are women of color, religiously affiliated, and already have children, and in recent years most are low-income or below the federal poverty line.
  • Characters getting pregnant or having babies can add exciting new avenues for storytelling, and this was especially true for shows that centered more complex, nuanced female characters in the 1990s and early 2000s. Here, TV attempted to have their feminist cake and eat it, too: Familiar characters were given the space to express and explore viewpoints that support abortion rights, but by them eventually relenting to parenthood, showrunners could still have the comedy of watching Murphy Brown navigate having a baby and doing the news. In execution, these plots often created an unintentional binary that sanctified motherhood and villainized abortion.
  • Throughout the 1980s and ’90s, many television shows endorsed a position on a variety of social issues through their characters, making it clear they considered one side “right.” Topics such as race, gender equality, rape, HIV/AIDS, sexuality, addiction, mental illness, and more were all explored in primetime, typically in progressive fashion, and eventually, society moved toward those beliefs.
    Whether it was Tom Hanks playing Elyse Keaton’s alcoholic brother on Family Ties, Ellen DeGeneres coming out in “The Puppy Episode” on her eponymous sitcom, Denzel Washington navigating racism as a doctor on St. Elsewhere, Chad Lowe playing an HIV-positive character on Life Goes On, or the late, great Dixie Carter’s Julia Sugarbaker delivering a stinging monologue about workplace sexual harassment on Designing Women, shows were not shy in writing strong, clear messages about where they stood on the biggest social debates of our time.
    Except abortion. Those stories went out of their way to show “both sides” in the best possible light.
  • Abortion was frequently represented as medically dangerous, as happening much more rarely than in actuality, and as mostly sought by demographics that don’t match national trends.
    Meanwhile, the complex elements of real public discourse were oversimplified into a pro/anti debate, where “reasonable” people on both sides framed the issue in moral terminologies. Abortion was shown as morally ambiguous, a necessary evil, regrettable, a consequence, a binary choice against parenthood, and/or reserved for specific examples of desperate need.
    Offscreen, this morality framework helped challenge a pregnant person’s right to the power of choice, creating a blueprint for how to take a private medical decision away from individuals and make it open to debate, because morality can be debated and judged in a way that medicine and access to medicine cannot. Like we saw on Party of Five, everyone gets a turn to give their opinion. Like we saw on Roseanne, it’s assumed all women are hardwired to want motherhood. Like we saw on Cagney & Lacey, “both sides” get equal time. These are the stories we’ve seen and heard over and over again, and now they are canon.

"The Safety and Quality of Abortion Care in the United States” (2018)

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National Academies of Sciences, Engineering; Division, Health Medicine; Board on Health Care Services; Board on Population Health Public Health Practice; Committee on Reproductive Health Services: Assessing the Safety Quality of Abortion Care in the U.S (2018). "The Safety and Quality of Abortion Care in the United States”, at NAP.edu. doi:10.17226/24950. ISBN 978-0-309-46818-3. PMID 29897702

  • There is little evidence on how preabortion care is typically provided, but there is consensus among professional guidelines that the preabortion encounter includes the following elements (Baker and Beresford, 2009; NAF, 2017a; RCOG, 2015; WHO, 2014):
    *individualized, sensitive, and respectful communication;
    *cultural sensitivity;
    * review of the risks and benefits of the available abortion procedures that is based on evidence and is easy to understand;
    *options for pain management, including nonpharmaceutical approaches, analgesia, sedation, and anesthesia;
    *support for emotional and other needs as they arise;
    *confirmation that the abortion decision is voluntary (not coerced);
    *explanation of what will be done before, during, and after the procedure, including the preabortion evaluation;
    *description of what the patient is likely to experience, clear instruction on aftercare, and how to recognize potential complications requiring emergency care;
    *whom to call and where to go for services for both routine and follow-up care; and
    *information and counseling on future prevention of unintended pregnancy and contraceptive options, including the option to obtain contraception immediately following the procedure.
    • ch.2, pp.47-48
  • Not every woman wants or needs psychological counseling in addition to patient education before an abortion (Baker and Beresford, 2009; Baron et al., 2015; Brown, 2013; Moore et al., 2011). Some women may wish to discuss the emotional aspects of the abortion with a counselor (Moore et al., 2011), and individualized counseling may be helpful for women having difficulty with their decision (Baker and Beresford, 2009). Women should also be referred to and have access to additional counseling and social services if needed (e.g., for counseling on intimate partner violence, sexual abuse care, rape crisis counseling, mental health services, substance abuse services, and postabortion counseling) (Goodman et al., 2016). As noted in Chapter 1, most women who undergo abortions are poor or low-income. Three-quarters of abortion patients have family incomes below 200 percent of the federal poverty level (Jerman et al., 2016) and thus may benefit from social support services. In addition, although the evidence is drawn largely from non-U.S. data (Australia, Canada, China, New Zealand, and the United Kingdom), epidemiological studies have shown that women who have abortions are disproportionately at risk of interpersonal and other types of violence (Bourassa and Berube, 2007; Evins and Chescheir, 1996; Fanslow et al., 2008; Fisher et al., 2005; Glander et al., 1998; Janssen et al., 2003; Keeling et al., 2004; Leung et al., 2002; Russo and Denious, 2001; Saftlas et al., 2010; Steinberg and Russo, 2008; Taft and Watson, 2007; Taft et al., 2004). Little is known about the extent to which abortion patients receive the follow-up social and psychological supports they need. A study of Finnish registry data provides some evidence that monitoring for mental health status in a follow-up visit after abortion may help reduce the consequences of serious mental health disorders (Gissler et al., 2015).
    • ch.2, p.48-49
  • Abortion care should always begin with a clinical evaluation, including a pertinent medical history and clinical assessment to assess the presence of comorbidities or contraindications relevant to the procedure. The primary aim of the evaluation is to confirm an intrauterine pregnancy and determine gestation. The physical exam may involve laboratory tests and ultrasonography to confirm an intrauterine pregnancy; assess gestation; screen for sexually transmitted infections (STIs) and cervical infections; document Rh status; or evaluate uterine size, position, and possible anomalies (ACOG and SFP, 2014; Goldstein and Reeves, 2009; Goodman et al., 2016; NAF, 2017a; RCOG, 2015; WHO, 2014). Women whose Rh status is unknown should be offered Rh testing and, if Rh negative, offered Rh immune globulin (ACOG and SFP, 2014, NAF, 2017a; RCOG, 2015). No evidence, however, indicates that Rh immune globulin is needed in pregnancies under 8 weeks’ gestation (NAF, 2017a). While it should not delay the abortion procedure, screening for STIs may be appropriate if available (NAF, 2017a; RCOG, 2015).
    • p.50
  • As noted in Chapter 1, abortion terminology can be confusing. All abortion methods are sometimes referred to as “induced,” and the term “medical” is often used to describe any nonsurgical method regardless of how early or late in pregnancy it occurs. In this section, the term “induction abortion” refers specifically to nonsurgical abortions that use medications to induce labor and delivery of the fetus. Relevant research and clinical guidelines use varying lower and upper gestation limits. In practice, the gestational parameters for induction vary depending on the facility, patient and provider preference, and state laws and regulations (SFP, 2011a).
    • p.66
  • The literature on the effectiveness of nonpharmacological approaches to reducing pain during abortion is inconclusive (Tschann et al., 2016). While a variety of methods have been assessed, including relaxation techniques (e.g., focused breathing, visualization, vocal coaching, and positive suggestion), hypnosis, aromatherapy, and abortion doulas, more definitive research is needed.
    • p.69
  • D&E is usually the medically preferred method for abortions at 14 weeks’ gestation or later. The alternative—induction—is more painful, slower, and more expensive.
    • p.80

"Abortion in American History" (May 1997)

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Katha Pollitt, "Abortion in American History". Atlantic Magazine. May 1997.

