Abortion has been a very polarizing topic since the beginning of abortive care, however like most controversial subjects, when there is a clear, factual explanation it is easier to see the other sides perspective. What is an abortion? Who gets abortions? When do abortions happen? Where do abortions happen? Why do women get abortion? And how is an abortion performed? Maybe with a more clear understanding on the subject, including the impact it has on communities and how to prevent them in the first place, it will lead to a more compassionate conversation.
WHAT?
Abortion is the ending of pregnancy by removing an embryo or fetus before it can survive outside the uterus. An abortion that occurs spontaneously is also known as a miscarriage. An abortion may be caused purposely and is then called an induced abortion, or less frequently, "induced miscarriage". The word abortion is often used to mean only induced abortions. A similar procedure after the fetus could potentially survive outside the womb is known as a "late termination of pregnancy". Around 56 million abortions are performed each year in the world, with about 45% done unsafely. Abortion rates changed little between 2003 and 2008, before which they decreased for at least two decades as access to family planning and birth control increased. As of 2008, 40% of the world's women had access to legal abortions without limits as to reason. When allowed by law, abortion in the developed world is one of the safest procedures for a patient performed in medicine.
WHO?
There is no standard or qualifying factor of a woman who has had or will have an abortion, there is only statistics on who these women are after the fact. Women in their 20s accounted for the majority (58.9%) of abortions and had the highest abortion rates (21.3 and 18.4 abortions per 1,000 women aged 20–24 and 25–29 years, respectively) according to the CDC, while women in the youngest (<15 years) and oldest (≥40 years) age groups accounted for the smallest percentages of abortions (0.3% and 3.6%, respectively) and had the lowest abortion rates (0.5 and 2.6 abortions per 1,000 women aged <15 and ≥40 years, respectively). For all age groups, including women aged ≥40 years, decreases in the abortion rate were greater from 2010 to 2014 than from 2005 to 2009, and these decreases continued from 2013 to 2014 for all age groups <25 years.
Acordding to the Guttmachern Institute found near the same result. In 2014, the largest proportion of abortion patients were in their 20s (60%), followed by those in their 30s (25%). Adolescents—those younger than 20—accounted for 12% of abortion patients, and fewer than 4% were younger than 18. The proportion of abortions accounted for by adolescents declined significantly between 2008 and 2014—by 32%. In particular, the proportion accounted for by 15–17-year-olds declined 44% over this period, and that among 18–19-year-olds dropped by 25%. The 2014 abortion index of 0.4 for the former group indicates that they were substantially underrepresented among abortion patients relative to their representation in the larger population of women. In contrast, women aged 20–24 were overrepresented by a factor of almost two, having the highest relative abortion rate of the age-groups examined (1.9). Abortion indices declined with increasing age thereafter. Both younger and older adolescents had slightly lower abortion indices in 2014 than in 2008; there was little change in the indices for women aged 20 or older.
Among the 42 areas that reported statistics to the CDC by marital status for 2014, 14.5% of all women who obtained an abortion were married, and 85.5% were unmarried. The abortion ratio was 43 abortions per 1,000 live births for married women and 373 abortions per 1,000 live births for unmarried women. Among unmarried women, the abortion ratio decreased 23% from 2005 to 2014 (from 481 to 369 abortions per 1,000 live births), with a larger decrease also occurring from 2010 to 2014 (16%) than from 2005 to 2009 (10%). Among married women, the abortion ratio decreased 25% from 2005 to 2014 (from 55 to 41 abortions per 1,000 live births), with a larger decrease occurring from 2010 to 2014 (18%) than from 2005 to 2009 (7%).
