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Abortion



Breast cancer hypothesis

Main article: Abortion-breast cancer hypothesis

The "abortion-breast cancer (ABC) hypothesis" (supporters call it the abortion-breast cancer link) posits induced abortion increases the risk of developing breast cancer;[69] it is a controversial subject and the current scientific consensus has concluded there is no significant association between first-trimester abortion and breast cancer risk.[70][71][72]

In early pregnancy, levels of estrogen increase, leading to breast growth in preparation for lactation. The hypothesis proposes that if this process is interrupted by an abortion – before full maturity in the third trimester – then more relatively vulnerable immature cells could be left than there were prior to the pregnancy, resulting in a greater potential risk of breast cancer. The hypothesis mechanism was first proposed and explored in rat studies conducted in the 1980s.[73][74][75]

The American Cancer Society concludes that presently the evidence does not support a causal abortion-breast cancer association,[76] yet a causal link continues to be championed by pro-life activists like Dr. Joel Brind, Dr. Angela Lanfranchi and Karen Malec.[72] In the past, pro-life advocates have sought legal action regarding disclosure of the abortion-breast cancer issue. This brought short-term legal and political intervention culminating with the Bush Administration changing the National Cancer Institute (NCI) fact sheet from concluding no link to a more ambiguous assessment.[77] In February 2003, the NCI responded by conducting a workshop with over 100 experts on the issue, which determined from selected evidence that it was well-established "abortion is not associated with an increase in breast cancer risk."[78]

Though the scientific community is largely skeptical of the hypothesis and has been rejected by some;[77][78] the ongoing promotion of an abortion-breast cancer "link" by pro-life advocates and medical associations is seen by others as merely a part of the current pro-life "women-centered" strategy against abortion.[79][80][81] Pro-life groups maintain they are providing legally necessary informed consent;[82] a concern shared by conservative Congressman Dr. Dave Weldon.[83] While early research indicated a correlation between breast cancer and abortion;[84][85] the current scientific consensus has solidified with the publication of large prospective cohort studies which find no clear association between abortion and breast cancer.[86][87] These studies along with all relevant research strive to remove from their results the many confounding factors, such as delayed child bearing (parity), which affect breast cancer risk apart from abortion. The abortion-breast cancer hypothesis continues to incite mostly political and some scientific debate.[72]

Mental health

Main article: Abortion and mental health

The relationship between induced abortion and mental health is an area of political and scientific controversy.[88][89][90] A number of studies have concluded that abortion is associated with no more psychological risk than carrying an unwanted pregnancy to term. Other studies have reported a statistical correlation between abortion and negative psychological effects, though no studies have demonstrated a direct causal relationship.[91][81][92] Pre-existing factors in a woman's life, such as emotional attachment to the pregnancy, lack of social support, pre-existing psychiatric illness, and conservative views on abortion increase the likelihood of experiencing negative feelings after an abortion.[93][94][95]

In a 1990 review, the American Psychological Association has found that "severe negative reactions [after abortion] are rare and are in line with those following other normal life stresses."[92] In light of additional studies undertaken since that time, both the APA and the United Kingdom Royal College of Psychiatrists are performing systematic reviews of the medical literature in order to update their position statements.

Some proposed negative psychological effects of abortion have been referred to by pro-life advocates as a separate condition called "post-abortion syndrome." However, the existence of "post-abortion syndrome" is not recognized by any medical or psychological organization,[96] and some physicians and pro-choice advocates have argued that the effort to popularize the idea of a "post-abortion syndrome" is a tactic used by pro-life advocates for political purposes.[88][81][97][98]

On March 14, 2008, the Royal College of Psychiatrists released a statement saying "The specific issue of whether or not induced abortion has harmful effects on women’s mental health remains to be fully resolved. The current research evidence base is inconclusive – some studies indicate no evidence of harm, whilst other studies identify a range of mental disorders following abortion."[90]

