Editing Abortion (section)

==Incidence==
There are two commonly used methods of measuring the incidence of abortion:
* Abortion rate&nbsp;– number of abortions annually per 1,000 women between 15 and 44 years of age;<ref>{{cite web| title = Facts on Induced Abortion Worldwide| date = January 2012| publisher = World Health Organization| url = https://www.who.int/reproductivehealth/publications/unsafe_abortion/induced_abortion_2012.pdf| access-date = 9 May 2021| archive-url = https://web.archive.org/web/20210309200507/http://www.who.int/reproductivehealth/publications/unsafe_abortion/induced_abortion_2012.pdf| archive-date = 9 March 2021| url-status = live}}</ref> some sources use a range of 15–49.
* Abortion percentage&nbsp;– number of abortions out of 100 known pregnancies; pregnancies include live births, abortions, and miscarriages.

In many places, where abortion is illegal or carries a heavy social stigma, medical reporting of abortion is not reliable.<ref name="Sedgh 2007">{{cite journal |vauthors=Sedgh G, Henshaw S, Singh S, Ahman E, Shah IH |date=October 2007 |title=Induced abortion: estimated rates and trends worldwide |journal=Lancet |volume=370 |issue=9595 |pages=1338–1345 |citeseerx=10.1.1.454.4197 |doi=10.1016/S0140-6736(07)61575-X |pmid=17933648 |s2cid=28458527}}</ref> For this reason, estimates of the incidence of abortion must be made without determining certainty related to [[standard error]].<ref name="Sedgh 2012" /> The number of abortions performed worldwide was characterized as stable in the early 2000s, with 41.6&nbsp;million having been performed in 2003 and 43.8&nbsp;million having been performed in 2008.<ref name="Sedgh 2012" /> The abortion rate worldwide was 28 per 1000 women per year, though it was 24 per 1000 women per year for developed countries and 29 per 1000 women per year for developing countries.<ref name="Sedgh 2012" /> The same 2012 study indicated that in 2008, the estimated abortion percentage of known pregnancies was at 21% worldwide, with 26% in developed countries and 20% in developing countries.<ref name="Sedgh 2012" />

On average, the incidence of abortion is similar in countries with restrictive abortion laws and those with more liberal access to abortion.<ref name="nytimes-abortion-rates"/> Restrictive abortion laws are associated with increases in the percentage of abortions performed unsafely.<ref name=IJGO10/><ref>{{cite journal | vauthors = Shah I, Ahman E | title = Unsafe abortion: global and regional incidence, trends, consequences, and challenges | journal = Journal of Obstetrics and Gynaecology Canada | volume = 31 | issue = 12 | pages = 1149–1158 | date = December 2009 | pmid = 20085681 | doi = 10.1016/s1701-2163(16)34376-6 | s2cid = 35742951 | quote = However, a woman's chance of having an abortion is similar whether she lives in a developed or a developing region: in 2003 the rates were 26 abortions per 1,000 women aged 15 to 44 in developed areas and 29 per 1,000 in developing areas. The main difference is in safety, with abortion being safe and easily accessible in developed countries and generally restricted and unsafe in most developing countries. }}</ref><ref name="nytimes-abortion-rates">{{cite news| vauthors = Rosenthal E |url= https://www.nytimes.com/2007/10/12/world/12abortion.html |title=Legal or Not, Abortion Rates Compare|newspaper=The New York Times|date=12 October 2007|access-date=18 July 2011|url-status=live|archive-url=https://web.archive.org/web/20110828173628/http://www.nytimes.com/2007/10/12/world/12abortion.html|archive-date=28 August 2011}}</ref> The unsafe abortion rate in developing countries is partly attributable to lack of access to modern contraceptives; according to the [[Guttmacher Institute]], providing access to contraceptives would result in about 14.5 million fewer unsafe abortions and 38,000 fewer deaths from unsafe abortion annually worldwide.<ref>{{cite web|url=http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |title=Facts on Investing in Family Planning and Maternal and Newborn Health |publisher=Guttmacher Institute |date=November 2010 |access-date=24 October 2011 |url-status=dead |archive-url=https://web.archive.org/web/20111020135329/http://www.guttmacher.org/pubs/FB-AIU-summary.pdf |archive-date=20 October 2011 }}</ref>