The Guttmacher Institute found that about 14% of abortion patients were married, and an additional 31% were cohabiting. A slight majority were not living with a partner in the month they became pregnant (46% had never married and 9% had been previously married). While the CDC's studies are near equal in data to The Guttmacher Institute, the GI used more descriptive terms (ie. co-habitating, never married, etc.) while the CDC only used married or unmarried. The 2014 abortion index of 0.4 for married patients indicates that they were substantially underrepresented among abortion patients relative to all women of reproductive age. Cohabiting women were over-represented by a factor of 2.1, meaning they had an abortion rate twice the national average. The abortion index for never-married, non-cohabiting patients was slightly higher than average (1.2).
Among the 30 areas that reported cross-classified race/ethnicity data to the CDC for 2014, non-Hispanic white women and non-Hispanic black women accounted for the largest percentages of all abortions (38.0% and 36.0%, respectively), and Hispanic women and non-Hispanic women in the other race category accounted for smaller percentages (18.3% and 7.7%, respectively). Yet non-Hispanic white women had the lowest abortion rate (7.5 abortions per 1,000 women aged 15–44 years) and ratio (121 abortions per 1,000 live births) and while non-Hispanic black women had the highest abortion rate (26.6 abortions per 1,000 women aged 15–44 years) and ratio (391 abortions per 1,000 live births). According to the Guttmacher Institute's study, the abortion index for Hispanics declined slightly from 2008 to 2014, and there was little change in the indices for non-Hispanic black and non-Hispanic white women.
A consistent pattern existed for abortions by maternal age across all race/ethnicity groups, with the smallest percentage of abortions occurring among adolescents aged <15 years (0.2%–0.4%) and the largest percentage occurring among women aged 20–24 years (27.3%–33.8%). A consistent pattern also existed for abortions by marital status across all race/ethnicity groups, with a higher percentage of abortions occurring among women who were unmarried (68.5%–91.9%) than among those who were married (8.1%–31.5%). However, for abortions among unmarried women, the percentage was higher for non-Hispanic black women (91.9%) than for non-Hispanic white (83.1%) or Hispanic women (84.7%).
The overwhelming majority of abortion patients in 2014 were born in the United States (84%), while the remaining 16% were born elsewhere; these proportions had remained stable since 2008. Of those patients born outside the United States, about half were Hispanic, 20% Asian, 16% black and 12% white. Some 9% of abortion patients aged 20 or older had less than a high school degree, and the overwhelming majority—91%—had graduated from high school; more than one in five had a college degree. The proportion of patients aged 20 or older who had not graduated from high school declined significantly over the six-year period (from 12% to 9%). In 2014, some 24% of all abortion patients were currently attending school, including 72% of minors and 53% of 18–19-year-olds (not shown). Only 14% of those currently in school had not graduated from high school; 66% had some college or a college degree, suggesting that most abortion patients who were students were pursuing post-secondary degrees.
Data from the 40 areas that reported to the CDC, the number of previous live births for women who obtained abortions in 2014 indicate that 40.4% of these women had zero previous live births, 45.7% had one to two, and 13.8% had three or more previous live births. Among the 32 reporting areas that provided these data for the relevant years of comparison, the percentage of women obtaining abortions who had no previous live births was stable from 2005 - 2014, 2005 - 2009, 2010 - 2014, and 2013 - 2014; by contrast, the percentage decreased for women who had one to two previous live births and increased for women who had three or more previous live births. Among the areas included in this comparison, 40.4% of women had zero previous live births, 47.0% had one to two, and 12.6% three or more previous live births in 2005; while 40.8%, 45.5%, and 13.7% of women had zero, one to two, or three or more previous live births, respectively, in 2014.
The majority of abortion patients indicated a religious affiliation to the Guttmacher Institute: 38% of women did not identify with any religion, 24% identify as Roman Catholic, 17% as mainline Protestant, 13% as evangelical Protestant, while 8% identified with some other religion. The proportion identifying as Catholic decreased from the earlier survey, though this change was only marginally significant. The abortion index had declined slightly for mainline Protestants, and had increased slightly for those with no affiliation, while for Catholic women the index showed that their relative abortion rate was nearly the same as that for all women. When it came to sexuality, the vast majority of abortion patients identified as heterosexual or straight (94%). Four percent of patients said they were bisexual, while only 1% identified as “something else” and 0.3% as homosexual, gay or lesbian. Respondents who indicated “something else” could write in a more specific response; 12 of the 81 who answered affirmatively indicated “pansexual,” which was the only response provided by more than one respondent.
