research essays on abortion

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Cell Rep Med
v.4(1); 2023 Jan 17

Abortion bans and their impacts: A view from the United States

Laura j. frye.

1 Gynuity Health Projects, New York, NY, USA

Beverly Winikoff

A retrospective study of abortion facilities in and around Texas by White et al. 1 and a spatial analysis by Rader et al. 2 are combined to illustrate the detrimental effects of abortion bans enacted in the United States.

Abortion restrictions have been introduced in various forms across many states for years, but since June 2022, when the right to abortion was no longer federally protected, we have seen a rapid increase in these restrictions. We are just starting to quantify and qualify their effects. Two recent studies published in JAMA offer early indications of the effects of draconian bans.

In “Association of Texas’ 2021 Ban on Abortion in Early Pregnancy with the Number of Facility-Based Abortion in Texas and Surrounding States,” White et al. used a large dataset containing information before and after the passage of SB8 in September 2021. 1 This bill banned most abortions after 6 weeks in the state of Texas. The data presented in this article allow for a careful examination of the law’s effects, and the authors paint a picture of how rapidly destabilizing such bans can be. The study clearly shows that, in the immediate aftermath of SB8’s implementation, there was both an absolute drop in documented abortions and a shift in the location of abortions as Texans went to neighboring states for medical care.

The paper explicitly examines abortions after 12 weeks as an important indicator of change, not because of the small decrease in safety and efficacy with increasing gestational durations, but rather because of the major increase in burdens to affected individuals (cost, time, travel) and to clinics (resources, scheduling) with gestations beyond this point.

A clearer and more detailed sense of how these patient travel dynamics play out can be found in the “Estimated Travel Time and Spatial Access to Abortion Facilities in the US Before and After the Dobbs v Jackson Women’s Health Decision” by Rader et al., which uses simulation and spatial analysis to measure changes in surface travel time to the closest abortion facility before and after the June 2022 Dobbs decision. 2

The average travel time to reach the nearest abortion facility significantly increased in the simulated post-Dobbs world, and, while the median change from 11 to 17 min is not jaw dropping, the spread of the data and the extremes of the curve are where the biggest problems lie. The authors show a doubling of the number of individuals who must travel more than 60 min to access abortion care. Then, through sensitivity analyses on geographic heterogeneity, they illustrate some of the extreme increases in travel time for people in the South, as in Texas, with a mean increase of over 7 h.

While the White paper notes that their data did not include individual-level demographic information (and thus was not able to explore the disparate effects of the ban on various subpopulations), the Raden paper is able to shed some light on the disproportionate impacts of abortion restrictions by use of census data. The latter paper shows that longer travel times occur more frequently in populations without insurance, with lower incomes, and who are racial and ethnic minorities. Documentation of these effects is important for advocacy, policy change, and resource allocation.

The White et al. paper wisely uses care in describing the data they have as “documented facility-based abortions,” acknowledging the now-frequent practice of non-facility-based self-managed abortion with pills. Similarly, Rader et al. note that their data are predicated on the idea of traveling to a physical facility and do not account for the mailing of pills to a person’s home. The TelAbortion study from 2016 to 2021 provided evidence on the safety and efficacy of direct-to-patient telemedicine abortion with mailing of pills, 3 , 4 and the FDA now allows for this method of abortion pill provision. We also know that self-managed abortion can be a safe and effective option 5 and is currently common in the United States. 6 , 7 There is increasing interest in determining its role in the care landscape. 8 , 9 , 10 Moving forward, it would be beneficial to see more information on how remote provision of care and self-management play into the dynamics illustrated in these articles.

These two papers, used together, can help prepare clinics in protective states for the influx of affected individuals as additional oppressive laws are passed in other states. The lessons documented only grow in relevance as the map of the United States darkens with more and more states passing restrictive abortion laws. We can use these data both to decry the negative and disproportionate effect of these bans and to call for action to prepare receiving clinics in protective states as they take on the care of more people who are denied medical services in their home states.

Declaration of interests

The authors declare no competing interests.

The Most Important Study in the Abortion Debate

Researchers rigorously tested the persistent notion that abortion wounds the women who seek it.

The demographer Diana Greene Foster was in Orlando last month, preparing for the end of Roe v. Wade , when Politico published a leaked draft of a majority Supreme Court opinion striking down the landmark ruling. The opinion, written by Justice Samuel Alito, would revoke the constitutional right to abortion and thus give states the ability to ban the medical procedure.

Foster, the director of the Bixby Population Sciences Research Unit at UC San Francisco, was at a meeting of abortion providers, seeking their help recruiting people for a new study . And she was racing against time. She wanted to look, she told me, “at the last person served in, say, Nebraska, compared to the first person turned away in Nebraska.” Nearly two dozen red and purple states are expected to enact stringent limits or even bans on abortion as soon as the Supreme Court strikes down Roe v. Wade , as it is poised to do. Foster intends to study women with unwanted pregnancies just before and just after the right to an abortion vanishes.

Read: When a right becomes a privilege

When Alito’s draft surfaced, Foster told me, “I was struck by how little it considered the people who would be affected. The experience of someone who’s pregnant when they do not want to be and what happens to their life is absolutely not considered in that document.” Foster’s earlier work provides detailed insight into what does happen. The landmark Turnaway Study , which she led, is a crystal ball into our post- Roe future and, I would argue, the single most important piece of academic research in American life at this moment.

The legal and political debate about abortion in recent decades has tended to focus more on the rights and experience of embryos and fetuses than the people who gestate them. And some commentators—including ones seated on the Supreme Court—have speculated that termination is not just a cruel convenience, but one that harms women too . Foster and her colleagues rigorously tested that notion. Their research demonstrates that, in general, abortion does not wound women physically, psychologically, or financially. Carrying an unwanted pregnancy to term does.

In a 2007 decision , Gonzales v. Carhart , the Supreme Court upheld a ban on one specific, uncommon abortion procedure. In his majority opinion , Justice Anthony Kennedy ventured a guess about abortion’s effect on women’s lives: “While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained,” he wrote. “Severe depression and loss of esteem can follow.”

Was that really true? Activists insisted so, but social scientists were not sure . Indeed, they were not sure about a lot of things when it came to the effect of the termination of a pregnancy on a person’s life. Many papers compared individuals who had an abortion with people who carried a pregnancy to term. The problem is that those are two different groups of people; to state the obvious, most people seeking an abortion are experiencing an unplanned pregnancy, while a majority of people carrying to term intended to get pregnant.

Foster and her co-authors figured out a way to isolate the impact of abortion itself. Nearly all states bar the procedure after a certain gestational age or after the point that a fetus is considered viable outside the womb . The researchers could compare people who were “turned away” by a provider because they were too far along with people who had an abortion at the same clinics. (They did not include people who ended a pregnancy for medical reasons.) The women who got an abortion would be similar, in terms of demographics and socioeconomics, to those who were turned away; what would separate the two groups was only that some women got to the clinic on time, and some didn’t.

In time, 30 abortion providers—ones that had the latest gestational limit of any clinic within 150 miles, meaning that a person could not easily access an abortion if they were turned away—agreed to work with the researchers. They recruited nearly 1,000 women to be interviewed every six months for five years. The findings were voluminous, resulting in 50 publications and counting. They were also clear. Kennedy’s speculation was wrong: Women, as a general point, do not regret having an abortion at all.

Researchers found, among other things, that women who were denied abortions were more likely to end up living in poverty. They had worse credit scores and, even years later, were more likely to not have enough money for the basics, such as food and gas. They were more likely to be unemployed. They were more likely to go through bankruptcy or eviction. “The two groups were economically the same when they sought an abortion,” Foster told me. “One became poorer.”

