The word abortion, in its essence refers to the removal of the developing fetus or embryo of a mammal from the body of its mother, which either causes its death or is caused due to its death. In either case, the developing mammal loses its life and does not develop as a complete individual. Abortion is thus of two types. It can either be spontaneous, or natural (that is due to the death of the embryo or fetus) or induced, or artificial (that is deliberately caused resulting in intentional death of the developing embryo or fetus). Generally speaking, the term abortion is used for humans, rather than all the mammalian group of animals collectively. Moreover, the term abortion is generally used for the induced abortion also known as “feticide” (meaning killing of the fetus), where as the spontaneous or natural abortion is commonly known as a “miscarriage”. Thus, from now on, the main topic of discussion will be induced abortion. (Shoshanna, 2002)
Induced abortion, or more simply abortion, basically refers to any method or procedure that results in the death and eventually the removal of a developing fetus or an embryo within the body of its mother; whether for therapeutic reasons or otherwise. There are many ways or inducing abortion, however, the relevant method selected chiefly depends upon the age and the development of the embryo of fetus. This age of the embryo or fetus is referred to as its gestational age and it is the major factor in the decision of the method to be used for sake of abortion. Broadly defined, there are three methods of induced abortion, that is, surgical methods, medical methods and other methods. (Shoshanna, 2002)
Talking about the surgical methods, the STOP (surgical termination of pregnancy) techniques can be used. The most common method of inducing abortion is the vacuum abortion, also known as suction-aspiration. This vacuum abortive process can either be performed manually using syringe as the tool used for suction, or it can be done using an electric pump, mainly depending upon the gestation age of the embryo or the fetus. if the gestation age is not more than 12 weeks, menstrual extraction can be performed, which does not even require dilation of the cervix, however, if the gestation age ranges from 15 to 26 weeks, cervical dilation and evacuation is to be carried out, which as compared to the menstrual extraction, is a more complicated process. The second most common method of abortion is called Dilation and curettage (D&C). In this process, the cervix is first dilated and then the uterine lining is cleaned with a sharp curettage. This technique is used only during the first trimester and the world health organization (WHO) recommends and / or allows this form of abortion only if the MVA process (menstrual extraction or cervical dilation and evacuation – D&E) is not possible to carry out due to medical reasons or health concerns of the mother like excessive or abnormal bleeding etc. (MariAnna, 2002). Later in the second trimester onwards, various other methods can be used. These procedures may include intact dilation and extraction (IDX) (or intrauterine cranial decompression). In this process the fetus’ head is decompressed prior to evacuation. The IDX method has raised some legal controversial arguments and is thus already banned in some countries. Contaminating the amniotic fluid using saline or urea inducing premature still birth may be an alternative method. In later stages of pregnancy, hysterotomy abortion (similar to a caesarian section) is used. Stopping the heart of the fetus through some injections can also be used in the later stages of pregnancy. (MariAnna, 2002)
The medical methods of induced abortion are effective only in the first trimester of pregnancy. It refers to the use of various medicines in order to cease the development of the growing embryo or fetus causing its death followed by its removal from the body of its mother. It is not a much prevalent form of abortive methods and in case of its failure, surgical methods like menstrual extraction or cervical dilation and evacuation are used. (MariAnna, 2002)
Other means of inducing abortion include use of various herbs, as it has been done over the course of historical times under what is now known as classical or folk medicine. These herbs include tansy, pennyroyal, black cohosh, silphium (extinct) etc, which have been known to possess abortifacient properties. However, these herbs can prove to be dangerously harmful to the mother resulting in the failure of various organs and can even be lethal in worst case scenarios. Therefore, use of such abortive means is not recommended by the physicians practicing modern medicine and these procedures are not actively prevalent anymore. (MariAnna, 2002)
There are many reasons due to which, women may seek to terminate pregnancy and induce abortion. Abortion may be induced due to various therapeutic and remedial reasons. For example, abortion may be induced in order to save the life of a pregnant woman or to restore or preserve her physical health, in cases where pregnancy might pose some serious threat to the health of the mother-to-be or might be hazardous or even lethal for her. Abortion may also be induced in cases where carrying out the pregnancy is causing mental illness or other psychological issues in order to restore the mental health of the mother-to-be. Abortion is also therapeutic when induced in cases where it is known that the pregnancy would result in a child born with some mental or physical disorder, and also in the cases of multiple pregnancy to reduce the health risks of one or more than one fetuses to be born, i.e. if for example a woman is pregnant with five children, and if all of them develop together inside the mother’s body, it might lead to some collective disorder, in such a case, one or more fetuses may be aborted so that the others may survive. (MariAnna, 2002)
There are many other reasons other than the above mentioned therapeutic grounds. These reasons may vary ethnically, regionally, socially and even personally. The most common reason of carrying out abortion among the females in the western part of the world is the growing single-mother pregnancy rate. The females do not seek to get pregnant and when they do, they seek to induce abortion. Statistics show that most of the abortive procedures are carried out in the very early stages of pregnancy and that among the females that tend to take abortive measures, unmarried girls of young age (minors) constitute a major part (Shoshanna, 2002). Other reasons for which women may seek to terminate their pregnancies include reasons such as: financial constraints, relationship stability issues, perceived immaturity of the mother-to-be, the desire to delay or end child-bearing, problems relating to work-life or education of the mother-to-be, etc. other reasons may include health concerns (as in India, Bangladesh, Kenya, etc), rape and incest, becoming pregnant even after using condoms or contraceptive techniques, or other reasons of unintended pregnancy. The social reasons of induction of abortion (especially in third world nations) are desire for children of a specific sex (sex selective abortion), condemnation of single motherhood, economic instability, etc. Extreme population control measures (e.g. in China) may also result in prevalence of induced abortion. (UN, 2001)
All of the above, and other related reasons for inducing abortion raise numerous ethical, religious, social, moral and legal issues, the prime issue being the question if terminating a life, even if it is not fully developed, is right or not on even a single basis be it socially, morally, ethically, religiously or legally. By all standards and through all platforms, terminating an innocent life is a form of murder and is considered a crime world wide no matter what the platform of discussion is. This is the biggest debate that strikes controversies all around the world. (Shoshanna, 2002)
Apart from this main controversy, induction of abortion also causes many other problems, the major issue being the health of the mother-to-be. The woman, on whom these abortive procedures are carried out, can undergo various health problems since the procedures are not natural and are forced upon the female against the normal phenomenon. Thus the body can react in many possible ways that might be very harmful for the mother. The health issues thus raised may include blood loss, reproductive health problems (including infertility in worst cases), and threat of cancers of the reproductive and related organs of the body (e.g. cancer of the uterus or breast cancer), mental health issues (especially if abortion has taken place without the consent of the mother-to-be), etc. (UN, 2001)
Due to these and many other concerns, many laws have been passed and are prevalent in many parts of the world, which define if abortion is allowed and if it is, to what extent and till what gestation age of the fetus it can be induced. Moreover, such laws also define and describe the processes that can be implemented to induce abortion and what processes are illegal with respect to the law of that particular country. Such laws, however, are more prevalent in the developed world and much is there to be done in the third world countries where there is neither the awareness about such issues, nor there is much willingness to work on these and related topics. (UN, 2001)
MariAnna, Cara J. (2002). Abortion: A Collective Story. Greenwood Publishing Group.
Shoshanna, J. (2002) Grounded in the Reality of their Lives: Listening to Teens who make the abortion decision without involving their parents. Boston.
UN, (2001) United Nations Dept. of Economic and Social Affairs. Population Division. Abortion Policies: A Global Review. United Nations Publications