What is abortion? 

Many religious extremists are quick to equate contraception (and family planning) with abortion. This is misleading. As pointed out earlier, contraception and abortion are distinct from each other and blurring the line between the two is a tactic employed by religious extremists to dissuade people from using contraception.

It is imperative to correct misleading information, untruths, misconceptions and myths about abortion. This would be an initial step towards dispelling the common perception among the general population that abortion is immoral and evil, that women who seek abortion services deserve to be judged harshly, and that abortion service providers are immoral and unethical. Such perception is fueled in large part by the scare tactics and moralistic teachings of religious extremists.

Following is a brief discussion which is hoped to help correct some of the myths and misconceptions about abortion as well as lessen the social stigma attached to abortion.

What are the types of abortion?

Spontaneous Abortion is defined as the loss of a pregnancy before fetal viability (22 weeks gestation). The stages of spontaneous abortion may include: threatened abortion (pregnancy may continue); and inevitable abortion (pregnancy will not continue and will proceed to incomplete abortion where the products of conception are partially expelled, or to complete abortion where the products of conception are completely expelled). (WHO, 2003)

In the Philippines, 27.3% of the respondents of the 1993 Safe Motherhood Survey (SMS) reported an early pregnancy loss (either spontaneous or induced abortion). Ninety-three percent of the early pregnancy losses were reported as spontaneous.

Induced Abortion is defined as a process by which pregnancy is terminated before fetal viability. (WHO, 2003)

Unsafe Abortion is defined as a procedure for terminating pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards, or both. (WHO, 2003)

Safe Abortion is a procedure performed by trained health care providers with proper equipment, correct technique, and sanitary standards. (WHO, 2003) However, there is more to safe abortion that the safety of the procedure itself. Frances Kissling of the Catholics for a Free Choice says that abortion safety and legality cannot be separated, as safety also means not having to fear a police raid or imprisonment when seeking and providing abortion services, and transforming abortion from a guilty secret into a socially accepted procedure that is openly available from sympathetic and well-trained providers. (Kissling, 1993)

Septic Abortion is defined as abortion complicated by infection. Sepsis may result from infection if organisms rise from the lower genital tract following either spontaneous or unsafe abortion. Sepsis is more likely to occur if there are retained products of conception and evacuation has been delayed. Sepsis is a frequent complication of unsafe abortion involving instrumentation. (WHO, 2003)

Are all abortions unsafe? Can abortion be performed safely?

Not all abortions are unsafe. Abortion can be performed safely when done by health care providers with the proper equipment and correct technique under sanitary conditions. In fact, in countries where women have access to safe services, their likelihood of dying as a result of an abortion performed with modern methods is no more that 1 per 100,000 procedures. In developing countries where most unsafe abortions occur, the risk of death following unsafe abortion complications is several hundred times higher that that of abortions performed professionally under safe conditions.

It is basically the illegal nature of induced abortion in this country that makes abortion unsafe for women. In counties where abortion is legal, it is generally performed early in pregnancy by a skilled practitioner under safe conditions. Induced abortions under these circumstances are therefore safe procedures that pose even lesser risk than carrying full-term pregnancies (Table 1). In addition, the experience of some countries has shown that legalizing abortion helps reduce or eliminate women's deaths related to abortion. For instance, when Romania legalized abortion, its abortion-related mortality rate fell to one-third of its peak level. The death rates due to abortion decreased 85% five years after its legalization in the United States. Where access to legal abortion was liberalized such as a Barbados, Canada, Tunisia and Turkey, abortion rates did not increase. (Center for Reproductive Rights, 2000)

	Chance of Death in a Year
Birth control pills (nonsmoker)	1 in 66,700
Birth control pills (heavy smoker, 25 or more cigarettes per day)	1 in 1,700
IUDs	1 in 10,000,000
Barrier methods	None
Natural methods	None
STERILIZATION :
Laparoscopic tubal ligation	1 in 38,500
Vasectomy	1 in 1,000,000
PREGNANCY:
Terminating pregnancy:
Illegal Abortion	1 in 3,000
Legal Abortion:
Before 9 weeks	1 in 100,100
Between 9 and 12 weeks	1 in 100,100
Between 13 and 15 weeks	1 in 34,400
After 15 weeks	1 in 10,200
Risk per pregnancy from continuing pregnancy	1 in 10,000 (underscoring ours)

Adapted from: R. Hatcher et.al., Contraceptive Technology, 17th rev.ed. (New York: Irvington 1998), Table 9-4, in Boston Women's Health Book Collective, Our Bodies, Our Selves for the New Century. 1998. New York: Simon and Schuster. Note: The table does not take into account other factors such as social class, race, nationality and pregnancy history.

