expository essay on dangers of abortion 450 words pdf

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Abortion Argumentative Essay: Definitive Guide

Academic writing

Abortion remains a debatable issue even today, especially in countries like the USA, where a controversial ban was upheld in 13 states at the point this article was written. That’s why an essay on abortion has become one of the most popular tasks in schools, colleges, and universities. When writing this kind of essay, students learn to express their opinion, find and draw arguments and examples, and conduct research.

It’s very easy to speculate on topics like this. However, this makes it harder to find credible and peer-reviewed information on the topic that isn’t merely someone’s opinion. If you were assigned this kind of academic task, do not lose heart. In this article, we will provide you with all the tips and tricks for writing about abortion.

Where to begin?

Conversations about abortion are always emotional. Complex stories, difficult decisions, bitter moments, and terrible diagnoses make this topic hard to cover. Some young people may be shocked by this assignment, while others would be happy to express their opinion on the matter.

One way or another, this topic doesn't leave anyone indifferent. However, it shouldn’t have an effect on the way you approach the research and writing process. What should you remember when working on an argumentative essay about abortion?

• Don’t let your emotions take over. As this is an academic paper, you have to stay impartial and operate with facts. The topic is indeed sore and burning, causing thousands of scandals on the Internet, but you are writing it for school, not a Quora thread.
• Try to balance your opinions. There are always two sides to one story, even if the story is so fragile. You need to present an issue from different angles. This is what your tutors seek to teach you.
• Be tolerant and mind your language. It is very important not to hurt anybody with the choice of words in your essay. So make sure you avoid any possible rough words. It is important to respect people with polar opinions, especially when it comes to academic writing. 
• Use facts, not claims. Your essay cannot be based solely on your personal ideas – your conclusions should be derived from facts. Roe v. Wade case, WHO or Mayo Clinic information, and CDC are some of the sources you can rely on.

Speaking of Outline

An argumentative essay on abortion outline is a must-have even for experienced writers. In general, each essay, irrespective of its kind or topic, has a strict outline. It may be brief or extended, but the major parts are always the same:

• Introduction. This is a relatively short paragraph that starts with a hook and presents the background information on the topic. It should end with a thesis statement telling your reader what your main goal or idea is.
• Body. This section usually consists of 2-4 paragraphs. Each one has its own structure: main argument + facts to support it + small conclusion and transition into the next paragraph.
• Conclusion. In this part, your task is to summarize all your thoughts and come to a general conclusive idea. You may have to restate some info from the body and your thesis statement and add a couple of conclusive statements without introducing new facts.

Why is it important to create an outline?

• You will structure your ideas. We bet you’ve got lots on your mind. Writing them down and seeing how one can flow logically into the other will help you create a consistent paper. Naturally, you will have to abandon some of the ideas if they don’t fit the overall narrative you’re building.
• You can get some inspiration. While creating your outline, which usually consists of some brief ideas, you can come up with many more to research. Some will add to your current ones or replace them with better options.
• You will find the most suitable sources. Argumentative essay writing requires you to use solid facts and trustworthy arguments built on them. When the topic is as controversial as abortion, these arguments should be taken from up-to-date, reliable sources. With an outline, you will see if you have enough to back up your ideas.
• You will write your text as professionals do. Most expert writers start with outlines to write the text faster and make it generally better. As you will have your ideas structured, the general flow of thoughts will be clear. And, of course, it will influence your overall grade positively.

Abortion Essay Introduction

The introduction is perhaps the most important part of the whole essay. In this relatively small part, you will have to present the issue under consideration and state your opinion on it. Here is a typical introduction outline:

• The first sentence is a hook grabbing readers' attention.
• A few sentences that go after elaborate on the hook. They give your readers some background and explain your research.
• The last sentence is a thesis statement showing the key idea you are building your text around.

Before writing an abortion essay intro, first thing first, you will need to define your position. If you are in favor of this procedure, what exactly made you think so? If you are an opponent of abortion, determine how to argue your position. In both cases, you may research the point of view in medicine, history, ethics, and other fields.

When writing an introduction, remember:

• Never repeat your title. First of all, it looks too obvious; secondly, it may be boring for your reader right from the start. Your first sentence should be a well-crafted hook. The topic of abortion worries many people, so it’s your chance to catch your audience’s attention with some facts or shocking figures.
• Do not make it too long. Your task here is to engage your audience and let them know what they are about to learn. The rest of the information will be disclosed in the main part. Nobody likes long introductions, so keep it short but informative.
• Pay due attention to the thesis statement. This is the central sentence of your introduction. A thesis statement in your abortion intro paragraph should show that you have a well-supported position and are ready to argue it. Therefore, it has to be strong and convey your idea as clearly as possible. We advise you to make several options for the thesis statement and choose the strongest one.

Hooks for an Abortion Essay

Writing a hook is a good way to catch the attention of your audience, as this is usually the first sentence in an essay. How to start an essay about abortion? You can begin with some shocking fact, question, statistics, or even a quote. However, always make sure that this piece is taken from a trusted resource.

Here are some examples of hooks you can use in your paper:

• As of July 1, 2022, 13 states banned abortion, depriving millions of women of control of their bodies.
• According to WHO, 125,000 abortions take place every day worldwide.
• Is abortion a woman’s right or a crime?
• Since 1994, more than 40 countries have liberalized their abortion laws.
• Around 48% of all abortions are unsafe, and 8% of them lead to women’s death.
• The right to an abortion is one of the reproductive and basic rights of a woman.
• Abortion is as old as the world itself – women have resorted to this method since ancient times.
• Only 60% of women in the world live in countries where pregnancy termination is allowed.

Body Paragraphs: Pros and Cons of Abortion

The body is the biggest part of your paper. Here, you have a chance to make your voice concerning the abortion issue heard. Not sure where to start? Facts about abortion pros and cons should give you a basic understanding of which direction to move in.

First things first, let’s review some brief tips for you on how to write the best essay body if you have already made up your mind.

Make a draft

It’s always a good idea to have a rough draft of your writing. Follow the outline and don’t bother with the word choice, grammar, or sentence structure much at first. You can polish it all later, as the initial draft will not likely be your final. You may see some omissions in your arguments, lack of factual basis, or repetitiveness that can be eliminated in the next versions.

Trust only reliable sources

This part of an essay includes loads of factual information, and you should be very careful with it. Otherwise, your paper may look unprofessional and cost you precious points. Never rely on sources like Wikipedia or tabloids – they lack veracity and preciseness.

Edit rigorously

It’s best to do it the next day after you finish writing so that you can spot even the smallest mistakes. Remember, this is the most important part of your paper, so it has to be flawless. You can also use editing tools like Grammarly.

Determine your weak points

Since you are writing an argumentative essay, your ideas should be backed up by strong facts so that you sound convincing. Sometimes it happens that one argument looks weaker than the other. Your task is to find it and strengthen it with more or better facts.

Add an opposing view

Sometimes, it’s not enough to present only one side of the discussion. Showing one of the common views from the opposing side might actually help you strengthen your main idea. Besides, making an attempt at refuting it with alternative facts can show your teacher or professor that you’ve researched and analyzed all viewpoints, not just the one you stand by.

If you have chosen a side but are struggling to find the arguments for or against it, we have complied abortion pro and cons list for you. You can use both sets if you are writing an abortion summary essay covering all the stances.

