Definition of "Abortion"

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Induced abortion is the intentional killing of a fetus/embryo, by forcing it out of a womb before it is able to survive of its own.

Late termination of pregnancy (aka late-term abortion) is an induced abortion of a fetus that may be able to survive on its own.


Methods depend on gestational age, and include:

  • Drugs (aka medical abortions), where abortion is induced by abortifacient drugs. In the 1st trimester are as effective as surgery:
    • Mifepristone (RU-486), an antiprogestogen. It is the most common early 1st trimester medical regimen, and is used in combination with a prostaglandin analog (misoprostol or gemeprost) up to 9 weeks gestational age
    • Prostaglandin analog alone, or with methotrexate, is used for up to 7 weeks gestation. Note however, that mifepristone-misoprostol combination regimen work faster and are more effective at later gestational ages than methotrexate-misoprostol combination regimens, and combination regimens are more effective than misoprostol alone
  • Surgery, which by the 2nd semester, have lower risk of side effects than medications
    • Vacuum aspiration (see page)
    • D&C (dilation and curettage, aka sharp curettage) is the dilation/widening of the cervix and surgical removal of part of the lining of the uterus (and/or its contents) by curettage/scraping. Curettage is cleaning the walls of the uterus with a curette. It can also be used as a therapeutic procedure. It is the 2nd most common method of surgical abortion, and 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 WHO recommends this procedure, only when manual vacuum aspiration is unavailable
    • Dilation and evacuation (D&E), involves opening the cervix of the uterus and emptying it using surgical instruments and suction 
    • Intact dilation and extraction (aka intrauterine cranial decompression, or partial-birth abortion), used after the 16th week of gestation, which requires surgical decompression of the fetus’ head before evacuation. It has been federally banned in the USA
    • Hysterotomy, a procedure similar to a C section and performed under general anesthesia. It requires a smaller incision than a C section and is used during alter stages of pregnancy
  • Birth control (e.g. pill, intrauterine devices) can be started immediately after an abortion
  • Labor induction abortion (aka induced miscarriage) can be done in places lacking the necessary medical skill for dilation and extraction, or where preferred by practitioners. It involves first inducing labor, and then inducing fetal demise if necessary. This procedure may be performed from 13 weeks gestation to 3rd trimester. It is very uncommon in the USA, but more than 80% of induced abortions throughout the 2nd trimester are labor induced abortions in Sweden and other nearby countries

Patient information

Ethics aside, there's lots of reasons why mothers' might decide to abort a fetus. How is this done?
There are 2 ways. Using medications, or surgery. In the 1st trimester, medications are just as effective as surgery, and there's less complications, so we opt for that. In the 2nd trimester, we usually do surgery. We can either manually remove the child using a vacuum, or surgically scraping it out.

  • Where lawful, it is a safe procedure, only causing maternal death in 0.7 per 100k procedures, or 13 times more safer than childbirth (8.8 maternal deaths per 100k)
  • When performed legally and safely, induced abortions don’t increase the risk of long-term mental or physical problems
  • In contrast, unsafe abortions results in 47k maternal deaths, and 5 million hospital admissions per annum globally
  • WHO recommends safe and legal abortions be available to all women
  • 44 million abortions are performed per annum globally, with slightly under 50% performed unsafely
  • Abortion rates have plateud after declining, due to education about birth control
  • 40% of the world's women had access to legal induced abortions without restriction as to reason, although there are limits regarding how far along the pregnancy they can be performed. Some jurisdictions legalize abortion based on specific conditions (e.g. incest, rape, problems with the fetus, socioeconomic factors, risk to a mother's health)
  • There is widespread controversy over the morality and ethics of abortion. Supporters emphasize a woman's right to decide matters concerning her own body, and dissidents emphasize a right to life and find abortion and murder synonymous
  • "Unlawful abortion' is a crime for both women and Dr's subject to 10 years imprisonment (NSW Crimes Act 1900 s82-84). "Lawful" was defined by Levine J in R v Wald (1971) 3 DCR (NSW) 25 as where a Dr believes on reasonable "economic, social or medical ground or reason" that an abortion was necessary to avoid a "serious danger to the pregnant woman's life or to her physical or mental health" at any point during pregnancy. Kirby J in CES v Superclinics ACES v Superclinics Australia Pty Ltd (1995) 38 NSWLR 47 expanded the period of which health concerns can be considered, to any period during the woman's life, even after the birth of the child. In NSW, a referral from a Dr is not required. Although it was thought to preclude successful prosecutions for illegal abortions, in R v Sood [2006] NSWSC 1141, Dr Suman Sood was convicted of 2 counts of performing an illegal abortion because she failed to enquire as to whether a lawful reason for performing the abortion existed
See also
  • Miscarriage (unintentional abortion)

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Definition of Abortion | Autoprac

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