Does abortion cause breast cancer?

Major medical and cancer organizations in the United States have issued statements disputing claims that abortion increases a woman's risk for cancer or that women who have abortions get a deadlier form of cancer. The National Cancer Institute, for one, concluded, "There is no direct evidence of a direct relationship between breast cancer and induced abortion."

Does abortion cause infertility?

There is no credible research evidence linking induced abortion with infertility. Abortions done under safe conditions by experienced providers are not likely to cause complications, like infections, which may cause infertility. Neither does this procedure make it more difficult to carry a future pregnancy to term. It is unsafe abortions that cause not only complications that may lead to infertility, but also the unnecessary deaths of women.

Is there such a thing as a post-abortion syndrome?

As defined by anti-choice groups, the so-called post abortion syndrome (PAS) is a "post traumatic stress disorder commonly experienced by women who have had one or more abortions." Its symptoms supposedly include "anxiety, suicidal impulses, regret/guilt, self-destructive behavior, sadness," and so on. However, the American Psychological Association (APA) concluded that legal abortion "does not create psychological hazards for most women undergoing the procedure" and that "data from [a] long-term study demonstrate that even highly religious women are not at significantly greater risk of psychological distress because they had an abortion." Serious emotional problems following abortion are uncommon. Research results show that most women report a sense of relief, although some may experience temporary depression. In fact, psychological disturbances after childbirth (post-partum depression) occur more frequently than after abortion. What needs to be looked into is the extend to which social biases against women and abortion contribute to the psychological disturbances women experience.

Will the availability of sex education or contraceptive information and services encourage teenagers to have sex, and maybe even bad to abortion in the event that pregnancy happens?

Teen sex happens because of complex societal causes, including peer pressure and perhaps sexually-oriented TV, movies and advertisements. The availability of contraceptive information and services do not give rise to teen sex. Reality dictates that these services in conjunction with non-judgmental sex education be made available to help teens make responsible decisions about their sexuality and prevent them from becoming parents at a time when they are not yet physically, emotionally and economically prepared.

We can no longer close our eyes to the fact that some teenagers do have a sex, get pregnant at a time when they are not yet ready, seek abortions, and sometimes even die due to maternal causes. These are the facts:

• 15% of young adult females and 31% of young adult males have engaged in "premarital sex" (YAFS3)
• 2% of births are to teenage women less than 18 years old (NDHS 1998)
• 20% of births to teenage women are unplanned (NDHS 1998)
• 8.5 % of women who undergo abortion are teenagers, 42% of whom had undergone abortion more than once (Raymundo and Cruz, 1999)
• 6.3% of women who died of maternal causes in 1998 are below 19 years old (VSR 1998)

These statistics point to the fact that teenagers have limited access to very essential reproductive health information and services. Turning a blind eye to these problems will not make these go away. The government's and society's continuing refusal or reluctance to confront the issue to teenage sexuality will mean that teenage women will continue to be exposed to the risks of early and unwanted pregnancies that pose a threat to their health and quality of life. Such a situation could lead them resort to unsafe abortions.

Status of laws on abortion

Different countries have different laws on abortion. There are some countries that severely restrict abortions while there are countries that permit abortions without restrictions as to reason. Table 2 shows that around 74 countries covering 26% of the world's population have adopted laws that restrict abortions while there are 121 countries covering 74% of the world's population which permit abortions on various grounds. Of these 121 countries, 54 (covering 40.5% of the world's population) allow abortions without restriction as to reason. Included in these countries are the United States of America, Canada, many European countries, Bahrain, South Africa, China and Italy (where the Vatican is located).