If we combined all the most likely factors of a woman who has an abortion into one hypothetical woman; she would most likely be single, straight, non-Hispanic white, agnostic/atheist, a high school graduate, and already have given birth to one or two children.
WHEN?
A 13-week old fetus in utero
Among 40 areas that reported gestational age at the time of abortion to the CDC for 2014, the majority (67.0%) of abortions were performed by ≤8 weeks’ gestation, and 91.5% were performed at ≤13 weeks’ gestation. Few abortions were performed at 14–20 weeks’ gestation (7.2%) or at ≥21 weeks’ gestation (1.3%). Among abortions performed at ≤13 weeks’ gestation and reported by individual week of gestation for 2014, 40.7% were performed at ≤6 weeks’ gestation. The percentage contribution to abortions performed at ≤13 weeks’ gestation was progressively smaller for each additional week of gestation: 18.5% were performed at 7 weeks’ gestation, and 2.9% were performed at 13 weeks’ gestation.
Among 32 areas that reported by exact week of gestation for abortions performed at ≤13 weeks’ gestation every year during 2005–2014, a shift occurred toward the earliest gestational age reported: abortions performed at ≤6 weeks’ gestation increased 21%, and those performed at 7–13 weeks’ gestation decreased 7%–20%. When it comes to late term abortion, the state of Massachusetts (least strict late term abortion law) allows abortion up to 27 weeks after the patient's last menstrual period, and past that date if the patient's life or health is endangered, while Idaho (most strict late term abortion law) has a time limit to abort by the time the fetus is viable (able to survive outside of the uterus), the abortion patients life must be endangered regardless of physical health repercussions caused by the pregnancy, and a secondary physician must approve post-viability.
WHERE?
Most surgical abortions take place in medical clinics (Planned Parenthood, pregnancy centers, etc.), while most medicinal (non-surgical) abortions are performed at the persons home without medical supervision, though most patients are properly informed on what will occur during the induction and how to tell if there is a medical problem or need to be seen by a medical professional. As of 2014, there are 788 abortion clinics running in the United States, a 6% decrease from 2011. During that same time period, there was also a wide range of additions and subtractions of abortion clinics varying by state, with Vermont gaining a 100% increase in clinics (from 3 clinics to 6), compared to Missouri losing 75% of their clinics (from 4 clinics to 1)
The states with the 5 highest numbers of abortions performed are New York (93,984), Texas (54,401), Illinois (33,918), Pennsylvania (32,683) and Michigan (26,646); with the highest abortion rates, New York (23.2 abortions per 1,000 women), Delaware (16.2 abortions per 1,000 women), Connecticut (15.5 abortions per 1,000 women), New Jersey (14.2 abortions per 1,000 women), and Michigan (14.1 abortions per 1,000 women); and highest abortion ratios, Connecticut (293 abortions per 1,000 women), Delaware (266 abortions per 1,000 women), New York (264 abortions per 1,000 women), Massachusetts (259 abortions per 1,000 women), and Rhode Island (238 abortions per 1,000 women).
While the states with the 5 lowest numbers of abortions performed are Wyoming (642), South Dakota (755), North Dakota (1,009), Vermont (1,161) and Washington D.C (1,407); with the lowest abortion rates, Utah (4.5 abortions per 1,000 women), South Dakota (4.8 abortions per 1,000 women), West Virginia (5.6 abortions per 1,000 women), Idaho (5.6 abortions per 1,000 women), and Kentucky (5.8 abortions per 1,000 women); and lowest abortion ratios, Utah (57 abortions per 1,000 women), South Dakota (61 abortions per 1,000 women), Idaho (77 abortions per 1,000 women), Nebraska (78 abortions per 1,000 women), and Wyoming (83 abortions per 1,000 women).