Read: The calamity of unwanted motherhood

In addition, those denied a termination were more likely to be with a partner who abused them. They were more likely to end up as a single parent. They had more trouble bonding with their infants, were less likely to agree with the statement “I feel happy when my child laughs or smiles,” and were more likely to say they “feel trapped as a mother.” They experienced more anxiety and had lower self-esteem, though those effects faded in time. They were half as likely to be in a “very good” romantic relationship at two years. They were less likely to have “aspirational” life plans.

Their bodies were different too. The ones denied an abortion were in worse health, experiencing more hypertension and chronic pain. None of the women who had an abortion died from it. This is unsurprising; other research shows that the procedure has extremely low complication rates , as well as no known negative health or fertility effects . Yet in the Turnaway sample, pregnancy ended up killing two of the women who wanted a termination and did not get one.

The Turnaway Study also showed that abortion is a choice that women often make in order to take care of their family. Most of the women seeking an abortion were already mothers. In the years after they terminated a pregnancy, their kids were better off; they were more likely to hit their developmental milestones and less likely to live in poverty. Moreover, many women who had an abortion went on to have more children. Those pregnancies were much more likely to be planned, and those kids had better outcomes too.

The interviews made clear that women, far from taking a casual view of abortion, took the decision seriously. Most reported using contraception when they got pregnant, and most of the people who sought an abortion after their state’s limit simply did not realize they were pregnant until it was too late. (Many women have irregular periods, do not experience morning sickness, and do not feel fetal movement until late in the second trimester.) The women gave nuanced, compelling reasons for wanting to end their pregnancies.

Afterward, nearly all said that termination had been the right decision. At five years, only 14 percent felt any sadness about having an abortion; two in three ended up having no or very few emotions about it at all. “Relief” was the most common feeling, and an abiding one.

From the May 2022 issue: The future of abortion in a post- Roe America

The policy impact of the Turnaway research has been significant, even though it was published during a period when states have been restricting abortion access. In 2018, the Iowa Supreme Court struck down a law requiring a 72-hour waiting period between when a person seeks and has an abortion, noting that “the vast majority of abortion patients do not regret the procedure, even years later, and instead feel relief and acceptance”—a Turnaway finding. That same finding was cited by members of Chile’s constitutional court as they allowed for the decriminalization of abortion in certain circumstances.

Yet the research has not swayed many people who advocate for abortion bans, believing that life begins at conception and that the law must prioritize the needs of the fetus. Other activists have argued that Turnaway is methodologically flawed; some women approached in the clinic waiting room declined to participate, and not all participating women completed all interviews . “The women who anticipate and experience the most negative reactions to abortion are the least likely to want to participate in interviews,” the activist David Reardon argued in a 2018 article in a Catholic Medical Association journal.

Still, four dozen papers analyzing the Turnaway Study’s findings have been published in peer-reviewed journals; the research is “the gold standard,” Emily M. Johnston, an Urban Institute health-policy expert who wasn’t involved with the project, told me. In the trajectories of women who received an abortion and those who were denied one, “we can understand the impact of abortion on women’s lives,” Foster told me. “They don’t have to represent all women seeking abortion for the findings to be valid.” And her work has been buttressed by other surveys, showing that women fear the repercussions of unplanned pregnancies for good reason and do not tend to regret having a termination. “Among the women we spoke with, they did not regret either choice,” whether that was having an abortion or carrying to term, Johnston told me. “These women were thinking about their desires for themselves, but also were thinking very thoughtfully about what kind of life they could provide for a child.”

The Turnaway study , for Foster, underscored that nobody needs the government to decide whether they need an abortion. If and when America’s highest court overturns Roe , though, an estimated 34 million women of reproductive age will lose some or all access to the procedure in the state where they live. Some people will travel to an out-of-state clinic to terminate a pregnancy; some will get pills by mail to manage their abortions at home; some will “try and do things that are less safe,” as Foster put it. Many will carry to term: The Guttmacher Institute has estimated that there will be roughly 100,000 fewer legal abortions per year post- Roe . “The question now is who is able to circumvent the law, what that costs, and who suffers from these bans,” Foster told me. “The burden of this will be disproportionately put on people who are least able to support a pregnancy and to support a child.”

Ellen Gruber Garvey: I helped women get abortions in pre- Roe America

Foster said that there is a lot we still do not know about how the end of Roe might alter the course of people’s lives—the topic of her new research. “In the Turnaway Study, people were too late to get an abortion, but they didn’t have to feel like the police were going to knock on their door,” she told me. “Now, if you’re able to find an abortion somewhere and you have a complication, do you get health care? Do you seek health care out if you’re having a miscarriage, or are you too scared? If you’re going to travel across state lines, can you tell your mother or your boss what you’re doing?”

In addition, she said that she was uncertain about the role that abortion funds —local, on-the-ground organizations that help people find, travel to, and pay for terminations—might play. “We really don’t know who is calling these hotlines,” she said. “When people call, what support do they need? What is enough, and who falls through the cracks?” She added that many people are unaware that such services exist, and might have trouble accessing them.

People are resourceful when seeking a termination and resilient when denied an abortion, Foster told me. But looking into the post- Roe future, she predicted, “There’s going to be some widespread and scary consequences just from the fact that we’ve made this common health-care practice against the law.” Foster, to her dismay, is about to have a lot more research to do.

Persuasive Essay Guide

Persuasive Essay About Abortion

Crafting a Convincing Persuasive Essay About Abortion

How To Write a Persuasive Essay About Abortion?

Abortion is a controversial topic, with people having differing points of view and opinions on the matter. There are those who oppose abortion, while some people endorse pro-choice arguments.

It is also an emotionally charged subject, so you need to be extra careful when crafting your persuasive essay .

Before you start writing your persuasive essay, you need to understand the following steps.

Step 1: Choose Your Position

The first step to writing a persuasive essay on abortion is to decide your position. Do you support the practice or are you against it? You need to make sure that you have a clear opinion before you begin writing.

Once you have decided, research and find evidence that supports your position. This will help strengthen your argument.

Check out the video below to get more insights into this topic:

Step 2: Choose Your Audience

The next step is to decide who your audience will be. Will you write for pro-life or pro-choice individuals? Or both?

Knowing who you are writing for will guide your writing and help you include the most relevant facts and information.

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Step 3: Define Your Argument

Now that you have chosen your position and audience, it is time to craft your argument.

Start by defining what you believe and why, making sure to use evidence to support your claims. You also need to consider the opposing arguments and come up with counter arguments. This helps make your essay more balanced and convincing.

Step 4: Format Your Essay

Once you have the argument ready, it is time to craft your persuasive essay. Follow a standard format for the essay, with an introduction, body paragraphs, and conclusion.

Make sure that each paragraph is organized and flows smoothly. Use clear and concise language, getting straight to the point.

Step 5: Proofread and Edit

The last step in writing your persuasive essay is to make sure that you proofread and edit it carefully. Look for spelling, grammar, punctuation, or factual errors and correct them. This will help make your essay more professional and convincing.

These are the steps you need to follow when writing a persuasive essay on abortion. It is a good idea to read some examples before you start so you can know how they should be written.

Continue reading to find helpful examples.

Persuasive Essay About Abortion Examples

To help you get started, here are some example persuasive essays on abortion that may be useful for your own paper.

Short Persuasive Essay About Abortion

Persuasive Essay About No To Abortion

What Is Abortion? - Essay Example

Persuasive Speech on Abortion

Legal Abortion Persuasive Essay

Persuasive Essay About Abortion in the Philippines

Persuasive Essay about legalizing abortion

You can also read m ore persuasive essay examples to imp rove your persuasive skills.

Examples of Argumentative Essay About Abortion

An argumentative essay is a type of essay that presents both sides of an argument. These essays rely heavily on logic and evidence.

Here are some examples of argumentative essay with introduction, body and conclusion that you can use as a reference in writing your own argumentative essay.

