Foal embryos that are homozygous for the dominant white gene (WW) are theorized to also be aborted or resorbed before birth. [121], A long term-study among US women found that about 99% of women felt that they made the right decision five years after they had an abortion. ", "Unsafe abortion: The preventable pandemic", "Evidence supporting broader access to safe legal abortion", "Abortion laws reform may reduce maternal mortality: an ecological study in 162 countries", "Medical methods for first trimester abortion", "Unsafe abortion: global and regional incidence, trends, consequences, and challenges", "Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends", "Worldwide, an estimated 25 million unsafe abortions occur each year", "Induced abortion: Incidence and trends worldwide from 1995 to 2008", "Legal abortion worldwide: incidence and recent trends", "1. He preferred abortion in such cases, with the restriction[172] "[that it] must be practised on it before it has developed sensation and life; for the line between lawful and unlawful abortion will be marked by the fact of having sensation and being alive". [116] A report by the American Psychological Association concluded that a woman's first abortion is not a threat to mental health when carried out in the first trimester, with such women no more likely to have mental-health problems than those carrying an unwanted pregnancy to term; the mental-health outcome of a woman's second or greater abortion is less certain. Pelvic inflammatory disease, also known as pelvic inflammatory disorder (PID), is an infection of the upper part of the female reproductive system, namely the uterus, fallopian tubes, and ovaries, and inside of the pelvis. These requirements usually depend on the age of the fetus, often using a trimester-based system to regulate the window of legality, or as in the U.S., on a doctor's evaluation of the fetus' viability. [115], Although some studies show negative mental-health outcomes in women who choose abortions after the first trimester because of fetal abnormalities,[119] more rigorous research would be needed to show this conclusively. [10] CDC estimated in 2019 that US pregnancy-related mortality was 17.2 maternal deaths per 100,000 live births,[84] while the US abortion mortality rate is 0.7 maternal deaths per 100,000 procedures. The right to life, the right to liberty, the right to security of person, and the right to reproductive health are major issues of human rights that sometimes constitute the basis for the existence or absence of abortion laws. "[110]:25 According to Rickie Solinger, A related myth, promulgated by a broad spectrum of people concerned about abortion and public policy, is that before legalization abortionists were dirty and dangerous back-alley butchers.... [T]he historical evidence does not support such claims. Female rodents may terminate a pregnancy when exposed to the smell of a male not responsible for the pregnancy, known as the Bruce effect. Abortion rates also vary depending on the stage of pregnancy and the method practiced. This allows the attending physician the room he needs to make his best medical judgment. [97] Preventive antibiotics (such as doxycycline or metronidazole) are typically given before abortion procedures,[98] as they are believed to substantially reduce the risk of postoperative uterine infection;[72][99] however, antibiotics are not routinely given with abortion pills. A combined abortion and spaying is performed on pregnant cats, especially in trap–neuter–return programs, to prevent unwanted kittens from being born. [5][124] Estimates of deaths vary according to methodology, and have ranged from 37,000 to 70,000 in the past decade;[5][15][125] deaths from unsafe abortion account for around 13% of all maternal deaths. [140][141], Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits,[22] while an additional 35 percent have access to legal abortion if they meet certain physical, mental, or socioeconomic criteria. [175][176][177] From 1750, excommunication became the punishment for abortions. Gynuity Health Projects [226], Spontaneous abortion occurs in various animals. [212] This deviation from the standard birth rates of males and females occurs despite the fact that the country in question may have officially banned sex-selective abortion or even sex-screening. Treatment with more than 40 Gy of radiation usually causes spontaneous abortion. China, which has ended their[199] one-child policy, and now has a two child policy,[200][201] has at times incorporated mandatory abortions as part of their population control strategy. [202], Other jurisdictions ban abortion almost entirely. [88], In the US from 2000 to 2009, abortion had a lower mortality rate than plastic surgery, and a similar or lower mortality rate than running a marathon. [15] Complications of unsafe abortion account for approximately an eighth of maternal mortalities worldwide,[142] though this varies by region. A non-inferiority study of outpatient mifepristone-misoprostol medical abortion at 64–70 days and 71–77 days of gestation 2020 May; 101 (5): 302-308 Elizabeth Raymond, MD, MPH Many, but not all, of these allow legal abortions in a variety of circumstances. [160] These might include the preference