The expulsion of a fetus from the uterus before it is able to live outside the womb (in human beings,

usually about the 20th week of gestation) is calledabortion. When abortion occurs spontaneously, it is often called a miscarriage. Abortion can also be intentionally caused, or induced. Spontaneous abortions occur for many reasons, including disease, trauma, genetic defect, or biochemical incompatibility of mother and fetus. Induced abortions may be performed for various reasons, including to preserve the life or physical or mental well-being of the mother; to prevent the completion of a pregnancy that has resulted from rape or incest; to prevent the birth of a child with serious deformity, mental deficiency, or genetic abnormality; or to prevent a birth for social or economic reasons (such as the extreme youth of the pregnant female or the sorely strained resources of the family unit). Induced abortion is regarded as a moral issue in some cultures. In others it is seen as an acceptable way to end unplanned pregnancy. Many different medical techniques exist for performing induced abortions. The usual surgical techniques during the first trimester (up to about 12 weeks after conception) include endometrial aspiration, suction, or curettage.Endometrial aspiration involves the insertion of a thin, flexible tube up the cervical canal to suck out the lining of the uterus by means of an electric pump. Another surgical technique for performing an abortion is called dilatation and evacuation. This procedure, done while the patient is under anesthesia, uses a rigid suction tube inserted into the uterus to remove the contents. If a thin metal tool called a curette is used to scrape (rather than vacuum out) the contents of the uterus, the procedure is called dilatation and curettage. Both of these procedures can be used up to about the 16th week of pregnancy. Another method of performing an induced abortion is the injection of a saline solution to trigger uterine contractions. This procedure may be done from the 12th to the 19th week of the pregnancy. Hysterotomy, the surgical removal of the uterine contents, may be used during the second trimester or later. In general, the more advanced the pregnancy, the greater the risk to the female of mortality or serious complications following an abortion. In the late 20th century a drug called RU-486 was developed in France as a new method to induce abortion. RU-486, an artificial steroid, blocks the hormone progesterone, which is needed to support the development of a fertilized egg. When ingested within weeks of conception, RU-486 effectively triggers the menstrual cycle and flushes the fertilized egg out of the uterus. Whether and to what extent induced abortions should be permitted, encouraged, or severely repressed is a social issue that has divided theologians, philosophers, and legislators for centuries. Although early Christian theologians condemned abortion, criminal sanctions to deter its practice did not become common until the 19th century. Some countries, however, perhaps because of the unavailability of birth-control devices, have accepted abortion for long periods of time. In the late 20th century China used abortion on a large scale as part of its population-control policy. In the early 21st century some jurisdictions with large Roman Catholic populations, such as Portugal and Mexico City, decriminalized abortion despite strong opposition from the church, while others, such as Nicaragua, increased restrictions on it.

In the United States the legality of abortion was affirmed with Roe vs. Wade in 1973 over the objections of some groups, the Roman Catholic church in particular. In 1989 and in 1992 the U.S. Supreme Court upheld provisions of a 1986 Missouri law and a 1989 Pennsylvania law restricting abortion. In Webstervs. Reproductive Health Services and Planned Parenthood vs. Casey the court stopped short of overturning the landmark Roe vs. Wade ruling, but it upheld the power of individual states to impose restrictions. In 2007 the court also upheld a federal ban on a rarely used abortion method known as intact dilation and evacuation. The debate on the issue of induced abortion continued into the 21st century. Many opposed to abortion believe it is the taking of a human life. Those who favor the legal availability of abortion cite the right of women to control their reproduction as well as the dangers of illegal abortion. (See alsobioethics; birth control.) http://school.eb.com/all/comptons/article-9272687

