Many Countries Are Starting To Change Their Laws To Allow For Greater Access To Abortion
Over the last 25 years, more than 50 countries have changed their laws to allow for greater access to abortion, at times recognizing the vital role that access to safe abortion plays in protecting womens lives and health. Ireland joined that list on 25 May 2018 when, in a long-awaited referendum, its people voted overwhelmingly to repeal the near-total constitutional ban on abortion.
Despite the trend towards reforming laws to prevent deaths and injuries, some countries, including Nicaragua and El Salvador, maintain draconian and discriminatory laws that still ban abortion in virtually all circumstances. In fact, according to the WHO, across the globe 40% of women of childbearing age live in countries with highly restrictive abortion laws, or where abortion is legal, is neither available or accessible. In these states, abortion is banned or only permitted in highly restricted circumstances, or if legal, is not accessible due to multiple barriers to access in practice.
Even in states with broader access to legal abortion, pregnant individuals can still face multiple restrictions on and barriers to access to services such as cost, biased counselling, mandatory waiting periods. The WHO has issued technical guidance for states on the need to identify and remove such barriers.
Enhancing Healthcare Team Outcomes
Treating patients who experience pregnancy loss requires close coordination between all members of the care team. Follow-up care with an obstetrician needs to be coordinated. Clear and concise discharge instructions need to be given to the patient. This experience for the patient can be very emotionally taxing and needs to be handled with extreme compassion and sensitivity.
The Unusual Relation Between Abortion Rates And Abortion Frequency
Perhaps surprisingly, studies show that abortion rates are often higher in nations where abortion is illegal than they are in nations where it is legal. This is because abortion tends to be more readily available in wealthier, more developed nations, where women are less likely to experience an unplanned pregnancyâin large part because birth control and proper sexual education are also widely available and sexual crimes are less common.
Conversely, women in developing and least-developed countries, who tend to have decreased access to birth control and education, but who are more often the victims of sexual crimes, are three times more likely to experience an unplanned pregnancy. Yet, 93 percent of the countries with the most restrictive abortion laws are developing nations.
As a result of these factors, the market for abortions is greater in underdeveloped countries even when abortion is legally prohibited. With no legal recourse, pregnant women in these countries often turn to unlicensed and illegal abortion clinics to obtain an abortion. Illegal abortions are more dangerous than legal abortions, as they tend to be conducted by people with less training, and they come with higher risks and complications, including the risk of death of the mother. Ultimately, according to the World Health Organization, roughly 45% of all abortions are unsafe, and 97% of those unsafe abortions are performed in developing countries.
Don’t Miss: When Does Breast Milk Come In During Pregnancy
Quality Journalism Doesn’t Come Free
Perhaps it goes without saying but producing quality journalism isn’t cheap. At a time when newsroom resources and revenue across the country are declining, The Texas Tribune remains committed to sustaining our mission: creating a more engaged and informed Texas with every story we cover, every event we convene and every newsletter we send. As a nonprofit newsroom, we rely on members to help keep our stories free and our events open to the public. Do you value our journalism? Show us with your support.
Failure Rate Of Birth Control Pills Patches And Rings
Theres no contraceptive method thats 100% effective in preventing pregnancy not even vasectomy or tubal ligation. Aside from surgical interventions, long-acting reversible contraceptives have the lowest rates of failure with implants and intrauterine devices, known as IUDs, having a less than 1% chance of unintended pregnancy within the first year of typical use, according to research from the reproductive-health policy organization Guttmacher Institute. Birth control pills, patches and vaginal rings have a 7% failure rate in the first year of typical use.
Weeks Of Gestation And Method Type
Among the 43 areas that reported gestational age at the time of abortion for 2019, 79.3% of abortions were performed at 9 weeks gestation, and nearly all were performed at 13 weeks gestation . Fewer abortions were performed at 1420 weeks gestation or at 21 weeks gestation . Among the 34 reporting areas that provided data every year on gestational age for 20102019, the percentage of abortions performed at 13 weeks gestation changed negligibly, from 91.9% to 92.0% . However, within this gestational age range, a shift occurred toward earlier gestational ages, with the percentage of abortions performed at 6 weeks gestation increasing 8% and the percentage of abortions performed at 79 weeks and 1013 weeks gestation decreasing 0.5% and 14%, respectively.
Among the 47 areas that reported by method type for 2019 and included medical abortion on their reporting form, 49.0% of abortions were surgical abortions at 13 weeks gestation, 42.3% were early medical abortions , 7.2% were surgical abortions at > 13 weeks gestation, and 1.4% were medical abortions at > 9 weeks gestation other methods, including intrauterine instillation and hysterectomy/hysterotomy, were both uncommon . During 20102019, 35 reporting areas provided continuous data and included medical abortion on their reporting form. Among these 35 areas, use of early medical abortion increased 10% from 2018 to 2019 and 123% from 2010 to 2019 .
