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103-410: The project originated when Lana Bogan, wife of recording engineer Joseph Bogan, watched a TV documentary on abortion and was inspired to write a poem from the perspective of an aborted fetus. While Seals and Crofts were working on their new album, Bogan approached Seals with the poem. She asked him to put the poem to music, which became the lead single "Unborn Child." Seals and Crofts were followers of

206-774: A 2012 study in Obstetrics & Gynecology , in the United States the risk of maternal mortality is 14 times lower after induced abortion than after childbirth. The CDC estimated in 2019 that US pregnancy-related mortality was 17.2 maternal deaths per 100,000 live births, while the US abortion mortality rate was 0.43 maternal deaths per 100,000 procedures. In the UK, guidelines of the Royal College of Obstetricians and Gynaecologists state that "Women should be advised that abortion

309-446: A blood transfusion occurred in 0.03–0.6% of women and serious infection in 0.01–0.5%. Because infection is rare after medication abortion, preventative antibiotics are not recommended (in contrast to surgical abortions, where antibiotics are routinely provided). A few rare cases of deaths from clostridial toxic shock syndrome have occurred following medical abortions. A 2013 systematic review which included 45,000 women who used

412-532: A child , domestic violence , lack of support, feeling they are too young, wishing to complete education or advance a career, and not being able or willing to raise a child conceived as a result of rape or incest . When done legally in industrialized societies, induced abortion is one of the safest procedures in medicine . Unsafe abortions —those performed by people lacking the necessary skills, or in inadequately resourced settings—are responsible for between 5–13% of maternal deaths , especially in

515-471: A combined regimen of mifepristone and misoprostol or surgical abortion. Vacuum aspiration in the first trimester is the safest method of surgical abortion, and can be performed in a primary care office , abortion clinic , or hospital. Complications, which are rare, can include uterine perforation , pelvic infection , and retained products of conception requiring a second procedure to evacuate. Infections account for one-third of abortion-related deaths in

618-696: A contraindication as well. A previous allergic reaction to mifepristone or misoprostol is also a contraindication. Many studies excluded women with severe medical problems such as heart and liver disease or severe anemia. Caution is required in a range of circumstances including: In some cases, it may be appropriate to refer people with preexisting medical conditions to a hospital-based abortion provider. Alternatively, some medical conditions may make medication abortion more favorable to surgical abortion such as large uterine fibroids , congenital uterine anomalies, or genital scarring related to infibulation . Most women will have cramping and bleeding heavier than

721-953: A delayed/suspended menstruation". Forty percent of the world's women are able to access therapeutic and elective abortions within gestational limits, while an additional 35 percent have access to legal abortion if they meet certain physical, mental, or socioeconomic criteria. While maternal mortality seldom results from safe abortions, unsafe abortions result in 70,000 deaths and 5 million disabilities per year. Complications of unsafe abortion account for approximately an eighth of maternal mortalities worldwide, though this varies by region. Secondary infertility caused by an unsafe abortion affects an estimated 24 million women. The rate of unsafe abortions has increased from 44% to 49% between 1995 and 2008. Health education, access to family planning, and improvements in health care during and after abortion have been proposed to address consequences of unsafe abortion. There are two commonly used methods of measuring

824-448: A generalist medical practitioner or specialist medical practitioner (in contrast to first trimester, where the patient may safely take the drugs at home without supervision). For medical abortion after 12 weeks' gestation, the WHO recommends 200 mg of mifepristone by mouth followed one to two days later by repeat doses of 400 μg misoprostol under the tongue, inside the cheek, or in

927-437: A healthy fetus. For those reasons, misoprostol should always be taken after the mifepristone. If the pregnancy involves twins, a higher dosage of mifepristone may be recommended. Medical abortion performed very early, before the pregnancy can be detected by ultrasound, is just as safe and effective as medical abortion after the pregnancy is detectable by ultrasound. In the first trimester, self-administered medical abortion

1030-441: A menstrual period. Other adverse effects may include nausea, vomiting, fever, chills, diarrhea, headache, dizziness, warmth or hot flashes. When used inside the vagina, misoprostol tends to have fewer gastrointestinal side effects. Nonsteroidal anti-inflammatory medications such as ibuprofen reduce pain with medication abortion. Complications under 10 weeks' pregnancy are rare; according to two large reviews, bleeding requiring

1133-510: A mifepristone–misoprostol combination regimen is considered to be more effective than surgical abortion ( vacuum aspiration ), especially when clinical practice does not include detailed inspection of aspirated tissue. Early medical abortion regimens using mifepristone, followed 24–48 hours later by buccal or vaginal misoprostol are 98% effective up to 9 weeks gestational age; from 9 to 10 weeks efficacy decreases modestly to 94%. If medical abortion fails, surgical abortion must be used to complete

