# 1

This is what an abortion looks like

img-embryomodel101812_163559827036Many abortion protest pictures are artist’s renderings or the result of image manipulation, and most photos of aborted fetuses are of very late-term fetuses aborted for emergency medical reasons. The vast majority of abortions are performed during the first trimester, often before the 6th week of pregnancy when the embryo is only about 15mm long. Anti-abortion photos of aborted fetuses are also false because they are hugely magnified, and  completely erase any sign of the woman. Further, the source of most of these photos are unknown and unattributed – many could actually be of miscarriages, stillbirths, or illegal abortions. Anti-abortionists have admitted to stealing fetal remains from hospitals and manipulating them for photos.

Early development of a pregnancy:
Up to 6 1/2 weeks from the first day of the last menstruation cycle, no embryo can be visualized yet, merely a gestational sac. A picture of a gestational sac in the fifth and the sixth week of pregnancy and a corresponding ultrasound image are shown below.

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An actual early abortion:

An actual early abortion

Sources:

Gynmed Clinic, Methods of Abortion

rabble.ca, Why fetus porn doesn’t help the anti-choice cause (2013)

# 2

Abortion contradicts the Hippocratic Oath

hippo-oathThe Hippocratic Oath, dating from about 460 to 377 BC, reflects the medical knowledge and social concepts of that time. For example, doctors were not allowed to share their knowledge with their patients and other lay people – only with their medical students, their own sons, and their teachers’ sons. Furthermore, the Oath contains a specific prohibition on performing bladder surgery on men (to remove stones), a job reserved for skilled practitioners only, apparently in case it impaired men’s fertility. The prohibition on abortion in the Oath is limited to a specific technique – a pessary (a vaginal suppository), which could cause lethal infections.

The archaic, faith-based Hippocratic Oath (students had to swear by pagan Greek gods) has no legal basis in any country today. It has been replaced in democratic countries with codes of ethics and democratically-decided laws regulating medical practice. The Declaration of Geneva and other modern ethical guidelines put the patient first, and include many directives that are nowhere to be found in the Hippocratic Oath. For example, the Canadian Medical Association’s code of ethics promotes lifelong learning, empathetic communication with patients, the right of patients to refuse treatment, prudent use of health care resources, and many other praiseworthy ethics.

Virtually all medical schools today require some sort of oath of its graduates, but they are largely seen as ceremonial and nonobligatory. The original Hippocratic Oath has been revised and modernized over the centuries to reflect society’s evolving values, changing laws, and new medical technologies. In 1993, of the American medical schools that were still using some version of the Hippocratic Oath, only 8% still included the prohibition on abortion and only 14% included the euthanasia ban. A survey in 2009 of 135 medical schools in the U.S. and Canada found that 11.1% used an unmodified translation of the traditional Hippocratic Oath.

Sources:

Pro-choice Action Network, Hypocrisy and the Hippocratic Oath (1999) (original Hippocratic Oath reproduced here)

Hagop Kantarjian, MD, and David P. Steensma, MD, Relevance of the Hippocratic Oath in the 21st Century (2014)

The Pharos, The uses of oaths in the 21st century (2016)

Wikipedia, Declaration of Geneva, and Wikipedia, Hippocratic Oath

# 3

Abortion is a very dangerous procedure

Abortion is one of the safest surgical procedures if done in a legal setting and using established standards of care. The risk of death associated with safe and legal abortion is extremely low, ranging from about 1 to 6 deaths for every million abortions in developed countries.  In fact, you are 10-14 times more likely to die giving birth than by having an abortion. Further, the risk of major complications from a first trimester abortion is 0.05 percent, and the overall rate of complications, both minor and major, is about 2-3%.

Abortions can be safely performed in standalone clinics, which multiple studies have confirmed are highly regulated and very safe. Many other outpatient procedures that don’t require hospital admission are statistically much riskier. You are 40 times more likely to die from a colonoscopy than from an abortion, for instance.

Abortion is only dangerous if done under illegal conditions, for several reasons: it is frequently done later in pregnancy, by an untrained person or by the woman herself, under unhygienic conditions, with improper equipment or substances, and without medical supervision or follow-up. Developing countries with strict abortion bans, such as in much of Africa, have the highest maternal mortality rates from unsafe abortion. Worldwide, the proportion of maternal mortality from unsafe, mostly illegal, abortion is 8 – 18% – between 22,500 and 44,000 deaths per year.  (Differing numbers arise from separate estimates.) Virtually all would be preventable if abortion was legal, safe, and accessible. In addition, over 7 million women are left injured. With about 22 million unsafe abortions a year, that means a third of women resorting to unsafe abortion suffer complications, compared to under 3% in developed countries.