A bortion Rate on the Decline, Study Finds By Tom Blackwell After climbing through the 1990s, the number of abortions in Canada has fallen steadily to fewer than 100,000 a year, according to a new study that maps out in detail the first few decades of the country's legalized-abortion era. The rate per capita has fallen 14% since 1997, with 97,000 surgeries in 2005, concluded the paper. The fastest decline has been among teenagers, while women in their 20s still account for about half of abortions. Despite the recent decline, close to a third of middle aged women have terminated a pregnancy at least once. A second new study notes that almost 40% of Canadian abortions are performed on women who have had one before - but it suggested that inserting IUDs right after the procedure might curb the number of repeat abortions. Dr. Wendy Norman, an author of both studies, said the prevailing theory for the overall downward slide is that better access to a wider range of contraception has curbed the number of unwanted pregnancies, about half of which typically are ended with abortion. The trend is a "very positive indication," said Dr. Vyta Senikas, spokeswoman for the Society of Obstetricians and Gynecologists of Canada. Still, she said, more needs to be done to ensure women get needed birth control. Dr. Norman's study also concludes the current numbers indicate there remains a "significant unmet need" for contraception. "You'd like to see that [abortion] rate down to virtually zero," said Dr. Senikas, who practices in Montreal. "We still at the end of the day have some work to do, to hope that when pregnancy occurs, it's planned, it's not going to end."

One anti-abortion advocate, however, said he does not believe the rate of abortions is, in fact, declining in Canada. Jack Fonseca of the Campaign Life Coalition said incomplete statistics submitted by some provinces and a likely tendency by clinics to play down how many abortions they perform to avoid controversy mean the prevalence of the surgery is underestimated. Promoting contraception only leads to more casual sex and, ultimately, more surgically terminated pregnancy, he said. Ending medicare funding of the procedure would do more to prevent repeats, Mr. Fonseca said. "Part of the reason for abortions being morally wrong is it is clearly being used for reasons of convenience, as a backup birth control method," he said. "That is not something the vast majority of Canadians would agree with." Dr. Norman belongs to a new research consortium trying to gather better evidence around sexual health. In one of the studies published recently in the journal Contraception, she tracked rates from 1974 to 2005, covering the first generation of women who had access to legal abortion from the start of their child-bearing years, after a 1969 change in the law. The numbers climbed fairly quickly from less than 70,000 to well above 100,000 annually following a 1988 Supreme Court of Canada ruling that made it legal to get an abortion in a freestanding clinic. Dr. Norman calculated that 31% of women who turned 45 in 2005 have had at least one abortion. She said statistics beyond 2005 are less reliable because of incomplete figures provided by B.C. and others. Reports from the Canadian Institute for Health Information show a continued downward slope. The other study cited data that 38% of abortions are repeats. Dr. Norman and coauthor Christina Ames looked at 1,100 women in 2003 and 2004 who had abortions in a B.C. health region, then examined their experiences five years down the road. Of those who had been fitted with an IUD immediately after their abortion, 9.4% had had another one in the ensuing years, compared to 17% of those who were given birth control pills at the clinic and 16% of women administered a contraceptive injection. Of those who said they would use condoms - who turned out to be chiefly married women - just 6% had another abortion. The research was preliminary and has prompted a bigger, randomized trial that should generate more definitive data, said Dr. Norman. Experience from such places as Scandinavia, however, has shown that wider use of long term, no-fuss contraception like IUDs leads to lower rates of unwanted pregnancy generally and of abortion, said the University of British Columbia familymedicine professor. Targeting women who have just had their first abortion makes sense, she said. "You've got a high-risk population - they're fertile by definition already and by definition they've

had unprotected intercourse," she said. "In other jurisdictions ... it's still more cost effective in almost all instances to be able to provide free sources of long-acting, reversible, forgettable contraception than to pay for the consequences of unplanned pregnancies." The high rate of repeat abortions "doesn't sound good," but some women end up having more than one simply because they are more fertile, birth control did not work or they have partners who prevented them from using contraception, said Joyce Arthur, executive-director of the AbortionRights Coalition of Canada. "It's very important that we never blame a woman who gets pregnant," she said. Mr. Fonseca said the 9.4% repeat rate with IUDs is still "abysmally high." http://sks.sirs.com/cgi-bin/hst-article-display?id=SIL3348H-06238&artno=0000319022&type=ART&shfilter=U&key=abortion&title=Abortion%20Rate%20on %20the%20Decline%2C%20Study%20Finds&res=Y&ren=Y&gov=Y&lnk=Y&ic=N Blackwell, Tom. "Abortion Rate on the Decline, Study Finds." National Post. 18 Nov 2011: A.1. SIRS Issues Researcher. Web. 31 Mar 2012.