Abortion generally refers to voluntary termination of human pregnancy. When faced with an unplanned pregnancy, a woman can either choose to have the baby, give it up for adoption or terminate the pregnancy.

Abortion has several ethical, social, cultural and religious issues. In most circumstances, it is a completely safe procedure, but in places of inadequate health care facilities, it may develop complications. It is performed in many different ways including medical or surgical.

When a pregnancy is terminated before birth, the phenomenon is called abortion. It is of two types. Spontaneous abortion is more commonly known as miscarriage. This happens if the fetus is destroyed naturally or unintentionally. The other type is induced abortion where active steps are taken to voluntarily terminate the pregnancy. In most cases, abortion refers to induced abortion.

There is a long history behind this process. Abortion has been used as early as 2700 BC in China. Since then, a number of traditional methods like herbs, sharp instruments or abdominal pressure have been used. Today, this procedure is legal in most developed and a few developing nations. As a result, 43.8 million abortions were performed in 2008. The worldwide abortion rate is 28 per 1000 women with 23 in developed countries and 29 in developing countries. In a study by Singh et al in 2012(Induced abortion: Incidence and trends worldwide from 1995 to 2008), it was found that 21% of all known pregnancies end in abortion. Early abortions are common in developed countries while later abortions are common in developing countries.

The incidence of abortion in USA can best be understood from the following table:

Year Number of abortions reported to CDC Induced abortions per 1000 live births
2000 857,475 246
2001 853,485 246
2002 854,122 246
2003 848,163 241
2004 839,226 238
2005 820,151 233
2006 846,181 236
2007 827,609 231
2008 825,564 234
2009 784,507 227
2010 765,651 228
2011 730,322 219
2012 699,202 210
2013 664,435 200

Source: Center for disease control and prevention

Reasons for abortion

There are a number of legal and ethical issues involved in abortion. A woman can choose to get an abortion for the following reasons:

  • You may feel that you are not mentally ready to have a child.
  • You cannot provide for the child.
  • The father of the child is not available or unwilling to share the responsibility with you.
  • Having a baby now can destroy your chances of schooling and having a chance at a career.
  • You come to know of severe fetal anomaly.
  • You or the father has a genetic defect and you do not want to transmit it to your child.
  • Your circumstance changes suddenly and tragically like a debilitating illness, a car accident, job loss etc.
  • The child has been conceived in unnatural circumstances like as a result of abuse, rape or incest.

Teen pregnancy and abortion must be mentioned in this regard. In spite of increasing campaign for awareness, teen pregnancy is quite high and most of them are unplanned and unwanted. Even if you are under the age of 18, you are perfectly entitled to get an abortion. But according to the state where you live, you may need a parental consent or a parental notification. The former means you need the permission of your parents while the latter means you need to notify them and not ask for permission though many clinics may refuse to perform an abortion if they do not give their consent. In that case, you may get a judicial bypass where you explain your situation to a judge and ask for permission to abort.

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Methods of abortion

In ancient days, several traditional methods were used. They were often of a hit or miss type of method and lead to complications. You should know that modern abortions performed by informed and qualified health personnel are one of the safest medical procedures and you can easily have a baby later. But, unsafe methods or unqualified practitioners still pose a danger to your health.
The common methods used for abortion are as follows:

Medical methods for abortion

When abortion is induced by the administration of some oral pill, it is known as medical abortion. They are carried out in different ways in different stages of pregnancy:

  • Early medical abortion occurs within the first 9 weeks of pregnancy. You are given a tablet called mifepristone. It blocks the hormones and prevents the embryo from latching on to the lining of the uterus. 48 to 72 hours later, you are given a second medicine called prostaglandin. Within 4 to six hours, the lining and the embryo is broken and then lost through menstrual bleeding.
  • Late medical abortions are carried out after 13 weeks of pregnancy. The medications are the same though a higher dose of prostaglandin may be required.
  • Medical abortions can also be obtained at 20 to 24 weeks of pregnancy. You need to get admitted to a hospital. Prostaglandin is injected into the womb. Contractions start which may last for 6 to 12 hours. Then, D&E is used to cleanse the womb completely.
  • Saline injection is used after 16 weeks. Here, a strong salt solution is injected through the abdomen of the mother into the sac of the fetus. The fetus swallows this solution and is poisoned. Labor sets in within 24 hours and a dead or dying baby is born.

Surgical methods for abortion

Surgical methods which are commonly used for abortion are as follows:

  • Vacuum aspiration or suction termination is performed during 7 to 15 weeks of pregnancy. In this process, a tablet is placed in the vagina to soften the cervix. It is then dilated with an instrument. A small plastic suction tube is inserted. It is attached to a pump and the fetus and the surrounding tissue is sucked out. The procedure is performed under local or general anesthesia.
  • Surgical dilation and evacuation or D&E is a procedure which is performed after 15 weeks of pregnancy. It is similar to the above method. A forceps is also sometimes used.
  • Dilation and curettage is a process where in addition to vacuuming, a sharp hook-shaped knife called a curette is inserted to cut the fetus to facilitate its removal.

Risks and facts about abortions

If you are going for an abortion, here are a few important things that you should know:

  • Earlier you get the abortion, lesser the risk.
  • You can have a child after having an abortion.
  • It is mostly a painless procedure. However, you may experience cramping, diarrhea, and bleeding. In the case of excessive bleeding or a fever, you will need to get medical assistance.
  • The next menstrual period begins 4 to 7 weeks after the abortion.
  • Follow the instruction of the medical personnel to reduce the risk of infection.

Care and recovery after abortion

Though the process takes only a few hours, you will need some time to recover from an abortion. Here are some steps:

  • Though you can resume normal activities almost immediately, it is advisable to get some rest. Consult your doctor about this.
  • Avoid heavy lifting or strenuous exercise.
  • Do not drive a car for at least 8 to 10 hours after the procedure. You may feel dizzy or may still be under the lingering influence of anesthesia.
  • Do not drink alcohol for a week or two as they interfere with the medication.
  • Bleeding, often with small blood clots are normal. You should not use tampons as they increase the risk of infection. Instead, use sanitary napkins.
  • Showering is ok. However, swimming is a big no-no. Also, avoid tub baths and bubble baths till your later checkup to reduce the chance of infection.
  • Painkillers may be taken in case of cramps. You can also use ice pads if your breasts ache.
  • Follow all medical instructions and complete all antibiotics even if you feel fine.
  • Return to normal activity, but avoid heavy exercise for a fortnight at least.
  • Chances of getting pregnant again after abortion is quite high. In fact, you can get pregnant even before you get your next period. You can start having intercourse only after your repeat checkup, but you should be careful with birth control methods now.
  • Increase the supply of iron in your diet. You have bled heavily and may develop anemia. This will help to counteract this iron deficiency.
  • Avoid cold, spicy or greasy foods. Instead, easily digestible nutritious foods are recommended.
  • Abortion is often followed by excessive sweating. So, be sure to drink plenty of water.
  • Eat plenty of protein to allow your body to recover.
  • Include dairy and dairy products as you now require a large supply of calcium.