Abortion Persuasive Essay Introduction

Argumentative Essay About Abortion Conclusion

Argumentative Essay About Abortion Pdf

Argumentative Essay About Abortion in the Philippines

Argumentative Essay About Abortion - Introduction

Abortion Persuasive Essay Topics

If you are looking for some topics to write your persuasive essay on abortion, here are some examples:

Should abortion be legal in the United States?
Is it ethical to perform abortions, considering its pros and cons?
What should be done to reduce the number of unwanted pregnancies that lead to abortions?
Is there a connection between abortion and psychological trauma?
What are the ethical implications of abortion on demand?
How has the debate over abortion changed over time?
Should there be legal restrictions on late-term abortions?
Does gender play a role in how people view abortion rights?
Is it possible to reduce poverty and unwanted pregnancies through better sex education?
How is the anti-abortion point of view affected by religious beliefs and values?

These are just some of the potential topics that you can use for your persuasive essay on abortion. Think carefully about the topic you want to write about and make sure it is something that interests you.

Check out m ore persuasive essay topics that will help you explore other things that you can write about!

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Facts About Abortion You Need to Know

Here are some facts about abortion that will help you formulate better arguments.

According to the Guttmacher Institute , 1 in 4 pregnancies end in abortion.
The majority of abortions are performed in the first trimester.
Abortion is one of the safest medical procedures, with less than a 0.5% risk of major complications.
In the United States, 14 states have laws that restrict or ban most forms of abortion after 20 weeks gestation.
Seven out of 198 nations allow elective abortions after 20 weeks of pregnancy.
In places where abortion is illegal, more women die during childbirth and due to complications resulting from pregnancy.
A majority of pregnant women who opt for abortions do so for financial and social reasons.
According to estimates, 56 million abortions occur annually.

In conclusion, these are some of the examples, steps, and topics that you can use to write a persuasive essay. Make sure to do your research thoroughly and back up your arguments with evidence. This will make your essay more professional and convincing.

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MyPerfectWords.com that provides help to students in the form of professionally written essays. Our persuasive essay writer can craft quality persuasive essays on any topic, including abortion.

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Frequently Asked Questions

What should i talk about in an essay about abortion.

When writing an essay about abortion, it is important to cover all the aspects of the subject. This includes discussing both sides of the argument, providing facts and evidence to support your claims, and exploring potential solutions.

What is a good argument for abortion?

A good argument for abortion could be that it is a woman’s choice to choose whether or not to have an abortion. It is also important to consider the potential risks of carrying a pregnancy to term.

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How to Write Abortion Research Paper Homework?

Table of Contents

Looking for easy tips on how to write a research paper on abortion? We’ve got you covered!

Abortion is probably the most controversial subject in modern society. It includes a number of complex questions concerning ethical, moral, legal, medical, philosophical, and religious issues related to the deliberate ending of pregnancy before normal childbirth.

Public opinions are polarized; they have strong feelings for or against this subject. That’s why writing a good abortion research paper with work cited requires in-depth research of existing literature. Students have to find a decent amount of relevant arguments (statistics, facts) about positive and negative aspects of the problem and create a convincing piece.

Abortion research paper specifics

Abortion research paper is a piece of academic writing based on original research performed by a writer. The author’s task is to analyze and interpret research findings on a particular topic.

Although research paper assignments may vary widely, there are two common types – analytical and argumentative.

In argumentative essay students have to establish their position in a thesis statement and convince their audience to adopt this point of view.
In analytical essay students state a research question, take a neutral stance on a topic, presenting information in a form of well-supported critical analysis without persuading the audience to adopt any particular point of view.

Thorough writing a college research paper on the subject is critical – it can help students develop their own opinions and build a strong argument.

Research paper on abortion: writing hints & tips

Abortion is among political and moral issues on which Americans are genuinely split. Their opinions on this controversial issue remain unchanged since 1995. There are two primary moral and legal questions related to the abortion debate, which divides public opinion for generations:

Are abortions morally wrong?
Should they be legal or banned?

Although these questions seem straightforward, they are more complex than students think. There are two separate camps. People who favor the “pro-choice” stance support the right of women to choose whether she carries a pregnancy to term or not. They think that abortions are acceptable.

People who take the strict religious “pro-life” stance think that abortions are always wrong because the fetus has rights and we should treat it the same way as any other human being.

If you have to write an argumentative research paper, you must choose either “pro-life” or “pro-choice” stance and develop a convincing argument to persuade readers.

If your research paper is analytical, you should examine both sides of the issue, evaluate the most important arguments, provide a balanced overview of both approaches, analyzing their weak and strong points.

Religion plays a great role in the debate but there are a lot of non-religious issues. Here are the most important ethical and legal issues, involving the rights of women and the rights of a fetus.

Is fetus a human being and does it have the basic legal right to live?
Does life begin at conception?
Should we consider the fetus a separate being or is it a part of its mother?
Does the fetus’ right to life have a priority over the woman’s right to control her body?
Under what circumstances is it acceptable to terminate the fetus’ life?
Can the removing of a fetus be considered as a murder?
Is it better to abort an unwanted child or allow it to be neglected by parents?
Can adoption be alternative to termination of pregnancy?
Is it possible to find a balance between the rights of a mother and those of a fetus?

A lot of arguments in favor of this procedure are based on respect for women’s reproductive rights.

“Pro-choice” camp argues that a woman is a person with her own rights and not a fetus’ carrier.

They say that governmental or religious authorities shouldn’t limit a woman’s right to control her own body. Besides, the fetus can’t be regarded as a separate entity because it can’t exist outside a woman’s womb.

Opponents of this procedure speak about respect for all forms of life, fetus’ right to life, and argue that it is actually the kill of an innocent human being.

Best abortion research paper topics

The first step in writing a research paper is selecting a good manageable topic that interests you and defining a research question or a thesis statement.

Wondering where to find powerful abortion research paper topics? Here is a short list of interesting ideas. Feel free to pick any of them for creating your own writings. You may also use them as a source of inspiration and further research of a specific issue.

Impact of legalizing abortions on the birth rate.
How terminations of pregnancies are regulated around the world.
How termination of pregnancy is considered within moral terms.
Analyze regional differences in Americans’ attitude to termination of pregnancy.
Examine the generation gap in abortion support.
Feminist beliefs and abortion rights supporters.
What is the future of abortion politics?
Give an overview of the legislation on the termination of pregnancies around the world.
The medical complications of pregnancy termination.
Discuss the abortion debate and human rights.
How having an abortion affects a woman’s life.
Will the abortion debate ever end?
How can we reduce the demand for termination of pregnancy?
Moral aspects of pregnancy termination.
Legal aspects of the abortion conflict.
Should termination of pregnancy be treated as a health issue?
Electoral politics and termination of pregnancy.
Is the termination of pregnancy a human issue or a gender issue?
Philosophical aspects of the abortion debate.
Liberal views on the termination of pregnancy.
Abortion demographics: race, poverty, and choice.
Why does the public support for legal termination of pregnancy remains high?
Should men be allowed to discuss the termination of pregnancy?
Is the abortion a “women’s only” issue?
Woman’s mental health after abortion.

How to write an abortion research paper outline?

Now let’s discuss how to write an abortion research paper outline. First, you have to write a thesis statement that summarizes the main point of your paper and outlines supporting points. The thesis will help you organize your structure and ensure that you stay focused while working on your project. Make a thesis statement strong, specific, and arguable.

After defining the thesis statement, you need to brainstorm ideas that are supporting the thesis in the best way. When it comes to the level of detail in an outline, you should take into account the length of a college project. You should choose the most suitable subtopics and arrange them logically. Decide which order is the most effective in arguing your thesis. Your paper should include at least 3 parts: an introduction, main body, and conclusion.

Have a look at simple abortion research paper outline example .