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1236-457: A prescription vary widely between countries. Many countries make the medical abortion drugs available over the counter , without a prescription, such as China, India, and others. Other countries require a prescription (Canada, most of Western Europe, the United States, and others). Some countries require a prescription but are lax about enforcing that requirement (Russia, Brazil, and others). Telehealth includes access to medical services that

1339-548: A prostaglandin analog alone. Mifepristone–misoprostol combination regimens work faster and are more effective at later gestational ages than methotrexate–misoprostol combination regimens, and combination regimens are more effective than misoprostol alone, particularly in the second trimester. Medical abortion regimens involving mifepristone followed by misoprostol in the cheek between 24 and 48 hours later are effective when performed before 70 days' gestation. In very early abortions, up to 7 weeks gestation , medical abortion using

1442-422: A public health measure. Abortion laws and views of the procedure are different around the world. In some countries abortion is legal and women have the right to make the choice about abortion. In some areas, abortion is legal only in specific cases such as rape, incest, fetal defects , poverty, and risk to a woman's health. An induced abortion is a medical procedure to end a pregnancy. In present-day English,

1545-484: A requirement that dispensing pharmacies be "certified", which requires the pharmacy to have special permission to dispense the medications – a requirement the FDA imposes on only 40 medications out of more than 19,000 it manages. The second medication used in medical abortion, misoprostol, is most commonly used for treating ulcers, and was never subject to the in-person dispensing constraints of mifepristone, and

1648-458: A result of COVID-19 fear, reduced travel ability, stay-at-home orders, greater concealment, and the solace of home-care. This data supported the safety and efficacy of telehealth abortion services, and demonstrated its increasing demand. The severity and rate of complications after telehealth abortion services were low, mirroring overall medical abortion complication rates, including those performed within clinics or other medical facilities. In

1751-577: A significantly increased chance of mortality or morbidity, and reducing the number of fetuses to lessen health risks associated with multiple pregnancy . An abortion is referred to as elective or voluntary when it is performed at the request of the woman for non-medical reasons. Confusion sometimes arises over the term elective because " elective surgery " generally refers to all scheduled surgery, whether medically necessary or not. About one in five pregnancies worldwide ends with an induced abortion. Most abortions result from unintended pregnancies. In

1854-402: A specific abortion procedure. Abortions can be characterized as either therapeutic or elective. When an abortion is performed for medical reasons, the procedure is referred to as a therapeutic abortion. Medical reasons for therapeutic abortion include saving the life of the pregnant woman, preventing harm to the woman's physical or mental health , preventing the birth of a child who will have

1957-916: A successful alternative method of abortion with the availability of prostaglandin analogs in the 1970s. One such analog is carboprost , which was successfully trialed in the United States in 1979. In 1981, French pharmaceutical company Roussel-Uclaf developed the antiprogestogen mifepristone (also known as RU-486). Mifepristone was first approved for use in China and France in 1988, in Great Britain in 1991, in Sweden in 1992, in Austria, Belgium, Denmark, Finland, Georgia, Germany, Greece, Iceland, Israel, Lichtenstein, Luxembourg, Netherlands, Russia, Spain, and Switzerland in 1999, in Norway, Taiwan, Tunisia, and

2060-445: A widespread trend towards greater legal access to abortion since 1973, but there remains debate with regard to moral, religious, ethical, and legal issues. Those who oppose abortion often argue that an embryo or fetus is a person with a right to life , and thus equate abortion with murder . Those who support abortion's legality often argue that it is a woman's reproductive right . Others favor legal and accessible abortion as

2163-623: Is a procedure similar to a caesarean section and is performed under general anesthesia . It requires a smaller incision than a caesarean section and can be used during later stages of pregnancy. Gravid hysterectomy refers to removal of the whole uterus while still containing the pregnancy. Hysterotomy and hysterectomy are associated with much higher rates of maternal morbidity and mortality than D&E or induction abortion. First trimester procedures can generally be performed using local anesthesia , while second trimester methods may require deep sedation or general anesthesia . In places lacking

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2266-459: Is as safe as provider-administered medical abortion, where a health care professional is present to help manage the medical abortion. Safely permitting women to self-administer abortion medication has the potential to improve access to abortion. The review also noted a research gap concerning methods to support women who take medication at home for a self-administered abortion. Up to 15 weeks' gestation, suction-aspiration or vacuum aspiration are

2369-439: Is as safe from 64 to 70 days' gestation as it before 63 days. 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. Medical abortion using the prostaglandin analog misoprostol alone is less effective and more painful than medical abortion using

2472-416: Is available for patients who prefer to take the abortion drugs at home without direct medical supervision (in contrast to provider-administered medical abortion where the patient takes the second abortion drug in the presence of a trained healthcare provider). Evidence from clinical trials indicates self-administered medical abortion is as effective as provider-administered abortion; however additional research