Why Should Abortion Be Legal

If you stick to the opinion that abortion is just a medical procedure, which should be a basic health care need for each woman, you will definitely want to write the pros of abortion essay. Here is some important information and a list of pros about abortion for you to use:

• Since the fetus is a set of cells – not an individual, it’s up to a pregnant woman to make a decision concerning her body. Only she can decide whether she wants to keep the pregnancy or have an abortion. The abortion ban is a violation of a woman’s right to have control over her own body.
• The fact that women and girls do not have access to effective contraception and safe abortion services has serious consequences for their own health and the health of their families.
• The criminalization of abortion usually leads to an increase in the number of clandestine abortions. Many years ago, fetuses were disposed of with improvised means, which included knitting needles and half-straightened metal hangers. 13% of women’s deaths are the result of unsafe abortions.
• Many women live in a difficult financial situation and cannot support their children financially. Having access to safe abortion takes this burden off their shoulders. This will also not decrease their quality of life as the birth and childcare would.
• In countries where abortion is prohibited, there is a phenomenon of abortion tourism to other countries where it can be done without obstacles. Giving access to this procedure can make the lives of women much easier.
• Women should not put their lives or health in danger because of the laws that were adopted by other people.
• Girls and women who do not have proper sex education may not understand pregnancy as a concept or determine that they are pregnant early on. Instead of educating them and giving them a choice, an abortion ban forces them to become mothers and expects them to be fit parents despite not knowing much about reproduction.
• There are women who have genetic disorders or severe mental health issues that will affect their children if they're born. Giving them an option to terminate ensures that there won't be a child with a low quality of life and that the woman will not have to suffer through pregnancy, birth, and raising a child with her condition.
• Being pro-choice is about the freedom to make decisions about your body so that women who are for termination can do it safely, and those who are against it can choose not to do it. It is an inclusive option that caters to everyone.
• Women and girls who were raped or abused by their partner, caregiver, or stranger and chose to terminate the pregnancy can now be imprisoned for longer than their abusers. This implies that the system values the life of a fetus with no or primitive brain function over the life of a living woman.
• People who lived in times when artificial termination of pregnancy was scarcely available remember clandestine abortions and how traumatic they were, not only for the physical but also for the mental health of women. Indeed, traditionally, in many countries, large families were a norm. However, the times have changed, and supervised abortion is a safe and accessible procedure these days. A ban on abortion will simply push humanity away from the achievements of the civilized world.

Types of abortion

There are 2 main types of abortions that can be performed at different pregnancy stages and for different reasons:

• Medical abortion. It is performed by taking a specially prescribed pill. It does not require any special manipulations and can even be done at home (however, after a doctor’s visit and under supervision). It is considered very safe and is usually done during the very first weeks of pregnancy.
• Surgical abortion. This is a medical operation that is done with the help of a suction tube. It then removes the fetus and any related material. Anesthesia is used for this procedure, and therefore, it can only be done in a hospital. The maximum time allowed for surgical abortion is determined in each country specifically.

Cases when abortion is needed

Center for Reproductive Rights singles out the following situations when abortion is required:

• When there is a risk to the life or physical/mental health of a pregnant woman.
• When a pregnant woman has social or economic reasons for it.
• Upon the woman's request.
• If a pregnant woman is mentally or cognitively disabled.
• In case of rape and/or incest.
• If there were congenital anomalies detected in the fetus.

Countries and their abortion laws

• Countries where abortion is legalized in any case: Australia, Albania, Bosnia and Herzegovina, Belgium, Canada, Denmark, Sweden, France, Germany, Greece, Italy, Hungary, the Netherlands, Norway, Ukraine, Moldova, Latvia, Lithuania, etc.
• Countries where abortion is completely prohibited: Angola, Venezuela, Egypt, Indonesia, Iraq, Lebanon, Nicaragua, Oman, Paraguay, Palau, Jamaica, Laos, Haiti, Honduras, Andorra, Aruba, El Salvador, Dominican Republic, Sierra Leone, Senegal, etc.
• Countries where abortion is allowed for medical reasons: Afghanistan, Israel, Argentina, Nigeria, Bangladesh, Bolivia, Ghana, Israel, Morocco, Mexico, Bahamas, Central African Republic, Ecuador, Ghana, Algeria, Monaco, Pakistan, Poland, etc. 
• Countries where abortion is allowed for both medical and socioeconomic reasons: England, India, Spain, Luxembourg, Japan, Finland, Taiwan, Zambia, Iceland, Fiji, Cyprus, Barbados, Belize, etc.

Why Abortion Should Be Banned

Essays against abortions are popular in educational institutions since we all know that many people – many minds. So if you don’t want to support this procedure in your essay, here are some facts that may help you to argument why abortion is wrong:

• Abortion at an early age is especially dangerous because a young woman with an unstable hormonal system may no longer be able to have children throughout her life. Termination of pregnancy disrupts the hormonal development of the body.
• Health complications caused by abortion can occur many years after the procedure. Even if a woman feels fine in the short run, the situation may change in the future.
• Abortion clearly has a negative effect on reproductive function. Artificial dilation of the cervix during an abortion leads to weak uterus tonus, which can cause a miscarriage during the next pregnancy.
• Evidence shows that surgical termination of pregnancy significantly increases the risk of breast cancer.
• In December 1996, the session of the Council of Europe on bioethics concluded that a fetus is considered a human being on the 14th day after conception.

You are free to use each of these arguments for essays against abortions. Remember that each claim should not be supported by emotions but by facts, figures, and so on.

Health complications after abortion

One way or another, abortion is extremely stressful for a woman’s body. Apart from that, it can even lead to various health problems in the future. You can also cover them in your cons of an abortion essay:

• Continuation of pregnancy. If the dose of the drug is calculated by the doctor in the wrong way, the pregnancy will progress.
• Uterine bleeding, which requires immediate surgical intervention.
• Severe nausea or even vomiting occurs as a result of a sharp change in the hormonal background.
• Severe stomach pain. Medical abortion causes miscarriage and, as a result, strong contractions of the uterus.
• High blood pressure and allergic reactions to medicines.
• Depression or other mental problems after a difficult procedure.

Abortion Essay Conclusion

After you have finished working on the previous sections of your paper, you will have to end it with a strong conclusion. The last impression is no less important than the first one. Here is how you can make it perfect in your conclusion paragraph on abortion:

• It should be concise. The conclusion cannot be as long as your essay body and should not add anything that cannot be derived from the main section. Reiterate the key ideas, combine some of them, and end the paragraph with something for the readers to think about.
• It cannot repeat already stated information. Restate your thesis statement in completely other words and summarize your main points. Do not repeat anything word for word – rephrase and shorten the information instead.
• It should include a call to action or a cliffhanger. Writing experts believe that a rhetorical question works really great for an argumentative essay. Another good strategy is to leave your readers with some curious ideas to ponder upon.

Abortion Facts for Essay

Abortion is a topic that concerns most modern women. Thousands of books, research papers, and articles on abortion are written across the world. Even though pregnancy termination has become much safer and less stigmatized with time, it still worries millions. What can you cover in your paper so that it can really stand out among others? You may want to add some shocking abortion statistics and facts:

• 40-50 million abortions are done in the world every year (approximately 125,000 per day).
• According to UN statistics, women have 25 million unsafe abortions each year. Most of them (97%) are performed in the countries of Africa, Asia, and Latin America. 14% of them are especially unsafe because they are done by people without any medical knowledge.
• Since 2017, the United States has shown the highest abortion rate in the last 30 years.
• The biggest number of abortion procedures happen in the countries where they are officially banned. The lowest rate is demonstrated in the countries with high income and free access to contraception.
• Women in low-income regions are three times more susceptible to unplanned pregnancies than those in developed countries.
• In Argentina, more than 38,000 women face dreadful health consequences after unsafe abortions.
• The highest teen abortion rates in the world are seen in 3 countries: England, Wales, and Sweden.
• Only 31% of teenagers decide to terminate their pregnancy. However, the rate of early pregnancies is getting lower each year.
• Approximately 13 million children are born to mothers under the age of 20 each year.
• 5% of women of reproductive age live in countries where abortions are prohibited.