Fetal pain debate

Main article: Fetal pain

The existence and implications of fetal pain are scientifically and politically disputed. A controversial[99] review by researchers from the University of California, San Francisco in JAMA concluded that data from dozens of medical reports and studies indicate that fetuses are unlikely to feel pain until the third trimester of pregnancy.[100][101] There may be an emerging consensus among developmental neurobiologists that the establishment of thalamocortical connections (at about 26 weeks) is a critical event with regard to fetal perception of pain.[102] Nevertheless, because pain can involve sensory, emotional and cognitive factors, it may be "impossible to know" when painful experiences are perceived, even if it is known when thalamocortical connections are established.[102]

Whether a fetus has the ability to feel pain and to suffer is part of the abortion debate.[103][104] For example, legislation has been proposed by pro-life advocates requiring abortion providers to tell a woman that the fetus may feel pain during the abortion procedure, and that require her to accept or decline anesthesia for the fetus.[105]

Abortion law

Main articles: Abortion law and History of abortion law
See also: Reproductive rights
International status of abortion law (detail).
International status of abortion law (detail).

Before the scientific discovery that human development begins at fertilization, English common law allowed abortions to be performed before "quickening", the earliest perception of fetal movement by a woman during pregnancy, until both pre- and post-quickening abortions were criminalized by Lord Ellenborough's Act in 1803.[106] In 1861, the British Parliament passed the Offences Against the Person Act, which continued to outlaw abortion and served as a model for similar prohibitions in some other nations.[107] The Soviet Union, with legislation in 1920, and Iceland, with legislation in 1935, were two of the first countries to generally allow abortion. The second half of the 20th century saw the liberalization of abortion laws in other countries. The Abortion Act 1967 allowed abortion for limited reasons in the United Kingdom. In the 1973 case, Roe v. Wade, the United States Supreme Court struck down state laws banning abortion, ruling that such laws violated an implied right to privacy in the United States Constitution. The Supreme Court of Canada, similarly, in the case of R. v. Morgentaler, discarded its criminal code regarding abortion in 1988, after ruling that such restrictions violated the security of person guaranteed to women under the Canadian Charter of Rights and Freedoms. Canada later struck down provincial regulations of abortion in the case of R. v. Morgentaler (1993). By contrast, abortion in Ireland was affected by the addition of an amendment to the Irish Constitution in 1983 by popular referendum, recognizing "the right to life of the unborn".

Current laws pertaining to abortion are diverse. Religious, moral, and cultural sensibilities continue to influence abortion laws throughout the world. The right to life, the right to liberty, the right to security of person, and the right to reproductive health are major issues of human rights that are sometimes used as justification for the existence or absence of laws controlling abortion. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained, often, but not always, using a trimester-based system to regulate the window of legality:

  • In the United States, some states impose a 24-hour waiting period before the procedure, prescribe the distribution of information on fetal development, or require that parents be contacted if their minor daughter requests an abortion.
  • In the United Kingdom, as in some other countries, two doctors must first certify that an abortion is medically or socially necessary before it can be performed.

Other countries, in which abortion is normally illegal, will allow one to be performed in the case of rape, incest, or danger to the pregnant woman's life or health. A few nations ban abortion entirely: Chile, El Salvador, Malta, Ireland and Nicaragua, although in 2006 the Chilean government began the free distribution of emergency contraception.[108][109] In Bangladesh, abortion is illegal, but the government has long supported a network of "menstrual regulation clinics", where menstrual extraction (manual vacuum aspiration) can be performed as menstrual hygiene.[110]

In places where abortion is illegal or is socially such a stigma that it would not be possible to continue to live there if it became known that a woman had undergone one, pregnant women may engage in medical tourism and travel overseas to countries where they can undergo a termination of their pregnancy. In the USA, it is not unusual for women to travel from one state to another for reasons of termination of pregnancy.

See also

References

  1. ^ The 20th week of gestational age is equivalent to the 18th week after fertilization (also known as "conception"). The embryonic stage lasts approximately until the end of the 8th week after fertilization, at which point the fetal stage begins.
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v • d • e
Birth control
Comparison:
Behavioral:
Barrier:
Spermicide:
Hormonal:
Anti-estrogen:
Ormeloxifene (a.k.a. Centchroman)
Intra-uterine:
IUD (copper or progestogen), IUS (progestogen)
Post-intercourse:
Contraception: Emergency contraception (pills or copper IUD)
Abortion: Surgical abortion, Medical abortion (RU-486/abortion pill)
Sterilization:



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