The rate of legal, induced abortion varies extensively worldwide. According to the report of employees of Guttmacher Institute it ranged from 7 per 1000 women per year (Germany and Switzerland) to 30 per 1000 women per year (Estonia) in countries with complete statistics in 2008. The proportion of pregnancies that ended in induced abortion ranged from about 10% (Israel, the Netherlands and Switzerland) to 30% (Estonia) in the same group, though it might be as high as 36% in Hungary and Romania, whose statistics were deemed incomplete.<ref>{{cite journal | vauthors = Sedgh G, Singh S, Henshaw SK, Bankole A | title = Legal abortion worldwide in 2008: levels and recent trends | journal = Perspectives on Sexual and Reproductive Health | volume = 43 | issue = 3 | pages = 188–198 | date = September 2011 | pmid = 21884387 | doi = 10.1363/4318811 | url = http://www.guttmacher.org/pubs/journals/3708411.html | url-status = live | archive-url = https://web.archive.org/web/20120107111306/http://www.guttmacher.org/pubs/journals/3708411.html | archive-date = 7 January 2012 }}</ref><ref>{{cite book|date=2011-05-15|chapter=Populație|url=http://www.insse.ro/cms/files/Anuar%2520statistic/02/02%2520Populatie_ro.pdf|access-date=2023-02-16|archive-url=https://web.archive.org/web/20110515195102/http://www.insse.ro/cms/files/Anuar%2520statistic/02/02%2520Populatie_ro.pdf |archive-date=15 May 2011 |title=Romanian Statistical Yearbook |page=62 |publisher=[[National Institute of Statistics (Romania)|National Institute of Statistics]]}}</ref>

An American study in 2002 concluded that about half of women having abortions were using a form of [[birth control|contraception]] at the time of becoming pregnant. Inconsistent use was reported by half of those using [[condom]]s and three-quarters of those using the [[combined oral contraceptive pill|birth control pill]]; 42% of those using condoms reported failure through slipping or breakage.<ref name=":8">{{cite journal | vauthors = Jones RK, Darroch JE, Henshaw SK | title = Contraceptive use among U.S. women having abortions in 2000-2001 | journal = Perspectives on Sexual and Reproductive Health | volume = 34 | issue = 6 | pages = 294–303 | year = 2002 | pmid = 12558092 | doi = 10.2307/3097748 | url = http://www.guttmacher.org/pubs/journals/3429402.pdf | url-status = live | archive-url = https://web.archive.org/web/20060615011127/http://www.guttmacher.org/pubs/journals/3429402.pdf | archive-date = 15 June 2006 | jstor = 3097748 }}</ref>  Of the other half of women, who were not using contraception at the time of becoming pregnant, the vast majority had used contraception at some point in the past, indicating some level of dissatisfaction with the contraceptive options available to them.  Indeed, 32% of these contraceptive nonusers cited concerns about contraceptive methods as their reason for nonuse,<ref name=":8" /> and a more recent study found similar results.<ref>{{Cite journal |last1=Mosher |first1=William |last2=Jones |first2=Jo |last3=Abma |first3=Joyce |date=2015 |title=Nonuse of contraception among women at risk of unintended pregnancy in the United States |journal=Contraception |volume=92 |issue=2 |pages=170–176 |doi=10.1016/j.contraception.2015.05.004 |issn=0010-7824 |pmc=6413311 |pmid=25998937}}</ref>  Taken together, these statistics suggest that new contraceptive methods, such as non-hormonal contraceptives or [[male contraceptive]]s, could reduce unintended pregnancy and abortion rates.<ref>{{Cite journal |last1=Dorman |first1=Emily |last2=Perry |first2=Brian |last3=Polis |first3=Chelsea B. |last4=Campo-Engelstein |first4=Lisa |last5=Shattuck |first5=Dominick |last6=Hamlin |first6=Aaron |last7=Aiken |first7=Abigail |last8=Trussell |first8=James |last9=Sokal |first9=David |date=2018 |title=Modeling the impact of novel male contraceptive methods on reductions in unintended pregnancies in Nigeria, South Africa, and the United States |url=|journal=Contraception |volume=97 |issue=1 |pages=62–69 |doi=10.1016/j.contraception.2017.08.015 |issn=0010-7824 |pmc=5732079 |pmid=28887053}}</ref>