California has the greatest amount of pregnancies in teenagers under 15 (990 pregnancies), with over 50% of those pregnancies ending in abortion (560 abortions), while the least amount of pregnancies was Vermont (10 pregnancies) though it has a 100% abortion rate, with all 10 pregnancies ended in abortion. 60% of the state of Arkansas' residents believe abortions should be illegal in all/most cases according to the PEW Research Center, yet the ratio between pregnancies ending in abortion compared to live birth in Arkansas is an estimated 1:10. 74% of Massachusetts residents believe abortions should be legal in all/most cases and have a an abortion to live birth ratio of 2.5:10, this is only an estimated 15% difference between two wildly differently opinionated states.
WHY?
There are a multitude of reasons women seek abortion services, some of these reasons are not included or may be inaccurate due to pressure/fear/embarrassment to give a more "acceptable" answer (ie. rape victim denies rape and states the reason for abortion is poverty, a teen unable to care for a child may state unwanted pregnancy, etc.), because of the stigma surrounding abortion, it is unlikely these studies will ever be 100% precise in their research concerning why women have to or choose to seek abortive services. Some reasons women seek these services include birth control (contraceptive) failure, with over half of all women who have an abortion used a contraceptive method during the month they became pregnant.
An inability to support or care for a child, to end an unwanted pregnancy. To prevent the birth of a child with birth defects or severe medical problems, some common defects are often unknown until routine second-trimester tests are done. Pregnancy resulting from rape or incest, physical or mental conditions that endanger the woman's health if the pregnancy is continued and many more. Unfortunately, there is little new research in regards to the reasons behind abortion; however one obvious conclusion to be drawn regardless of research of the factors behind the abortion, is that low-income women have a higher chance of needing abortive services in comparison to higher-income women. There is a common misconception that many pregnancies are simply "unwanted", while this answer is usually a simple cover for a more serious reason that the patient may not feel comfortable sharing with their provider.
HOW?
Abortions are performed in many ways depending on the health needs of the patient and the gestational age of the fetus. With the exception of Montana, most other states that reported to the CDC had far more surgically induced abortions as opposed to medicinal (medical) abortions (upwards of 50% being surgical), some states had less of a drastic difference but surgical was always more common none the less. These methods also do not include non-legal abortive methods (ie. herbs, sharp tools, impact, etc):
An early non-surgical (medical) abortion is performed in weeks 2 to 10 of pregnancy, a combination of drugs (usually mifepristone and misoprostol) is given to the patient stop the development of the pregnancy and expel the contents of the uterus. The doctor or nurse gives you the first pill, mifepristone, at the clinic. Pregnancy needs a hormone called progesterone to grow normally, (mifepristone blocks a woman's own progesterone), and they will also get antibiotics to keep infection away. The patient then uses the second medicine, misoprostol, 6-48 hours later, usually at home.
It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. Often the woman will pass the uterine contents within hours, sometimes as soon a 30 minutes. The woman's body has usually completely expelled the contents within the length of a period, while the next few periods after the abortion may be irregular or stronger than usual. The pills in combination are very effective. For people who are 8 weeks pregnant or less, it works about 98 out of 100 times; from 8-9 weeks pregnant, it works about 96 out of 100 times; from 9-10 weeks, it works 93 out of 100 times.
Vacuum aspiration is an outpatient abortive procedure that generally involves a clinic visit of several hours, the procedure itself typically takes less than 15 minutes most commonly performed in between the 2nd and 14-16th week of pregnancy. The clinician may first use a local anesthetic to numb the cervix. Then, the clinician may also use instruments called "dilators" to open the cervix, or sometimes medically induce dilation with drugs. Pain medication and sedatives may also be available to the patient as well. Finally, a sterile cannula is inserted into the uterus and attached via tubing to the pump, in which suction is created with either an electric pump (electric vacuum aspiration or EVA) or a manual pump (manual vacuum aspiration or MVA). Both methods use the same level of suction, and so can be considered equivalent in terms of effectiveness and safety.