for children of a specific sex or race, disapproval of single or early motherhood, stigmatization of people with disabilities, insufficient economic support for families, lack of access to or rejection of contraceptive methods, or efforts toward population control (such as China's one-child policy). Do not prescribe flucloxacillin to people with: A true penicillin hypersensitivity.Gastrointestinal adverse effects alone (such as nausea, vomiting, or diarrhoea) do not constitute an allergy to penicillin. [19][31] Most abortions result from unintended pregnancies. [147], The rate of legal, induced abortion varies extensively worldwide. Hysterotomy and hysterectomy are associated with much higher rates of maternal morbidity and mortality than D&E or induction abortion. According to Soranus' 1st or 2nd century CE work Gynaecology, one party of medical practitioners banished all abortives as required by the Hippocratic Oath; the other party—to which he belonged—was willing to prescribe abortions, but only for the sake of the mother's health. [89] Five years after seeking abortion services, women who gave birth after being denied an abortion reported worse health than women who had either first or second trimester abortions. [7] Making safe abortion legal and accessible reduces maternal deaths. [137] The analysis, however, did not take into account travel to other states without such laws to obtain an abortion. [235][236][237] On January 1, 2018, Illinois became the first Midwestern state to cover abortion care for Medicaid enrollees. Abortions occur 2–12 wk after infection, usually between months 7 and 11 of gestation. [72], In places lacking the necessary medical skill for dilation and extraction, or where preferred by practitioners, an abortion can be induced by first inducing labor and then inducing fetal demise if necessary. MVA can be used up to 14 weeks but is more often used earlier in the U.S. EVA can be used later. [73] This is sometimes called "induced miscarriage". Among these are: tansy, pennyroyal, black cohosh, and the now-extinct silphium. [100] The rate of failed procedures does not appear to vary significantly depending on whether the abortion is performed by a doctor or a mid-level practitioner. The development of this technology has led to sex-selective abortion, or the termination of a fetus based on its sex. The degree of force, if severe, can cause serious internal injuries without necessarily succeeding in inducing miscarriage. [105][106], Some purported risks of abortion are promoted primarily by anti-abortion groups,[107][108] [173], In Christianity, Pope Sixtus V (1585–90) was the first Pope before 1869 to declare that abortion is homicide regardless of the stage of pregnancy;[174] and his pronouncement of 1588 was reversed three years later by his successor. [79] In Southeast Asia, there is an ancient tradition of attempting abortion through forceful abdominal massage. The organizations released the personal information online, of those involved with construction, sending them up to 1200 phone calls a day and contacting their churches. [23] Abortion laws and cultural or religious views of abortions are different around the world. [138] In addition, a lack of access to effective contraception contributes to unsafe abortion. Oakland, CA, USA [pdf] We use cookies to help provide and enhance our service and tailor content and ads. ", Son Preference in Asia – Report of a Symposium, "Selective abortion blamed for India's missing girls", "Female Demographic Disadvantage in India 1981–1991: Sex Selective Abortions and Female Infanticide", "Son Preference in Anhui Province, China", "2017 VIOLENCE AND DISRUPTION STATISTICS", "Incidence of Violence & Disruption Against Abortion Providers in the U.S. & Canada", "Beef cattle and Beef production: Management and Husbandry of Beef Cattle", "Effect on abortion of feeding Korean pine needles to pregnant Korean native cows", "Sharks, rays and abortion: The prevalence of capture-induced parturition in elasmobranchs", "Feline abortion: often an unnerving necessity", "Feline abortion: often an unnerving necessity (Part 2)", "Male infanticide in captive plains zebra, Equus burchelli". [187][188][189][190][191], Soviet Russia (1919), Iceland (1935), and Sweden (1938) were among the first countries to legalize certain or all forms of abortion. [68] Manual vacuum aspiration (MVA) consists of removing the fetus or embryo, placenta, and membranes by suction using a manual syringe, while electric vacuum aspiration (EVA) uses an electric pump. [165][166], The process of birth itself may also put the mother at risk. Induced abortion has long been the source of considerable debate. [114]:223, Current evidence finds no relationship between most induced abortions and mental health problems[14][115] other than those expected for any unwanted pregnancy. [3][4], When properly done, abortion is one of the safest procedures in medicine,[5]:1 [6]:1 but unsafe abortion is a major cause of maternal death, especially in the developing world. [80] One of the bas reliefs decorating the temple of Angkor Wat in Cambodia depicts a demon performing such an abortion upon a woman who has been sent to the underworld. 