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ABORTION

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Abortion is the ending of a pregnancy before birth. Early in a pregnancy, the fertilized egg that grows and develops is called an embryo. After three months of development, it is usually called a fetus. An abortion causes the embryo or fetus to die. In a spontaneous abortion, also called a miscarriage, the fetus passes from the woman's body. Spontaneous abortions may result from such natural causes as an abnormality in the embryo, a hormonal imbalance, a long-term disease, or some other disorder in the woman. In an induced abortion, the fetus is purposely removed from the woman's body. This article deals with induced abortion.

Induced abortion has been a topic of dispute for hundreds of years. People disagree on two basic questions. One question is whether the law should permit a woman to have an abortion and, if so, under what circumstances. The other is whether the law should protect the unborn. Those who wish to legally limit or forbid abortion describe their position as "right-to-life" or "pro-life." Those who believe a woman should have the right to an abortion refer to themselves as "pro-choice."

Arguments against abortion are generally based on the belief that an abortion is the unjustified killing of an unborn child. Most people who oppose abortion believe that human life begins as soon as a sperm fertilizes an egg. Some believe that human embryos and fetuses should have legal rights and that abortion is actually a form of murder. Many pro-life people believe that legalization of abortion increases the number of irresponsible pregnancies and leads to a disrespect for human life.

The Roman Catholic Church is probably the leading opponent of abortion. Conservative branches of other religions also disapprove of abortion.

Arguments for abortion. Many people would allow abortion under certain circumstances. Some approve of abortion if a woman's life or health is endangered by her pregnancy. Others find abortion permissible if medical tests predict that the child will be born with a serious mental or physical defect. Some people would permit abortion when a pregnancy has resulted from rape or incest. Others believe that a woman should have an unrestricted right to an abortion, especially before the fetus becomes viable--that is, capable of living outside the mother's body. Most fetuses become viable after the sixth month of the pregnancy.

People who favor an unrestricted right to abortion during early pregnancy often separate human life from personhood. They argue that personhood includes an ability to experience self-consciousness and to be accepted as a member of a community. These people believe fetuses are not persons and thus should not be granted the rights given to persons. Such pro-choice thinkers consider birth the beginning of personhood.

Another pro-choice argument is that legal abortion eliminates many of the illegal abortions performed by unskilled individuals under unsanitary conditions. These abortions cause many women permanent injury or result in their deaths. Also, some argue that women should not have to give birth to unwanted children because the world's population is growing rapidly and natural resources are becoming scarce.

Abortion history. Abortion has been widely known, practiced, and debated since ancient times. The ancient Hebrews had laws against abortion, but they permitted it in cases where the mother's life was at risk.

The early Christian church generally opposed abortion. For hundreds of years, however, the church debated whether abortion might be justifiable before animation. Church scholars defined animation as the point at which the fetus received a soul. According to church teachings, animation occurred between 40 and 80 days after conception (fertilization). From about the 1300's to the 1800's, abortion before animation became generally accepted in Europe if the pregnancy endangered the life of the mother. If an abortion before animation took place for a less serious reason, many church scholars considered it to be wrong, but not homicide.

In 1869, Pope Pius IX condemned abortion from the moment of conception, but some Catholic church scholars continued to teach that abortions performed to save the mother were morally acceptable. In 1895, the Roman Catholic Church declared that abortion is never justifiable. Today, the Catholic church condemns all forms of direct abortion--that is, the intentional ending of pregnancy. Current Catholic teaching permits indirect abortion, in which the fetus is lost as a side effect of medical treatment designed to save the mother's life.

Abortion in the United States is a subject of public debate. Opinion polls show that most people think abortion should be legal. These people might disapprove of abortion or disagree with some of the reasons that women seek abortions, but they would permit a legal choice. Some believe only the states--and not the federal government--should regulate or outlaw abortion.

Before the mid-1800's, abortion was not a crime under U.S. common law if it took place before quickening. Quickening is the time when the mother first feels the fetus moving. State laws prohibiting abortion began to appear in the 1820's. By 1900, every state except Kentucky had made abortion a serious crime. But some courts refused to impose penalties for early abortion.

By the 1960's, pro-choice organizations in the United States had begun working to change state abortion laws. By the early 1970's, 14 states had laws permitting abortion if the woman's health was in danger or if the woman was a victim of incest or rape.

In 1973, the Supreme Court of the United States delivered a historic decision on abortion in the case of Roe v. Wade. The court ruled that states could not forbid a woman to have an abortion during the first trimester (three months) of pregnancy. The court based this ruling on the assumption that an early abortion is usually safer for the woman than a pregnancy that lasts a full nine months. The court also ruled that, during the second trimester, states may regulate abortion only to protect women's health. Once the fetus becomes viable in the third trimester, states may regulate abortion to protect the interests of both women and the unborn. The Roe v. Wade decision stated that the U.S. Constitution implies the right of privacy and allows a woman to decide for herself if she will have an abortion.