We hope that this abortion information was useful for you, and you can use some of these facts for your own argumentative essay. If you find some additional facts, make sure that they are not manipulative and are taken from official medical resources.

Abortion Essay Topics

Do you feel like you are lost in the abundance of information? Don’t know what topic to choose among the thousands available online? Check our short list of the best abortion argumentative essay topics:

• Why should abortion be legalized essay
• Abortion: a murder or a basic human right?
• Why we should all support abortion rights
• Is the abortion ban in the US a good initiative?
• The moral aspect of teen abortions
• Can the abortion ban solve birth control problems?
• Should all countries allow abortion?
• What consequences can abortion have in the long run?
• Is denying abortion sexist?
• Why is abortion a human right?
• Are there any ethical implications of abortion?
• Do you consider abortion a crime?
• Should women face charges for terminating a pregnancy?

Want to come up with your own? Here is how to create good titles for abortion essays:

• Write down the first associations. It can be something that swirls around in your head and comes to the surface when you think about the topic. These won’t necessarily be well-written headlines, but each word or phrase can be the first link in the chain of ideas that leads you to the best option.
• Irony and puns are not always a good idea. Especially when it comes to such difficult topics as abortion. Therefore, in your efforts to be original, remain sensitive to the issue you want to discuss.
• Never make a quote as your headline. First, a wordy quote makes the headline long. Secondly, readers do not understand whose words are given in the headline. Therefore, it may confuse them right from the start. If you have found a great quote, you can use it as your hook, but don’t forget to mention its author.
• Try to briefly summarize what is said in the essay. What is the focus of your paper? If the essence of your argumentative essay can be reduced to one sentence, it can be used as a title, paraphrased, or shortened.
• Write your title after you have finished your text. Before you just start writing, you might not yet have a catchy phrase in mind to use as a title. Don’t let it keep you from working on your essay – it might come along as you write.

Abortion Essay Example

We know that it is always easier to learn from a good example. For this reason, our writing experts have complied a detailed abortion essay outline for you. For your convenience, we have created two options with different opinions.

Topic: Why should abortion be legal?

Introduction – hook + thesis statement + short background information

Essay hook: More than 59% of women in the world do not have access to safe abortions, which leads to dreading health consequences or even death.

Thesis statement: Since banning abortions does not decrease their rates but only makes them unsafe, it is not logical to ban abortions.

Body – each paragraph should be devoted to one argument

Argument 1: Woman’s body – women’s rules. + example: basic human rights.

Argument 2: Banning abortion will only lead to more women’s death. + example: cases of Polish women.

Argument 3: Only women should decide on abortion. + example: many abortion laws are made by male politicians who lack knowledge and first-hand experience in pregnancies.

Conclusion – restated thesis statement + generalized conclusive statements + cliffhanger

Restated thesis: The abortion ban makes pregnancy terminations unsafe without decreasing the number of abortions, making it dangerous for women.

Cliffhanger: After all, who are we to decide a woman’s fate?

Topic: Why should abortion be banned?

Essay hook: Each year, over 40 million new babies are never born because their mothers decide to have an abortion.

Thesis statement: Abortions on request should be banned because we cannot decide for the baby whether it should live or die.

Argument 1: A fetus is considered a person almost as soon as it is conceived. Killing it should be regarded as murder. + example: Abortion bans in countries such as Poland, Egypt, etc.

Argument 2: Interrupting a baby’s life is morally wrong. + example: The Bible, the session of the Council of Europe on bioethics decision in 1996, etc.

Argument 3: Abortion may put the reproductive health of a woman at risk. + example: negative consequences of abortion.

Restated thesis: Women should not be allowed to have abortions without serious reason because a baby’s life is as priceless as their own.

Cliffhanger: Why is killing an adult considered a crime while killing an unborn baby is not?

Examples of Essays on Abortion

There are many great abortion essays examples on the Web. You can easily find an argumentative essay on abortion in pdf and save it as an example. Many students and scholars upload their pieces to specialized websites so that others can read them and continue the discussion in their own texts.

In a free argumentative essay on abortion, you can look at the structure of the paper, choice of the arguments, depth of research, and so on. Reading scientific papers on abortion or essays of famous activists is also a good idea. Here are the works of famous authors discussing abortion.

A Defense of Abortion by Judith Jarvis Thomson

Published in 1971, this essay by an American philosopher considers the moral permissibility of abortion. It is considered the most debated and famous essay on this topic, and it’s definitely worth reading no matter what your stance is.

Abortion and Infanticide by Michael Tooley

It was written in 1972 by an American philosopher known for his work in the field of metaphysics. In this essay, the author considers whether fetuses and infants have the same rights. Even though this work is quite complex, it presents some really interesting ideas on the matter.

Some Biological Insights into Abortion by Garret Hardin

This article by American ecologist Garret Hardin, who had focused on the issue of overpopulation during his scholarly activities, presents some insights into abortion from a scientific point of view. He also touches on non-biological issues, such as moral and economic. This essay will be of great interest to those who support the pro-choice stance.

H4 Hidden in Plain View: An Overview of Abortion in Rural Illinois and Around the Globe by Heather McIlvaine-Newsad 

In this study, McIlvaine-Newsad has researched the phenomenon of abortion since prehistoric times. She also finds an obvious link between the rate of abortions and the specifics of each individual country. Overall, this scientific work published in 2014 is extremely interesting and useful for those who want to base their essay on factual information.

H4 Reproduction, Politics, and John Irving’s The Cider House Rules: Women’s Rights or “Fetal Rights”? by Helena Wahlström

In her article of 2013, Wahlström considers John Irving’s novel The Cider House Rules published in 1985 and is regarded as a revolutionary work for that time, as it acknowledges abortion mostly as a political problem. This article will be a great option for those who want to investigate the roots of the abortion debate.

FAQs On Abortion Argumentative Essay

• Is abortion immoral?

This question is impossible to answer correctly because each person independently determines their own moral framework. One group of people will say that abortion is a woman’s right because only she has power over her body and can make decisions about it. Another group will argue that the embryo is also a person and has the right to birth and life.

In general, the attitude towards abortion is determined based on the political and religious views of each person. Religious people generally believe that abortion is immoral because it is murder, while secular people see it as a normal medical procedure. For example, in the US, the ban on abortion was introduced in red states where the vast majority have conservative views, while blue liberal states do not support this law. Overall, it’s up to a person to decide whether they consider abortion immoral based on their own values and beliefs.

• Is abortion legal?

The answer to this question depends on the country in which you live. There are countries in which pregnancy termination is a common medical procedure and is performed at the woman's request. There are also states in which there must be a serious reason for abortion: medical, social, or economic. Finally, there are nations in which abortion is prohibited and criminalized. For example, in Jamaica, a woman can get life imprisonment for abortion, while in Kenya, a medical worker who volunteers to perform an abortion can be imprisoned for up to 14 years.

• Is abortion safe?

In general, modern medicine has reached such a level that abortion has become a common (albeit difficult from various points of view) medical procedure. There are several types of abortion, as well as many medical devices and means that ensure the maximum safety of the pregnancy termination. Like all other medical procedures, abortion can have various consequences and complications.

Abortions – whether safe or not - exist in all countries of the world. The thing is that more than half of them are dangerous because women have them in unsuitable conditions and without professional help. Only universal access to abortion in all parts of the world can make it absolutely safe. In such a case, it will be performed only after a thorough assessment and under the control of a medical professional who can mitigate the potential risks.