The Guttmacher Institute has found that "most abortions in the United States are obtained by minority women" because minority women "have much higher rates of unintended pregnancy".<ref>{{cite journal | vauthors = Cohen SA |url= http://www.guttmacher.org/pubs/gpr/11/3/gpr110302.html |title=Abortion and Women of Color: The Bigger Picture |journal=Guttmacher Policy Review |year=2008 |volume=11 |issue=3 |url-status=live |archive-url=https://web.archive.org/web/20080915094346/http://www.guttmacher.org/pubs/gpr/11/3/gpr110302.html |archive-date=15 September 2008 }}</ref> In a 2022 analysis by the [[Kaiser Family Foundation]], while people of color comprise 44% of the population in Mississippi, 59% of the population in Texas, 42% of the population in Louisiana, and 35% of the population in Alabama, they comprise 80%, 74%, 72%, and 70%, respectively, of those receiving abortions.<ref>{{cite news | vauthors = Pettus EW, Willingham L |title=Minority women most affected if abortion is banned, limited |url=https://apnews.com/article/abortion-us-supreme-court-business-health-race-and-ethnicity-3fff455cce7ef0d8694f5371f805ea18 |access-date=1 February 2022 |work=Associated Press |date=1 February 2022 |archive-date=1 February 2022 |archive-url=https://web.archive.org/web/20220201144918/https://apnews.com/article/abortion-us-supreme-court-business-health-race-and-ethnicity-3fff455cce7ef0d8694f5371f805ea18 |url-status=live }}</ref>

===Gestational age and method===
{{multiple image
| align = right
| image1 = UK abortion by gestational age 2019 histogram.svg
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| image2 = US abortion by gestational age 2016 histogram.svg
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| caption2 = 
| footer = [[Histogram]] of abortions by [[Gestational age (obstetrics)|gestational age]] in England and Wales during 2019 (left). Abortion in the United States by gestational age, 2016 (right).
}}

Abortion rates vary depending on the stage of pregnancy and the method practiced. In 2003, the [[Centers for Disease Control and Prevention]] (CDC) reported that 26% of reported legal induced abortions in the United States were known to have been obtained at the end of 6 weeks of gestation or less, 18% at 7 weeks, 15% at 8 weeks, 18% at 9 through 10 weeks, 10% at 11 through 12 weeks, 6% at 13 through 15 weeks, 4% at 16 through 20 weeks and 1% at more than 21 weeks. 91% of these were classified as having been done by "[[curettage]]" ([[Suction-aspiration abortion|suction-aspiration]], [[dilation and curettage]], [[dilation and evacuation]]), 8% by "[[medical abortion|medical]]" means ([[mifepristone]]), >1% by "[[instillation abortion|intrauterine instillation]]" (saline or [[prostaglandin]]), and 1% by "other" (including [[hysterotomy abortion|hysterotomy]] and [[hysterectomy]]).<ref name="cdc2003">{{cite journal | vauthors = Strauss LT, Gamble SB, Parker WY, Cook DA, Zane SB, Hamdan S | title = Abortion surveillance--United States, 2003 | journal = Morbidity and Mortality Weekly Report. Surveillance Summaries | volume = 55 | issue = 11 | pages = 1–32 | date = November 2006 | pmid = 17119534 | url = https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5511a1.htm | url-status = live | author7 = Centers for Disease Control Prevention | archive-url = https://web.archive.org/web/20170602171423/https://www.cdc.gov/mmwr/preview/mmwrhtml/ss5511a1.htm | archive-date = 2 June 2017 }}</ref> According to the CDC, due to data collection difficulties the data must be viewed as tentative and some fetal deaths reported beyond 20 weeks may be natural deaths erroneously classified as abortions if the removal of the dead fetus is accomplished by the same procedure as an induced abortion.<ref name="guttmacher">{{cite web |publisher=The Guttmacher Institute |title=The limitations of U.S. statistics on abortion |work=Issues in Brief |location=New York |year=1997 |url=http://www.guttmacher.org/pubs/ib14.html |archive-url=https://web.archive.org/web/20120404080239/http://www.guttmacher.org/pubs/ib14.html |archive-date=4 April 2012 |url-status=dead}}</ref>