  • My files are crammed with articles assessing the question of when human life begins, the personhood of the fetus and its putative moral and legal status, and acceptable versus deplorable motives for terminating a pregnancy and the philosophical groundings of each one—not to mention the interests of the state, the medical profession, assorted religions, the taxpayer, the infertile, the fetal father, and even the fetal grandparent. Farfetched analogies abound: abortion is like the Holocaust, or slavery; denial of abortion is like forcing a person to spend nine months intravenously hooked up to a medically endangered stranger who happens to be a famous violinist. It sometimes seems that the further abortion is removed from the actual lives and circumstances of real girls and women, the more interesting it becomes to talk about. The famous-violinist scenario, the invention of the philosopher Judith Jarvis Thomson, has probably inspired as much commentary as any philosophical metaphor since Plato's cave.
  • Abortion as philosophical puzzle and moral conundrum is all very well, but what about abortion as a real-life social practice? Since the abortion debate is, theoretically at least, aimed at shaping social policy, isn't it important to look at abortion empirically and historically? Opponents often argue as if the widespread use of abortion were a modern innovation, the consequence of some aspect of contemporary life of which they disapprove (feminism, promiscuity, consumerism, Godlessness, permissiveness, individualism), and as if making it illegal would make it go away. What if none of this is true? In When Abortion Was a Crime, Leslie J. Reagan demonstrates that abortion has been a common procedure—"part of life"—in America since the eighteenth century, both during the slightly more than half of our history as a nation when it has been legal and during the slightly less than half when it was not.
  • If the abortion debate were really about abortion, Reagan's work would consign many of its terms to the scrap heap: it seems absurd to suggest that the overburdened mothers, desperate young girls, and precariously employed working women who populate these pages risked public humiliation, injury, and death for mere "convenience," much less out of "secular humanism" or a Lockean notion of property rights in their bodies. It's even more preposterous—not to mention insulting—to see them as standing in relation to their fetuses as a slaveowner to a slave or a Nazi to a Jew.
    Reagan suggests that the abortion debate is really an ideological struggle over the position of women. How free should they be to have sexual experiences, in or out of marriage, without paying the price of pregnancy, childbirth, and motherhood? How much right should they have to consult their own needs, interests, and well-being with respect to childbearing or anything else? How subordinate should they be to men, how deeply embedded in the family, how firmly controlled by national or racial objectives? If she is right, and I think she is, a work of history is not going to make much of a dent in the certainties of those who would like to see abortion once again made a crime.

"The Seven Most Common Lies About Abortion" (February 26, 2014)

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Rankin, Lauren (February 26, 2014). "The Seven Most Common Lies About Abortion". Rolling Stone.

  • In 2003, the National Cancer Institute conducted a workshop with more than 100 of the world’s leading experts on pregnancy and breast cancer risk, and they found that “induced abortion is not linked to an increase in breast cancer risk.” This was corroborated by a 2009 study by the American College of Obstetricians and Gynecologists, which demonstrated that recent, rigorous, methodologically-sound studies display “no causal relationship between induced abortion and a subsequent increase in breast cancer.”
  • According to the Mayo Clinic, “abortion isn’t thought to cause fertility issues or complications in subsequent pregnancies.” What’s more, the Guttmacher Institute, a nonpartisan organization dedicated to advancing sexual and reproductive health and rights, found that abortions performed in the first trimester “pose virtually no long-term risk” of infertility.
  • A recent study at the University of California, San Francisco found that 90 percent of women who were able to obtain an abortion reported that they were relieved and those who did cite negative emotions after their abortion didn’t indicate that they felt they had made the wrong choice. In that study, 80 percent of women who experienced mostly negative emotions still felt that abortion was the right choice for them.
  • Even though 23 states currently regulate the provision of ultrasound by abortion providers in some way, viewing an ultrasound doesn’t stop women from having an abortion. Not even close. According to a recent study featured in the Obstetrics and Gynecology Journal, of the 40 percent of women who chose to view their ultrasound, 98.4 percent still went through with their abortion.
  • The American Psychological Association’s Task Force on Mental Health and Abortion decisively states that there is “no evidence that having a single abortion causes mental health problems.”
  • According the Guttmacher Institute, the risk of death with abortion is 10 times lower than the risk of death from childbirth. Having an abortion is far safer than having a baby. What’s more, the Guttmacher Institute also notes that first trimester abortion is among “the safest medical procedures” and carries less than 0.05 percent risk of major complications that could require hospital care, and the risk of death for an abortion at or before eight weeks is literally one in a million. The real risk of death comes when abortion is unsafe: In 2008, 47,000 deaths from unsafe abortion were reported worldwide.

"Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion stigma" (13 January 2020)

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Rocca, Corinne H.; Samari, Goleen; Foster, Diana G.; Gould, Heather; Kimport, Katrina (13 January 2020). "Emotions and decision rightness over five years following an abortion: An examination of decision difficulty and abortion stigma". Social Science & Medicine. 248: 112704. doi:10.1016/j.socscimed.2019.112704. ISSN 0277-9536. PMID 31941577.

  • Despite weak theoretical grounding and ample research indicating women feel high levels of decision rightness and relief post-abortion, claims that abortion is inherently stressful and causes emergent negative emotions and regret undergirds state-level laws regulating abortion in the United States. Nonetheless, scholarship does identify factors that put a woman at risk for short-term negative postabortion emotions—including decision difficulty and perceiving abortion stigma in one's community—pointing to a possible mechanism behind later emergent or persistent post-abortion negative emotions.
  • Results
    We found no evidence of emerging negative emotions or abortion decision regret; both positive and negative emotions declined over the first two years and plateaued thereafter, and decision rightness remained high and steady (predicted percent: 97.5% at baseline, 99.0% at five years). At five years postabortion, relief remained the most commonly felt emotion among all women (predicted mean on 0-4 scale: 1.0; 0.6 for sadness and guilt; 0.4 for regret, anger and happiness). Despite converging levels of emotions by decision difficulty and stigma level over time, these two factors remained most important for predicting negative emotions and decision non-rightness years later.
    Conclusions
    These results add to the scientific evidence that emotions about an abortion are associated with personal and social context, and are not a product of the abortion procedure itself. Findings challenge the rationale for policies regulating access to abortion that are premised on emotional harm claims.
  • In the later decades of the twentieth century, opponents of abortion put forward an argument against access to legal abortion premised on the idea that abortion harms women by causing negative emotions and regret (for detailed discussion, see APA Task Force on Mental Health and Abortion, 2008; Kelly, 2014; Siegel, 2008; Steinberg and Finer, 2011). The theoretical grounding for this proposed phenomenon is only weakly established (Charles et al., 2008); it typically relies on a framework founded on paternalistic, and often religious, beliefs about women's “nature” and supposedly innate maternal desire that constructs abortion as inherently stressful (Kelly, 2014; Lee, 2001; Siegel, 2008). Analyses testing this conceptual framework, named the “abortion-as-trauma” framework, as an explanation for post-abortion psychological health have found no rigorous support for it (APA Task Force on Mental Health and Abortion, 2008; Steinberg and Finer, 2011). Nonetheless, in recent years, this assertion has undergirded United States (U.S.) court decisions (Siegel, 2008) as well as the development and passage of state-level laws in the U.S. regulating abortion (Coleman, 2006). In eight states, for example, state-mandated materials that every abortion patient receives include claims that abortion causes lasting emotional (and mental health) harm (Guttmacher Institute, 2019). Similarly, 27 states require patients seeking an abortion to wait a specified period of time, usually 24 hours, to ensure that they have had sufficient time to decide if abortion is right for them (Khazan, 2015), a rationale premised on the assumption that regret is likely.
  • About half of participants felt that deciding to have the abortion was very difficult (27%) or somewhat difficult (27%), while almost half felt it was not a difficult decision (46%) (Table 1). Those who had more difficulty deciding were more likely to be raising children already and less likely to be raising no children, compared to those reporting no difficulty (p < 0.01). Those who expressed more difficulty deciding had higher pregnancy planning scores (p < 0.001), had more negative feelings about the pregnancy (p < 0.001), and were more likely to be seeking near-limit abortions (p = 0.003). Finally, decision difficulty at baseline increased with higher levels of perceived abortion stigma in their community: among those reporting the decision was very difficult, 45% perceived high levels and 26% perceived no stigma; these figures were 24% and 46%, respectively, among those having no difficulty. There were no differences in difficulty deciding by participant age, race, education, or history of depression/anxiety.
  • One week post-abortion, decision rightness did not differ by perceived level of abortion stigma in women's communities (Table 4): women perceiving no stigma were similarly likely to report abortion was the right decision (98.0%) as those perceiving low (97.5%) or high (96.8%) levels of stigma. The odds of reporting the decision was right increased significantly each year among those with no perceived abortion stigma (aOR = 1.45, 95% CI: 1.12, 1.87), with similar patterns of decision rightness among those perceiving low or high stigma. Despite the trend of increasing decision rightness across all participants regardless of the perceived stigma level of their communities, those who reported perceiving high stigma beginning two years after the abortion had lower levels of decision rightness compared to those perceiving no stigma. Beginning at three years' post-abortion, those perceiving low stigma in their communities had lower levels of decision rightness. At five years' post-abortion, the percentages feeling abortion was the right decision were 99.5% (no stigma), 98.7% (low stigma), and 97.7% (high stigma).
  • In this five-year longitudinal study of 667 women having abortions across 21 states, the presence and intensity of all emotions felt about the abortion – both negative and positive – declined with time, with the sharpest declines in the first year and emotions plateauing between two and five years (see Fig. 1, Fig. 2). In addition, the predicted percent of women reporting that the abortion was the right decision increased gradually from over 97% one week post-abortion to 99% at five years (see Fig. 3). Extending existing research showing high levels of reports that abortion was the right decision immediately (APA Task Force on Mental Health and Abortion, 2008; Major et al., 2000; Rocca et al., 2013) and up to three years after the abortion (Broen et al., 2004, 2005; Kero et al., 2004; Miller, 1992; Rocca et al., 2015), we found no evidence of emergent negative or positive emotions over the five years following the abortion, demonstrating no support for claims that abortion causes negative emotions or that women typically come to regret their abortions. Indeed, at all time points, relief was the most commonly felt emotion (see Fig. 2), consistent with the body of literature on women's emotions in the short-term after an abortion (APA Task Force on Mental Health and Abortion, 2008; Major et al., 2000; Rocca et al., 2013).
  • Despite the overall high numbers of women reporting that abortion was the right decision, when we examined the factors associated with ever reporting abortion was not the right decision (or “don't know”) between three and five years, decision difficulty and perceived abortion stigma remained significant factors. This finding expands our prior result that decision difficulty and perceived community abortion stigma are most important in shaping emotions in the short term post-abortion (Rocca et al., 2013, 2015), and are the first to show they remain important years later. These factors are, notably, personal and social factors, providing further evidence that emotions and feeling that an abortion was not the right decision are associated with personal and social context, not associated with (or predicted by) demographics and not engendered by the abortion procedure itself.
  • Over the five years after having an abortion, the intensity of negative and positive emotions about the abortion declined, particularly over the first year, with relief predominating at all times. The overwhelming majority of women felt that the abortion was the right decision for them at all times. Our findings challenge the rationale for state-mandated counseling protocols on post-abortion emotions and other policies regulating access to abortion premised on emotional harm claims (e.g. waiting periods).
    Despite converging levels of emotions by decision difficulty and stigma level over time, these two factors remained most important for predicting negative emotions and decision non-rightness years later. Notably, however, while we can establish temporal associations between the variables we measured, we are unable to identify the actual causal mechanisms leading some individuals to experience negative emotions or decision regret. Indeed, future research should explore the possibility that the social discourse, perhaps including antiabortion discourse that assert negative emotional outcomes (Kelly, 2014), may itself contribute to the negative emotions it describes. In terms of clinical practice, findings do not offer evidence of a need for clinicians and other providers to specifically counsel women seeking abortions on post-abortion emotional trajectories, though they may offer support for interventions aimed at coping with community abortion stigma.