• How safe is abortion?

If we do not talk about the ethical side of the issue related to abortion, it still has some risks. In fact, any medical procedure has them to a greater or lesser extent.

The effectiveness of the safe method in a medical setting is 80-99%. An illegal abortion (for example, the one without special indications after 12 weeks) can lead to a patient’s death, and the person who performed it will be criminally liable in this case.

Doctors do not have universal advice for all pregnant women on whether it is worth making this decision or not. However, many of them still tend to believe that any contraception - even one that may have negative side effects - is better than abortion. That’s why spreading awareness on means of contraception and free access to it is vital.

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Unsafe Abortion: Consequences, Facts & Statistics

Abortion   |   1 October 2022    |    9 min read

This year, 35 million women will make the agonising decision to have an unsafe abortion.

It’s a preventable public health crisis taking many lives. We can and must put an end to unsafe abortion.

What is an unsafe abortion? 

When women face unintended pregnancy and don’t have access to safe abortion care, some are forced to resort to an unsafe abortion method, putting their health and lives at risk. The  World Health Organisation  (WHO)’s definition of unsafe abortion is as follows:

“An abortion is unsafe when it is carried out either by a person lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both.”

The least safe conditions are when an abortion is carried out by untrained people using dangerous or invasive methods. A leading cause of maternal deaths, unsafe abortion can be devastating to women, their families and communities.

Why do people have unsafe abortions? 

No one should have to risk their life or health to determine their own future. Abortion care is one of the most safe and common forms of healthcare worldwide. But to this day, abortion continues to be stigmatised and legally restricted in many countries, preventing many from accessing  safe abortion care .

Women and girls who want to end their pregnancy may face:

• local  laws  that restrict abortion access
• a  lack of understanding  or clarity about what the law allows
• poor access  to health services (i.e., not enough providers, clinics are too far away, high cost makes it unaffordable)
• abortion discrimination and social  stigma , making people feel that they can’t ask for help, shrouding abortion care in shame
• needless requirements  like mandatory waiting periods or medically unnecessary tests that delay access to care
• a  humanitarian   crisis or conflict  situation that hinders access to healthcare

Barriers to accessing safe abortion don’t stop women wanting or needing an abortion.  Evidence shows  that restrictions don’t prevent abortion, they just make them less safe—forcing women to turn to dangerous methods, leading to injuries and sometimes death. 

Every minute of every day, 67 women around the world resort to an unsafe abortion. This means today, 96,000 women will risk their lives for the right to choose their own future.

What are the consequences of unsafe abortion .

Unsafe abortion remains one of the  leading causes of maternal deaths  around the world, despite being almost entirely preventable.

There are immediate and long-term health risks of having an unsafe abortion—the toll on women is devastating. This year, over  9 million women  will face complications as a result of unsafe abortion including life-long injuries, severe disability, heavy bleeding, damage to internal organs, or losing the ability to become pregnant in the future.  22,800  of these women will die .

And it’s not just physical danger at risk. Barriers to safe abortion access and the stigma associated with abortion are detrimental to a woman’s mental wellbeing throughout her lifetime, as she battles with the notion that choices about her reproductive health are not her own.

There are also  economic  consequences, with medical costs forcing women into making a financial sacrifice (e.g. using their life savings), or simply making abortion inaccessible to those with fewer resources. When abortion is restricted and stigma is rife, it’s often marginalised and poor communities that are most affected. They are less likely to be able to access private healthcare or travel to other places where abortion care is safe and legal.

Determining your own future should not come at such a physical, mental, and financial cost.  It simply doesn’t have to be this way—if we break down all the unnecessary barriers, we could live in a world where no abortion is unsafe. That is what MSI is working towards.

Unsafe abortion statistics

Here are some quick numbers to answer questions like ‘how many unsafe abortions happen each year?’

(almost half of all) abortions every year are unsafe

women will die from unsafe abortions this year

unsafe abortions occur in low and middle-income countries

of global maternal deaths are due to unsafe abortions

of women live in the 125 countries where abortion is highly restricted

Catherine’s unsafe abortion story

“I’m lucky to have survived. I share my experience because I wouldn’t want girls to go through what I went through.”

Some girls, like Catherine, live to tell their unsafe abortion story. Many others do not. 

MSI is working towards a goal of  no unsafe abortion by 2030 .  Abortion is a very safe and simple medical procedure to end a pregnancy, and no one should be forced to put themselves in danger to have one.

How Ethiopia tackled unsafe abortion

“The methods women used to terminate an unwanted pregnancy were desperate. Ranging from traditional remedies including tree roots and herbs, women would also insert harmful objects like catheters and metallic tools inside of them to try and end their pregnancy. In an average week, around two or three women died. It was normal to see half of the delivery and gynaecology rooms filled with women who needed immediate medical assistance.”  

– MSI Ethiopia’s Country Director, Abebe Shibru (pictured right)

Unsafe abortion used to contribute to nearly a third of all maternal deaths in Ethiopia before the country decided to liberalise its abortion laws in 2005. Since then,  Ethiopia has made huge strides  in the prevention of unsafe abortion and recent studies show that maternal deaths from unsafe abortion have dropped sharply to 1%. 

Our work to provide safe abortion services and prevent unsafe abortion 

As one of the world’s leading providers of sexual and reproductive healthcare,  we are unapologetic in our defence of  the right to abortion , and we’re proud to provide safe abortion services wherever the law permits. In every country that we work in, we provide post-abortion care to save lives following an unsafe or incomplete abortion.  

According to the World Health Organisation , with access to comprehensive sex education, contraception, and safe and legal abortion, nearly every single unsafe abortion (and the maternal deaths that follow) could be prevented.  

We must remove local laws that restrict access, ensure there are enough safe abortion clinics and providers available, and make sure services are included in national health coverage schemes, so that cost isn’t a barrier.  

That’s why  MSI—as well as providing abortion services— advocates globally  for access to abortion . Partnering across sectors and working closely with  local communities  and governments , we’re working to make abortion safe, legal and affordable.  

We stand shoulder to shoulder with women and girls worldwide in the global drive to liberalise abortion laws, end unsafe abortion and prevent maternal deaths—so that everyone has the reproductive choice to determine their own future. 

With your help we can go further. Consider making a gift to fund safe abortion access globally .

Looking for safe abortion services? 

If you ever need to speak openly, with full comfort and confidentiality about your experiences and choices, we are here to help. If you’re looking for safe abortion services, we may be able to assist you depending on where you live and your situation.  Find your local service  or contact your local contact centre where someone will be able to advise on the reproductive healthcare available to you.  

How you can help end unsafe abortion

Learn more about abortion.

When we’re in the know about our reproductive health and rights, we can help change the narrative and fight for everyone’s right to access safe services. To remain up to date on the latest news and campaigns on reproductive rights, follow us on social media and sign up to our newsletter.

SHARE by joining the conversation online

Smashing stigma starts with people normalising abortion. You can go online to share a personal story, retweet a statistic showing the realities of unsafe abortion, or share a resource, like this page. If you’re unsure how to talk about abortion in a destigmatising way, our abortion language guide is here to help.

FUND abortion

Until all countries across the globe actively protect and promote safe and legal abortion access (we’re working on it), abortion providers need donations to keep their doors open. You can donate today, or set up a monthly donation, to help everyone determine their own futures. Help make reproductive choice possible worldwide.

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Start Learning About Your Topic

Create research questions to focus your topic, featured current news, find articles in library databases, find web resources, find books in the library catalog, cite your sources, key search words.

Use the words below to search for useful information in books and articles .

