Abortion

Although it is an intimately personal medical procedure, abortion is also a complex and contentious social issue on both national and global levels. As a health procedure, abortion is the voluntary disruption of a pregnancy. The larger social meaning of abortion is best understood within the larger social, political, and economic context where geography, nation, social position, and law intersect in ways that matter to women's lives.

Abortion can be performed with the use of instruments or by taking drugs. Worldwide there are an estimated 42 million pregnancies (about 1 in 5) that end in abortion each year. The most common technique for abortion is uterine aspiration (with either manual or electric suction), but medication abortion with mifepristone (aka the abortion pill) and misoprostol is growing in popularity. Use of misoprostol alone to induce abortion occurs in places where abortion is highly restricted, but the medication is available in the clandestine marketplace. Regardless of the legal status of abortion, women terminate their pregnancies under both safe and unsafe and legal and illegal conditions. Worldwide, an estimated 68,000 women die annually as a result of unsafe abortion, although the risk of dying from abortion where it is legal and safe is very low.

Women of all ages, races, nations, and religious backgrounds have abortions. Most abortions take place before the 12th week of pregnancy, but women continue to need access to later abortion services even where earlier services are readily available. There are many reasons women decide to have abortions. The most common reasons include inability to afford a(nother) child, relationship instability, and work/school obligations. Newer research in this field exposes how women understand these reasons within the larger context of wanting to be a good mother to current and/or future children. Unwanted pregnancies also result from acts of sexual coercion and violence, especially where women have less social power or in conflict areas. Women with wanted pregnancies may also have abortions when their own health or the health of the fetus is compromised. Work within the larger field of reproductive health has measured the significant unmet need for family planning across the globe as it contributes to high rates of abortion, even in countries where abortion is highly restricted. Low access to contraception and social disapproval of premarital sex also contribute to the higher abortion rate in the United States as compared to its western European counterparts.

The legal status of abortion differs across the world. The most liberal abortion laws can be found in South Africa, which recognizes abortion as a human right, and Canada, which has no abortion law and thus leaves the entire matter to the health care system. Some countries, such as the United States and most of western Europe, limit abortion based on the gestational age of the pregnancy. In the United States, this limit is the point of potential [Page 2]viability when it is believed that the fetus has a reasonable chance of survival outside the womb. Both Mexico City and Cambodia allow abortion for any reason through the 12th week of pregnancy. In contrast, many other developing countries limit access to abortion based on the circumstances of the pregnancy itself, for example, when the pregnancy threatens the life or health of the pregnant woman or when it is the result of rape or incest. Some countries, like Ethiopia and Israel, interpret these exceptions broadly, allowing many women to access abortion. Other countries limit legal abortion to only a small number of cases, as does Colombia. A few countries, including Nicaragua and Iraq, prohibit abortion in all circumstances.

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