2575-487: Is available through 63 days. The WHO authorizes the methotrexate-misoprostol combination but recommends the mifepristone combination because methotrexate may be teratogenic to the embryo in cases of incomplete abortion. The methotrexate-misoprostol combination is considered more effective than misoprostol alone. Contraindications to mifepristone are inherited porphyria , chronic adrenal failure , and ectopic pregnancy. Some consider an intrauterine device in place to be

2678-524: Is essential for the attainment of the highest possible level of sexual and reproductive health". Historically , abortions have been attempted using herbal medicines , sharp tools, forceful massage , or other traditional methods . Around 73 million abortions are performed each year in the world, with about 45% done unsafely. Abortion rates changed little between 2003 and 2008, before which they decreased for at least two decades as access to family planning and birth control increased. As of 2018 , 37% of

2781-541: Is generally safer than continuing a pregnancy to term." Worldwide, on average, abortion is safer than carrying a pregnancy to term. 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." In Indonesia in 2000 it was estimated that 2 million pregnancies ended in abortion, 4.5 million pregnancies were carried to term, and 14–16 percent of maternal deaths resulted from abortion. In

2884-414: Is legal and available. The health risks of abortion depend principally on how, and under what conditions, the procedure is performed. The World Health Organization (WHO) defines unsafe abortions as those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities. Legal abortions performed in the developed world are among the safest procedures in medicine. According to

2987-457: Is legally allowed, a considerable number of unsafe abortions occur. Approximately 7 million women are hospitalized annually in these areas as a result of complications arising from unsafe abortion. Unsafe abortion is attributed to 4.7% to 13.2% of maternal deaths each year, with the estimated expense for managing its complications reaching $ 553 million. Many factors contribute to these health risks including lack of education about available choices,

3090-666: Is legally restricted. They may attempt self-induced abortion or seek the help of a person without proper medical training or facilities. This can lead to severe complications, such as incomplete abortion, sepsis , hemorrhage, and damage to internal organs. Unsafe abortions are a major cause of injury and death among women worldwide. Although data are imprecise, it is estimated that approximately 20 million unsafe abortions are performed annually, with 97% taking place in developing countries . Unsafe abortions are believed to result in millions of injuries. Estimates of deaths vary according to methodology, and have ranged from 37,000 to 70,000 in

3193-460: Is legally risky in the United States. Historically, a number of herbs reputed to possess abortifacient properties have been used in folk medicine . Such herbs include tansy , pennyroyal , black cohosh , and the now-extinct silphium . In 1978, one woman in Colorado died and another developed organ damage when they attempted to terminate their pregnancies by taking pennyroyal oil. Because

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3296-494: Is recommended to take the second drug in a clinic, provider's office, or other supervised medical facility. For medical abortion up to 12 weeks' gestation, the recommended drug dosages are 200 milligrams of mifepristone by mouth, followed one to two days later by 800 micrograms of misoprostol inside the cheek, vaginally, or under the tongue. The success rate of this drug combination is 96.6% through 10 weeks' pregnancy. Misoprostol should be administered 24 to 48 hours after

3399-411: Is required to confirm that safety is equivalent. The procedure used to administer the two drugs depends on specific drugs prescribed. A typical procedure, for 200 mg mifepristone tablets, is: Medical abortion is safe and effective in the second and third trimesters. The World Health Organization (WHO) recommends that medical abortions performed after 12 weeks' gestation be supervised by

3502-507: Is significantly more than the mifepristone-misoprostol combination. Tests have shown that letrozole or methotrexate may be included in the mifepristone-misoprostol regimen to improve the outcome in the first trimester. A rarely used drug combination for uterine pregnancies is methotrexate -misoprostol, which is typically reserved for ectopic pregnancies . Methotrexate is given either orally or intramuscularly, followed by vaginal misoprostol 3–5 days later. The methotrexate combination

3605-642: Is the legal standing of abortion. Countries with restrictive abortion laws have higher rates of unsafe abortion and similar overall abortion rates compared to countries where abortion is legal and available. For example, the 1996 legalization of abortion in South Africa led to an immediate reduction in abortion-related complications, with abortion-related deaths dropping by more than 90%. Similar reductions in maternal mortality have been observed after other countries have liberalized their abortion laws, such as Romania and Nepal . A 2011 study concluded that in

3708-631: Is the termination of a pregnancy by removal or expulsion of an embryo or fetus . An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of all pregnancies. When deliberate steps are taken to end a pregnancy, it is called an induced abortion , or less frequently "induced miscarriage". The unmodified word abortion generally refers to an induced abortion. The most common reasons given for having an abortion are for birth-timing and limiting family size. Other reasons reported include maternal health , an inability to afford