"Therapeutic Abortion" (28 September 2004)

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Roche, Natalie E. (28 September 2004). "Therapeutic Abortion". eMedicine. Archived from the original on 14 December 2004. Retrieved 19 June 2011.

  • History of the Procedure: Termination of pregnancy has been practiced since ancient times and by all cultures. The indications and social context for termination of pregnancy vary with culture and time.
    The use of abortion to preserve the life of the mother has been widely accepted. Early Jewish scholars' interpretation of the Talmud required that the fetus be destroyed if it posed a threat to the mother during delivery. The ancient Greeks allowed abortion under certain circumstances. Ancient Romans did not consider a fetus a person until after birth, and abortion was practiced widely. Early Christians had varying practices regarding abortion. By 1869, the Catholic Church declared abortion a sin punishable by excommunication.
  • Therapeutic abortions to save the life of the mother or to preserve the health of the mother are rare events. The decision should be based on the collaborative agreement of a multidisciplinary team. At minimum, the team should consist of the patient, the obstetrician, a specialist with knowledge of the disease in question, an expert in genetic counseling, and a neonatologist. Additional members may include spiritual counselors, nurses, psychologists/psychiatrists, intensive care specialists, ethicists, and family members.
    The decision to terminate the pregnancy includes consideration of the effect of the pregnancy on disease outcome, the effect of treatment on fetal outcome, the gestational age of the pregnancy, the level of attachment of the patient to the pregnancy, the desires of the patient and the father, and the availability of family resources/support. This complex situation requires thought and excellent communication among the involved parties regarding the short- and long-term consequences of the decision to abort or continue the pregnancy. The decision must be individualized for each patient. There must be an inherent acceptance of the subjective nature of decisions made in this area. The clinical situations may be rare, and clinical data available may be anecdotal, incomplete, and/or inconclusive.
  • Contraindications: Absolute contraindications to termination of pregnancy are virtually unknown. In the face of significant maternal risk of medical or psychiatric morbidity/mortality, continuation of pregnancy usually presents far greater risk than termination of pregnancy. A particular type of abortion procedure or the timing of abortion may be contraindicated based on the current medical, surgical, or psychiatric condition of a patient.
  • Surgical abortion is 99% effective in terminating pregnancy. Medical abortion using mifepristone and misoprostol has a mean effectiveness of 94%. Medical abortion using methotrexate and misoprostol has effectiveness ranging from 88-96%. Medical abortion in the second trimester using misoprostol has effectiveness ranging from 40-89% within 24 hours. Instillation methods of abortion have effectiveness ranging from 81-86% at 48 hours to 97% at 72 hours.
  • Medical abortions in the first trimester are very safe and well-tolerated procedures. The major problem is decreased efficacy with increasing gestational age. In the case of methotrexate, a long period of time between administration of medication to abortion is problematic.
    First-trimester abortions performed by surgical or medical methods are well tolerated, have little effect on future fertility, and are not associated with long-term psychological consequences. Second-trimester abortions are well known to be associated with increased risk of morbidity and mortality with increasing gestational age. An association of increased risk for preterm delivery after dilation with metal dilators has been reported.

"Philly Abortion Horrors: What Matters Is How and Not When an Abortion Is Done, Says Expert" (Jan 21, 2011)

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Rochman, Bonnie. "Philly Abortion Horrors: What Matters Is How and Not When an Abortion Is Done, Says Expert". Time – via healthland.time.com. (Jan. 21, 2011)

  • Warren Hern, likely the last U.S. doctor to openly specialize in abortions performed late in pregnancy, authored a textbook on how to properly do abortions. In it, he quotes a colleague, Robert Crist, who had experience with abortions late in pregnancy: “Abortion is a simple procedure except for the uterus’ complete intolerance for bad technique.”
    Bad technique — that’s what it comes down to when speaking of what transpired in a filthy Philadelphia abortion clinic where blood-stained blankets and fetal body parts in milk jugs were found. Its proprietor, Dr. Kermit Gosnell, was charged Wednesday with performing illegal late-term abortions.
  • Hern makes the case that it’s really not about when an abortion is performed. What’s more important is how it’s performed.
    Hern emphasized that while he has no personal knowledge of how Gosnell operated at the Women’s Medical Society, his clinic in a low-income neighborhood of West Philadelphia, he chalks it up to incompetence.
    “It’s horrifying,” says Hern. “It’s a question of applying good principles of surgery and medical practice to whatever you’re doing and doing the safest thing you can for the patient.”
  • For sure, late abortions have the potential to be more dangerous than first-trimester abortions. The fetus is larger, the uterus is larger, and there is a greater chance of serious complications. But early abortions can be deadly too if they’re not done properly.
    Hern declined to make a direct association between Gosnell’s clinic and laws curtailing abortion, but he did allow himself to speak in generalities. “As a rule, any law restricting abortion is almost automatically going to make abortion more dangerous for women,” he says.

"Legal or Not, Abortion Rates Compare" (12 October 2007)

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Rosenthal, Elizabeth (12 October 2007). "Legal or Not, Abortion Rates Compare". The New York Times. Archived from the original on 28 August 2011. Retrieved 18 July 2011.

  • A comprehensive global study of abortion has concluded that abortion rates are similar in countries where it is legal and those where it is not, suggesting that outlawing the procedure does little to deter women seeking it.
    Moreover, the researchers found that abortion was safe in countries where it was legal, but dangerous in countries where it was outlawed and performed clandestinely. Globally, abortion accounts for 13 percent of women’s deaths during pregnancy and childbirth, and there are 31 abortions for every 100 live births, the study said.
  • “We now have a global picture of induced abortion in the world, covering both countries where it is legal and countries where laws are very restrictive,” Dr. Paul Van Look, director of the W.H.O. Department of Reproductive Health and Research, said in a telephone interview. “What we see is that the law does not influence a woman’s decision to have an abortion. If there’s an unplanned pregnancy, it does not matter if the law is restrictive or liberal.”
    But the legal status of abortion did greatly affect the dangers involved, the researchers said. “Generally, where abortion is legal it will be provided in a safe manner,” Dr. Van Look said. “And the opposite is also true: where it is illegal, it is likely to be unsafe, performed under unsafe conditions by poorly trained providers.”
  • In Eastern Europe, where contraceptive choices have broadened since the fall of Communism, the study found that abortion rates have decreased by 50 percent, although they are still relatively high compared with those in Western Europe. “In the past we didn’t have this kind of data to draw on,” Ms. Camp said. “Contraception is often the missing element” where abortion rates are high, she said.
  • The wealth of information that comes out of the study provides some striking lessons, the researchers said. In Uganda, where abortion is illegal and sex education programs focus only on abstinence, the estimated abortion rate was 54 per 1,000 women in 2003, more than twice the rate in the United States, 21 per 1,000 in that year. The lowest rate, 12 per 1,000, was in Western Europe, with legal abortion and widely available contraception.