• birth control
• pro-choice movement
• pro-life movement
• reproductive rights
• Roe v. Wade
• Dobbs v. Jackson Women's Health Organization (Dobbs v. Jackson)

Background Reading:

It's important to begin your research learning something about your subject; in fact, you won't be able to create a focused, manageable thesis unless you already know something about your topic.

This step is important so that you will:

• Begin building your core knowledge about your topic
• Be able to put your topic in context
• Create research questions that drive your search for information
• Create a list of search terms that will help you find relevant information
• Know if the information you’re finding is relevant and useful

If you're working from off campus , you'll be prompted to sign in if you aren't already logged in to your MJC email or Canvas. If you are prompted to sign in, use the same credentials you use for email and Canvas. 

Most current background reading 

• Issues and Controversies: Should Women in the United States Have Access to Abortion? June 2022 article (written after the Supreme Court overturned Roe v Wade) that explores both sides of the abortion debate.
• Access World News: Abortion The most recent news and opinion on abortion from US newspapers.

More sources for background information

• CQ Researcher Online This link opens in a new window Original, comprehensive reporting and analysis on issues in the news. Check the dates of results to be sure they are sufficiently current.
• Gale eBooks This link opens in a new window Authoritative background reading from specialized encyclopedias (a year or more old, so not good for the latest developments).
• Gale In Context: Global Issues This link opens in a new window Best database for exploring the topic from a global point of view.

Choose the questions below that you find most interesting or appropriate for your assignment.

• Why is abortion such a controversial issue?
• What are the medical arguments for and against abortion?
• What are the religious arguments for and against abortion?
• What are the political arguments for and against abortion?
• What are the cultural arguments for and against abortion?
• What is the history of laws concerning abortion?
• What are the current laws about abortion?
• How are those who oppose access to abortion trying to affect change?
• How are those who support access to abortion trying to affect change?
• Based on what I have learned from my research, what do I think about the issue of abortion?
• State-by-State Abortion Laws Updated regularly by the Guttmacher Institute
• What the Data Says About Abortion in the U.S. From the Pew Research Center in March of 2024, a look at the most recent available data about abortion from sources other than public opinion surveys.

Latest News on Abortion from Google News

All of these resources are free for MJC students, faculty, & staff.

• Gale Databases This link opens in a new window Search over 35 databases simultaneously that cover almost any topic you need to research at MJC. Gale databases include articles previously published in journals, magazines, newspapers, books, and other media outlets.
• EBSCOhost Databases This link opens in a new window Search 22 databases simultaneously that cover almost any topic you need to research at MJC. EBSCO databases include articles previously published in journals, magazines, newspapers, books, and other media outlets.
• Facts on File Databases This link opens in a new window Facts on File databases include: Issues & Controversies , Issues & Controversies in History , Today's Science , and World News Digest .
• MEDLINE Complete This link opens in a new window This database provides access to top-tier biomedical and health journals, making it an essential resource for doctors, nurses, health professionals and researchers engaged in clinical care, public health, and health policy development.
• Access World News This link opens in a new window Search the full-text of editions of record for local, regional, and national U.S. newspapers as well as full-text content of key international sources. This is your source for The Modesto Bee from January 1989 to the present. Also includes in-depth special reports and hot topics from around the country. To access The Modesto Bee , limit your search to that publication. more... less... Watch this short video to learn how to find The Modesto Bee .

Browse Featured Web Sites:

• American Association of Pro-Life Obstetricians and Gynecologists Medical information and anti-abortion rights advocacy.
• American Congress of Obstetricians and Gynecologists Use the key term "abortion" in the search box on this site for links to reports and statistics.
• Guttmacher Institute Statistics and policy papers with a world-wide focus from a "research and policy organization committed to advancing sexual and reproductive health and rights worldwide."
• NARAL Pro-Choice America This group advocates for pro-abortion rights legislation. Current information abortion laws in the U.S.
• National Right to Life Committee This group advocates for anti-abortion rights legislation in the U.S.

Why Use Books:

Use books to read broad overviews and detailed discussions of your topic. You can also use books to find  primary sources , which are often published together in collections.  

Where Do I Find Books?

You'll use the library catalog to search for books, ebooks, articles, and more.  

What if MJC Doesn't Have What I Need?

If you need materials (books, articles, recordings, videos, etc.) that you cannot find in the library catalog , use our  interlibrary loan service .

Your instructor should tell you which citation style they want you to use. Click on the appropriate link below to learn how to format your paper and cite your sources according to a particular style.

• Chicago Style
• ASA & Other Citation Styles
• Last Updated: Sep 12, 2024 3:24 PM
• URL: https://libguides.mjc.edu/abortion

Except where otherwise noted, this work is licensed under CC BY-SA 4.0 and CC BY-NC 4.0 Licenses .

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• School Education /

Essay on Abortion in English in 650 Words

• Updated on  
• Feb 5, 2024

Essay on Abortion: Abortion is the termination of pregnancy. The termination happens due to the removal of the embryo or fetus. 

The process of abortion can be natural as well as intentional. The intentional forces abortion involves a decision to end the pregnancy while when this process unfolds naturally without any external forces such as genetic abnormalities, maternal age, hormonal imbalances, or lifestyle, it is termed as miscarriage or spontaneous abortion. It is important to understand the difference between intentional abortion and miscarriage to explore reproductive health. 

Master the art of essay writing with our blog on How to Write an Essay in English .

Table of Contents

• 1 Types of Abortion
• 2 Law in India for Abortion
• 3.1 1. Comprehensive Sex Education 
• 3.2 2. Access to Contraceptives
• 3.3 3. Support System for Pregnant Women 

Also Read: 3-Minute Speech on Motherhood and Education

Types of Abortion

Abortion procedures can be classified into two main types, Medical abortion and Surgical abortion. Medical abortion involves the termination of pregnancy using medications, such as the combination of mifepristone and misoprostol. This medication method is generally effective within nine weeks of pregnancy and does not involve any penetration or incision of the body or the insertion of instruments into the body. 

On the other hand, surgical abortion involves a physical procedure to remove the pregnancy. The common surgical abortion method includes aspiration (suction) abortion, dilation and curettage (D&C), and dilation and evacuation (D&E) also called vacuum aspiration.

Law in India for Abortion

Laws of abortion play a vital role in the complexities of reproductive health. These laws aim to safeguard the well-being of women by ensuring that the abortion procedures are conducted under safe and medically supervised conditions.

In India, the legal framework for governing abortion primarily comes under the guidance of the Medical Termination of Pregnancy (MTP) Act. The act was enacted in the year 1971 and aimed to liberalize the voluntary absorption largely decriminalized Section 312 of the IPC. To have safe and legal abortion services in India The Medical Termination of Pregnancy Regulations,2003 were issued under the MTP Act. 

Further in the year 2021, certain amendments were passed for safe abortion services in case of failures of contraceptive failures, increase in gestation limit to 24 weeks, and the opinion of one abortion service provider up to 20 weeks of gestation. Moreover, the amendment also supported abortion until 24 weeks of pregnancy. The amendment acknowledges 7 specific circumstances to the MTP Act where a female can go for an abortion and those include Minor pregnancies, rape survivors, women with mental and physical disabilities, and more. 

Alternative and Support of Abortion

Some alternative measures that will help to raise awareness about abortion are as follows:

1. Comprehensive Sex Education 

The physical experience of abortion for women can be hazardous too, therefore, to provide an alternative it is necessary that comprehensive sex education should be provided in schools beyond subjects like Biology, healthy relationships, consent, and making responsible choices. Through this knowledge, students will not only be equipped with information but will also navigate relationships and avoid unintended pregnancies.

