Elective Abortion:

Elective abortions are those initiated by personal choice for reasons other than maternal health or fetal disease. Roughly 20% of all pregnancies (other than miscarriages) end in elective abortion.

Elective abortions are common in the United States and worldwide. Since the 1973 US Supreme Court decisions legalizing abortions, more than one million abortions have been performed in the United States every year. Medical termination of pregnancy with mifepristone was approved in the United States in 2000 and is used in 31 countries worldwide. Approximately half of all surgical abortions are performed with this method. More than 40% of all women will end a pregnancy by abortion at some time in their reproductive lives. Worldwide, some 20-30 million legal abortions are performed annually, with another 10-20 million abortions performed illegally (see The Alan Guttmacher Institute). Illegal abortions are unsafe and account for 13% of all maternal mortality and serious complications. Death from abortion is almost unknown in the United States or in other countries where abortion is legally available. In spite of the introduction of newer, more effective, and more widely available contraceptive methods, more than half of the 6 million pregnancies occurring each year in the United States are considered unplanned by the women who are pregnant. Of these pregnancies, approximately half end in elective terminations. Each year in the United States, almost 3% of all reproductive-aged women terminate their pregnancies. While women of every social class seek terminations, the typical woman who terminates her pregnancy is young, white, unmarried, and poor.

Procedure

Elective abortions involve dilating the cervix and removing the contents of the uterus by suctioning the inner walls. In 2000, the FDA approved the medication mifepristone as an alternative to surgical abortion in the United States. Other medications that have been available to terminate an early pregnancy include methotrexate, misoprostol, or a combination of these medications. Most women who use medication do so because of a desire to avoid anesthesia and surgery.

Side Effects and Complications

Teenagers may not be aware that they are pregnant until the second trimester and could increase the danger to their own lives with second trimester abortions. Infection resulting from the procedure occurs most commonly in women who have a preexisting gonorrheal or chlamydial infection. Side effects of medication may include nausea, vomiting, diarrhea, warmth or chills, headache, more visits to the doctor's office, prolonged vaginal bleeding, and more aware of cramping than with surgical abortion. Excessive loss of blood, uterine perforation and infection, and an incomplete abortion are the most frequent complications. With medication, passage of the products of conception most likely will occur at home, but some women may still require a surgical procedure to complete the abortion.These complications are rare when the procedure is performed by a competent provider in an adequate facility.

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