What Is Pregnancy Loss
How pregnancy loss is categorized largely depends on when in the pregnancy it occurred. The U.S. medical community most often definesmiscarriage as the spontaneous loss of a nonviable, intrauterine pregnancy before 20 weeks gestational age , while stillbirth describes this event at 20 weeks GA. A late stillbirth or late intrauterine fetal demise occurs after 28 weeks. Pregnancy loss serves as an umbrella term for all gestational ages . Consensus around these terms does not fully exist for example, other countries use different gestational ages to distinguish miscarriage from stillbirth, while many journalists use miscarriage to describe pregnancy loss at any stage of pregnancy. The terms miscarriage and stillbirth have been found to be preferred by people experiencing these events, therefore will be used in this brief as opposed to alternative terms .
Common symptoms of pregnancy loss include vaginal bleeding and cramping, which may prompt presentation to a healthcare facility. Alternatively, some miscarriages and stillbirths have no symptoms and are discovered during routine prenatal care .
How are miscarriages different from abortions?
Read Also: What Are The Healthy Foods During Pregnancy
Deterrence And Patient Education
Patient education is important in early pregnancy loss as this can be an emotionally difficult diagnosis. Patient education should focus on maternal health and preparing for future pregnancy. There has been no data to support delaying conception after an early pregnancy loss to prevent subsequent miscarriage or complications. Although most physicians recommend abstaining from vaginal intercourse for 1 to 2 weeks after the passage of tissues, there is no data to support this recommendation.
Patients should also be provided with education regarding contraception after a miscarriage including the use of an intrauterine device or hormonal contraception as both have been deemed safe for use immediately following an early pregnancy loss.
It is important to provide each Rh negative patient education on alloimmunization and risk of future pregnancy with regards to receiving Rh immune globulin.
Most importantly, while there are no proven strategies to reduce the risk of subsequent pregnancy loss after a miscarriage, patient education on maternal health is important. Patients should be provided with education on managing blood pressure, extremes of weight, and cigarette smoking cessation.
Estimation Of Due Date
Due date estimation basically follows two steps:
- Determination of which time point is to be used as origin for gestational age, as described in the section above.
- Adding the estimated gestational age at childbirth to the above time point. Childbirth on average occurs at a gestational age of 280 days , which is therefore often used as a standard estimation for individual pregnancies. However, alternative durations as well as more individualized methods have also been suggested.
Naegeleâs rule is a standard way of calculating the due date for a pregnancy when assuming a gestational age of 280 days at childbirth. The rule estimates the expected date of delivery by adding a year, subtracting three months, and adding seven days to the origin of gestational age. Alternatively there are mobile apps, which essentially always give consistent estimations compared to each other and correct for leap year, while pregnancy wheels made of paper can differ from each other by 7 days and generally do not correct for leap year.
Furthermore, actual childbirth has only a certain probability of occurring within the limits of the estimated due date. A study of singleton live births came to the result that childbirth has a standard deviation of 14 days when gestational age is estimated by first trimester ultrasound, and 16 days when estimated directly by last menstrual period.
Recommended Reading: Can You Get Pregnant When You Re Not Fertile
Enjoy Our Daily Newsletter From Today
Access exclusive newsletters, along with previews of new media releases.
Making health for all a reality, and moving towards the progressive realisation of human rights, required that all individuals had access to quality health care, including comprehensive abortion care services which included information, management of abortion, and post-abortion care.
WHO said lack of access to safe, timely, affordable and respectful abortion care posed a risk to not only the physical, but also the mental and social, well-being of women and girls.
It said ensuring that women and girls had access to abortion care that was evidence-based, included being safe, respectful and non-discriminatory, was fundamental to meeting the Sustainable Development Goals relating to good health and well-being and gender equality .
About 1 In 5 Us Pregnancies Ended In Abortion In : Report
More than 930,000 abortions took place in the U.S. in 2020, up 8% from 862,000 abortions in 2017. About 1 in 5 pregnancies ended in abortion in 2020, the report said.
The Guttmacher Institute, a research organization that supports abortion rights, said the trend shows a rising need for abortion care as the Supreme Court is poised to overturn the Roe v. Wade decision in coming weeks.
National abortion numbers reached the lowest point in 2017 since the landmark 1973 ruling that legalized the procedure. In the years following the ruling, abortion numbers rose above 1.5 million annually throughout the 1980s and then began declining in the 1990s, though they remained above 1 million annually through the early 2010s.
The latest data shows that the abortion rate increased from 13.5 abortions per 1,000 women between ages 15 to 44 in 2017 to 14.4 abortions per 1,000 women in 2020, marking a 7% increase.
Similarly, the abortion ratio â or the number of abortions per 100 pregnancies â increased from 18.4% in 2017 to 20.6% in 2020, marking a 12% increase.
The increase in abortions was accompanied by a 6% decline in births between 2017 and 2020, the Guttmacher Institute said.
You May Like: Are Protein Shakes Safe During Pregnancy
Consequences Of Inaccessible Quality Abortion Care
Lack of access to safe, affordable, timely and respectful abortion care, and the stigma associated with abortion, pose risks to womens physical and mental well-being throughout the life-course.