2. Access to Contraceptives

Easy access to contraceptives is another way to empower women to take charge of their reproductive health. Whether it is condoms, birth control pills, or any other methods of protection ensures to make responsible decisions and help in taking precautions against unplanned pregnancies.

3. Support System for Pregnant Women 

To support women with unwanted pregnancies it is important to create a supportive environment for them mentally as well as emotionally. The government can offer counselling services, and access to healthcare information, and can provide resources to help pregnant women make informed choices or decisions about their future for example parenting classes, legal guidance and financial assistance programs. 

In conclusion, we can say that the topic of abortion is complex as well as deep with emotions as well as with different perspectives. The ethical, religious, and legal debate on this sophisticated topic makes it challenging to find a common ground. Therefore it is necessary to have open and respectful communication, understanding empathy and healthcare options for the women. 

Also Read: National Safe Motherhood Day 2023

Ans. 1 Abortion is the termination of pregnancy. The termination happens due to the removal of the embryo or fetus. 

Ans. 2 As she was going through many health issues the family decided to go for an abortion. 

The causes of abortion in the first trimester can be emotional or psychological, maternal health concerns, unintended pregnancies, contraceptive failure and more.  

Ans. 4 The opposite of abortion is success, continuation, accomplishment, and achievement.

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Deepika Joshi

Deepika Joshi is an experienced content writer with educational and informative content expertise. She has hands-on experience in Education, Study Abroad and EdTech SaaS. Her strengths lie in conducting thorough research and analysis to provide accurate and up-to-date information to readers. She enjoys staying updated on new skills and knowledge, particularly in the education domain. In her free time, she loves to read articles, and blogs related to her field to expand her expertise further. In her personal life, she loves creative writing and aspires to connect with innovative people who have fresh ideas to offer.

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• Knowledge Base
• How to write an expository essay

How to Write an Expository Essay | Structure, Tips & Examples

Published on July 14, 2020 by Jack Caulfield . Revised on July 23, 2023.

“Expository” means “intended to explain or describe something.” An expository essay provides a clear, focused explanation of a particular topic, process, or set of ideas. It doesn’t set out to prove a point, just to give a balanced view of its subject matter.

Expository essays are usually short assignments intended to test your composition skills or your understanding of a subject. They tend to involve less research and original arguments than argumentative essays .

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Table of contents

When should you write an expository essay, how to approach an expository essay, introducing your essay, writing the body paragraphs, concluding your essay, other interesting articles, frequently asked questions about expository essays.

In school and university, you might have to write expository essays as in-class exercises, exam questions, or coursework assignments.

Sometimes it won’t be directly stated that the assignment is an expository essay, but there are certain keywords that imply expository writing is required. Consider the prompts below.

The word “explain” here is the clue: An essay responding to this prompt should provide an explanation of this historical process—not necessarily an original argument about it.

Sometimes you’ll be asked to define a particular term or concept. This means more than just copying down the dictionary definition; you’ll be expected to explore different ideas surrounding the term, as this prompt emphasizes.

Prevent plagiarism. Run a free check.

An expository essay should take an objective approach: It isn’t about your personal opinions or experiences. Instead, your goal is to provide an informative and balanced explanation of your topic. Avoid using the first or second person (“I” or “you”).

The structure of your expository essay will vary according to the scope of your assignment and the demands of your topic. It’s worthwhile to plan out your structure before you start, using an essay outline .

A common structure for a short expository essay consists of five paragraphs: An introduction, three body paragraphs, and a conclusion.

Like all essays, an expository essay begins with an introduction . This serves to hook the reader’s interest, briefly introduce your topic, and provide a thesis statement summarizing what you’re going to say about it.

Hover over different parts of the example below to see how a typical introduction works.

In many ways, the invention of the printing press marked the end of the Middle Ages. The medieval period in Europe is often remembered as a time of intellectual and political stagnation. Prior to the Renaissance, the average person had very limited access to books and was unlikely to be literate. The invention of the printing press in the 15th century allowed for much less restricted circulation of information in Europe, paving the way for the Reformation.

The body of your essay is where you cover your topic in depth. It often consists of three paragraphs, but may be more for a longer essay. This is where you present the details of the process, idea or topic you’re explaining.

It’s important to make sure each paragraph covers its own clearly defined topic, introduced with a topic sentence . Different topics (all related to the overall subject matter of the essay) should be presented in a logical order, with clear transitions between paragraphs.

Hover over different parts of the example paragraph below to see how a body paragraph is constructed.

The invention of the printing press in 1440 changed this situation dramatically. Johannes Gutenberg, who had worked as a goldsmith, used his knowledge of metals in the design of the press. He made his type from an alloy of lead, tin, and antimony, whose durability allowed for the reliable production of high-quality books. This new technology allowed texts to be reproduced and disseminated on a much larger scale than was previously possible. The Gutenberg Bible appeared in the 1450s, and a large number of printing presses sprang up across the continent in the following decades. Gutenberg’s invention rapidly transformed cultural production in Europe; among other things, it would lead to the Protestant Reformation.

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The conclusion of an expository essay serves to summarize the topic under discussion. It should not present any new information or evidence, but should instead focus on reinforcing the points made so far. Essentially, your conclusion is there to round off the essay in an engaging way.

Hover over different parts of the example below to see how a conclusion works.

The invention of the printing press was important not only in terms of its immediate cultural and economic effects, but also in terms of its major impact on politics and religion across Europe. In the century following the invention of the printing press, the relatively stationary intellectual atmosphere of the Middle Ages gave way to the social upheavals of the Reformation and the Renaissance. A single technological innovation had contributed to the total reshaping of the continent.

If you want to know more about AI tools , college essays , or fallacies make sure to check out some of our other articles with explanations and examples or go directly to our tools!

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An expository essay is a broad form that varies in length according to the scope of the assignment.

Expository essays are often assigned as a writing exercise or as part of an exam, in which case a five-paragraph essay of around 800 words may be appropriate.

You’ll usually be given guidelines regarding length; if you’re not sure, ask.

An expository essay is a common assignment in high-school and university composition classes. It might be assigned as coursework, in class, or as part of an exam.

Sometimes you might not be told explicitly to write an expository essay. Look out for prompts containing keywords like “explain” and “define.” An expository essay is usually the right response to these prompts.

An argumentative essay tends to be a longer essay involving independent research, and aims to make an original argument about a topic. Its thesis statement makes a contentious claim that must be supported in an objective, evidence-based way.

An expository essay also aims to be objective, but it doesn’t have to make an original argument. Rather, it aims to explain something (e.g., a process or idea) in a clear, concise way. Expository essays are often shorter assignments and rely less on research.

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What is the best site to search for quality abortion paper samples?

Students can find many quality abortion essay examples and related materials in our database.

How to use abortion essay examples to create my paper?

Students can find essays that they can use as references for writing their work on abortion and searching for primary sources.

Is it allowed to submit your abortion essay samples as mine?

Since our abortion essays are in the public domain, we do not recommend passing them off as your own since other students may have already referred to them.

What college paper and essay examples can students find on our site?

The Samples database contains many examples and ready-made papers on abortion, philosophy, culture, art, and many other areas.

Good samples may come in handy in various ways. We usually emulate ideal templates or try to exceed the best results to achieve the aim. You may use our abortion essay examples as an excellent database to follow and refer to while writing. All the papers are of high academic standards and correspond to all the requirements. In addition, the list of topics related to abortion papers covers sensitive and widely discussed issues.

Abortion Essay Examples: Path to Argumentative Essay Writing

The hot discussion around women’s rights is underway today. One of the global questions is the legalization of abortions. When writing a why should abortion be legalized essay , it is worth paying attention to the last statistical data. More than 61% of American adults agree with the legalization of pregnancy interruption, while 37% state that it should be illegal.