"The Care of Women Requesting Induced Abortion" (27 July 2013)

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(Royal College of Obstetricians and Gynaecologists: "The Care of Women Requesting Induced Abortion" (PDF). Royal College of Obstetricians and Gynaecologists. Archived from the original (PDF) on 27 July 2013. Retrieved 29 June 2008.

  • The earlier in pregnancy an abortion is performed, the lower the risk of complications. Services should therefore offer arrangements that minimise delay (for example, a telephone referral system and a formal care pathway with arrangements for access from a wide range of referral sources, not just general practitioners).
    • p.7
  • 16. Clinicians providing abortion services should possess accurate knowledge about possible complications and sequelae of abortion. This will permit them to provide women with the information they need in order to give valid consent.
    16.1 The risk of haemorrhage at the time of abortion is low. It complicates around 1 in 1000 abortions overall. The risk is lower for early abortions (0.88 in 1000 at less than 13 weeks; 4.0 in 1000 at more than 20 weeks).
    16.2 The risk of uterine perforation at the time of surgical abortion is moderate. The incidence is of the order of 1—4 in 1000. The risk is lower for abortions performed early in pregnancy and those performed by experienced clinicians.
    16.3 Uterine rupture has been reported in association with mid-trimester medical abortion. However, the risk is very low, at well under 1 in 1000.
    16.4 Cervical trauma: the risk of damage to the external cervical os at the time of surgical abortion is moderate (no greater than 1 in 100). The risk is lower when abortion is performed early in pregnancy and when it is performed by an experienced clinician.
    16.5 Failed abortion and continuing pregnancy: all methods of first-trimester abortion carry a small risk of failure to terminate the pregnancy, thus necessitating a further procedure. The risk for surgical abortion is around 2.3 in 1000 and for medical abortion between 1 and 14 in 1000 (depending on the regimen used and the experience of the centre).
    16.6 Post-abortion infection: genital tract infection, including pelvic inflammatory disease of varying degrees of severity, occurs in up to 10% of cases. The risk is reduced when prophylactic antibiotics are given or when lower genital tract infection has been excluded by bacteriological screening.
    16.7 Breast cancer: induced abortion is not associated with an increase in breast cancer risk.
    16.8 Future reproductive outcome: there are no proven associations between induced abortion and subsequent ectopic pregnancy, placenta praevia or infertility. Abortion may be associated with a small increase in the risk of subsequent miscarriage or preterm delivery.
    16.9 Psychological sequelae: some studies suggest that rates of psychiatric illness or self-harm are higher among women who have had an abortion compared with women who give birth and to nonpregnant women of similar age. It must be borne in mind that these findings do not imply a causal association and may reflect continuation of pre-existing conditions.
    • pp.8-9
  • Intrauterine contraception can be inserted immediately following a first- or second-trimester termination of pregnancy.
    Sterilisation can be safely performed at the time of induced abortion. However, combined procedures are associated with higher rates of failure and of regret on the part of the woman.
    • p.13

"Legal abortion worldwide: incidence and recent trends" (September 2007)

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Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J (September 2007). "Legal abortion worldwide: incidence and recent trends". International Family Planning Perspectives. 33 (3): 106–16. doi:10.1363/3310607. PMID 17938093. Archived from the original on 19 August 2009.

  • RESULTS
    In recent years, more countries experienced a decline in legal abortion rates than an increase, among those for which statistics are complete and trend data are available. The most dramatic declines were in Eastern Europe and Central Asia, where rates remained among the highest in the world. The highest estimated levels were in Armenia, Azerbaijan and Georgia, where surveys indicate that women will have close to three abortions each on average in their lifetimes. The U.S. abortion rate dropped by 8% between 1996 and 2003, but remained higher than rates in many Northern and Western European countries. Rates increased in the Netherlands and New Zealand. The official abortion rate declined by 21% over seven years in China, which accounted for a third of the world's legal abortions in 1996. Trends in the abortion rate differed across age-groups in some countries.
    CONCLUSIONS
    The abortion rate varies widely across the countries in which legal abortion is generally available and has declined in many countries since the mid-1990s.
  • Accurate information on abortion levels and trends can help donors, policymakers and program planners assess the extent to which women experience unintended pregnancies, and can facilitate the development of policies and programs to respond to unmet need for effective contraceptive services. Accurate measures of abortion can also inform the public discourse by providing impartial, empirical evidence of abortion prevalence.
    The last assessment of abortion levels in countries where legal abortion is generally available was conducted nearly a decade ago. According to that study, up to the mid-1990s, legal abortion rates had been falling in many parts of the world, either as contraceptive prevalence was increasing or as contraceptives were being used more effectively. The investigators speculated that although the legalization of abortion may initially result in an increase in the number of reported abortions in countries where desired fertility is low, abortion rates will eventually decline as access to family planning education and contraceptive services increases.
  • In many countries, a general pattern emerged, in which the abortion rate was low for women younger than 20, peaked among those aged 20–24 and declined with each successive age-group. In Eastern Europe, abortion rates remained high for women aged 25–34 and descended more gradually with successive age-groups than rates in Western Europe and other developed countries. Survey findings for the Western and Central Asian countries, where abortion rates were among the highest in the world, show that rates tended to peak among women aged 25–34 (not shown). The age-specific abortion pattern in these regions reflects that many women have abortions to limit family size rather than to delay the start of childbearing.
    The abortion rate among 20–24-year-olds was higher in the United States than in other developed countries; however, U.S. rates among women aged 30 or older were lower than those in many developed countries. By 2003, the teenage abortion rate in the United States (22 per 1,000 women) was comparable to that in England and Wales and Sweden. This situation marks a change from the mid-1990s, when this rate was substantially higher in the United States than in these countries (22 and 18, respectively); the change is due in part to a decline in the adolescent abortion rate in the United States between 1996 and 2003. Over the same period, however, the adolescent abortion rate rose in Sweden—a trend that Swedish researchers attribute partly to cuts in funding for sex education and increases in the incidence of casual sex without contraceptive use. Nevertheless, the English-speaking developed countries have higher adolescent abortion rates than many other developed countries, with the exception of the former Soviet states. This difference is ascribed to the more pragmatic approach to adolescent sexuality in other developed countries, including easier access to contraceptive services for adolescents.
  • The prevalence of legal abortion varies widely across the countries in which it is generally available. Where the abortion rate is high, it likely reflects that levels of contraceptive use are not sufficient to meet the fertility desires and family planning needs of women and couples.
    Many abortion rates in Eastern Europe and Western and Central Asia remain among the highest in the world. In Armenia, Azerbaijan, Georgia and the Russian Federation, more abortions than births still occur each year; this may also be the case in other countries of these regions with incomplete reporting. Abortion levels in Northern Europe and parts of Western Europe are among the lowest in countries with legal abortions. Abortion rates in the United States, while moderately low, are higher than rates in many developed countries outside of the former Soviet region, particularly among women younger than 30.
    Since 1996, more countries have experienced a decline in abortion rates than an increase, among those with complete abortion counts and trend data. The downward trend in reported legal abortions is most marked in Eastern Europe, and the incomplete statistics suggest that this trend was also strong in Central and Western Asia. The actual decrease in abortion rates is probably smaller than suggested by the data, because in these regions, abortions are increasingly being paid for privately (in either public or private facilities), and such procedures are less likely than others to be reported. These countries, along with Cuba, have a legacy of an "abortion culture" that characterized the Soviet era, when abortion was freely available but contraceptive options were limited and supplies not always available.
  • In developed countries where contraception is accepted socially and family planning services are generally available, the abortion rate ranges from about seven to 20 per 1,000 women. In some subpopulations, the rate has been as low as 3–4 per 1,000, as among the Dutch-born population of the Netherlands in the recent past. Evidence suggests, however, that unwanted pregnancies and induced abortions occur to some degree in every society, for a number of reasons—contraceptive methods fail on occasion, couples do not always use their methods correctly or consistently, some women have partners who oppose contraceptive use, some become pregnant as a result of coerced sex and some seek abortion for health reasons or because of changes in their circumstances.
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Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH (2007). "Induced abortion: estimated rates and trends worldwide". Lancet. 370 (9595): 1338–45. doi:10.1016/S0140-6736(07)61575-X. PMID 17933648. S2CID 28458527.