The pump creates a vacuum which empties uterine contents. The fetus, placenta and all other contents are then suctioned from the uterus. After a procedure for abortion or miscarriage treatment, the tissue removed from the uterus is examined for completeness. Expected contents include the embryo or fetus, as well as the decidua, chorionic villi, amniotic fluid, amniotic membrane and other tissue. This may be followed by a procedure to scrape the walls of the uterus if the completed contents are not found, in order to prevent infection. Some residual pain from the procedure can last from days to weeks. Post-treatment care includes brief observation in a recovery area, usually sent home with pain medication and antibiotics, and given a follow-up appointment approximately two weeks later.
Follow-ups tend to include tests for infection in case any biological material was not properly removed. Additional medications used in vacuum aspiration include NSAID analgesics that may be started already the day before the procedure, as well as misoprostol the day before. Vacuum aspiration is 98% effective in removing all uterine contents. Retained products of conception require a second aspiration procedure, but this is more common when the procedure is performed very early in pregnancy, before 6 weeks gestational age. Other complications occur at a rate of less than 1 per 100 procedures and include excessive blood loss, infection, injury to the cervix or uterus, including perforation and uterine adhesions.
Dilation and evacuation (also sometimes called dilation and extraction) is the dilation of the cervix and surgical evacuation of the contents of the uterus. It is a method of abortion as well as a therapeutic procedure used after miscarriage to prevent infection by ensuring that the uterus is fully evacuated. In various health care centers it may be called by different names: D&E (Dilation and evacuation); ERPOC (Evacuation of Retained Products of Conception); TOP or STOP ((Surgical) Termination Of Pregnancy). D&E normally refers to a specific second trimester procedure. However, some sources use the term D&E to refer more generally to any procedure that involves the processes of dilation and evacuation, which includes the first trimester procedures of manual and electric vacuum aspiration.
A dilation and vacuum curettage/vacuum suction curettage (DVC, VSC) is a vacuum aspiration procedure with the addition of the curette tool on the tip of the vacuum used in the D&E. The reason for D&E rather than the simpler DVC or VSC is that the fetal skeleton begins to calcify at 14 weeks and the fetus can no longer be removed by suction alone. A D&E is also recommended for women diagnosed in the second trimester with a fetus that has severe medical problems or abnormalities. Abnormalities such as severe neural tube defects or congenital heart anomalies are typically diagnosed by ultrasound during weeks 18-23, because detailed anatomy cannot be fully evaluated before that time due to requirements for fetal size.
D&E is performed under anesthesia, most commonly sedation with light general anesthesia, although local paracervical block or regional anesthesia may be used. It may be performed with or without ultrasound guidance. Performance under ultrasound guidance has greatly improved the understanding about what actually occurs during a D&E. Prior to the procedure, the cervix is usually softened and passively dilated using osmotic (cervical) dilators and/or misoprostol. This facilitates cervical dilation during the procedure without injury to the cervix. The first step in the procedure itself is that dilation of the cervix. The second step is insertion of a vacuum curette through the cervix.
Under ultrasound, the tip of that curette is placed up against the fetal chest or abdomen. The suction is turned on causing the amniotic fluid to removed and the fetus dies instantly due to removal of the fetal heart, lungs, and abdominal contents. In the absence of ultrasound guidance, the surgeon will carefully observe the tissue extracted by the vacuum curette to insure the fetal liver, which has a characteristic black appearance, has been removed as confirmation that the fetus has died. This leaves the fetal cranium and skeleton with soft tissue to be removed. The thorax, pelvis, cranium, and each arm and leg are removed separately using surgical instruments. The fetal cranium will usually have to be crushed in order to be extracted. Use of ultrasound greatly facilitates this part of the procedure although it may be done safely without ultrasound guidance.