Inaccessibility of quality abortion care risks violating a range of human rights of women and girls, including the right to life the right to the highest attainable standard of physical and mental health the right to benefit from scientific progressand its realization the right to decide freely and responsibly on the number, spacing and timing of children and the right to be free from torture, cruel, inhuman and degrading treatment and punishment.
Each year, 4.713.2% of maternal deaths can be attributed to unsafe abortion . In developed regions, it is estimated that 30 women die for every 100 000 unsafe abortions. In developing regions, that number rises to 220 deaths per100 000 unsafe abortions . Estimates from 2012 indicate that in developing countries alone, 7 million women per year were treated in hospital facilities for complications of unsafe abortion .
Physical health risks associated with unsafe abortion include:
- incomplete abortion
- uterine perforation and
Abortion Rates In The United States
The United States has an abortion rate of 20.8 abortions per 1,000 women. A women’s right to abortion was decided by the U.S. Supreme Court in the case of Roe v. Wade. The decision states that the government cannot regulate a women’s choice to have an abortion before the fetus’s viability. However, specific abortion laws vary by state, including some that attempt to restrict abortions before viability. Because of different regulations on abortion and other factors, abortion rates also vary significantly between states. Moreover, many political analysts and legal experts believe it is increasingly likely that the U.S. Supreme Court will overturn Roe vs Wade in the near future.
Abortions Reported To The Cdc In 2019
The CDC received reports of 629,898 abortions in 2019, the last full year of available data. The agency started tracking the number of legal abortions in the United States in 1969. Providers voluntarily submit data to states, which means the dataset is incomplete , so the actual number is likely far higher. A model-based approach developed by researchers from the Guttmacher Institute, World Health Organization and United Nations puts the average annual number of abortions in the U.S. around 886,000.
People Have Abortions All The Time Regardless Of What The Law Says
Ending a pregnancy is a common decision that millions of people make every year a quarter of pregnancies end in abortion.
And regardless of whether abortion is legal or not, people still require and regularly access abortion services. According to the Guttmacher Institute, a US-based reproductive health non-profit, the abortion rate is 37 per 1,000 people in countries that prohibit abortion altogether or allow it only in instances to save a womans life, and 34 per 1,000 people in countries that broadly allow for abortion, a difference that is not statistically significant.
When undertaken by a trained health-care provider in sanitary conditions, abortions are one of the safest medical procedures available, safer even than child birth.
But when governments restrict access to abortions, people are compelled to resort to clandestine, unsafe abortions, particularly those who cannot afford to travel or seek private care. Which brings us to the next point.
You May Like: How Often Is Frequent Urination In Early Pregnancy
What Causes Pregnancy Loss
More often than not, the cause of a pregnancy loss is unknown even after thorough evaluation. Of those with a suspected cause, the majority of miscarriages are attributed to genetic abnormalities , and less commonly uterine cavity distortion , autoimmune and clotting disorders. Similarly, most stillbirths are caused by genetic abnormalities, problems with the placenta, fetal growth restriction or infection.2Risk factors for pregnancy loss include maternal age < 20 or > 35 years old, non-Hispanic Black race, diabetes, obesity, tobacco use and certain illicit drug use. However, risk factors do not cause pregnancy loss, thus a pregnant person with one or more of these risk factors should not be faulted for their pregnancy loss. Providing psychological support for those experiencing these events is important, as many people feel guilty, alone or ashamed.
Variables And Categorization Of Data
Each year, CDC sends a suggested template to central health agencies in the United States for compilation of aggregated abortion data among women obtaining legal induced abortions. Aggregate abortion numbers, without individual-level records, are requested for the following variables:
- Age group in years of women obtaining legal induced abortions
- Gestational age of pregnancy in completed weeks at the time of abortion
- Race , ethnicity , and race by ethnicity
- Number of previous live births
- Number of previous induced abortions
In addition, the template provided by CDC requests that aggregate numbers for certain variables be cross-tabulated by a second variable. The cross-tabulations presented in this report include weeks of gestation separately by method type, by age group, and by race/ethnicity.
Recommended Reading: How To Get Pregnant At 50 Naturally
Abortion Statistics In The United States
Both the Guttmacher Institute and the Centers for Disease Control and Prevention regularly report abortion statistics in the United States. They use different methodologies, so they report somewhat different abortion rates, but they show similar trends. The Guttmacher Institute attempts to contact every abortion provider. The CDC relies on voluntary reporting of abortion data from the states and the District of Columbia. As of July 2022, the Guttmacher Institute had reported abortion data for the years 1973 through 2020 and the CDC had reported abortion data for the years 1970 through 2019.
Abortion statistics are commonly presented as the number of abortions, the abortion rate , and the abortion ratio. The Guttmacher Institute defines the abortion ratio as the number of abortions per 100 pregnancies ending in an abortion or a live birth, excluding miscarriages, and the CDC defines it as the number of abortions per 1,000 live births.
The figures reported by both organizations include only the legal induced abortions conducted by clinics, hospitals or physicians offices, or that make use of abortion pills dispensed from certified facilities such as clinics or physicians offices. They do not account for the use of abortion pills that were obtained outside of clinical settings.