ABORTION

Abortion

Abortion

Introduction

An abortion is the termination of a pregnancy. It may be spontaneous (also called miscarriage) or induced. About one in five pregnancies ends in spontaneous abortion, typically at an early stage and due to chromosomal abnormality of the conceptus. Such spontaneous embryonic wastage often causes grief for the pregnant woman and is ignored by communities. In contrast, induced abortion (hereafter, abortion) may bring relief from an unwanted pregnancy and is often condemned by societies. Abortion is widely resorted to for birth control; most of the world's women are likely to have had one or more abortions by the time they complete their childbearing years.

Historically, women who underwent abortions risked their personal health and social standing. This situation changed slowly in the 20th century as abortion procedures became much safer and as efforts to legalize abortion gained momentum (Hull, 2004). Abortion is nowadays a minimum-risk procedure when it is performed by a trained professional in a hygienic setting. But in many countries where it is illegal, and in some where it is legal, unsafe abortion is a common cause of maternal mortality and its complications contribute to serious sequelae for women's health such as infertility. Despite these realities, abortion is often stigmatized within medicine and is deeply controversial in some societies and polities.

Incidence of Abortion

Worldwide, an estimated 46 million pregnancies end in induced abortions each year, nearly half of them in unsafe circumstances. Given that some 210 million pregnancies occur annually, this implies that about 22 percent of all pregnancies worldwide are aborted. However, the incidence of abortion is only known in detail for those countries in which abortion is legally permitted with few restrictions and where official statistics are reasonably complete (Jones, 2002).

The abortion rate refers to the annual number of abortions per 1,000 women of reproductive age. For many years, the lowest abortion rates in the world have been in the Netherlands, Belgium, and Scandinavia (about 5-6/1,000 women aged 15-44). These countries are characterized by a culture of contraceptive responsibility and some of the world's most liberal abortion laws, with services legal, free, and widely available. The highest abortion rates in the world are found in many former Soviet Bloc republics, where family planning services have been severely lacking. The total abortion rate (TAR) expresses the average number of abortions experienced by a woman during her childbearing years. It is highest in Georgia at 3.7 abortions per woman (Luker, 1984).

The TAR declines to low levels as more effective contraceptive methods become available and widely adopted. In the United States, 1.3 million abortions occurred in 2002 and each year, 2 out of every 100 women aged 15-44 have an abortion. At the current rate of 21 abortions per 1,000 women aged 15-44, over one-third (35 percent) of U.S. women will have had an abortion by the time they reach age 45. These levels are higher than in Western Europe, Australia, or New Zealand, where contraceptive practice is more widespread and ...