3811-577: Is usually termed " stillborn ". Premature births and stillbirths are generally not considered to be miscarriages, although usage of these terms can sometimes overlap. Studies of pregnant women in the US and China have shown that between 40% and 60% of embryos do not progress to birth. The vast majority of miscarriages occur before the woman is aware that she is pregnant , and many pregnancies spontaneously abort before medical practitioners can detect an embryo. Between 15% and 30% of known pregnancies end in clinically apparent miscarriage, depending upon

3914-577: 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. Some older reviews concluded that abortion was associated with an increased risk of psychological problems; however, later reviews of

4017-473: The Baháʼí Faith , a religion founded in the 19th-century which teaches that life begins at conception. After listening to the full album, Seals and Crofts named it after the lead single because they decided that it best represented the concept of the album. According to Crofts, Warner Bros. warned them not to release the album, because the subject of abortion was highly controversial. The duo insisted that

4120-562: 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 . Reported methods of unsafe, self-induced abortion include misuse of misoprostol and insertion of non-surgical implements such as knitting needles and clothes hangers into the uterus. These and other methods to terminate pregnancy may be called "induced miscarriage". Such methods are rarely used in countries where surgical abortion

4223-436: The cervix and emptying the uterus using surgical instruments and suction. D&E is performed vaginally and does not require an incision. Intact dilation and extraction (D&X) refers to a variant of D&E sometimes used after 18 to 20 weeks when removal of an intact fetus improves surgical safety or for other reasons. Abortion may also be performed surgically by hysterotomy or gravid hysterectomy. Hysterotomy abortion

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4326-435: The developing world . However, medication abortions that are self-managed are highly effective and safe throughout the first trimester . Public health data show that making safe abortion legal and accessible reduces maternal deaths. Modern methods use medication or surgery for abortions. The drug mifepristone (aka RU-486) in combination with prostaglandin appears to be as safe and effective as surgery during

4429-748: The first and second trimesters of pregnancy. The most common surgical technique involves dilating the cervix and using a suction device . Birth control , such as the pill or intrauterine devices , can be used immediately following abortion. 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. In contrast, unsafe abortions performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities cause between 22,000 and 44,000 deaths and 6.9 million hospital admissions each year. The World Health Organization states that "access to legal, safe and comprehensive abortion care, including post-abortion care ,

4532-437: The 200 mg mifepristone followed by misoprostol combination found that less than 0.4% had serious complications requiring hospitalization (0.3%) and/or blood transfusion (0.1%). Vaginal bleeding generally diminishes gradually over about two weeks after a medical abortion, but in individual cases spotting can last up to 45 days. Emergency surgical or medical interventions for prolonged bleeding may be considered based on how

4635-460: The COVID-19 pandemic led to an increased incidence of complications and fatalities during pregnancy. Pregnant individuals requested access to medical abortion more than surgical abortion during the pandemic, and preferred the ability to perform medical abortions at home via telehealth services. Data suggest that the increased use of telemedicine for abortion services during this period were

4738-537: The Swedish physician Lars Engström published a paper on a clinical trial, conducted at the women's clinic of Karolinska Hospital in Stockholm, of the compound F6103 on pregnant Swedish women with the aim of inducing abortion. It was the first clinical trial of an abortion pill to be conducted in Sweden. The paper, originally titled The Swedish Abortion Pill , was renamed to The Swedish Postconception Pill , due to

4841-551: The U.S., historian Linda Gordon states: "In fact, illegal abortions in this country have an impressive safety record." 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. A 1940s American physician spoke of his pride in having performed 13,844 illegal abortions without any fatalities. In 1870s New York City,

4944-505: The US Food and Drug Administration (FDA). This model has been shown to be safe, effective, efficient, and satisfactory. Complete abortion can be confirmed via telephone-based assessment. The COVID-19 pandemic challenged health policymakers worldwide which led to both indirect and direct affects on reproductive health access. The overall decrease in availability and delivery of crucial sexual health care, including safe abortions, amid

5047-523: The US from 2000 to 2009, abortion had a mortality rate lower than plastic surgery , lower or similar to running a marathon, and about equivalent to traveling 760 miles (1,220 km) in a passenger car. 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. The risk of abortion-related mortality increases with gestational age, but remains lower than that of childbirth. Outpatient abortion

5150-615: The US, medical abortions accounted for 32% of first trimester abortions in 2008, 35% of all abortions in 2010 and 43% of all abortions in 2014. In 2009, medical abortion regimens using mifepristone in combination with a prostaglandin analog were the most common methods used to induce second-trimester abortions in Canada, most of Europe, China and India; in contrast to the US, where 96% of second-trimester abortions were performed surgically by dilation and evacuation . Swedish researchers began testing potential abortifacients in 1965. In 1968,