In the absence of ultrasound, the tissue will be carefully inspected to insure all fetal tissue is removed. It is important to recognize that this is the removal of dead tissue to protect the patient from bleeding and infection well after the fetus died instantly. With proper training and equipment, under no circumstances is the fetus being dismembered alive. In some countries where ultrasound guidance is not used and the prior step of removal of internal organs is not performed, the dismemberment occurs while the fetus is alive. After removal of all fetal tissue, the uterine cavity is thoroughly curetted to insure that all placental tissue, blood, and membranes are removed. The uterus will then be massaged to insure it is firmly contracted to minimize post operative bleeding. The entire procedure usually takes less than 30 minutes and is well tolerated by the body.
The standard D&E procedure is difficult after 20 weeks gestational age due to the toughness of the fetal tissues. If the fetus is removed intact, the procedure is referred to as intact dilation and extraction by the American Medical Association, and referred to as "intact dilation and evacuation" by the American Congress of Obstetricians and Gynecologists (ACOG). When this intact evacuation is done with a live fetus which dies midway through, it has also been termed a partial birth abortion. Approximately 11% of induced abortions are performed in the second trimester. In 2002, there were an estimated 142,000 second-trimester abortions in the United States (the second trimester of pregnancy begins at 13 weeks gestation).
Induction abortion is a procedure that starts (induces) labor and delivery in the second or third trimester of a pregnancy and is done using medication given in a variety of delivery methods. To prevent complications, the cervix may be slowly opened with an osmotic (cervical) dilator before the induction is started. Medications used to start early labor can be injected into the amniotic sac surrounding the fetus (instillation) or injected into the fetus itself, substances injected include salt water (saline), digoxin, or potassium chloride. Medication can also inserted into the vagina to start uterine contractions and soften the cervix, this allows uterine contents to pass through the cervix. Vaginal medications include prostaglandins, such as misoprostol.
These drugs can also be injected into a vein (intravenously, or IV) to start uterine contractions, oxytocin (Pitocin) is commonly used for this purpose. Induction abortions must be done in a hospital so that the patient can be monitored during the entire procedure. Less than 1% of (therapeutic) abortions in the United States use an induction method. Induction abortions may be used more in other countries around the world where skilled health professionals are not available or trained to perform D&E procedures. An induction abortion that is done for a planned pregnancy because of fetal abnormalities might include time after the procedure for the parents to be with their child. With an induction abortion, genetic testing and an autopsy can also be done.
Intact dilation and extraction (Intact D&E) is a surgical procedure that removes an intact fetus from the uterus. The procedure is used both after late-term miscarriages and in late-term abortions. It is also known as intact dilation and evacuation, dilation and extraction (D&X, or DNX, disfavored term), and, known in United States federal law, as partial-birth abortion. Patients who are experiencing a miscarriage or who have fetuses diagnosed with severe congenital anomalies may prefer an intact procedure to allow for viewing of the remains, grieving, and achieving closure. In cases where an autopsy is requested, an intact procedure allows for a more complete examination of the remains.
An intact D&E is also used in abortions to minimize instruments introduced into the uterus, therefore reducing the risk of trauma. It also reduces the risk of cervical lacerations that may be caused by the removal of bony parts from the uterus, or retention of any fetal parts in the uterus. The rate of minor complications is approximately 50 in 1,000 (5%), the same as the minor complication rate for non-intact D&E; the rate of serious complications is higher in non-intact D&E. The surgery is preceded by cervical preparation which may take several days. Laminaria sticks, natural or synthetic rods that absorb moisture from the cervix, mechanically dilate the cervix. Misoprostol can be used to soften the cervix further; an intact D&E can only be performed with 2-5 centimeters of cervical dilation.