Introduction

Hook sentence
Thesis statement
Transition to Main Body
History of abortion
Abortion demographics in countries where it is legal
Impact of legal termination of pregnancy on women’s life and health
Negative consequences of illegal termination of pregnancy
What measures should be taken to reduce the number of abortions?
Transition to Conclusion
Unexpected twist or a final argument
Food for thought

Academic writing is very challenging, especially if it involves complex controversial topics . Writing an abortion research paper is a time-consuming and arduous task, which involves a lot of researching, reading, writing, revising, rewriting, editing, and proofreading. Make sure you are ready to create several drafts and then improve the content and style to make your paper perfect.

We hope that our quick tips will help you get started. But if you are new to academic writing, a good idea is to find well-written abortion research paper examples. Read and analyze them to have a better idea about proper paper structure, academic writing style, references, and different approaches to organizing thoughts.

How about we take care of your abortion research paper, while you enjoy your free time? Several clicks and we’re on!

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Abortion in the US: What you need to know

Subscribe to the center for economic security and opportunity newsletter, isabel v. sawhill and isabel v. sawhill senior fellow emeritus - economic studies , center for economic security and opportunity @isawhill kai smith kai smith research assistant - the brookings institution, economic studies.

May 29, 2024

Key takeaways:

One in every four women will have an abortion in their lifetime.

The vast majority of abortions (about 95%) are the result of unintended pregnancies.
Most abortion patients are in their twenties (61%), Black or Latino (59%), low-income (72%), unmarried (86%), between six and twelve weeks pregnant (73%), and already have given birth to one or more children (55%).
Despite state bans, U.S. abortion totals increased in the first full year after the Supreme Court overturned Roe v. Wade.

Introduction

Two years after the Supreme Court overturned Roe v. Wade, abortion remains one of the most hotly contested issues in American politics. The abortion landscape has become highly fractured, with some states implementing abortion bans and restrictions and others increasing protections and access. The Supreme Court heard two more cases on abortion this term and will likely release those decisions in June. Beyond the Supreme Court, pro-choice and pro-life advocates are fiercely battling it out in the voting booths, state legislatures, and courts. If the 2022 midterm elections are any indication , abortion will be one of the most influential issues of the 2024 election. So what are the basic facts about abortion in America? This primer is designed to tell you most of what you need to know.

What are the different types of abortion?

There are two main types of abortion: procedural abortions and medication abortions. Procedural abortions (also called in-clinic or surgical abortions) are provided by health care professionals in a clinical setting. Medication abortions (also called medical abortions or the abortion pill) typically involve the oral ingestion of two drugs in succession, mifepristone and misoprostol.

Most women discover they are pregnant in the first five to six weeks of pregnancy, but about a third of women do not learn they are pregnant until they are beyond six weeks of gestation. 1 Women with unintended pregnancies detect their pregnancies later than women with intended pregnancies, between six and seven weeks of gestation on average. Even if a woman discovers she is pregnant relatively early, for many it takes time to decide what to do and how to arrange for an abortion if that is her preference.

Why do women have abortions?

The vast majority of abortions (about 95%) are the result of unintended pregnancies. That includes pregnancies that are mistimed as well as those that are unwanted.

Women’s reasons for not wanting a child—or not wanting one now—include finances, partner-related issues, the need to focus on other children, and interference with future education or work opportunities.

In short, if there were fewer unintended pregnancies, there would be fewer abortions.

How common are abortions?

About two in every five pregnancies are unintended (40% in 2015). Roughly the same share of these unintended pregnancies end in abortion (42% in 2011). About one in every five pregnancies are aborted (21% in 2020).

How have abortion totals changed over time?

The number of abortions occurring in the U.S. jumped up after the Roe v. Wade decision in 1973. After peaking in 1990, the number of abortions declined steadily for two and a half decades until reaching its lowest point since 1973 in 2017. 2 Possible contributing factors explaining this long-term decline include delays in sexual activity amongst young people, improvements in the use of effective contraception , and overall declines in pregnancy rates , including those that are unintended . In addition, state restrictions which became more prevalent beginning in 2011 prevented at least some individuals in certain states from having abortions.

In 2018 (four years before the Supreme Court overturned Roe v. Wade), the number of abortions in the U.S. began to increase. The causes of this uptick are not yet fully understood, but researchers have identified multiple potential contributing factors. These include greater coverage of abortions under Medicaid that made abortions more affordable in certain states, regulations issued by the Trump administration in 2019 which decreased the size of the Title X network and therefore reduced the availability of contraception to low-income individuals, and increased financial support from privately-financed abortion funds to help pay for the costs associated with getting an abortion.

Another contributing factor, whose importance bears emphasizing, is the surging popularity of medication abortions .

The use of medication abortions has increased steadily since becoming available in the U.S. in 2000. However, in 2016, the FDA increased the gestational limit for the use of mifepristone from seven to ten weeks and thereby doubled the share of abortion patients eligible for medication abortions from 37% to 75%.

Later, during the COVID-19 pandemic, the FDA revised its policy in 2021 so that clinicians are no longer required to dispense medication abortion pills in person. Patients can now have medication abortion pills mailed to their homes after conducting remote consultations with clinicians via telehealth. In January 2023, the FDA issued another change which allows retail pharmacies like CVS and Walgreens to dispense medication abortion pills to patients with a prescription. Previously only doctors, clinics, or some mail-order pharmacies could dispense abortion pills.

Although access varies widely by state , medication abortions are now the most commonly used abortion method in the U.S. and account for nearly two-thirds of all abortions (63% in 2023). 3

This is why the Supreme Court’s upcoming decision in the Mifepristone case (FDA v. Alliance for Hippocratic Medicine) is so consequential. Among other issues, at stake is whether access to medication abortion will be sharply curtailed and whether regulations regarding medication abortions will revert to pre-2016 rules when abortion pills were not authorized for use after seven weeks of pregnancy and could not be prescribed via telemedicine, sent to abortion patients by mail, or dispensed by retail pharmacies.

Who has abortions?

Most abortion patients are in their twenties (61%), Black or Latino (59%), low-income (72%), unmarried (86%), and between six and twelve weeks pregnant (73%). 4

The majority of abortion patients have already given birth to one or more children (55%) and have not previously had an abortion (57%). 5 Among abortion patients twenty years old or older, most had attended at least some college (63%). The vast majority of abortions occur during the first trimester of pregnancy (91%). So-called “late-term abortions” performed at or after 21 weeks of pregnancy are very rare and represent less than 1% of all abortions in the U.S.

The abortion rate per 1,000 women of reproductive age is disproportionately high for certain population groups. Among women living in poverty, for example, the abortion rate was 36.6 abortions per 1,000 women of reproductive age in 2014, compared to 14.6 abortions per 1,000 women among all women of reproductive age.

How much does an abortion cost?

The cost of an abortion varies depending on what kind of abortion is administered, how far along the patient is in their pregnancy, where the patient lives, where the patient is seeking an abortion, and whether health insurance or financial assistance is available. In 2021, the median self-pay cost for abortion services was $625 for a procedural abortion in the first trimester of pregnancy and $568 for a medication abortion.

Since 1977, the Hyde Amendment has banned the use of federal funds to pay for abortions except in cases of rape, incest, or life endangerment. Today, among the 36 states that have not banned abortion, fewer than half (17 as of March 2024) allow the use of state Medicaid funds to pay for abortions. 6 Many insurance plans do not cover abortions, often due to state limitations. Most abortion patients pay for abortions out of pocket (53%). State Medicaid funding is the second-most-commonly used method of payment (30%), followed by financial assistance (15%) and private insurance (13%). 7

Whether state law allows state Medicaid funds to cover abortions has a very large impact on the difficulty of paying for abortions and the methods used by women to pay for them. In the year before the Dobbs Supreme Court decision, 50% of women residing in states where state Medicaid funds did not cover abortion reported it was very or somewhat difficult to pay for their abortions, compared to only 17% of women residing in states where abortions were covered.