5253-543: The US, prescriptions for mifepristone may be filled by any pharmacy - online or brick-and-mortar - that has obtained a special certification. This regulation was provisionally implemented in Dec 2021, and was finalized by the US Food and Drug Administration (FDA) in January 2023. From 2011 until 2021, a woman was required to visit a healthcare provider in-person (at a clinic or office) and receive mifepristone directly from

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5356-504: The United Kingdom, 1 to 2% of abortions are done because of genetic problems in the fetus. Miscarriage, also known as spontaneous abortion, is the unintentional expulsion of an embryo or fetus before the 24th week of gestation . A pregnancy that ends before 37 weeks of gestation resulting in a live-born infant is a " premature birth " or a "preterm birth". When a fetus dies in utero after viability , or during delivery , it

5459-499: The United States in 2000, and in 70 additional countries from 2001 to 2023. In 2000, mifepristone was approved by the US FDA for abortions through 49 days gestation. In 2016, the US FDA updated mifepristone's label to support usage through 70 days gestation. Both drugs – mifepristone and misoprostol – are no longer covered by drug patents, and hence are available as generic drugs . The requirements for

5562-403: The United States where 96% of second trimester abortions are performed surgically by dilation and evacuation . A 2020 Cochrane Systematic Review concluded that providing women with medications to take home to complete the second stage of the procedure for an early medical abortion results in an effective abortion. Further research is required to determine if self-administered medical abortion

5665-726: The United States, some state-level anti-abortion laws are correlated with lower rates of abortion in that state. The analysis, however, did not take into account travel to other states without such laws to obtain an abortion. In addition, a lack of access to effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by up to 75% (from 20 million to 5 million annually) if modern family planning and maternal health services were readily available globally. Rates of such abortions may be difficult to measure because they can be reported variously as miscarriage, "induced miscarriage", "menstrual regulation", "mini-abortion", and "regulation of

5768-565: The United States. The rate of complications of vacuum aspiration abortion in the first trimester is similar regardless of whether the procedure is performed in a hospital, surgical center, or office. Preventive antibiotics (such as doxycycline or metronidazole ) are typically given before abortion procedures, as they are believed to substantially reduce the risk of postoperative uterine infection; however, antibiotics are not routinely given with abortion pills. The rate of failed procedures does not appear to vary significantly depending on whether

5871-498: The abortion is not successful. If the pregnancy continues after using mifepristone and misoprostol, it is advised to seek proper medical care to discuss pregnancy options, with a thorough discussion of the risks and benefits for each. There is no evidence of mifepristone causing birth defects, but misoprostol, when used in the first trimester, can be teratogenic and lead to congenital anomalies like limb defects, with or without Möbius' syndrome (facial paralysis). Mifepristone blocks

5974-461: The abortion is performed by a doctor or a mid-level practitioner . Complications after second trimester abortion are similar to those after first trimester abortion, and depend somewhat on the method chosen. 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

6077-439: The abortion, including drug overdoses, homicides, and a suicide. When not taking the 11 likely unrelated deaths into account, the mortality rate for medication abortion is half the mortality rate of abortion overall. Including all deaths in the study, the data shows that the mortality rate for medication abortion is about equal to abortion overall, which is 14 times lower than the mortality rate for childbirth, and also lower than

6180-411: The abortionist/midwife Madame Restell (Anna Trow Lohman) is said to have lost very few women among her more than 100,000 patients —a lower mortality rate than the childbirth mortality rate at the time. In 1936, obstetrics and gynecology professor Frederick J. Taussig wrote that a cause of increasing mortality during the years of illegality in the U.S. was that With each decade of the past fifty years

6283-467: The actual and proportionate frequency of this accident [perforation of the uterus] has increased, due, first, to the increase in the number of instrumentally induced abortions; second, to the proportionate increase in abortions handled by doctors as against those handled by midwives; and, third, to the prevailing tendency to use instruments instead of the finger in emptying the uterus. Women seeking an abortion may use unsafe methods, especially when abortion

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6386-435: The age and health of the pregnant woman. 80% of these spontaneous abortions happen in the first trimester. The most common cause of spontaneous abortion during the first trimester is chromosomal abnormalities of the embryo or fetus, accounting for at least 50% of sampled early pregnancy losses. Other causes include vascular disease (such as lupus ), diabetes , other hormonal problems , infection, and abnormalities of

6489-444: The availability of prostaglandin analogs in the 1970s and the antiprogestogen mifepristone (also known as RU-486) in the 1980s. The most common early first trimester medical abortion regimens use mifepristone in combination with misoprostol (or sometimes another prostaglandin analog, gemeprost ) up to 10 weeks (70 days) gestational age, methotrexate in combination with a prostaglandin analog up to 7 weeks gestation, or