The Guttmacher Institute estimated there were 2,200 [[intact dilation and extraction]] procedures in the US during 2000; this accounts for <0.2% of the total number of abortions performed that year.<ref>{{cite journal | vauthors = Finer LB, Henshaw SK | title = Abortion incidence and services in the United States in 2000 | journal = Perspectives on Sexual and Reproductive Health | volume = 35 | issue = 1 | pages = 6–15 | year = 2003 | pmid = 12602752 | doi = 10.1363/3500603 | doi-broken-date = 17 May 2025 | url = http://www.guttmacher.org/pubs/journals/3500603.html | url-status = live | archive-url = https://web.archive.org/web/20160122204324/http://www.guttmacher.org/pubs/journals/3500603.html | archive-date = 22 January 2016 | url-access = subscription }}</ref> Similarly, in England and Wales in 2006, 89% of terminations occurred at or under 12 weeks, 9% between 13 and 19 weeks, and 2% at or over 20 weeks. 64% of those reported were by vacuum aspiration, 6% by D&E, and 30% were medical.<ref>{{cite web|author=Department of Health |year=2007 |title=Abortion statistics, England and Wales: 2006 |access-date=12 October 2007 |url=http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_075697 |url-status=dead |archive-url=https://web.archive.org/web/20101206002417/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsStatistics/DH_075697 |archive-date=6 December 2010 }}</ref> There are more second trimester abortions in developing countries such as China, India and Vietnam than in developed countries.<ref>{{cite web| vauthors = Cheng L |date=1 November 2008|title=Surgical versus medical methods for second-trimester induced abortion: RHL commentary|work=The WHO Reproductive Health Library|location=Geneva|publisher=World Health Organization|url=https://www.who.int/rhl/fertility/abortion/CD006714_chengl_com/en/index.html|access-date=10 February 2009|url-status=dead|archive-url= https://web.archive.org/web/20090215134007/http://www.who.int/rhl/fertility/abortion/CD006714_chengl_com/en/index.html|archive-date=15 February 2009}} commentary on:<br />{{cite journal | vauthors = Lohr PA, Hayes JL, Gemzell-Danielsson K | title = Surgical versus medical methods for second trimester induced abortion | journal = The Cochrane Database of Systematic Reviews | issue = 1 | pages = CD006714 | date = January 2008 | pmid = 18254113 | doi = 10.1002/14651858.CD006714.pub2 | s2cid = 205184764 }}</ref>

There are both medical and non-medical reasons to have an abortion later in pregnancy (after 20 weeks). A study was conducted from 2008 to 2010 at the University of California San Francisco where more than 440 women were asked about why they experienced delays in obtaining abortion care, if there were any. This study found that almost half of individuals who obtained an abortion after 20 weeks did not suspect that they were pregnant until later in their pregnancy.<ref name=":7">{{cite web |date=December 5, 2019 |title=Abortions Later in Pregnancy |url=https://www.kff.org/womens-health-policy/fact-sheet/abortions-later-in-pregnancy/ |website=KFF (Kaiser Family Foundation) |access-date=10 November 2023 |archive-date=10 November 2023 |archive-url=https://web.archive.org/web/20231110191733/https://www.kff.org/womens-health-policy/fact-sheet/abortions-later-in-pregnancy/ |url-status=live }}</ref> Other barriers to abortion care found in the study included lack of information about where to access an abortion, difficulties with transportation, lack of insurance coverage, and inability to pay for the abortion procedure.<ref name=":7" />

Medical reasons for seeking an abortion later in pregnancy include [[Birth defect|fetal anomalies]] and health risk to the pregnant person.<ref name=":6">{{cite book |last=Vaughn |first=Lewis |title=Bioethics: Principles, Issues, and Cases |publisher=Oxford University Press |year=2023 |isbn=978-0-19-760902-6 |edition=5th |pages=328}}</ref> There are prenatal tests that can diagnose [[Down syndrome|Down Syndrome]] or [[cystic fibrosis]] as early as 10 weeks into gestation, but structural fetal anomalies are often detected much later in pregnancy.<ref name=":7" /> A proportion of structural fetal anomalies are lethal, which means that the fetus will almost certainly die before or shortly after birth.<ref name=":7" /> Life-threatening conditions may also develop later in pregnancy, such as [[Pre-eclampsia|early severe preeclampsia]], newly diagnosed cancer in need of urgent treatment, and [[Chorioamnionitis|intrauterine infection (chorioamnionitis)]], which often occurs along with [[Prelabor rupture of membranes|premature rupture of the amniotic sac (PPROM)]].<ref name=":7" /> If serious medical conditions such as these arise before the fetus is viable, the person carrying the pregnancy may pursue an abortion to preserve their own health.<ref name=":7" />