So, all the abortion essays are controversial as they always have different points of view and are pro-choice oriented. But in writing about birth control in a persuasive essay, students should not forget the rather sensitive issue of the strong wish of one to have a baby but inability due to infertility. And be ready to showcase enough arguments to protect the life principles of those who support abortions.

Writing pro-life essays on abortion is a thought-provoking assignment. In such a way, teachers make their students consider human rights and gender equality issues. Therefore, in an argumentative essay on abortion, it is essential to provide deep analysis, undeniable facts, and personal attitude.

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If you write an abortion argumentative essay or abortion persuasive essay , it is advisable to dig deeper into our abortion debate essays. There you may get to know a lot of facts and watch professional writing.

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If you have to write an abortion paper but do not possess enough information or are unknowledgeable about writing on delicate subjects, we are ready to help. After reading through a few examples from our free database, you will be full of ideas and inspiration to start your creation. Furthermore, we are glad to demonstrate the presence of the right thoughts to keep a neutral position, which is required in professional essay writing.

Structure and Topic: Find Perfect to Follow

If you want to get high grades, following an abortion research paper outline is obligatory to keep a logical structure. Additionally, in an argumentative abortion essay, it will not be superfluous to define with an actual and catchy topic. You may find solutions by referring to our resources of cost-free examples with perfect formatting, high-standard structure, and up-to-date topics.

Teachers always pay attention to the visual look, proper formatting, and structuring while grading. Remember that your topic should encourage reading and serve as proficient advertising for your essay. Implementation of this advice is vivid in our samples.

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You will not find plagiarism, unreliable information, or illogical writing in any essay about abortion from our database. On the contrary, expert writers with significant experience write highly graded persuasive essays and research papers full of facts and arguments. They use only reliable data to create unique projects. Moreover, students may not hesitate to use our samples as a reference or self-education tool.

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The Safety and Quality of Abortion Care in the United States (2018)

Chapter: 5 conclusions, 5 conclusions.

This report provides a comprehensive review of the state of the science on the safety and quality of abortion services in the United States. The committee was charged with answering eight specific research questions. This chapter presents the committee’s conclusions by responding individually to each question. The research findings that are the basis for these conclusions are presented in the previous chapters. The committee was also asked to offer recommendations regarding the eight questions. However, the committee decided that its conclusions regarding the safety and quality of U.S. abortion care responded comprehensively to the scope of this study. Therefore, the committee does not offer recommendations for specific actions to be taken by policy makers, health care providers, and others.

1. What types of legal abortion services are available in the United States? What is the evidence regarding which services are appropriate under different clinical circumstances (e.g., based on patient medical conditions such as previous cesarean section, obesity, gestational age)?

Four legal abortion methods—medication, 1 aspiration, dilation and evacuation (D&E), and induction—are used in the United States. Length of gestation—measured as the amount of time since the first day of the last

___________________

1 The terms “medication abortion” and “medical abortion” are used interchangeably in the literature. This report uses “medication abortion” to describe the U.S. Food and Drug Administration (FDA)-approved prescription drug regimen used up to 10 weeks’ gestation.

menstrual period—is the primary factor in deciding what abortion procedure is the most appropriate. Both medication and aspiration abortions are used up to 10 weeks’ gestation. Aspiration procedures may be used up to 14 to 16 weeks’ gestation.

Mifepristone, sold under the brand name Mifeprex, is the only medication specifically approved by the FDA for use in medication abortion. The drug’s distribution has been restricted under the requirements of the FDA Risk Evaluation and Mitigation Strategy program since 2011—it may be dispensed only to patients in clinics, hospitals, or medical offices under the supervision of a certified prescriber. To become a certified prescriber, eligible clinicians must register with the drug’s distributor, Danco Laboratories, and meet certain requirements. Retail pharmacies are prohibited from distributing the drug.

When abortion by aspiration is no longer feasible, D&E and induction methods are used. D&E is the superior method; in comparison, inductions are more painful for women, take significantly more time, and are more costly. However, D&Es are not always available to women. The procedure is illegal in Mississippi 2 and West Virginia 3 (both states allow exceptions in cases of life endangerment or severe physical health risk to the woman). Elsewhere, access to the procedure is limited because many obstetrician/gynecologists (OB/GYNs) and other physicians lack the requisite training to perform D&Es. Physicians’ access to D&E training is very limited or nonexistent in many areas of the country.

Few women are medically ineligible for abortion. There are, however, specific contraindications to using mifepristone for a medication abortion or induction. The drug should not be used for women with confirmed or suspected ectopic pregnancy or undiagnosed adnexal mass; an intrauterine device in place; chronic adrenal failure; concurrent long-term systemic corticosteroid therapy; hemorrhagic disorders or concurrent anticoagulant therapy; allergy to mifepristone, misoprostol, or other prostaglandins; or inherited porphyrias.

Obesity is not a risk factor for women who undergo medication or aspiration abortions (including with the use of moderate intravenous sedation). Research on the association between obesity and complications during a D&E abortion is less certain—particularly for women with Class III obesity (body mass index ≥40) after 14 weeks’ gestation.

A history of a prior cesarean delivery is not a risk factor for women undergoing medication or aspiration abortions, but it may be associated

2 Mississippi Unborn Child Protection from Dismemberment Abortion Act, Mississippi HB 519, Reg. Sess. 2015–2016 (2016).

3 Unborn Child Protection from Dismemberment Abortion Act, West Virginia SB 10, Reg. Sess. 2015–2016 (2016).

with an increased risk of complications during D&E abortions, particularly for women with multiple cesarean deliveries. Because induction abortions are so rare, it is difficult to determine definitively whether a prior cesarean delivery increases the risk of complications. The available research suggests no association.

2. What is the evidence on the physical and mental health risks of these different abortion interventions?

Abortion has been investigated for its potential long-term effects on future childbearing and pregnancy outcomes, risk of breast cancer, mental health disorders, and premature death. The committee found that much of the published literature on these topics does not meet scientific standards for rigorous, unbiased research. Reliable research uses documented records of a prior abortion, analyzes comparable study and control groups, and controls for confounding variables shown to affect the outcome of interest.

Physical health effects The committee identified high-quality research on numerous outcomes of interest and concludes that having an abortion does not increase a woman’s risk of secondary infertility, pregnancy-related hypertensive disorders, abnormal placentation (after a D&E abortion), preterm birth, or breast cancer. Although rare, the risk of very preterm birth (<28 weeks’ gestation) in a woman’s first birth was found to be associated with having two or more prior aspiration abortions compared with first births among women with no abortion history; the risk appears to be associated with the number of prior abortions. Preterm birth is associated with pregnancy spacing after an abortion: it is more likely if the interval between abortion and conception is less than 6 months (this is also true of pregnancy spacing in general). The committee did not find well-designed research on abortion’s association with future ectopic pregnancy, miscarriage or stillbirth, or long-term mortality. Findings on hemorrhage during a subsequent pregnancy are inconclusive.

Mental health effects The committee identified a wide array of research on whether abortion increases women’s risk of depression, anxiety, and/or posttraumatic stress disorder and concludes that having an abortion does not increase a woman’s risk of these mental health disorders.

3. What is the evidence on the safety and quality of medical and surgical abortion care?

Safety The clinical evidence clearly shows that legal abortions in the United States—whether by medication, aspiration, D&E, or induction—are

safe and effective. Serious complications are rare. But the risk of a serious complication increases with weeks’ gestation. As the number of weeks increases, the invasiveness of the required procedure and the need for deeper levels of sedation also increase.