6592-555: The bleeding is heavy or prolonged, or causes anemia , or if there is evidence of endometritis . Globally, individuals who can get pregnant face substantial dangers to their health due to the significant challenges in obtaining safe abortion services. These negative outcomes arise from stringent abortion regulations, ineffective healthcare systems, a shortage of adequately trained healthcare professionals, societally imposed stigma, and limited services in remote regions. Additionally, within low and middle-income countries where abortion

6695-481: The cervix (dilation) and removing tissue (curettage) via suction or sharp instruments. D&C is a standard gynecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion. The World Health Organization recommends sharp curettage only when suction aspiration is unavailable. Dilation and evacuation (D&E), used after 12 to 16 weeks, consists of opening

6798-559: The embryo through the vagina. Letrozole is an aromatase inhibitor that prevents estrogen synthesis and encourages ovulation. Recent studies suggest the use of letrozole before misoprostol or mifepristone for initiation of medical abortion can enhance treatment efficacy and reduce the need for surgical interventions. A Guttmacher Institute survey of all known abortion providers in the US found that medical abortions accounted for 53% of all abortions in 2020. This count did not include self-induced abortions . At Planned Parenthood clinics in

6901-428: The first dose. After the patient takes mifepristone, they must also administer the misoprostol. Failure to take the misoprostol may result in any of these outcomes: the fetus may be terminated, but not fully expelled from the uterus (possibly accompanied by hemorrhaging) and may require surgical intervention to remove the fetus; or the pregnancy may be successfully aborted and expelled; or the pregnancy may continue with

7004-466: The first trimester because of fetal abnormalities, more rigorous research would be needed to show this conclusively. Some proposed negative psychological effects of abortion have been referred to by anti-abortion advocates as a separate condition called " post-abortion syndrome ", but this is not recognized by medical or psychological professionals in the United States. A 2020 long term-study among US women found that about 99% of women felt that they made

7107-421: The hormone progesterone, causing the lining of the uterus to thin, preventing an embryo from latching on to the uterine wall to grow. Methotrexate, which is sometimes used instead of mifepristone, stops the cytotrophoblastic tissue from growing and becoming a functional placenta, the organ that supplies nutrients to a developing fetus. Misoprostol, a synthetic prostaglandin, causes the uterus to contract and expel

7210-508: The incidence of abortion: In many places, where abortion is illegal or carries a heavy social stigma, medical reporting of abortion is not reliable. For this reason, estimates of the incidence of abortion must be made without determining certainty related to standard error . The number of abortions performed worldwide was characterized as stable in the early 2000s, with 41.6 million having been performed in 2003 and 43.8 million having been performed in 2008. The abortion rate worldwide

7313-482: The indiscriminant use of herbs as abortifacients can cause serious—even lethal—side effects, such as multiple organ failure , such use is not recommended by physicians. Abortion is sometimes attempted by causing trauma to the abdomen. The degree of force, if severe, can cause serious internal injuries without necessarily succeeding in inducing miscarriage . In Southeast Asia, there is an ancient tradition of attempting abortion through forceful abdominal massage. One of

7416-631: The last menstrual period). It appears that having had a prior surgical uterine evacuation (whether because of induced abortion or treatment of miscarriage) correlates with a small increase in the risk of preterm birth in future pregnancies. 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. Current evidence finds no relationship between most induced abortions and mental health problems other than those expected for any unwanted pregnancy. A report by

7519-562: The media on Women's Equality Day. However, it did receive a mostly positive review from Noel Coppage, who, in a July 1974 issue of what was then known as Stereo Review described the song "Windflowers" as "truly beautiful, one of the most dazzling opening songs I've heard on an album in a long time," with "two-part harmonies that soar above inspired and single-minded runs on Crofts' mandolin and unbelievably clean and understanding strums on Seals' acoustic guitar, backed by some restrained and brilliant strums on Louis Shelton's electric guitar." Of

7622-412: The medical literature found that previous reviews did not use an appropriate control group. When a control group is utilized, receiving abortion is not associated with adverse psychological outcomes. However, women seeking abortion who are denied access to abortion have an increase in anxiety after the denial. Although some studies show negative mental-health outcomes in women who choose abortions after

7725-467: The message of "Unborn Child" was universal, and Crofts stated that they made the record "to save lives." Despite Warner's warnings, the album was released in February 1974 to great controversy. The title track garnered backlash and was banned from some radio stations because of its anti-abortion stance. Unborn Child hurt the duo's popularity and was criticized by music critics. The controversy lowered