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Sources:

World Health Organization, Unsafe Abortion (2011)

Guttmacher Institute, Unsafe Abortion: The Missing Link in Global Efforts to Improve Maternal Health (2011)

Guttmacher Institute, Induced Abortion Worldwide (2016)

International Journal of Gynecology and Obstetrics. (Berer Blog). A call for consensus and cooperation to resolve differing estimates of abortion-related deaths (2016)

# 4

The pills for medical abortion are harmful

Since 1988, tens of millions of women have terminated their pregnancies safely and legally with the drugs mifepristone and misoprostol, including over 1.5 million in Europe, over 1 million in the United States, and over 25 million in China. The drugs are now approved in at least 59 countries. Medical abortion accounts for more than 60% of abortions in some European countries, and about 20% in the U.S.

Mifepristone and misoprostol have been on the list of essential medicines of the World Health Organization since 2005. Mifepristone blocks the hormone progesterone needed to maintain the pregnancy, causing the uterine lining to shed. Misoprostol causes contractions resulting in a miscarriage.

Although all drugs have side effects, medical abortion is safer than the use of antibiotics. The risk of fatal anaphylaxis with penicillin is about 1 in 100,000.  The overall complication rate of medical abortion, including the most common complication of continued pregnancy, is about 1%.

The advent of medical abortion has also made illegal abortion safer because the drugs are gradually replacing much more dangerous methods such as inserting objects into the uterus, ingesting poisons, or jumping down stairs or off a roof. Many women in developing countries are able to buy the drugs at local pharmacies or online. Although the drugs can sometimes be unsafe when taken incorrectly without medical supervision, a professionalized network has emerged in recent years that offers online medical advice and counseling to women undergoing DIY (“do it yourself”) abortions in countries where abortion is highly restricted. The decrease in the maternal mortality rate from unsafe abortion, from 68,000 in 1995 to 22,000 in 2014 (according to the World Health Organization), may be due at least in part to increased use of safer medical abortion, as well as improved research methods.

Sources / More Information:

Women on Web

Women Help Women

Gynmed Clinic – Medical Abortion

Misoprostol (safe usage guide)

World Health Organization, Preventing Unsafe Abortion (2017)

# 5

Abortion is riskier than pregnancy

Abortions are very safe when performed by qualified practitioners. Reputable research confirms that continuing a pregnancy and going through childbirth carries greater risk to a woman’s health than having a first trimester abortion. You are 14 times more likely to die in childbirth than by having an abortion.

In general, the risks of pregnancy termination increase with gestational length, which means earliest abortions are safest and childbirth is the riskiest. The risk of major complications from a first trimester abortion is 0.05 percent, and the overall rate of complications, both minor and major, is about 2-3%.  Complications of childbirth are far more common – to give just two examples of serious complications, 5-6% of pregnant women in the U.S. will suffer preeclampsia, and 7% will be diagnosed with gestational diabetes. About 800 women die every day around the world from pregnancy complications, with unsafe (mostly illegal) abortion accounting for about 8-18% of those deaths.

In addition to the much greater risk of childbirth over abortion, most pregnant women will experience some unpleasant side effects for months at a time, such as morning sickness, frequent urination, hemorrhoids, constipation, bleeding gums, or other problems. Severe morning sickness, “hyperemesis gravidarum,” can be fatal without proper treatment. Among the most serious risks of pregnancy is preeclampsia (related to high blood pressure). Ten million women develop preeclampsia each year around the world, and 76,000 pregnant women die each year from preeclampsia and related hypertensive disorders. There are also contraindications to pregnancy that can significantly increase the risk for some women, such as diabetes, heart disease, kidney disease, and asthma. Factors such as a multiple pregnancy (twins) also increase risk. After birth, post-partum depression is experienced by 1 in 9 women in the U.S.

Sources:

Guttmacher Institute, Induced Abortion Worldwide (2016)

Government of South Australia, Myths and Facts About Abortion

Obstetrics & Gynecology, The comparative safety of legal induced abortion and childbirth in the United States (2012)

American Pregnancy Association, Pregnancy Complications

Johns Hopkins Bloomberg School of Public Health, Complications of Pregnancy

Centers for Disease Control and Prevention (CDC), Depression of Women Among Reproductive Age

Preeclampsia Foundation, Preeclampsia and Maternal Mortality: a Global Burden

# 6

Abortion providers are in it for the money

Abortion providers generally charge less for their services than physicians in other specialties. Not only is abortion care less profitable than most other areas of medicine  – including obstetrics – it is usually less-respected and less prestigious as well. The stigma of abortion means that providers are often stigmatized too, even by their colleagues in other specialties. In addition, many of them continue their work in spite of regular threats to their lives and safety. These factors make profit an unlikely or low priority for most abortion providers. Indeed, personal accounts of providers often stress the satisfaction and joy they get from being able to help women in a direct and tangible way. For example, a provider from New York, Dr. Maureen Paul, said:

“I absolutely love my work. Each abortion is one woman’s story, and some of those stories are difficult. It is really important to help women through the abortion experience so that they come out on the other side feeling they have made the best choice for their lives. It is wonderful to be a part of that process. I know that every time I do an abortion on a woman who chooses it, I am saving her life both literally and figuratively.”