How has the Supreme Court handled abortion?

In Roe v. Wade (1973), the Supreme Court established that states could not ban abortions before fetal viability, the point at which a fetus can survive outside the womb. Under the three-trimester framework established by Roe, states were not allowed to ban abortions during the first two trimesters of pregnancy but were allowed to regulate or prohibit abortions in the third trimester, except in cases where abortions were necessary to protect the life or health of a pregnant person. The Court ruled that the fundamental right to have an abortion is included in the right to privacy implicit in the “liberty” guarantee of the Due Process Clause of the Fourteenth Amendment.

Since it was decided, Roe v. Wade has faced legal criticism. Notwithstanding these critiques, the Court upheld Roe multiple times over the next half-century including in Planned Parenthood v. Casey (1992). But after former President Trump appointed three new Justices to the Supreme Court, a new conservative supermajority overturned Roe v. Wade in Dobbs v. Jackson Women’s Health Organization (2022) and established that there is no Constitutional right to have an abortion.

In his Dobbs majority opinion , Justice Alito concluded “Roe was egregiously wrong from the start.” Writing for the majority, he underscored that “[t]he Constitution makes no reference to abortion,” and while he recognized there are constitutional rights not expressly enumerated in the Constitution, he concluded the right to have an abortion is not one of them. Justice Alito reasoned that the only legitimate rights not explicitly stated in the Constitution are those “deeply rooted in the nation’s history and traditions,” and he found no evidence of this for abortion.

Because the Court determined there is no Constitutional right to abortion, it allowed the Mississippi state law which banned abortion after 15 weeks of pregnancy with limited exceptions to go into effect. The Court ruled that states have the authority to restrict access to abortion or ban it completely and that the power to regulate or prohibit abortions would be “returned to the people and their elected representatives.”

The Court’s three liberal Justices criticized the majority’s decision in a withering joint dissent . The dissenting Justices argued the right to abortion established in Roe and upheld in Casey is necessary to respect the autonomy and equality of women and prevent the government from controlling “a woman’s body or the course of a woman’s life.” They lamented “one result of today’s decision is certain: the curtailment of women’s rights, and of their status as free and equal citizens.”

How did the states respond to the overturning of Roe v. Wade?

Since Roe v. Wade was overturned, many states have implemented abortion bans or restrictions, while others have added protections and expanded access. The abortion landscape in America is now fractured and highly variegated .

As of May 2024, abortion is banned completely in almost all circumstances in 14 states. In 7 states, abortion is banned at or before 18 weeks of gestation. Many states with abortion bans do not include exceptions in cases where the health of the pregnant person is at risk, the pregnancy is the result of rape or incest, or there is a fatal fetal anomaly.

Access to abortion varies widely even among states without bans since many states have restrictions such as waiting periods, gestational limits, or parental consent laws making it more difficult to get an abortion.

Many state bans and restrictions are still being litigated in court. The interjurisdictional issues and legal questions arising from the post-Dobbs abortion landscape have not been fully resolved.

Despite the Supreme Court’s stated intention in Dobbs to leave the abortion issue to elected officials, the Court will likely hear more cases on abortion in the near future. This term, in addition to the case about Mifepristone, the Court will decide in Moyle v. United States whether a federal law called the Emergency Medical Treatment and Labor Act (EMTLA) can require hospitals in states with abortion bans to perform abortions in emergency situations that demand “stabilizing treatment” for the health of pregnant patients.

What are the trends in abortion statistics post-Dobbs?

In 2023, the first full year since the Dobbs Supreme Court decision, states with abortion bans experienced sharp declines in the number of abortions occurring within their borders. But these declines were outweighed by increases in abortion totals in states where abortion remained legal. Nearly all states without bans witnessed increases in 2023. Taken together, abortions in non-ban states increased by 26% in 2023 compared to 2020 levels.

As a result, the nationwide abortion statistics from 2023 represent the highest total number (1,037,000 abortions) and abortion rate (15.9 abortions per 1,000 women of reproductive age) in the U.S. in over a decade. The 2023 U.S. total represents an 11% increase from 2020 levels.

It’s unclear why, despite Dobbs, abortions have continued to rise . It may be because of the increased use of medication abortions , especially after the FDA liberalized regulations related to telehealth and in-person visits. In addition, multiple states where abortion remains legal have implemented shield laws and other new protections for abortion patients and providers, increased insurance coverage, or otherwise expanded access . Abortion funds provided greater financial and practical assistance . Interstate travel for abortions doubled after the Dobbs decision.

In short, the impacts of Dobbs are being felt unevenly. Although most women who want abortions are still able to obtain them, a significant minority are instead carrying their pregnancies to term. In the first six months of 2023, state abortion bans led between one-fifth and one-fourth of women living in ban states who may have otherwise gotten an abortion not to have one.

Young, low-income, and minority women will be most affected by state bans and restrictions because they are disproportionately likely to have unintended pregnancies and less able to overcome economic and logistical barriers involved in travelling across state lines or receiving medication abortion pills through out-of-state networks.

What are the effects of expanding or restricting abortion access on women and their families?

Effects of abortion restrictions on women.

Abortion bans jeopardize the lives and health of women. The impacts on their health can be especially troublesome. Pregnancies can go wrong for many reasons—fetal abnormalities, complications of a miscarriage, ectopic pregnancies—and without access to emergency care, some women could face serious threats to their own health and future ability to bear children. Abortion restrictions can place doctors in difficult situations and undermine women’s health care.

Although medication abortions are safe and effective, abortion bans could also increase the number of women who use unsafe methods to induce self-managed abortions, thereby endangering their own health or even their lives. State abortion legalizations in the years before Roe reduced maternal mortality among non-white women by 30-40%.

Enforcement of state laws that restricted access to abortion in the years before Dobbs has even been associated with increases in intimate partner violence-related homicides of women and girls.

In addition, lack of access to abortion leads to worse economic outcomes for women. After a conservative group suggested that such effects have not been well documented, a group of economists filed an amicus brief to the Supreme Court in the Dobbs case, noting that in recent years methods for establishing the causal effects of abortion have shown that they do affect women’s life trajectories. Although there has been some difficulty in separating the effects of access to abortion from access to the Pill or other forms of birth control, an extensive literature shows that reducing unintended pregnancies increases educational attainment , labor force participation , earnings , and occupational prestige for women. These trends are especially pronounced for Black women .

One example that focuses solely on abortion is the Turnaway study, in which researchers compared the outcomes for women who were denied abortions on the basis of just being a little beyond the gestational cutoff for eligibility to the outcomes of otherwise similar women who were just under that cutoff. The study along with subsequent related research has shown that women who are denied abortions are nearly four times more likely to be living in poverty six months after being denied an abortion, a difference that persists through four years after denial. They are also more likely to be unemployed , rely on public assistance , and experience financial distress such as bankruptcies, evictions and court judgements.

Finally, increased access to abortion results in lower rates of single and teen parenthood. State abortion legalizations in the years before Roe reduced the number of teen mothers by 34%. The effects were especially large for Black teens.

Effects of abortion restrictions on children

Along with contraception, access to abortion reduces unplanned births. That means fewer children dying in infancy, growing up in poverty, needing welfare, and living with a single parent. One study suggests that if all currently mistimed births were aligned with the timing preferred by their mothers, children’s college graduation rates would increase by about 8 percentage points (a 36% increase), and their lifetime incomes would increase by roughly $52,000.

Despite this evidence that the denial of abortions to women who want them would be harmful to women and to children once born, those who are pro-life argue that these costs are well worth the price to save the lives of the unborn. As of April 2024, 36% of Americans believe abortion should be illegal in all (8%) or most (28%) cases, while 63% of Americans believe abortion should be legal in all (25%) or most (28%) cases.