Feticidal injection of digoxin or potassium chloride may be administered at the beginning of the procedure to allow for softening of the fetal bones or to comply with relevant laws in the physician's jurisdiction. During the surgery, the fetus is removed from the uterus in the breech position, with mechanical collapse of the fetal skull if it is too large to fit through the cervical canal. Decompression of the skull can be accomplished by incision and suction of the contents, or by using forceps. If the fetus is in a vertex presentation, forceps can be used to turn it to a breech presentation while in the uterus (internal version).
Recovery from an intact dilation and evacuation procedure is similar to recovery from a non-intact dilation and extraction. Prophylactic antibiotics are given to prevent infection of the Fallopian tubes or endometrium. Postoperative pain is usually minimal and managed with NSAIDs. In cases of uterine atony (loss of tone in the uterine musculature) and corresponding blood loss, methergine or misoprostol can be given to encourage uterine contraction and achieve hemostasis (the stopping of a flow of blood). Patients who have recently undergone an intact D&E are monitored for signs of coagulopathy, uterine perforation, uterine atony, retained tissue, or hemorrhage.
Hysterotomy abortion is a form of abortion in which the uterus is opened through an abdominal incision and the fetus is removed, similar to a caesarean section, but requiring a smaller incision. As major abdominal surgery, hysterotomy is performed under general anesthesia, and is only used in rare situations where less invasive procedures have failed or are medically inadvisable (such as in the case of placenta accreta). After the initial incisions are made into the abdomen and uterus, the umbilical cord is then clamped or cut to remove blood supply to the fetus. After it is no longer viable, the fetus is removed from the uterus and the patient is sent to recovery. This method has the greatest risk of complications out of all the abortion procedures. Health officials in the United States warned practitioners against performing hysterotomy abortion in an outpatient setting after it led to the deaths of two women in New York during 1971.
Though I have personally been affected by abortion both positively and negatively in multiple ways, I do have an understanding of people who believe that abortion should always/almost always be illegal. However, I also believe a lot of pro-life people think this way due to heavy propaganda and misinformation about the facts about abortion by companies and politicians with much larger agendas. I can see how a person would believe all of the lies surrounding abortion because of how widespread the misinformation is. One extremely painful misconception about abortion, is that all of the fetuses are "unwanted" by the person who goes through this; when in reality, most women want to keep their children, but are forced into aborting (ie. financial reasons, lack of support, rape/incest, etc.).
I personally was forced to have an abortion due to a combination of multiple factors, the ages of the father and myself, the father was not going to stay to raise it, my mother told me I had to, I have multiple mental and physical disabilities that prevent me from taking care of myself (as well as the father). Most strongly, because my baby was 50% the size it should have been at its gestational age, and given my medical problems in combination with using drugs to cope with my mental illnesses, I knew my baby would either die soon after it was born or it would be severely disabled for life. I would have loved to keep my baby and take care of it if I could, but I loved it too much to let it suffer. I do not refer to what happened to my baby an abortion, but rather a sacrifice. That is why it both sickens me and breaks my heart to see people who have never had to sacrifice their child, to talk about abortion as if it is an enjoyable experience for anyone involved.
Of course, there are a very slight percentage of women who are completely capable in all manners (secure finances, secure relationship, strong family support, etc.) who get abortions purely as birth control, because they don't want it or to deal with the consequences of keeping a child. When it comes to these women, though I feel if you are in a completely sound, healthy and secure environment, you should be using preventive birth control rather than abortive. Yet, I will still support these women's right to have the abortion; not only because it is her choice to carry, but also because many women who abort for other reasons claim "unwanted pregnancy" as the reason for the abortion. When it comes to the women who have access to preventative birth control, secure finances, and early access to abortion and options to adopt, and still choose to get late-term abortions while the fetus and patient are completely healthy, while the fetus can survive outside of the uterus; that I can not support. However, not only are less than 3% of abortions are performed on fetuses that are viable outside of pregnancy, most of those cases are not a "wanted" abortion, they are performed due to the life of the fetus or mother being endangered.
