Abortion

Abortion is the early termination of pregnancy through the removal or expulsion of an embryo or fetus. When such a pregnancy ends on its own, it is termed a miscarriage or spontaneous abortion, events that occur in roughly 30–40% of all pregnancies. When deliberate steps are taken to end a pregnancy, the procedure is known as an induced abortion, which is the meaning typically conveyed by the unmodified word abortion in modern usage.

Reasons for Abortion

Individuals choose abortion for a wide range of personal, social, and medical reasons. Commonly reported motivations include:

• Timing and limiting childbearing
• Maternal physical or mental health
• Financial constraints or poverty
• Lack of partner or social support
• Experiences of domestic violence
• Feeling too young or wishing to complete education
• Career considerations
• Pregnancies resulting from rape or incest

In countries with safe and legal access, induced abortion is a very low-risk procedure. Unsafe abortions—typically performed by untrained providers or in inadequate conditions—are responsible for significant maternal morbidity and mortality, particularly in low-resource settings.

Safety and Public Health

In industrialised nations, legal abortion has become one of the safest medical procedures, with very low complication and mortality rates. By contrast, unsafe abortions contribute to an estimated 22,000–44,000 deaths each year and millions of hospital admissions.
Evidence from public health studies shows that:

• Legal, accessible abortion reduces maternal mortality
• Criminalising abortion does not reduce abortion rates but increases unsafe procedures
• Self-managed medication abortion, using approved regimens, is highly effective and safe throughout much of pregnancy

The World Health Organization recognises access to safe abortion and post-abortion care as essential to achieving the highest attainable standard of reproductive health.

Global Trends and Legal Status

Approximately 73 million abortions occur worldwide each year, about 45% of which are performed under unsafe conditions. Global abortion rates remained relatively stable between 2003 and 2008 after decades of decline, a trend attributed largely to increased access to contraception.
Countries vary in their abortion laws. Some permit abortion upon request, while others allow it only under specific circumstances, such as rape, incest, severe fetal anomaly, or risk to the pregnant person’s health. As of recent estimates, 37% of the world’s women live in countries where abortion is available without restriction as to reason. Since the early 1970s, there has been a general global movement toward liberalising abortion laws, though significant regional differences and ongoing political debates persist.

Ethical, Moral, and Legal Debate

Abortion remains a deeply contested issue. Opponents often argue that the embryo or fetus has a right to life and equate abortion with the unjust taking of life. Supporters emphasise reproductive autonomy, bodily integrity, and public health. These debates engage legal, ethical, religious, and philosophical considerations and differ widely across cultures.

Types of Abortion

Induced Abortion

Induced abortion refers to deliberate medical intervention to end a pregnancy. It is subdivided into:

• Therapeutic abortion, performed for medical indications, such as preserving the pregnant person’s life or health or reducing risks in multiple gestation
• Elective or voluntary abortion, performed at the pregnant person’s request for non-medical reasons

Most induced abortions occur during the first trimester, and most result from unintended pregnancies.

Spontaneous Abortion (Miscarriage)

A spontaneous abortion is the unintentional loss of a pregnancy before approximately 24 weeks of gestation. Most occur in the first trimester, often due to chromosomal abnormalities. Additional causes include endocrine disorders, immune conditions such as lupus, infections, anatomical anomalies of the uterus, and maternal age. Between 15% and 30% of clinically recognised pregnancies end in miscarriage.
Pregnancy losses later in gestation are classified as preterm birth (before 37 weeks with a liveborn infant) or stillbirth (death of the fetus after the point of viability).

Methods of Abortion

Medical Abortion

Medical abortion uses pharmaceuticals to end pregnancy. Key medications include:

• Mifepristone, an antiprogestin that halts pregnancy progression
• Misoprostol, a prostaglandin analogue that induces uterine contractions
• Gemeprost (used in some clinical settings)
• Methotrexate, occasionally used with prostaglandins

For early pregnancies, combinations such as mifepristone followed by misoprostol are highly effective, generally up to around 10 weeks’ gestation.

Surgical Abortion

Common surgical procedures include:

• Vacuum aspiration, typically used in the first trimester
• Dilation and evacuation (D&E), used in the second trimester

These methods involve dilating the cervix and removing pregnancy tissue with suction and specialised instruments.

Aftercare and Contraception

Following abortion, most individuals can begin contraception immediately, including oral contraceptives or intrauterine devices. When performed safely, induced abortion does not increase risks of infertility, long-term physical complications, or chronic mental health disorders.