Looking ahead

The abortion landscape in America is continually evolving. Whereas pro-choice advocates will seek to expand access and add additional protections for abortion patients and providers, opponents of abortion will continue to criminalize abortions and further restrict availability.

Abortion will be one of the top issues of the 2024 elections in November. Democratic candidates in particular believe abortion is a winning issue for them and will broadcast their pro-choice stance on the campaign trail. Some evidence suggests the overturning of Roe has galvanized a new class of abortion-rights voters. Multiple states will have abortion referenda on the ballot .

The Supreme Court’s Dobbs decision will not prevent women and other citizens from affecting the legislative process by voting, organizing, influencing public opinion, or running for office. What they do with that power in November remains to be seen.

Reproductive rights in America

Despite state bans, abortions nationwide are up, driven by telehealth.

Elissa Nadworny

Abortion rights activists at the Supreme Court in Washington, D.C. on March 26, the day the case about the abortion drug mifepristone was heard. The number of abortions in the U.S. increased, a study says, surprising researchers. Drew Angerer/AFP via Getty Images hide caption

In the 18 months following the Supreme Court's decision that ended federal protection for abortion, the number of abortions in the U.S. has continued to grow, according to The Society of Family Planning's WeCount project .

"We are seeing a slow and small steady increase in the number of abortions per month and this was completely surprising to us," says Ushma Upadhyay , a professor and public health scientist at the University of California, San Francisco who co-leads the research. According to the report, in 2023 there were, on average, 86,000 abortions per month compared to 2022, where there were about 82,000 abortions per month. "Not huge," says Upadhyay, "but we were expecting a decline."

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What's at stake in the supreme court mifepristone case.

The slight increase comes despite the fact that 14 states had total abortion bans in place during the time of the research. According to the report, there were about 145,000 fewer abortions in person in those states since the Dobbs decision, which triggered many of the restrictive state laws.

"We know that there are people living in states with bans who are not getting their needed abortions," says Upadhyay. "The concern we have is that that might be overlooked by these increases."

Florida, California and Illinois saw the largest surges in abortions, which is especially interesting given Florida's recent 6-week ban that started on May 1.

Abortion rights opponents demonstrate in New York City, on March 23. Some states' abortion bans are known as "heartbeat bills," because they make abortion illegal after cardiac activity starts, usually around six weeks of pregnancy. Kena Betancur/AFP via Getty Images hide caption

The latest report also captures for the first time the impact of providers offering telehealth abortions from states with protections for doctors and clinics known as shield laws – statutes that say they can't be prosecuted or held liable for providing abortion care to people from other states.

Between July and December 2023, more than 40,000 people in states with abortion bans and telehealth restrictions received medication abortion through providers in states protected by shield laws. Abortion pills can be prescribed via telehealth appointments and sent through the mail; the pills can safely end pregnancies in the first trimester.

The report includes abortions happening within the U.S. health care system, and does not include self-managed abortions, when people take pills at home without the oversight of a clinician. For that reason, researchers believe these numbers are still an undercount of abortions happening in the U.S.

Tessa Longbons Cox is a senior research associate at Charlotte Lozier Institute, a research organization that opposes abortion. She says the WeCount report, "highlights a concerning trend" that policies around mail-order abortion pills are boosting abortion rates. "By recklessly removing in-person medical visits and safeguards, abortion advocates have put women's health and safety last," Longbons Cox says in a statement.

Accounting for the increases

A major factor in the uptick in abortions nationwide is the rise of telehealth, made possible in part by regulations first loosened during the coronavirus pandemic.

According to the report, telehealth abortions now make up 19% of all abortions in the U.S. In comparison, the first WeCount report which spanned April 2022 through August 2022 showed telehealth abortions accounted for just 4% of all abortions. Research has shown that telehealth abortions are as safe and effective as in-clinic care.

"It's affordable, it's convenient, and it feels more private," says Jillian Barovick, a midwife in Brooklyn and one of the co-founders of Juniper Midwifery , which offers medication abortion via telehealth to patients in six states where abortion is legal. The organization saw its first patient in August 2022 and now treats about 300 patients a month.

A Supreme Court abortion pill case with potential consequences for every other drug

"Having an in-clinic abortion, even a medication abortion, you could potentially be in the clinic for hours, whereas with us you get to sort of bypass all of that," she says. Instead, patients can connect with a clinician using text messages or a secure messaging platform. In addition to charging $100 dollars for the consultation and medication – which is well below the average cost of an abortion – Barovick points to the cost savings of not having to take off work or arrange child care to spend multiple hours in a clinic.

She says her patients receive their medication within 1 to 4 business days, "often faster than you can get an appointment in a clinic."

A study published in JAMA Internal Medicine on Monday followed about 500 women who had medication abortions with the pills distributed via mail order pharmacy after an in-person visit with a doctor. More than 90% of the patients were satisfied with the experience; there were three serious adverse events that required hospitalization.

In addition to expansions in telehealth, there have been new clinics in states like Kansas, Illinois and New Mexico, and there's been an increase in funding for abortion care – fueled by private donors and abortion funds.

The impact of shield laws

During the period from October to December 2023, nearly 8,000 people per month in states with bans or severe restrictions accessed medication abortions from clinicians providing telehealth in the 5 states that had shield laws at the time. That's nearly half of all monthly telehealth abortions.

"It's telemedicine overall that is meeting the need of people who either want to or need to remain in their banned or restricted state for their care," says Angel Foster, who founded The MAP, a group practice operating a telehealth model under Massachusetts' shield laws. "If you want to have your abortion care in your state and you live in Texas or Mississippi or Missouri, right now, the shield law provision is by far the most dominant way that you'd be able to get that care."

Foster's group offers medication abortions for about 500 patients a month. About 90% of their patients are in banned or restrictive states; about a third are from Texas, their most common state of origin, followed by Florida.

"Patients are scared that we are a scam," she says, "they can't believe that we're legit."

Since the WeCount data was collected, additional states including Maine and California have passed shield laws protecting providers who offer care nationwide. The new shield laws circumvent traditional telemedicine laws, which often require out-of-state health providers to be licensed in the states where patients are located. States with abortion bans or restrictions and/or telehealth bans hold the provider at fault, not the patient.

The NPR Politics Podcast

One small pill — one big court case.

Existing lawsuits brought by abortion opponents, including the case awaiting a Supreme Court decision, have the potential to disrupt this telehealth surge by restricting the use of the drug mifepristone nationwide. If the Supreme Court upholds an appeals court ruling, providers would be essentially barred from mailing the drug and an in-person doctor visit would be required.

There is also an effort underway in Louisiana to classify abortion pills as a controlled substance.

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Abortion rights

A woman holding a baby surrounded by her family and dogs.

The Unlikely Women Fighting for Abortion Rights

The end of Roe has turned women who terminated pregnancies for medical reasons into a political force.

Riata Little Walker, right, with her husband, Ian Walker, and their family in Casper, Wyo. Credit... Jimena Peck for The New York Times

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By Kate Zernike

Kate Zernike covers abortion for The Times.

May 27, 2024

For a long time, many women who had abortions because of catastrophic fetal diagnoses told their stories only privately. Grieving pregnancies they dearly wanted and fearing the stigma of abortion, they sought the closely guarded comfort of online communities identified by the way many doctors had described the procedure — TFMR, or “termination for medical reasons.”

In the two years since the Supreme Court overturned Roe v. Wade, their pain has been compounded into anger by new abortion bans across the country. While these women account for a fraction of abortions in the United States, they have emerged as the most powerful voices in the nation’s post-Roe debate, speaking out against bans with their stories of being forced across state lines and left to feel like criminals in seeking care.

Many of these women started out opposing abortion, but as they have changed their minds, they have changed the way Americans speak about it. Shifting from private anguish to public outrage, they have also helped shift public opinion toward more support for abortion.