64% of those reported were by vacuum aspiration, 6% by D&E, and 30% were medical. [19], The number of abortions performed worldwide seems to have remained stable in recent years, with 41.6 million having been performed in 2003 and 43.8 million having been performed in 2008. In 1973. [150] The Guttmacher Institute estimated that "most abortions in the United States are obtained by minority women" because minority women "have much higher rates of unintended pregnancy".[151]. [12] When performed legally and safely on a woman who desires it, induced abortions do not increase the risk of long-term mental or physical problems. These and other methods to terminate pregnancy may be called "induced miscarriage". Pregnancy preferences and contraceptive use among US women Work by Editor/authors is assessed using the same criteria as that applied to all Contraception submissions. However, conservatism by most physicians with regards to sexual matters prevented the wide expansion of safe abortion techniques. See the CKS topic on Angio-oedema and anaphylaxis for more information. [135] Similar reductions in maternal mortality have been observed after other countries have liberalized their abortion laws, such as Romania and Nepal. Visit ScienceDirect to see if you have access via your institution. [40] When a fetus dies in utero after viability, or during delivery, it is usually termed "stillborn". [81], The health risks of abortion depend principally upon whether the procedure is performed safely or unsafely. Relief was the primary emotion with few women feeling sadness or guilt. In some areas abortion is legal only in specific cases such as rape, problems with the fetus, poverty, risk to a woman's health, or incest. [102] The risk of death from abortion approaches roughly half the risk of death from childbirth the farther along a woman is in pregnancy; from one in a million before 9 weeks gestation to nearly one in ten thousand at 21 weeks or more (as measured from the last menstrual period). On the same day that the Court decided Roe, it also decided Doe v. Bolton, in which the Court defined health very broadly: "The medical judgment may be exercised in the light of all factors—physical, emotional, psychological, familial, and the woman's age—relevant to the well-being of the patient. Outstanding Article Award. ... doxycycline, clindamycin topical, erythromycin topical, tetracycline, Tazorac. [192] In 1935, Nazi Germany, a law was passed permitting abortions for those deemed "hereditarily ill", while women considered of German stock were specifically prohibited from having abortions. [233], Viral infection can cause abortion in dogs. [107] For example, the question of a link between induced abortion and breast cancer has been investigated extensively. New York, NY [pdf] Gravid hysterectomy refers to removal of the whole uterus while still containing the pregnancy. Congenital syphilis. The infection is usually diagnosed by a blood test (rapid slide agglutination test). [22][146][145] The unsafe abortion rate in developing countries is partly attributable to lack of access to modern contraceptives; according to the Guttmacher Institute, providing access to contraceptives would result in about 14.5 million fewer unsafe abortions and 38,000 fewer deaths from unsafe abortion annually worldwide. [152] According to the CDC, due to data collection difficulties the data must be viewed as tentative and some fetal deaths reported beyond 20 weeks may be natural deaths erroneously classified as abortions if the removal of the dead fetus is accomplished by the same procedure as an induced abortion. The term mother-to-child transmission (MTCT) of syphilis should be used so as to highlight all the possible adverse outcomes of the disease, which include spontaneous abortion, stillbirth, prematurity, clinical manifestations of congenital syphilis, infant death, and late sequelae []. Social stigma was a main factor predicting negative emotions and regret years later. [92], There is little difference in terms of safety and efficacy between medical abortion using a combined regimen of mifepristone and misoprostol and surgical abortion (vacuum aspiration) in early first trimester abortions up to 10 weeks gestation. This procedure may be performed from 13 weeks gestation to the third trimester. [153][157] Some of the reasons may include an inability to afford a child, domestic violence, lack of support, feeling they are too young, and the wish to complete education or advance a career. For sources describing abortion policy in Nazi Germany, see: woman's right to make decisions about her own body, Centers for Disease Control and Prevention, International Conference on Population and Development, "Abortion Law Development: A Brief Overview", "Birthing a Nation: Fertility Control Access and the 19th Century Demographic Transition", "How many people are affected by or at risk for pregnancy loss or miscarriage? Hysterotomy abortion is a procedure similar to a caesarean section and is performed under general anesthesia. The Dublin Declaration on Maternal Health, signed in 2012, notes, "the prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women. [38], Miscarriage, also known as spontaneous abortion, is the unintentional expulsion of an embryo or fetus before the 24th week of