7828-550: The mifepristone; taking the misoprostol before 24 hours have elapsed reduces the probability of success. However, one study showed that the two drugs may be taken simultaneously with nearly the same efficacy. For pregnancies after 9 weeks, two doses of misoprostol (the second drug) makes the treatment more effective. From 10 to 11 weeks of pregnancy, the National Abortion Federation suggests second dose of misoprostol (800 micrograms) four hours after

7931-404: The mortality rate for Penicillin and Viagra . Medical abortion has been demonstrated to be safe by international health organizations such as the WHO even into the second and third trimesters, but legal access to these services change frequently in the US and globally. Before taking medication for abortion, individuals should be advised about the potential harmful effects of misoprostol if

8034-615: The most common surgical methods of induced abortion. 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. Both techniques can be used very early in pregnancy. MVA can be used up to 14 weeks but is more often used earlier in the U.S. EVA can be used later. MVA, also known as "mini-suction" and " menstrual extraction ", or EVA can be used in very early pregnancy when cervical dilation may not be required. Dilation and curettage (D&C) refers to opening

8137-425: The most recommended drug regimen for medical abortions, but other drug combinations are available. Misoprostol alone, without mifepristone, may be used in some circumstances for medical abortion, and has even been demonstrated to be successful in the second trimester. Misoprostol is more commonly available than mifepristone, and is easier to store and administer, so misoprostol without mifepristone may be suggested by

8240-418: The necessary medical skill for dilation and extraction, or when preferred by practitioners, an abortion can be induced by first inducing labor and then inducing fetal demise if necessary. This is sometimes called "induced miscarriage". This procedure may be performed from 13 weeks gestation to the third trimester. Although it is very uncommon in the United States, more than 80% of induced abortions throughout

8343-470: The past decade; deaths from unsafe abortion account for around 13% of all maternal deaths . The World Health Organization believes that mortality has fallen since the 1990s. To reduce the number of unsafe abortions, public health organizations have generally advocated emphasizing the legalization of abortion, training of medical personnel, and ensuring access to reproductive-health services. A major factor in whether abortions are performed safely or not

8446-400: The patient feels and if the bleeding seems to be getting better. Overall, less than 1% of individuals who undergo a medical abortion must obtain emergency services for excessive bleeding, and about 0.1% require a blood transfusion . Remaining products of conception will be expelled during subsequent vaginal bleeding. Still, surgical intervention may be carried out on the woman's request, if

8549-421: The patient receives counseling and instruction from the abortion provider via videoconference. The patient can be at any location, including their home. The medications necessary for the abortion are mailed directly to the patient. This is a model, called TelAbortion or no-test medication abortion (formerly no-touch medication abortion), being piloted and studied by Gynuity Health Projects, with special approval from

8652-505: The person can perform at home, without in-person visits to clinic or provider offices. People who have used telehealth report being satisfied with the access it provides to abortion services. However, those who might need the service the most (those who are incarcerated, unhoused, or live on low income) are often inhibited from accessing it. In this model, a provider communicates with a patient located at another site using clinic-to-clinic videoconferencing to provide medication abortion. This

8755-571: The procedure. Early medical abortions account for the majority of abortions before 9 weeks gestation in Britain , France , Switzerland , United States , and the Nordic countries . 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 , in contrast to

8858-621: The profile of Seals and Crofts and slowed down their music career. According to Bill DeYoung, the duo crossed the thin line that separated their music from the Baháʼí Faith , and abortion-rights advocates boycotted the record and the duo's concerts. For the album, Seals and Crofts won the "Keep Her in Her Place" award from the National Organization for Women (tying with Paul Anka for his recording of " (You're) Having My Baby ") during its "annual putdown of male chauvinism" in

8961-430: The provider if mifepristone is not available. If misoprostol is used without mifepristone, the WHO recommends 800 μg of misoprostol inside the cheek, under the tongue, or in the vagina. The success rate of misoprostol alone for terminating pregnancy (93%) is nearly the same as the mifepristone-misoprostol combination (96%). However, 15% of the women using misoprostol alone required a surgical follow-up procedure, which

9064-522: The provider. The requirement to visit a clinic to receive the medication was removed by the FDA in December 2021, during the COVID-19 pandemic . Under the new rules, the prescription may be obtained via telehealth (phone calls or video conferencing with a healthcare provider), and then filled at any certified pharmacy. At the same time the FDA removed the requirement for an in-person visit, they added

9167-436: The question of a link between induced abortion and breast cancer has been investigated extensively. Major medical and scientific bodies (including the WHO, National Cancer Institute , American Cancer Society , Royal College of OBGYN and American Congress of OBGYN ) have concluded that abortion does not cause breast cancer. In the past even illegality has not automatically meant that the abortions were unsafe. Referring to