Quality Health care quality is a multidimensional concept. Six attributes of health care quality—safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity—were central to the committee’s review of the quality of abortion care. Table 5-1 details the committee’s conclusions regarding each of these quality attributes. Overall, the committee concludes that the quality of abortion care depends to a great extent on where women live. In many parts of the country, state regulations have created barriers to optimizing each dimension of quality care. The quality of care is optimal when the care is based on current evidence and when trained clinicians are available to provide abortion services.

4. What is the evidence on the minimum characteristics of clinical facilities necessary to effectively and safely provide the different types of abortion interventions?

Most abortions can be provided safely in office-based settings. No special equipment or emergency arrangements are required for medication abortions. For other abortion methods, the minimum facility characteristics depend on the level of sedation that is used. Aspiration abortions are performed safely in office and clinic settings. If moderate sedation is used, the facility should have emergency resuscitation equipment and an emergency transfer plan, as well as equipment to monitor oxygen saturation, heart rate, and blood pressure. For D&Es that involve deep sedation or general anesthesia, the facility should be similarly equipped and also have equipment to provide general anesthesia and monitor ventilation.

Women with severe systemic disease require special measures if they desire or need deep sedation or general anesthesia. These women require further clinical assessment and should have their abortion in an accredited ambulatory surgery center or hospital.

5. What is the evidence on what clinical skills are necessary for health care providers to safely perform the various components of abortion care, including pregnancy determination, counseling, gestational age assessment, medication dispensing, procedure performance, patient monitoring, and follow-up assessment and care?

Required skills All abortion procedures require competent providers skilled in patient preparation (education, counseling, and informed consent);

TABLE 5-1 Does Abortion Care in the United States Meet the Six Attributes of Quality Health Care?

a These attributes of quality health care were first proposed by the Institute of Medicine’s Committee on Quality of Health Care in America in the 2001 report Crossing the Quality Chasm: A New Health System for the 21st Century.

b Elsewhere in this report, effectiveness refers to the successful completion of the abortion without the need for a follow-up aspiration.

clinical assessment (confirming intrauterine pregnancy, determining gestation, taking a relevant medical history, and physical examination); pain management; identification and management of expected side effects and serious complications; and contraceptive counseling and provision. To provide medication abortions, the clinician should be skilled in all these areas. To provide aspiration abortions, the clinician should also be skilled in the technical aspects of an aspiration procedure. To provide D&E abortions, the clinician needs the relevant surgical expertise and sufficient caseload to maintain the requisite surgical skills. To provide induction abortions, the clinician requires the skills needed for managing labor and delivery.

Clinicians that have the necessary competencies Both trained physicians (OB/GYNs, family medicine physicians, and other physicians) and advanced practice clinicians (APCs) (physician assistants, certified nurse-midwives, and nurse practitioners) can provide medication and aspiration abortions safely and effectively. OB/GYNs, family medicine physicians, and other physicians with appropriate training and experience can perform D&E abortions. Induction abortions can be provided by clinicians (OB/GYNs,

family medicine physicians, and certified nurse-midwives) with training in managing labor and delivery.

The extensive body of research documenting the safety of abortion care in the United States reflects the outcomes of abortions provided by thousands of individual clinicians. The use of sedation and anesthesia may require special expertise. If moderate sedation is used, it is essential to have a nurse or other qualified clinical staff—in addition to the person performing the abortion—available to monitor the patient, as is the case for any other medical procedure. Deep sedation and general anesthesia require the expertise of an anesthesiologist or certified registered nurse anesthetist to ensure patient safety.

6. What safeguards are necessary to manage medical emergencies arising from abortion interventions?

The key safeguards—for abortions and all outpatient procedures—are whether the facility has the appropriate equipment, personnel, and emergency transfer plan to address any complications that might occur. No special equipment or emergency arrangements are required for medication abortions; however, clinics should provide a 24-hour clinician-staffed telephone line and have a plan to provide emergency care to patients after hours. If moderate sedation is used during an aspiration abortion, the facility should have emergency resuscitation equipment and an emergency transfer plan, as well as equipment to monitor oxygen saturation, heart rate, and blood pressure. D&Es that involve deep sedation or general anesthesia should be provided in similarly equipped facilities that also have equipment to monitor ventilation.

The committee found no evidence indicating that clinicians that perform abortions require hospital privileges to ensure a safe outcome for the patient. Providers should, however, be able to provide or arrange for patient access or transfer to medical facilities equipped to provide blood transfusions, surgical intervention, and resuscitation, if necessary.

7. What is the evidence on the safe provision of pain management for abortion care?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended to reduce the discomfort of pain and cramping during a medication abortion. Some women still report high levels of pain, and researchers are exploring new ways to provide prophylactic pain management for medication abortion. The pharmaceutical options for pain management during aspiration, D&E, and induction abortions range from local anesthesia, to minimal sedation/anxiolysis, to moderate sedation/analgesia, to deep sedation/

analgesia, to general anesthesia. Along this continuum, the physiological effects of sedation have increasing clinical implications and, depending on the depth of sedation, may require special equipment and personnel to ensure the patient’s safety. The greatest risk of using sedative agents is respiratory depression. The vast majority of abortion patients are healthy and medically eligible for all levels of sedation in office-based settings. As noted above (see Questions 4 and 6), if sedation is used, the facility should be appropriately equipped and staffed.

8. What are the research gaps associated with the provision of safe, high-quality care from pre- to postabortion?

The committee’s overarching task was to assess the safety and quality of abortion care in the United States. As noted in the introduction to this chapter, the committee decided that its findings and conclusions fully respond to this charge. The committee concludes that legal abortions are safe and effective. Safety and quality are optimized when the abortion is performed as early in pregnancy as possible. Quality requires that care be respectful of individual patient preferences, needs, and values so that patient values guide all clinical decisions.

The committee did not identify gaps in research that raise concerns about these conclusions and does not offer recommendations for specific actions to be taken by policy makers, health care providers, and others.

The following are the committee’s observations about questions that merit further investigation.

Limitation of Mifepristone distribution As noted above, mifepristone, sold under the brand name Mifeprex, is the only medication approved by the FDA for use in medication abortion. Extensive clinical research has demonstrated its safety and effectiveness using the FDA-recommended regimen. Furthermore, few women have contraindications to medication abortion. Nevertheless, as noted earlier, the FDA REMS restricts the distribution of mifepristone. Research is needed on how the limited distribution of mifepristone under the REMS process impacts dimensions of quality, including timeliness, patient-centeredness, and equity. In addition, little is known about pharmacist and patient perspectives on pharmacy dispensing of mifepristone and the potential for direct-to-patient models through telemedicine.

Pain management There is insufficient evidence to identify the optimal approach to minimizing the pain women experience during an aspiration procedure without sedation. Paracervical blocks are effective in decreasing procedural pain, but the administration of the block itself is painful, and

even with the block, women report experiencing moderate to significant pain. More research is needed to learn how best to reduce the pain women experience during abortion procedures.

Research on prophylactic pain management for women undergoing medication abortions is also needed. Although NSAIDs reduce the pain of cramping, women still report high levels of pain.

Availability of providers APCs can provide medication and aspiration abortions safely and effectively, but the committee did not find research assessing whether APCs can also be trained to perform D&Es.

Addressing the needs of women of lower income Women who have abortions are disproportionately poor and at risk for interpersonal and other types of violence. Yet little is known about the extent to which they receive needed social and psychological supports when seeking abortion care or how best to meet those needs. More research is needed to assess the need for support services and to define best clinical practice for providing those services.

Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed.

The Safety and Quality of Abortion Care in the United States offers a comprehensive review of the current state of the science related to the provision of safe, high-quality abortion services in the United States. This report considers 8 research questions and presents conclusions, including gaps in research.

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