  • Induced abortion is one of the greatest human rights dilemmas of our time. The need for scientific and objective information on the matter is therefore imperative. However, because of the sensitive nature of the topic, data sources are limited and accurate information on the occurrence of induced abortion is difficult to obtain.
    • p.1338
  • The estimated absolute number of abortions was greater in 2003 than in 1995 in Africa, but was lower in 2003 in Asia, and Latin America and the Caribbean. However, the abortion rate seemed to have decreased in Africa, Asia, and Latin America and the Caribbean. Contrasting trends in the numbers of abortions and abortion rates were explained by population growth during this time. Because of the concentration of the world’s population in Asia, more than half of the world’s abortions in 2003 (26•4 million) took place there, and a substantial proportion of these (8•6 million) were in China.
    Almost half of all abortions in 2003 were unsafe. In developed regions, most abortions (92%) were safe, but in developing countries, more than half (55%) were unsafe, including 38% of abortions in Asia, 94% in Latin America and the Caribbean, and 98% in Africa. Overall, 97% of all unsafe abortions in 2003 were in developing countries.
    • p.1342
  • There were an estimated 205 million pregnancies (live births, spontaneous miscarriages, stillbirths, and induced abortions) worldwide in 2003, of which about 20% ended in induced abortion. In eastern Europe, almost half of all pregnancies ended in induced abortion, whereas in northern America, one in five pregnancies ended in abortion. Even in regions where small proportions of pregnancies end in induced abortion, such as middle and western Africa, about one in ten pregnancies were terminated.
    • p.1343
  • The estimates presented here indicate that the incidence of induced abortion worldwide has declined since 1995, but trends have been variable across regions. The change in developing regions (excluding China) has been modest. However, a definite and much larger decrease in the incidence of abortion was seen in the developed regions as a whole. The most pronounced change was in countries of the former Soviet Union (principally consisting of Eastern Europe, but also including a few countries in northern Europe, south-central Asia, and western Asia). Although the magnitude of this decline might be overestimated because abortions were increasingly being done in the private sector and the incidence of such procedures might be underestimated, the reduction in abortion rates did coincide with substantial increases in contraceptive use in the region. With respect to family planning, the Soviet era was characterised by restricted access to contraceptive services, combined with the availability of abortion services at little or no cost to the woman. Since that time, the efforts of international donors and governmental agencies have resulted in improved access to contraceptive information and supplies, whereas the cost of abortion has increased in many settings.
    • p.1343
  • At the root cause of induced abortion is unintended pregnancy. An estimated 108 million married women in developing countries have an unmet need for contraception, 35 and 51 million unintended pregnancies in developing countries occur every year to women not using a contraceptive method. Another 25 million happen as a result of incorrect or inconsistent use of contraception or method failure. Meeting the need for contraception and improving the effectiveness of use among women and couples who are already using contraception are crucial steps toward reducing the incidence of unintended pregnancy.
    • p.1344

"Legal Abortion Worldwide in 2008: Levels and Recent Trends" (2011)

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Sedgh, G.; Singh, S.; Henshaw, S.K.; Bankole, A. (2011). "Legal Abortion Worldwide in 2008: Levels and Recent Trends"]. Perspectives on Sexual and Reproductive Health. 43 (3): 188–98. doi:10.1363/4318811. PMID 21884387. Archived from the original on 7 January 2012.

  • RESULTS: Of the 77 countries with liberal abortion laws, 36 are in the developing world. In 2008, abortion rates in the 25 countries with complete records—all of which were developed—ranged from seven (Germany and Switzerland) to 30 (Estonia) per 1,000 women aged 15–44. Abortion rates declined in the majority of the 20 countries with consistently reliable information on trends between 1996 and 2008; declines were generally steeper than increases, although the pace of decline slowed after 2003. The highest observed abortion rates were in developing countries with incomplete estimates. For most developing countries that had liberal laws, the reported abortion rates were incomplete and varied widely.
  • The incidence of induced abortion is an important indicator of the frequency with which women experience unintended pregnancies, and it can point to gaps in contraceptive services and effective contraceptive use. Periodic assessments of abortion incidence are therefore essential for monitoring trends in these critical aspects of the well-being of women and couples.
    However, documentation of this incidence is often unavailable or incomplete, in part because of the sensitive nature of abortion. Although it is extremely difficult to obtain reliable counts of the numbers of procedures performed in countries that have highly restrictive abortion laws, abortion data collection systems or other means of abortion estimation are in place in most countries that have liberal laws.
  • The quality of abortion statistics varies greatly, and the completeness of the statistics depends on such factors as whether abortion reporting is voluntary or required by law; whether medication abortions are reliably reported; whether clinicians face consequences for failure to report abortions, such as lack of reimbursement for services rendered; whether reporting systems include services provided in the private sector (and, if not, the proportion of abortions performed in the private sector); and whether abortion stigma negatively influences reporting. The completeness of reporting can change over time if circumstances that influence reporting change.
  • Among the countries with reliable information on abortion trends between 1996 and 2008, more have experienced decreases than increases in their rates. Moreover, the declines in abortion rates tended to be steeper than the increases. In 2008, the highest rates of legal abortion were in Azerbaijan and Armenia, and the lowest were in Germany, Switzerland and the Netherlands.
  • Abortion rates continued to decline in the former Soviet countries after 2003, as they had between 1996 and 2003, and the changes in incidence continue to be more dramatic there than in any other region of the world. Abortion levels in these countries, once uniformly high, varied widely in 2008, and rates in several of them were comparable with those of other developed countries. However, estimates for others, including Russia, Armenia and Azerbaijan, remained high. Overall, the pace of decline in this region appears to have greatly slowed, and if abortion rates plateau at or near current levels, some of the countries in this region will continue to have the highest rates of legal abortion in the world.
  • The extent to which the declines in abortion rates in some countries reflect declines in unintended pregnancy or barriers to abortion services is unclear. In some of the former Soviet countries, significant fees have been imposed on services that once were free.58 In Russia, the grounds for legal abortion after the 12th week of gestation were narrowed in 2003; however, this seems to have had little impact on incidence, as the proportion of all abortions that occur beyond the 12th week remained at 1–2% in 2008.
  • In many countries with liberal abortion laws, contraceptive prevalence is high and abortions are nevertheless taking place. The fact that abortions occur in measurable numbers in all of the countries reviewed here—including those where contraceptive prevalence is high—adds to the evidence that in all societies, some women and couples will have unintended pregnancies, and some of them will decide to end their pregnancies. Because all contraceptive methods, including sterilization, have failures, it is important to ensure access to safe abortion services.
    However, research does consistently indicate that abortion is less common where contraceptive use is widespread. Whether safe or unsafe, abortions are generally more demanding of women and health care systems than contraception. Improving access to contraceptives for all women and couples and improving the effectiveness of use among those who are already using a method are crucial steps toward reducing the incidence of unintended pregnancy and induced abortion worldwide.

"Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends" (May 2016)

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Sedgh, Gilda; Bearak, Jonathan; Singh, Susheela; Bankole, Akinrinola; Popinchalk, Anna; Ganatra, Bela; Rossier, Clémentine; Gerdts, Caitlin; Tunçalp, Özge; Johnson, Brooke Ronald; Johnston, Heidi Bart; Alkema, Leontine (May 2016). "Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends". The Lancet. 388 (10041): 258–67. doi:10.1016/S0140-6736(16)30380-4. PMC 5498988. PMID 27179755.

  • We estimated that 35 abortions (90% uncertainty interval [UI] 33 to 44) occurred annually per 1000 women aged 15–44 years worldwide in 2010–14, which was 5 points less than 40 (39–48) in 1990–94 (90% UI for decline −11 to 0). Because of population growth, the annual number of abortions worldwide increased by 5•9 million (90% UI −1•3 to 15•4), from 50•4 million in 1990–94 (48•6 to 59•9) to 56•3 million (52•4 to 70•0) in 2010–14. In the developed world, the abortion rate declined 19 points (–26 to −14), from 46 (41 to 59) to 27 (24 to 37). In the developing world, we found a non-significant 2 point decline (90% UI −9 to 4) in the rate from 39 (37 to 47) to 37 (34 to 46). Some 25% (90% UI 23 to 29) of pregnancies ended in abortion in 2010–14. Globally, 73% (90% UI 59 to 82) of abortions were obtained by married women in 2010–14 compared with 27% (18 to 41) obtained by unmarried women. We did not observe an association between the abortion rates for 2010–14 and the grounds under which abortion is legally allowed.
    Interpretation
    Abortion rates have declined significantly since 1990 in the developed world but not in the developing world. Ensuring access to sexual and reproductive health care could help millions of women avoid unintended pregnancies and ensure access to safe abortion.
  • We estimate that the abortion rate declined significantly in the developed world from 46 (41–59) per 1000 women aged 15–44 years in 1990–94 to 27 (24–37) in 2010–14. The abortion rate in 2010–14 was higher in the developing world than in the developed world at 37 (34–46), and the decline in the developing world from 39 (37–47) in 1990–94 was not significant.
    Implications of all the available evidence
    The findings underscore that investments are needed to meet women’s and couples’ contraceptive needs and ensure access to safe abortion care, especially in the developing world, where abortion rates are high and many abortions are unsafe. Reliable estimates of abortion incidence in the developing world are scarce and additional research in this area is needed to improve our ability to monitor and more accurately estimate trends in this region.
  • Our findings indicate the abortion rate declined significantly in the developed world, but not in the developing world, between 1990 and 2014. Although it is likely that current numbers and rates of abortion would be even higher in the absence of investments in family planning services in recent decades, the findings suggest that much more investment is needed to meet the demands of the growing population, the increasingly widespread desire for small families, and the growing strength of women’s and couples’ motivation to control family size and the timing of births.
    We estimate that more than 15 million unmarried women obtained an abortion each year in 2010–14. The findings should motivate efforts to ensure that unmarried women and their partners have access to the reproductive health services they need to prevent and manage unintended pregnancies.
    Although the estimated rates for subgroups of married women were sensitive to model assumptions, we found that a non-trivial number of abortions occur in all subgroups of married women, including women using a contraceptive method and those who had been classified as having no need for contraception. These findings suggest that some contraceptive users need more effective methods, methods better suited to their circumstances, more secure contraceptive supply, and information and counselling to help them use their methods more effectively and consistently. It is also the case that nearly all methods sometimes fail, even when used consistently and correctly.
    Findings from the descriptive analysis presented here indicate that abortion rates are not substantially different across groups of countries classified according to the grounds under which abortion is legally allowed. The level of unmet need for contraception is higher in countries with the most restrictive abortion laws than in countries with the most liberal laws, and this contributes to the incidence of abortion in countries with restrictive laws. Additional research on women’s and couples’ decision making in the face of an unintended pregnancy in different legal settings and sociocultural contexts is needed to improve our understanding of the factors that influence the decision to have an abortion.
  • The UN Sustainable Development Goals include the target of ensuring universal access to sexual and reproductive health-care services, including for contraceptive services. Achieving this goal would help millions of women to avoid unintended pregnancies and the need for abortion. But our findings indicate that, even if all couples who wished to avoid pregnancy used contraception, unintended pregnancies and abortions would occur because no method is perfect and methods are sometimes used imperfectly. Moreover, some women who want to have a child face circumstances that lead them to seek an abortion after they become pregnant. Access to safe abortion is necessary to help women seeking an abortion to avoid recourse to clandestine and unsafe procedures.