“After going through all this I wondered, why are we not the poster child for abortion rights?” said Riata Little Walker, who traveled from her home in Casper, Wyo., for an abortion in Colorado at 22 weeks, after doctors diagnosed Down syndrome and a heart defect in her fetus, which they said would require surgery and later a transplant if it survived until delivery.

“Yes, your body, your choice, but that’s not the story that pulls people in,” she said. “We have to bring our stories to the front because otherwise it’s so easy for those over here to do, ‘But they’re killing babies.’”

Ms. Walker is Catholic and had worked for Wyoming Republicans, including Senator John Barrasso. She opposed abortion, and did not realize she was having one because doctors called it “termination.” In the months that followed, she came to support abortion whatever the reason, and after Roe was overturned in June 2022, she testified against the ban on abortion passed by the Wyoming Legislature.

Although most bans allow abortions to save the life or health of the pregnant woman, few women have been granted these exceptions, and only a handful of bans allow abortions for fatal fetal anomalies. There are no bright lines to define “fatal,” or “medical reason,” and the procedure is the same whether it’s described as termination, TFMR, or abortion.

A photo book about “The Hardest Week of our Life.”

That makes these cases complicated for doctors, lawmakers, and for the women themselves: What qualifies as a medical reason?

The women speaking out say their experiences made them believe that the law can’t and shouldn’t try to address complex and endlessly varying medical cases. In this, they appeal to rare common ground in what has been a bitter, decades-long debate: Regardless of whether they identify as “pro-life” or “pro-choice” in polls, Americans overwhelmingly say that the decision to have an abortion should be up to women and doctors, not the government.

These women say they now feel compelled not only to speak out but to use the word “abortion,” to remove the stigma they themselves put on it.

“All these things we never even knew before, because before all of this it was never spoken about,” said Kimberly Manzano, who flew from Texas for an abortion in New Mexico at 18 weeks after scans showed her fetus was missing limbs, organs and genitalia.

Ms. Manzano describes herself and her husband as “big Christians,” who thought abortion was something “promiscuous women” did to end unwanted pregnancies. Their pastor assumed they would qualify as a medical exception to Texas’ ban. They did not.

“We feel it’s our calling to our child that we lost that we do need to talk about it, to educate people, because I feel that we were so uneducated,” she said.

Some of the women are appearing in ads in favor of abortion rights ballot measures or candidates . Others are confronting politicians on the campaign trail, testifying or joining lawsuits . But mostly, they are talking to friends, family members and colleagues.

Polls show that people who have heard stories about women who had to cross state lines for abortions because of severe pregnancy complications are more likely to support legalized abortion. That is true even for Republicans or those who think that abortion should be illegal in most cases. Stories like these have also moved voters who oppose abortion to support ballot measures that have enshrined broad abortion rights in conservative states like Ohio and Kansas.

“By telling people’s stories, it makes it reality,” said Megan Kling, who traveled from her home in Wisconsin to Minnesota for an abortion at 23 weeks after a scan revealed that her fetus had no kidneys , so was not creating amniotic fluid, and would die after delivery, if not in utero. “You want to think every woman is perfectly healthy, every pregnancy is perfectly healthy, when in reality there’s a lot of things that can go wrong.”

Ms. Kling said some family members have argued that her situation is different: They support abortion if the fetus has a devastating condition, they just don’t want women using it as birth control. She understands, because she never thought of herself as someone who would choose abortion. “But women need health care options, and that’s what they don’t understand: Abortion is health care,” she said. “That’s what these stories raise up.”

Researchers say it’s not clear how many of the roughly one million abortions each year in the United States would be considered “for medical reasons,” but that they are rare.

Still, TFMR or “ending wanted pregnancy” communities have flourished online, with websites , private groups on social media where thousands of women share their stories — and separate sites for their partners — as well as podcasts and psychotherapists devoted solely to TFMR, and an awareness day in early May.

Many of these women don’t fit the usual angles of the abortion debate. They bristle at the clinical language of abortion rights groups; instead of saying “fetus,” they speak of the pregnancies they lost as unborn children. They name them, mark birthdays and imprint their tiny feet on keepsakes.

Ms. Kling found herself in an awkward position after she wrote letters to her state legislators, including the Republicans who represent her, in an attempt to move beyond her grief and anger after losing her pregnancy. She heard back only from a Democrat, and later, from Planned Parenthood and other groups who asked her to speak at events in support of President Biden. She agreed, but explained that she did not necessarily support him. She doesn’t think of herself as a Democrat, but she doesn’t feel like a Republican anymore, either.

“I feel like most people feel that way,” she said. “All the extremists are so loud you almost feel like you can’t speak up.”

Anti-abortion groups argue that bans prohibit only what they call “elective abortions” for unwanted pregnancies, and that any woman who needs an abortion for medical reasons can get one under the exceptions in those bans. They accuse Democrats of manipulating medical patients for political ends.

“Women have been falsely told this is a compassionate option, however, it feeds into the growing trend of disability discrimination and the pressure women face from the medical community to abort children who might have a disability,” said Dr. Ingrid Skop, of the American Association of Pro-Life Obstetricians and Gynecologists.

On the other side, abortion rights groups fear that elevating TFMR stories promotes the message that abortion should be protected only if it is “justified,” not that it should be every woman’s right. “People need abortions for all kinds of reasons — financial, medical, life circumstances — and none should be stigmatized,” said Nancy Northup, the president of the Center for Reproductive Rights.

Even within online communities, there is debate: Is it acceptable to terminate if a child would live only a few hours? A few days, a few years? What about the “gray” diagnoses — where a fetus is likely to survive into childhood but live a life severely constrained by surgeries, medications, machinery and hospitalizations?

Women describe weeks of waiting for additional scans, hoping for miracles, poring over statistics on survival rates and research on quality of life. Some elect to continue their pregnancies.

“Theoretically, if I had a Down syndrome diagnosis, I would keep them,” said Martha Sheppard. She and her husband, a teacher, learned on a 20-week anatomy scan that their daughter’s spine had not fused — the diagnosis was spina bifida — and would require an unknown number of surgeries, the first in utero. They moved from their home in Virginia to a Ronald McDonald House near a hospital in North Carolina for further tests, and researched. Three weeks later, they decided to terminate.

“To keep a child with spina bifida is also a loving decision,” Ms. Sheppard said, “but my husband and I decided that it was a loving decision not to bring her into the world with the body that she had.”

The women might seem to be making the case for medical exceptions — dozens have joined lawsuits filed by the Center for Reproductive Rights in four states , seeking to clarify what conditions qualify as exceptions under abortion bans. Instead, “Exceptions don’t work, is what we’re proving,” said Ashley Brandt, a plaintiff in Texas.

Ms. Brandt traveled to Colorado to abort a twin that had acrania — it had no skull — and posed a threat to her other fetus. “It wasn’t just me at risk, it was my viable daughter,” she said. “We still were not an exception.”

She learned of the option to selectively abort only from a TFMR group online; her doctors had been afraid to mention termination for fear of prosecution. She saw the shame and isolation that women in those groups felt, and felt it herself. Some of the harshest comments, Ms. Brandt said, came from women struggling with infertility who cannot imagine choosing to end any pregnancy. Like many of the women now telling their stories in public, she said her experience has made her feel more compassion for women who choose abortion no matter what the reason.

“Picking and choosing, it has to stop,” she said. “We need to trust people to make their own decisions.”

But the women say it remains a fight simply to explain that what they had was an abortion.

Months after Ms. Manzano’s abortion, she noticed her doctor had recorded it as “spontaneous miscarriage” on her chart.

“We had to travel to New Mexico,” Ms. Manzano said. “There was nothing spontaneous about it.”

She has been seeing a grief counselor, who refers to it as her “medical miscarriage,” even after Ms. Manzano told him she prefers to say “abortion.”

“Neither one of us corrects the other,” she said. Still, “for me to be able to grieve and heal through the process, I have to be able to say what it is.”