gestation. [239] Feticide can occur in horses and zebras due to male harassment of pregnant mares or forced copulation,[240][241][242] although the frequency in the wild has been questioned. [180] but lack scientific support. [206] In places where abortion is illegal or carries heavy social stigma, pregnant women may engage in medical tourism and travel to countries where they can terminate their pregnancies. [76]:44–47, 62–63, 154–55, 230–31. A 2007 study reported that "26% of all pregnancies worldwide are terminated by induced abortion," whereas "deaths from improperly performed [abortion] procedures constitute 13% of maternal mortality globally. Exposures above 0.005–0.025 Gy cause a dose-dependent reduction in IQ. A National Opinion Research Center poll in 1965 showed 73% supported abortion when the mother's life was at risk, 57% when birth defects were present and 59% for pregnancies resulting from rape or incest. [228] Eating pine needles can also induce abortions in cows. [65], Medical abortion regimens using mifepristone in combination with a prostaglandin analog are the most common methods used for second-trimester abortions in Canada, most of Europe, China and India,[52] in contrast to the United States where 96% of second-trimester abortions are performed surgically by dilation and evacuation. We examined whether contraceptive method type, satisfaction with use, and confidence in correct use were independently associated with switching intentions, a precursor of switching behaviors. Myth: You won’t be fertile for a while after stopping the pill. [23] Church groups as well as physicians were highly influential in anti-abortion movements. The studies supporting this did not control for factors not related to abortion or miscarriage, and hence the causes of this correlation have not been determined, although multiple possibilities have been suggested. "[167], Since ancient times abortions have been done using a number of methods, including herbal medicines, sharp tools, with force, or through other traditional methods. [20] As of 2018[update], 37% of the world's women had access to legal abortions without limits as to reason. Although it is very uncommon in the United States, more than 80% of induced abortions throughout the second trimester are labor-induced abortions in Sweden and other nearby countries. In jurisdictions where abortion is legal, certain requirements must often be met before a woman may obtain a safe, legal abortion (an abortion performed without the woman's consent is considered feticide). [217], Many countries have taken legislative steps to reduce the incidence of sex-selective abortion. [46], The most common cause of spontaneous abortion during the first trimester is chromosomal abnormalities of the embryo or fetus,[37][47] accounting for at least 50% of sampled early pregnancy losses. [148][149], An American study in 2002 concluded that about half of women having abortions were using a form of contraception at the time of becoming pregnant. [6][85] In the UK, guidelines of the Royal College of Obstetricians and Gynaecologists state that "Women should be advised that abortion is generally safer than continuing a pregnancy to term. Copyright © 2021 Elsevier Inc. except certain content provided by third parties. [note 2] However, other sources maintain that in the 19th century early abortions under the hygienic conditions in which midwives usually worked were relatively safe. Contraception’s Editors have active research programs and, on occasion, publish work in Contraception. Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. [42], Only 30% to 50% of conceptions progress past the first trimester. [24] There is debate over the moral, ethical, and legal issues of abortion. Please enter a term before submitting your search. [229][230] Flucloxacillin, Prescribing information, Cellulitis - acute, CKS. [74], Only limited data are available comparing this method with dilation and extraction. [44] Between 15% and 30% of known pregnancies end in clinically apparent miscarriage, depending upon the age and health of the pregnant woman. Think you may forget to restart the pill after a pill-free break and are happier taking a pill every day. Through most of its history the Catholic Church was divided on whether it believed that early abortion was murder, and it did not begin vigorously opposing abortion until the 19th century. Understanding your Cat’s Body Language. Because the indiscriminant use of herbs as abortifacients can cause serious—even lethal—side effects, such as multiple organ failure,[78] such use is not recommended by physicians. [95] Infections account for one-third of abortion-related deaths in the United States. [67] Safely permitting women to self-administer abortion medication has the potential to improve access to abortion. Groups who favor greater legal restrictions on abortion, including complete prohibition, most often describe themselves as "pro-life" while groups who are against such legal restrictions describe themselves as "pro-choice". The preference for male children is reported in many areas of Asia, and abortion used to limit female births has been reported in Taiwan, South Korea, India, and China.
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