"Unsafe abortion: global and regional incidence, trends, consequences, and challenges" (December 2009)

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Shah I, Ahman E (December 2009). "Unsafe abortion: global and regional incidence, trends, consequences, and challenges". Journal of Obstetrics and Gynaecology Canada. 31 (12): 1149–58. doi:10.1016/s1701-2163(16)34376-6. PMID 20085681.

  • Results: Each year 42 million abortions are estimated to take place, 22 million safely and 20 million unsafely. Unsafe abortion accounts for 70 000 maternal deaths each year and causes a further 5 million women to suffer temporary or permanent disability. Maternal mortality ratios (number of maternal deaths per 100 000live births) due to complications of unsafe abortion are higher in regions with restricted abortion laws than in regions with no or few restrictions on access to safe and legal abortion.
    Conclusion: Legal restrictions on safe abortion do not reduce the incidence of abortion. A woman’s likelihood to have an abortion is about the same whether she lives in a region where abortion is available on request or where it is highly restricted. While legal and safe abortions have declined recently, unsafe abortions show no decline in numbers and rates despite their being entirely preventable. Providing information and services for modern contraception is the primary prevention strategy to eliminate unplanned pregnancy. Providing safe abortion will prevent unsafe abortion. In all cases, women should have access to post-abortion care, including services for family planning. The Millennium Development Goal to improve maternal health is unlikely to be achieved without addressing unsafe abortion and associated mortality and morbidity.
  • Induced abortion may be the most difficult indicator of women’s health to measure. Where induced abortion is restricted and largely inaccessible, or legal but difficult to obtain, it is hard to quantify and classify. The available information is, therefore, not completely reliable, because of legal, ethical, and moral considerations that hinder reporting. Occurrence tends to be under-reported in surveys and unreported or under-reported in hospital records. Of course, there are no records for women who do not seek post-abortion care in hospitals or other facilities, including private clinics and pharmacies. Only the tip of the iceberg, therefore, is visible in the number of deaths and the number of women who suffer severe trauma, infection, or severe blood loss and seek medical care.
  • While the legal status of abortion does not completely predict its incidence, there is however an important distinction between developed and developing regions in the circumstances and the safety of induced abortion. Abortion laws are largely restrictive in developing regions (Table 4), with the exception of Eastern Asia and a few countries in other developing regions. Where abortion is legally available on request or under broad conditions, it is generally safe, and where it is highly restricted, it is often unsafe. As a result, three out of four induced abortions in developing countries, excluding China, are carried out in unsafe conditions. In these countries, few women meet the legal conditions, or know their right, to receive safe abortion services to the full extent of the law.
  • Whether legally restricted or not, a woman’s chance of having an abortion is about the same. The legal restrictions, however, force women to seek abortion from unskilled providers, or under unhygienic conditions, or both, exposing them to a high risk of death or disability. The maternal mortality ratio (MMR) per 100 000 live births due to unsafe abortion is higher in countries with major restrictions and lower in countries where abortion is available on request or under broad conditions. The scatter plot of countries by level of MMR and legal restrictions on abortion shows lower MMRs associated with fewer legal restrictions. The accumulated evidence shows that the removal of restrictions on abortion results in the reduction of maternal mortality due to unsafe abortion and, thus, in the reduction of the overall level of maternal mortality.
  • Legal restrictions on safe abortion do not reduce the incidence of abortion. A woman's likelihood to have an abortion is about the same whether she lives in a region where abortion is available on request or where it is highly restricted. While legal and safe abortions have declined recently, unsafe abortions show no decline in numbers and rates despite their being entirely preventable.
  • [A] woman's chance of having an abortion is similar whether she lives in a developed or a developing region: in 2003 the rates were 26 abortions per 1000 women aged 15 to 44 in developed areas and 29 per 1000 in developing areas. The main difference is in safety, with abortion being safe and easily accessible in developed countries and generally restricted and unsafe in most developing countries.

"Fetuses Feel Pain at 20 Weeks, and 4 Other Anti-Abortion Myths"

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Kate Sheppard, "Fetuses Feel Pain at 20 Weeks, and 4 Other Anti-Abortion Myths". Mother Jones. Retrieved June 28, 2015.

  • Claim: Virtually no rape victims conceive.
    Source: Dr. John Willke, former National Right to Life president
    Why it’s bunk: In a 1999 article, Willke, an “expert in human sexuality,” used some really fuzzy math to argue that fewer than 400 victims of sexual assault get pregnant annually. (The reason? Hormones and stuff.) This idea, also found in medieval texts, has been repeated by lawmakers who don’t believe abortion bans should make exceptions for rape.
  • Claim: Abortion can lead to PTSD, bipolar disorder, panic disorders, major depression, alcohol and drug abuse, agoraphobia, and suicide.
    Source: Priscilla Coleman, professor of human development and family studies at Bowling Green State University
    Why it’s bunk: Her 2009 study in the Journal of Psychiatric Research failed to screen whether her subjects had those disorders before their abortions. The paper has been criticized for its “fundamental analytical errors,” yet it has been used to justify state laws that require abortion providers to warn women of these effects.
  • Claim: A fetus can feel pain 20 weeks after conception.
    Source: Dr. Kanwaljeet “Sunny” Anand, professor of pediatrics, anesthesiology, and neurobiology at the University of Tennessee
    Why it’s bunk: Anand argues that because fetuses can respond to stress or other stimuli at 20 weeks, abortion after that point causes them “severe and excruciating pain.” The bulk of the scientific literature on the subject, however, finds that the brain connections needed to feel pain are not in place until at least 24 weeks, which is also the earliest possible time a fetus becomes viable outside the womb. Anand’s testimony has been used to justify state and federal laws banning abortions after 20 weeks; those efforts have passed in nine states since 2010.
  • Claim: Having an abortion significantly increases your risk of breast cancer if you’ve been pregnant before.
    Source: A 1994 paper published in the Journal of the National Cancer Institute
    Why it’s bunk: Subsequent research led the institute to conclude that abortion is not in fact associated with an increase in breast cancer risk. The original claim resurfaced in early 2012 after abortion foes attacked Susan G. Komen for the Cure for funding cancer screenings at Planned Parenthood.

"Clinical Guidelines, Labor induction abortion in the second trimester" (February 2011)

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Society of Family Planning (February 2011). "Clinical Guidelines, Labor induction abortion in the second trimester". Contraception. 84 (1): 4–18. doi:10.1016/j.contraception.2011.02.005. PMID 21664506. Retrieved 25 September 2015.