Another unavoidable fact surrounding abortion, aside from the issue of low-income women and women without support being forced to abort wanted babies, and even more low-income women forced to keep theirs due to lack of payment for abortion, is that abortion is tragically disproportionate towards non-Hispanic black women in particular. From a glance, it seems non-Hispanic white women have more abortions than any other race; however, only 2% more abortions by numbers of procedures are performed on non-Hispanic white women than the next largest percentage, ahead of non-Hispanic black women. Non-Hispanic white women (an approximate 35% of the population) have 38% of the the abortions in the U.S, while non-Hispanic black women (an approximate 6.5% of the population) have 36% of the abortions in America!
On top of the many other tools used against our non-Hispanic black population, including segregation by means of projects and ghettos, media propaganda urging a gang or criminal lifestyle rather than an educated and healthy one, and instilling self-hate products such as hair relaxer and skin bleach, abortion is one of the most effective tools geared towards non-Hispanic black women with a deeper reasoning of keeping the demographic of the non-Hispanic black population as low as possible. Margaret Sanger, the founder of Planned Parenthood, a well-known racist and eugenicist was quoted as saying, "Eugenics without birth control seems to us a house builded [sic] upon the sands. It is at the mercy of the rising stream of the unfit,” in The Birth Control Review.
If we use the number of abortions for non-Hispanic black population in 2014 as an average for each year since Roe v. Wade, and every fetus aborted since 1973 were alive today, the non-Hispanic black population would have an increase of nearly 16%! Compared to if we use the abortion rate for non-Hispanic white women in 2014 as an average for each year since Roe v. Wade, and every fetus aborted since 1973 were alive today, the non-Hispanic white population would only have an increase of 2.8%. If we use the number of abortions for non-Hispanic black population in 2014 as an average for each year since the founding of Planned Parenthood, and every fetus aborted since 1916 were alive today, the non-Hispanic black population would have an increase of nearly 35%! Compared again, to if we use the abortion rate for non-Hispanic white women in 2014 as an average for each year since the founding of Planned Parenthood, and every fetus aborted since 1916 were alive today, the non-Hispanic white population would only have an increase of 6%. These numbers of course do not include such atrocities as forced sterilization and the impact those created.
Though there is a percentage of women who had forced sexual intercourse (ie. rape, incest, etc) who through absolutely no fault of there own, became pregnant and may feel inclined to abort, they are a small portion of abortion patients. Preventative birth control can not necessarily help these women as many rapists and predators avoid protection and there is no way to know when a sexual assault or rape may happen to give women time to protect themselves; this is an issue of sexual violence, not reproductive awareness. For most every other women (not all, of course), abortion could be completely prevented with the use of education, awareness, access to free birth control (ie. condoms, birth control pills, IUD's, etc.), and proper support (emotional, financial, partner, etc.). Though abortion is both a cause and a symptom of long-term population deterioration of the non-Hispanic black community in particular, it does effect every type of woman; regardless of age, race, color, income, education, relationship status and even sexuality. With activism and action on the part of people who want to see women, any race or color, have babies they want to keep and help women prevent pregnancies they do not want, it will someday be possible for all babies to be born wanted.
Sources:
https://www.guttmacher.org/united-states/abortion/
https://www.guttmacher.org/report/characteristics-us-abortion-patients-2014
https://www.guttmacher.org/state-policy/explore/state-policies-later-abortions
https://www.cdc.gov/reproductivehealth/data_stats/abortion.htm
https://www.cdc.gov/mmwr/volumes/66/ss/ss6624a1.htm?s_cid=ss6624a1_w
http://www.pewforum.org/religious-landscape-study/compare/views-about-abortion/by/state/
https://en.wikipedia.org/wiki/Dilation_and_evacuation
https://en.wikipedia.org/wiki/Intact_dilation_and_extraction
https://en.wikipedia.org/wiki/Hysterotomy_abortion
https://en.wikipedia.org/wiki/Demography_of_the_United_States
https://www.census.gov/quickfacts/fact/table/US#viewtop