9270-557: The right decision five years after they had an abortion. Relief was the primary emotion with few women feeling sadness or guilt. Social stigma was a main factor predicting negative emotions and regret years later. The researchers also stated: "These results add to the scientific evidence that emotions about an abortion are associated with personal and social context, and are not a product of the abortion procedure itself." Some purported risks of abortion are promoted primarily by anti-abortion groups, but lack scientific support. For example,

9373-414: The second and third trimester. In the United States, the mortality rate for medical abortion is 14 times lower than the mortality rate for childbirth, and the rate of serious complications requiring hospitalization or blood transfusion is less than 0.4%. Medical abortion can be administered safely by the patient at home, without assistance, in the first trimester. In the second trimester and beyond, it

9476-403: The second trimester are labor-induced abortions in Sweden and other nearby countries. Only limited data are available comparing labor-induced abortion with the dilation and extraction method. Unlike D&E, labor-induced abortions after 18 weeks may be complicated by the occurrence of brief fetal survival, which may be legally characterized as live birth. For this reason, labor-induced abortion

9579-484: The small number of induced abortions that occurred in the trial population. After these efforts were largely unsuccessful with F6103, the same researchers attempted to find an abortion pill with prostaglandins , capitalizing on the number of well-established prostaglandin scientists working in Sweden at the time; they were eventually awarded the 1982 Nobel Prize in Physiology for their work. Medical abortion became

9682-416: The term abortion , when used without further qualification, generally refers to induced abortion. A pregnancy can be intentionally aborted in several ways. The abortion method depends upon the gestational age of the embryo or fetus, which gains mass as the pregnancy progresses. Abortion laws , regional availability, and the personal preference of the women and her doctor may inform the women's choice of

9785-417: The title cut, he wrote that its "message is anti-abortion propaganda, pure and simple, but it is delivered gently and poetically inside a layered, meaty melody–and hardworking liberals like me can like the song while disagreeing with the tract it could be prosaically reduced to." All songs written by James Seals and Dash Crofts , except where indicated. Side One Side Two Abortion Abortion

9888-476: The uterus. Advancing maternal age and a woman's history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion. A spontaneous abortion can also be caused by accidental trauma ; intentional trauma or stress to cause miscarriage is considered induced abortion or feticide . Medical abortions are those induced by abortifacient pharmaceuticals. Medical abortion became an alternative method of abortion with

9991-507: The vagina. Misoprostol should be taken every 3 hours until successful abortion is achieved, the mean time to abortion after starting misoprostol is 6–8 hours, and approximately 94% will abort within 24 hours after starting misoprostol. When mifepristone is not available, misoprostol may still be used though the mean time to abortion after starting misoprostol will be extended compared to regimens using mifepristone followed by misoprostol. The mifepristone-misoprostol combination is, by far,

10094-411: The varying stances of healthcare providers on abortion, a shortage of qualified personnel for safe abortion services, insufficient privacy and confidentiality, and services that fall short of meeting the demand. In the United States, an FDA report states that of the 3.7 million women who have had a medication abortion between 2000 and 2018, 24 died afterward, with 11 of those deaths likely unrelated to

10197-425: The world's women had access to legal abortions without limits as to reason. Countries that permit abortions have different limits on how late in pregnancy abortion is allowed. Abortion rates are similar between countries that restrict abortion and countries that broadly allow it, though this is partly because countries which restrict abortion tend to have higher unintended pregnancy rates. Globally, there has been

10300-401: The world. Medical abortions are most commonly performed by administering a two-drug combination: mifepristone followed by misoprostol . This two-drug combination is more effective than other drug combinations. When mifepristone is not available, misoprostol alone may be used in some situations. Medical abortion is both safe and effective throughout a range of gestational ages, including

10403-732: Was 28 per 1000 women per year, though it was 24 per 1000 women per year for developed countries and 29 per 1000 women per year for developing countries. The same 2012 study indicated that in 2008, the estimated abortion percentage of known pregnancies was at 21% worldwide, with 26% in developed countries and 20% in developing countries. Medication abortion A medical abortion , also known as medication abortion or non-surgical abortion, occurs when drugs ( medication ) are used to bring about an abortion . Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage . Medical abortions are more common than surgical abortions in most places around

10506-400: Was always available from pharmacies with a prescription. The FDA does not authorize the use of mifepristone for medical abortion after 70 days, unlike most other countries, which authorize medical abortion into the second trimester and even the third trimester. Some states have passed laws that prohibit providers from examining the woman via phone or video conferencing, and instead require

10609-559: Was introduced by Planned Parenthood of the Heartland in Iowa to allow a patient at one health facility to communicate via secure video with a health provider at another facility. This model has expanded to other Planned Parenthoods in multiple states as well other clinics providing abortion care. The direct-to-patient model allows for medication abortion to be provided without an in-person clinic visit. Instead of an in-person clinic visit,

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