  • Labor induction abortion is effective throughout the second trimester. Patterns of use and gestational age limits vary by locality. Earlier gestations (typically 12 to 20 weeks) have shorter abortion times than later gestational ages, but differences in complication rates within the second trimester according to gestational age have not been demonstrated. The combination of mifepristone and misoprostol is the most effective and fastest regimen. Typically, mifepristone 200 mg is followed by use of misoprostol 24-48 h later. Ninety-five percent of abortions are complete within 24 h of misoprostol administration. Compared with misoprostol alone, the combined regimen results in a clinically significant reduction of 40% to 50% in time to abortion and can be used at all gestational ages. However, mifepristone is not widely available. Accordingly, prostaglandin analogues without mifepristone (most commonly misoprostol or gemeprost) or high-dose oxytocin are used. Misoprostol is more widely used because it is inexpensive and stable at room temperature. Misoprostol alone is best used vaginally or sublingually, and doses of 400 mcg are generally superior to 200 mcg or less. Dosing every 3 h is superior to less frequent dosing, although intervals of up to 12 h are effective when using higher doses (600 or 800 mcg) of misoprostol. Abortion rates at 24 h are approximately 80%-85%. Although gemeprost has similar outcomes as compared to misoprostol, it has higher cost, requires refrigeration, and can only be used vaginally. High-dose oxytocin can be used in circumstances when prostaglandins are not available or are contraindicated. Osmotic dilators do not shorten induction times when inserted at the same time as misoprostol; however, their use prior to induction using misoprostol has not been studied. Preprocedure-induced fetal demise has not been studied systematically for possible effects on time to abortion. While isolated case reports and retrospective reviews document uterine rupture during second-trimester induction with misoprostol, the magnitude of the risk is not known. The relationship of individual uterotonic agents to uterine rupture is not clear. Based on existing evidence, the Society of Family Planning recommends that, when labor induction abortion is performed in the second trimester, combined use of mifepristone and misoprostol is the ideal regimen to effect abortion quickly and completely. The Society of Family Planning further recommends that alternative regimens, primarily misoprostol alone, should only be used when mifepristone is not available.
  • Where both methods are available, the choice between induction and D&E may be made for either personal or medical reasons. In some instances, the woman may wish to see or hold her fetus. Examination of an intact fetus may improve the chances for accurate diagnosis of anatomic abnormalities. When an intact fetus is necessary for these reasons or others, use of induction techniques is required. However, chromosomal analysis can be performed with specimens obtained by D&E. These procedures do not have an effect on bereavement; women who self-select their technique have similar measures of grief resolution.
  • Very few studies compare labor induction and D&E abortion, with only two randomized trials. One older study compared women predominantly at 13–16 weeks' gestation undergoing D&E to women at 17–24 weeks' gestation undergoing labor induction abortion with prostaglandin F2 (PGF2) or urea. Major complications were more common in the induction group than in the D&E group (1.03 vs. 0.49 per 100 abortions). The incidences of coagulopathy or cardiac arrest were rare for D&E (1 to 2 per 10,000) and not reported with labor induction, although the numbers were too small to be significantly different. Overall, an additional technique was necessary to complete the procedure more frequently with labor induction than D&E (1.7% vs. 0.15%, respectively; RR 11.7 [95% confidence interval (CI), 7.3–18.7]).
  • Deliberately causing demise of the fetus before labor induction abortion is performed primarily to avoid transient fetal survival after expulsion; this approach may be for the comfort of both the woman and the staff, to avoid futile resuscitation efforts. Some providers allege that feticide also facilitates delivery, although little data support this claim. Transient fetal survival is very unlikely after intraamniotic installation of saline or urea, which are directly feticidal. Transient survival with misoprostol for labor induction abortion at greater than 18 weeks ranges from 0% to 50% and has been observed in up to 13% of abortions performed with high-dose oxytocin. Factors associated with a higher likelihood of transient fetal survival with labor induction abortion include increasing gestational age, decreasing abortion interval and the use of nonfeticidal inductive agents such as the PGE1 analogues.

"Why We Should Stop Using the Term "Elective Abortion"" (December 20, 2019)

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Watson, Katie (December 20, 2019). "Why We Should Stop Using the Term "Elective Abortion"". AMA Journal of Ethics. 20 (12): 1175–1180.

 
The phrase "knee surgery on demand" is as silly as the phrase "abortion on demand," yet the latter phrase appears in political rhetoric and judicial opinions. Medicine designates all but the most emergent procedures as elective, which means they are all done on request of the patient. Yet the way in which abortion is categorized as elective or medically indicated is quite different than the way in which other medical procedures are so categorized, and it both reflects and feeds the politics of abortion. This dynamic has bad consequences for patients, which should motivate serious examination of how clinicians, health care organizations, and insurers have used—and misused—the term elective abortion.
  • In abortion care, the term "elective" is often used as a moral judgment that determines which patients are entitled to care. Secular health care organizations that attempt to avoid controversy by allowing "therapeutic" but not "elective" abortions are using medical terminology to reinforce regressive social norms concerning motherhood and women's sexuality because what distinguishes pregnant women with medical indications for abortion is that they originally wanted to become mothers or, in cases of rape, that they did not consent to sex. Secular health care organizations should stop denying the moral agency of patients and physicians who conclude abortion is morally acceptable and should only use the word elective when billing codes require it. Regardless of reason, the proper label for all abortion is health care.
  • The phrase "knee surgery on demand" is as silly as the phrase "abortion on demand," yet the latter phrase appears in political rhetoric and judicial opinions. Medicine designates all but the most emergent procedures as elective, which means they are all done on request of the patient. Yet the way in which abortion is categorized as elective or medically indicated is quite different than the way in which other medical procedures are so categorized, and it both reflects and feeds the politics of abortion. This dynamic has bad consequences for patients, which should motivate serious examination of how clinicians, health care organizations, and insurers have used—and misused—the term elective abortion.
  • Some private and public insurance plans will not pay for "elective" abortions, and one could argue that clinicians and health care facilities are simply using terminology that reflects this coding issue. But whether the patient or her insurer will be billed for the procedure is not the primary significance of the term. Many secular hospitals and private practice groups attempt to avoid internal and external controversy by prohibiting their physicians from performing elective abortions. As a result, women with medical indications can often receive therapeutic abortions within their current health care delivery systems, and those whose abortions are labeled elective must go elsewhere. For some patients, getting to a clinic requires significant travel, added expense, and braving a picket line. For all patients, being rejected by the organization that provides all their other health care sends a stigmatizing message: “We won’t perform this simple, safe, life-altering procedure for you because of your reasons.”
  • Every abortion is elective. No pregnant woman with health problems is required to terminate her pregnancy—she can choose to deliver a baby with a disability or a terminal condition, risk her own health to deliver a baby, or decide the risks outweigh the benefits and choose abortion.5 But like women considering nonmedical risks and benefits of pregnancy and parenthood, every woman analyzing medical indications for abortion also has a choice.
    Alternatively, perhaps no abortion is elective. Pregnancy is a radical bodily change, and the risk of death from childbirth is 14 times higher than from abortion.6 Deciding whether to bring a new child into the world is a serious moral commitment, and doing so can cause some women economic or interpersonal harm that could result in deeper or more sustained suffering than many medical conditions. Several physicians who perform abortions have told me that many of their patients do not perceive themselves as having any choice at all—dire social circumstances lead them to see abortion as their only option.
  • Social abortion is another term that is occasionally used to describe abortions that are not chosen in response to disease or anomaly. However, the decision to become a parent and the decision to not become a parent are equally "social." Both are lifestyle choices that revolve around women’s or couple’s visions of their most happy and meaningful lives, yet women with planned pregnancies are never described as pursuing social childbearing.
    The term medical indication can falsely suggest the kind of medical complexity that typically justifies hospital care, implying a logic to some hospitals’ willingness to do therapeutic abortions while referring elective abortions to clinics. Yet abortion for the medical reason of an embryonic genetic anomaly discovered at 8 weeks does not require hospital-level abortion care, and abortion for the social reason of a partner’s abandonment at 20 weeks might be more safely done at a hospital in some communities. With the exception of some maternal health conditions, the reason for the abortion rarely changes the procedure. Instead, it is advancing gestational age that increases the procedure’s complexity and risks. Labeling an abortion therapeutic usually signifies whether it will be done, not how.
  • Ultimately, the term elective abortion is moral judgment dressed up as medical judgment. Medical versus elective is code for morally justified versus morally unjustified, as decided by someone other than the patient and her physician. Yet the patients’ rights and medical ethics revolutions of the 1970s were premised on the idea that ordinary people were serious moral thinkers entitled to request or refuse medical care according to their own values, and patients’ expressions of values and priorities in this area of medicine are as worthy of respect as in any other. When you learn a woman’s or a couple’s reason for an abortion, you also learn what moral status that woman or couple assigned to their embryo or fetus. When a woman does not want to have a child, and she has concluded that her embryo or fetus does not have moral status that outweighs her own, she is entitled to decide the risk of childbirth is not outweighed by its benefits. However, instead of treating a patient who has decided she needs an abortion as a moral decision maker and allowing her physician to respond to her as a medical professional, secular hospitals and practice groups that prohibit their willing physicians from performing "elective" abortions are using their institutional power to unjustly impose the judgment of strangers on her instead. As a result, this misappropriated medical terminology allows politics to rob patients of access to legal medical care.
  • The distinction between elective and medically indicated abortions is a regressive, destructive conceit. What really distinguishes abortion patients with medical indications is that these pregnant women are presumed to have initially wanted a child—they would not have asked for an abortion if it weren’t for this health problem—or, in cases of rape and incest, that they did not consent to sex. The allowance hospitals, private practice groups, and insurers make for medically necessary abortions is not a medical line, it is a sex-discriminatory social line: We will only care for women who accept the social norms that women are meant to be mothers and that women cannot have sex solely for pleasure instead of for procreation. Mainstream medicine will cast out all others.
    Women’s ability to control their fertility, which medicine can now safely and effectively provide, is a prerequisite to their full citizenship. By labeling the vast majority of abortions women request as elective, the medical profession labels women’s equality optional.
  • Who is a candidate for care? If my stepfather had only sprained his knee and had requested knee replacement surgery, his request would have been refused—his physician would have told him that was not the appropriate medical solution for his condition, and therefore he would not have been a candidate for surgery. The way the term "elective" is used in abortion means this is what the vast majority of women confronting unwanted pregnancies are told by their health care practitioners—pregnancy termination is not the appropriate medical solution for your condition. That is a moral judgment, in many cases colored by a gender judgment, not a medical judgment.
  • I’ve discarded the term "elective abortion." Instead, my scholarship focuses on what I think of as "ordinary abortion." I use this term to describe the vast majority of abortions, which are done at early gestational ages for the most common reasons—eg, “Not ready for another child/timing is wrong,” “Can’t afford a baby now,” or “Have completed my childbearing/have other people depending on me/children are grown.” Ordinary abortion is in contrast to extraordinary abortion, which describes the minority of abortion cases that have a variety of distinctive features but often include increased medical complexity and later gestational age. For the same reasons, secular health care organizations should stop discriminating among pregnant patients who want to end their pregnancy. Only use the word "elective" when billing codes require it, and otherwise resist the urge to categorize abortions when it’s not relevant to the medicine.
  • The term "elective abortion" obscures the fact that abortion restrictions and bans are government policies of forced childbearing. Instead of categorizing abortions, the medical profession should continue working to make the word "elective" an accurate descriptor of every woman’s childbearing.

“Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008” (2011)

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World Health Organisation (2011). “Unsafe abortion: global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008”, (PDF). (6th ed.). World Health Organisation. ISBN 978-92-4-150111-8. Archived (PDF) from the original on 28 March 2014.

  • Abortion laws are diverse and can be complex, usually stipulating limitations to gestational age; however, in some instances it requires conditions that may be contrary to the stated intent of the law with the effect that scarcely any official abortions can take place. For example in Zambia, abortion procedure requires the endorsement of several doctors, including a specialist, in a country where doctors and specialists are scarce. Also, additional requirements regarding consent and counselling may complicate and prolong the application procedure, sometimes meaning that a pregnancy progresses past the legally permitted time period for induced abortion. There may also be discrepancies between the wording of the law (de jure) and its application (de facto), which means that common practice can help or hinder the procurement of a safe and legal abortion.
    • p.4
  • Access to abortion can be restricted by the law, but also by other barriers. These barriers may make women turn to unsafe abortion, or make them hesitant to seek care when urgently needed due to complications of an unsafe abortion. One compelling issue of access is the low availability of hospital services in developing countries, particularly in rural areas. Comparing with hospital services for delivery, we find that only 55% of women in developing countries deliver in hospitals. The situation is even worse in rural areas; on average only 35% of women in Africa and Asia (when excluding the Eastern Asia Subregion where unsafe abortions are negligible) and 60% of women in Latin America have access to facilities in rural areas. In the rural Eastern and Western Africa and South-Central Asia Subregions hospital care for deliveries is below 30%. In urban areas conditions are noticeably better, i.e. 78% in urban areas of Africa, 68% in Asia, and 92% in Latin America, nevertheless still much lower than the 95%–100% in developed countries.
    • p.7
  • In an article reviewing the use of facilities in South Africa in 2000, Jewkes summarized that “54% had not used legal services because they did not know about the law, while 15% knew of their legal rights, but did not know a legal facility. Others did know where to access legal services but feared rude staff or breaches of confidentiality. Others had been unable to get a legal abortion early enough to comply with the law.” Another study from South Africa documents: “Reasons why women delayed seeking an abortion were complex and were linked to changes in personal circumstances often leading to indecision, delays in detecting a pregnancy and health-service related barriers that hindered access to abortion services.” A report from Turkey describes the situation in rural areas: “Despite the liberal nature of the abortion law, the number of legal abortions up to 10 weeks performed in the country has been sharply restricted by the requirement that the procedure be carried out only by or under the supervision of gynaecologists. This factor is especially critical in rural Turkey, where medical specialists of any type are uncommon. Many rural health facilities that are without a trained specialist are excluded from providing services. Consequently, a rural Turkish woman seeking an abortion within the first 10 weeks of pregnancy may not be able to obtain one.” It is difficult to overcome legal barriers to safe abortion in Zambia according to a local report: “Zambia has one of the most liberal abortion laws in sub-Saharan Africa. Several factors explain the limited access to legal abortion: the abortion must be performed in hospital and three physicians (including one specialist) must sign the consent form. The abortion fees are exorbitant. In 1988 for every legally performed abortion, 25 incomplete abortions were treated.” From Uganda it is reported that “Fear of being questioned by providers constitutes one of the primary reasons identified by the respondents for why women delay seeking treatment for abortion complications.” The British Medical Journal recently carried the headline “Woman dies after doctors fail to intervene because of new abortion law in Nicaragua.” The text explains the circumstances “...the fear of punishment seems to be discouraging doctors from treating some women. ...A young woman died at a Managua hospital after doctors failed to intervene to stop vaginal bleeding. Some doctors told local media they did not treat the woman for fear of breaking the law.” The Mauritius Ministry of Health report in 2007 states that “In Mauritius, abortion for social or personal reasons is illegal as stipulated in the law of 1838 except in cases where the mother’s life is in danger. In order for the woman to procure the abortion, it has to be approved by the Supreme Court. The process is so long that there is no reported case where this has ever been accomplished. This law has never been reviewed, but there are reports that abortion is an issue in Mauritius.
    • p.8
  • In Bangladesh where menstrual regulation services are available at all levels, one report indicates: “Thus, it is not clear why so many women visited the traditional practitioners for abortion. Social stigma attached to induced abortion may be a reason for not seeking safe abortion services, since it may not remain confidential.” A first-hand account describes a large hospital’s management of abortion complications in Southern Lima where there is one case of abortion complications for every four deliveries and one in three maternal deaths are due to septic abortion: “Induced abortion is illegal and clandestine in Peru. Safe backstreet abortions are available, but these are expensive and most of our patients are too poor to pay for such safe procedures. They risk serious complications from the cheap, unsafe procedures, but fears of being reported to the police prevent them from seeking prompt medical attention.”
    • p.9
  • Where induced abortion is restricted and largely inaccessible, or legal but inaccessible, little information is available on abortion practice. In such circumstances, it is difficult to quantify and classify abortion. Occurrence tends to be underreported in surveys, and unreported or underreported in hospital records. No records are available on women who had unsafe abortion complications but who did not seek postabortion care in public facilities. Only the “tip of the iceberg” is, therefore, visible in the number of deaths and the number of women who seek medical care following complications.
    • p.15

"Facts on Induced Abortion Worldwide" (January 2012)

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"Facts on Induced Abortion Worldwide" (PDF). World Health Organization. January 2012. Archived (PDF) from the original on 9 March 2021. Retrieved 9 May 2021.

  • Since 2003, the number of abortions fell by 600,000 in the developed world but increased by 2.8 million in the developing world. In 2008, six million abortions were performed in developed countries and 38 million in developing countries, a disparity that largely reflects population distribution.
    • p.1
  • The overall abortion rate in Africa where the vast majority of abortions are illegal and unsafe, showed no decline between 2003 and 2008, holding at 29 abortions per 1,000 women of child bearing age.
    The southern Africa subregion, dominated by South Africa, where abortion was legalized in 1997, has the lowest abortion rate of all African subregions, at 15 per 1,000 women in 2008. East Africa has the highest rate, at 38, followed by Middle Africa at 36, West Africa at 28 and North Africa at 18.
    • p.1
  • Both the lowest and highest subregional abortion rates are in Europe, where abortion is generally legal under broad grounds. In Western Europe, the rate is 12 per 1,000 women, while in Eastern Europe it is 43. The discrepancy in rates between the two regions reflects relatively low contraceptive use in Eastern Europe, as well as a high degree of reliance on methods with relatively high user failure rates, such as the condom, withdrawal and the rhythm method.
    • p.1
  • Highly restrictive abortion laws are not associated with lower abortion rates. For example, the abortion rate is 29 per 1,000 women of childbearing age in Africa and 33 per 1,000 in Latin America-regions in which abortion is illegal under most circumstances in the majority of countries. The rate is 12 per 1,000 in Western Europe, where abortion is generally permitted on broad grounds.
    • p.2
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