The 1973 decision also dealt with the question of when a fetus becomes viable. It stated, "Viability is usually placed at about seven months (28 weeks) but may occur earlier, even at 24 weeks." The court said that states may forbid abortion of a viable fetus except when the abortion is necessary to protect the life or health of the mother.

Since the Roe v. Wade decision, many groups have organized in the United States to oppose abortion and the legislation and court decisions that permit it. These groups include the National Right to Life Committee and the Christian Coalition as well as Operation Rescue, which conducts demonstrations near abortion clinics. Most pro-life groups strongly oppose illegal acts. However, some individuals have vandalized, bombed, or set fire to abortion clinics. Others have attacked and killed doctors and other clinic employees.

Pro-choice groups also have expanded their efforts. They contact lawmakers, hold demonstrations, and attack restrictive abortion laws in court. Pro-choice organizations include the National Abortion and Reproductive Rights Action League, the Planned Parenthood Federation of America, and the National Organization for Women.

Since 1973, some Supreme Court decisions have limited the influence of Roe v. Wade. One example is the case of Webster v. Reproductive Health Services (1989). The court ruled that states may require physicians to test the viability of a fetus before performing an abortion on a woman pregnant for 20 weeks or more. The court also ruled that states may outlaw abortions in public hospitals and prohibit public employees from assisting in abortions.

Following the Roe v. Wade decision, the federal government and many state governments began to pay for abortions for poor women under the Medicaid program. Many opponents of abortion objected to this use of government funds. In 1977, the Supreme Court ruled that the government was not obligated to finance abortions considered unnecessary to preserve the mother's physical or emotional health. In 1980, the court said the government had no obligation to pay for even most medically necessary abortions. This ruling upheld a federal law called the Hyde Amendment.

In 1990, the Supreme Court decided that states may require minors to obtain parental or court consent before having an abortion. In Rust v. Sullivan (1991), the court upheld a federal regulation prohibiting workers in federally funded clinics from giving patients advice about using abortion as a family planning method. However, the regulation was eliminated in 1993.

In Planned Parenthood of Eastern Pennsylvania v. Casey (1992), both sides of the abortion dispute asked the Supreme Court to review the ruling in Roe v. Wade. The justices upheld the ruling by a vote of 5 to 4. The court also ruled that states may require women seeking an abortion to first receive counseling by a doctor about fetal development and abortion risks. The court also decided that states may require women to wait 24 hours between the counseling and the abortion.

The case of National Organization for Women v. Scheidler (1994) was a legal response to incidents at abortion clinics. The Supreme Court decided that protesters who block access to clinics can be prosecuted under federal racketeering laws. In 1994, Congress passed the Freedom of Access to Clinic Entrances Act, which protects abortion clinics and their staff members from violence and blockades.

In other countries, abortion laws differ. Lawmakers in some countries have considered abortion an effective tool for limiting family size and combating poverty. In China, for example, abortions are legal and common because the government allows only a limited number of children per family. Chinese women may have an abortion at any time during their pregnancy. In Russia, abortion is allowed up to the 29th week of pregnancy. Japan restricts abortions to the first 24 weeks of pregnancy. Both Russian and Japanese women are allowed to use abortion as a method of birth control.

In the United Kingdom, an abortion may be performed up to the 24th week of pregnancy. However, it must be shown that continuing the pregnancy would endanger the physical or mental health of the woman or her children.

Canadian law permits abortion at any time during pregnancy and for any reason. However, most physicians avoid performing abortions during the later stages of pregnancy and do not offer abortion as a method of birth control.

Abortion methods. Physicians perform abortions in several ways. During the first trimester of pregnancy, the most common method is suction curettage, also known as vacuum aspiration. This method involves removing the fetus by suction, then scraping the woman's uterus with surgical instruments called curettes.

Abortion can also be caused in the first trimester by a drug called mifepristone or RU-486. The drug blocks the action of the hormone progesterone in the woman's body. Normally, this hormone prepares the woman's uterus to receive and nourish the embryo.

In the second trimester, many physicians use a method called dilation and evacuation, or simply D and E. In this method, the fetus is taken apart in the uterus and removed. Another method involves adding a salt solution to the amniotic fluid, the liquid that surrounds the fetus. The fetus then dies and passes from the woman's body. A second-trimester abortion also may be performed by adding hormonelike drugs called prostaglandins to the amniotic fluid. The drugs cause muscle contractions that expel the fetus.

Contributor: David M. O'Brien, Ph.D., Leone Reaves and George Spicer Prof. of Government, Univ. of Virginia.

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