Kate Zernike is a national reporter at The Times. More about Kate Zernike

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Pro-Choice Does Not Mean Pro-Abortion: An Argument for Abortion Rights Featuring the Rev. Carlton Veazey

Since the Supreme Court’s historic 1973 decision in Roe v. Wade , the issue of a woman’s right to an abortion has fostered one of the most contentious moral and political debates in America. Opponents of abortion rights argue that life begins at conception – making abortion tantamount to homicide. Abortion rights advocates, in contrast, maintain that women have a right to decide what happens to their bodies – sometimes without any restrictions.

To explore the case for abortion rights, the Pew Forum turns to the Rev. Carlton W. Veazey, who for more than a decade has been president of the Religious Coalition for Reproductive Choice. Based in Washington, D.C., the coalition advocates for reproductive choice and religious freedom on behalf of about 40 religious groups and organizations. Prior to joining the coalition, Veazey spent 33 years as a pastor at Zion Baptist Church in Washington, D.C.

A counterargument explaining the case against abortion rights is made by the Rev. J. Daniel Mindling, professor of moral theology at Mount St. Mary’s Seminary.

Featuring: The Rev. Carlton W. Veazey, President, Religious Coalition for Reproductive Choice

Interviewer: David Masci, Senior Research Fellow, Pew Forum on Religion & Public Life

Question & Answer

Can you explain how your Christian faith informs your views in support of abortion rights?

I grew up in a Christian home. My father was a Baptist minister for many years in Memphis, Tenn. One of the things that he instilled in me – I used to hear it so much – was free will, free will, free will. It was ingrained in me that you have the ability to make choices. You have the ability to decide what you want to do. You are responsible for your decisions, but God has given you that responsibility, that option to make decisions.

I had firsthand experience of seeing black women and poor women being disproportionately impacted by the fact that they had no choices about an unintended pregnancy, even if it would damage their health or cause great hardship in their family. And I remember some of them being maimed in back-alley abortions; some of them died. There was no legal choice before Roe v. Wade .

But in this day and time, we have a clearer understanding that men and women are moral agents and equipped to make decisions about even the most difficult and complex matters. We must ensure a woman can determine when and whether to have children according to her own conscience and religious beliefs and without governmental interference or coercion. We must also ensure that women have the resources to have a healthy, safe pregnancy, if that is their decision, and that women and families have the resources to raise a child with security.

The right to choose has changed and expanded over the years since Roe v. Wade . We now speak of reproductive justice – and that includes comprehensive sex education, family planning and contraception, adequate medical care, a safe environment, the ability to continue a pregnancy and the resources that make that choice possible. That is my moral framework.

You talk about free will, and as a Christian you believe in free will. But you also said that God gave us free will and gave us the opportunity to make right and wrong choices. Why do you believe that abortion can, at least in some instances, be the right choice?

Dan Maguire, a former Jesuit priest and professor of moral theology and ethics at Marquette University, says that to have a child can be a sacred choice, but to not have a child can also be a sacred choice.

And these choices revolve around circumstances and issues – like whether a person is old enough to care for a child or whether a woman already has more children than she can care for. Also, remember that medical circumstances are the reason many women have an abortion – for example, if they are having chemotherapy for cancer or have a life-threatening chronic illness – and most later-term abortions occur because of fetal abnormalities that will result in stillbirth or the death of the child. These are difficult decisions; they’re moral decisions, sometimes requiring a woman to decide if she will risk her life for a pregnancy.

Abortion is a very serious decision and each decision depends on circumstances. That’s why I tell people: I am not pro-abortion, I am pro-choice. And that’s an important distinction.

You’ve talked about the right of a woman to make a choice. Does the fetus have any rights?

First, let me say that the religious, pro-choice position is based on respect for human life, including potential life and existing life.

But I do not believe that life as we know it starts at conception. I am troubled by the implications of a fetus having legal rights because that could pit the fetus against the woman carrying the fetus; for example, if the woman needed a medical procedure, the law could require the fetus to be considered separately and equally.

From a religious perspective, it’s more important to consider the moral issues involved in making a decision about abortion. Also, it’s important to remember that religious traditions have very different ideas about the status of the fetus. Roman Catholic doctrine regards a fertilized egg as a human being. Judaism holds that life begins with the first breath.

What about at the very end of a woman’s pregnancy? Does a fetus acquire rights after the point of viability, when it can survive outside the womb? Or let me ask it another way: Assuming a woman is healthy and her fetus is healthy, should the woman be able to terminate her pregnancy until the end of her pregnancy?

There’s an assumption that a woman would end a viable pregnancy carelessly or without a reason. The facts don’t bear this out. Most abortions are performed in the first 12 weeks of pregnancy. Late abortions are virtually always performed for the most serious medical and health reasons, including saving the woman’s life.

But what if such a case came before you? If you were that woman’s pastor, what would you say?

I would talk to her in a helpful, positive, respectful way and help her discuss what was troubling her. I would suggest alternatives such as adoption.

Let me shift gears a little bit. Many Americans have said they favor a compromise, or reaching a middle-ground policy, on abortion. Do you sympathize with this desire and do you think that both sides should compromise to end this rancorous debate?

I have been to more middle-ground and common-ground meetings than I can remember and I’ve never been to one where we walked out with any decision.

That being said, I think that we all should agree that abortion should be rare. How do we do that? We do that by providing comprehensive sex education in schools and in religious congregations and by ensuring that there is accurate information about contraception and that contraception is available. Unfortunately, the U.S. Congress has not been willing to pass a bill to fund comprehensive sex education, but they are willing to put a lot of money into failed and harmful abstinence-only programs that often rely on scare tactics and inaccurate information.

Former Surgeon General David Satcher has shown that abstinence-only programs do not work and that we should provide young people with the information to protect themselves. Education that stresses abstinence and provides accurate information about contraception will reduce the abortion rate. That is the ground that I stand on. I would say that here is a way we can work together to reduce the need for abortions.

Abortion has become central to what many people call the “culture wars.” Some consider it to be the most contentious moral issue in America today. Why do many Catholics, evangelical Christians and other people of faith disagree with you?

I was raised to respect differing views so the rigid views against abortion are hard for me to understand. I will often tell someone on the other side, “I respect you. I may disagree with your theological perspective, but I respect your views. But I think it’s totally arrogant for you to tell me that I need to believe what you believe.” It’s not that I think we should not try to win each other over. But we have to respect people’s different religious beliefs.

But what about people who believe that life begins at conception and that terminating a pregnancy is murder? For them, it may not just be about respecting or tolerating each other’s viewpoints; they believe this is an issue of life or death. What do you say to people who make that kind of argument?

I would say that they have a right to their beliefs, as do I. I would try to explain that my views are grounded in my religion, as are theirs. I believe that we must ensure that women are treated with dignity and respect and that women are able to follow the dictates of their conscience – and that includes their reproductive decisions. Ultimately, it is the government’s responsibility to ensure that women have the ability to make decisions of conscience and have access to reproductive health services.

Some in the anti-abortion camp contend that the existence of legalized abortion is a sign of the self-centeredness and selfishness of our age. Is there any validity to this view?

Although abortion is a very difficult decision, it can be the most responsible decision a person can make when faced with an unintended pregnancy or a pregnancy that will have serious health consequences.

Depending on the circumstances, it might be selfish to bring a child into the world. You know, a lot of people say, “You must bring this child into the world.” They are 100 percent supportive while the child is in the womb. As soon as the child is born, they abort the child in other ways. They abort a child through lack of health care, lack of education, lack of housing, and through poverty, which can drive a child into drugs or the criminal justice system.

So is it selfish to bring children into the world and not care for them? I think the other side can be very selfish by neglecting the children we have already. For all practical purposes, children whom we are neglecting are being aborted.

This transcript has been edited for clarity, spelling and grammar.

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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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