Most doctors enter medicine out of a desire to help people, and abortion providers are no different. After all, we don’t assume that because many other doctors are highly paid, such as heart surgeons, that they are therefore “only in it for the money.” Of course, all doctors deserve a reasonable income because they undergo years of specialized training and their profession carries a huge responsibility to society.

In the U.S., the cost of an early abortion has remained about the same since at least 2008 – about $500 US. Abortion is far from a lucrative business, but trying to restrict access to information about reproductive freedom costs taxpayers billions. In 2010, for example, unintended pregnancy cost American taxpayers $21 billion. Taxpayers paid for 68% of the 1.5 million unplanned births, at an average cost of $12,770 per birth. Abortion clinics actually save taxpayers’ money by preventing future unintended pregnancies through provision of birth control and education.

Sources:

Physicians for Reproductive Choice and Health, Why I Provide Abortions (2005)

Guttmacher Institute, Public Costs from Unintended Pregnancies

Guttmacher Institute, The Cost of Abortion, When Providers Offer Services and Harassment of Abortion Providers All Remained Stable Between 2008 And 2012 (2015)

Ms. Magazine, 10 Worst Abortion Myths–and How to Refute Them (2010)

Public Eye, Abortion Myths, by Marlena Sobel

# 7

Doctors perform abortions without prior consent and women don’t know what will happen to them

Informed consent is a basic ethical requirement for all healthcare treatments, and abortion is no exception.  In fact, the model of delivering abortion care via standalone reproductive health clinics has allowed providers to develop more comprehensive counseling and informed consent protocols than other areas of medicine. Unfortunately, in the United States, the informed consent process is often marred by the inclusion of medically-incorrect information mandated by the state through anti-abortion laws. Further, anti-choice agencies (frequently known as “crisis pregnancy centres”) are known to deceive, confuse, and scare women with misinformation about abortion. In other words, it is anti-choice proponents who are often guilty of depriving women of proper informed consent around abortion – not providers.

The only reason abortion is legal and abortion clinics exist, is because it is women who have always requested and demanded abortion care. When abortion is illegal, women seek abortions anyway, and many will knowingly risk their health and lives with unsafe abortion.  The anti-choice movement insults women by claiming they don’t consent to abortion or don’t understand what they’re doing. Most women having abortions already have at least one child (59% in the United States and 55% in the UK), so they understand what pregnancy means and what an abortion does.

Most women contacting an abortion clinic have already decided to have an abortion. Other women may be unsure or ambivalent, and need time and discussion with trusted people. Abortion clinics employ professional counselors that are available to all women. Counseling is tailored to ensure that women are clear and resolved about their choice and have addressed any possible emotional issues, or if women are unsure, they are guided compassionately to help them arrive at the best decision for themselves. Many women who were unsure will decide not to have an abortion after counseling. But those going forward will receive all the information they need about the procedure and what will happen, and how it may affect them. Often, women who are sent away because they are unsure come back in a week or two for the abortion.

Sources:

The Express (UK), Rise in proportion of women who are already mothers having abortions (2017)

Guttmacher Institute, Induced Abortion in the United States (2017)

Guttmacher Institute, State Abortion Counseling Policies and Fundamental Principles of Informed Consent

National Women’s Law Centre, Crisis Pregnancy Centers

Pregnancy Options Workbook

# 8

Abortion can be reversed

An anti-choice doctor in the United States has been using flimsy evidence and experimenting unethically on women in order to supposedly “reverse” a medical abortion. Dr. George Delgado is a family medicine physician who founded the organization “Abortion Pill Reversal”. Capitalizing on the anti-choice myth that women regret their abortions, he claims that a woman who has taken the first dose of the abortion pill can undo the process by taking large doses of progesterone. This is an unproven medical treatment.

Medical abortion is the use of drugs rather than surgery to end a pregnancy. The regimen includes a combination of two drugs — mifepristone, taken first, and misoprostol, taken at a later point. Mifepristone stops the pregnancy growth by blocking the hormone progesterone; misoprostol makes the uterus contract to complete the abortion. Medical abortion is more effective when both drugs are used because mifepristone alone will not always cause abortion. In fact, as many as half of women who take only mifepristone continue their pregnancies.

This is the key to why the experimental treatment is unproven – a large percentage of women will continue their pregnancy simply by not taking the second pill, and Dr. Delgado has failed to distinguish this from his claimed “success” rate. Expert Dr. Daniel Grossman has said: “There is no evidence that any kind of treatment reverses or stops the effect of the abortion pill.”  Dr. Grossman has also pointed to major methodological flaws in the only real actual on the topic (by Dr. Delgado). “The study is just not designed in a way that would be useful to determine if this is effective or not.” Dr. Hal Lawrence, the head of American Congress of Obstetricians and Gynecologists said regarding Delgado’s study: “It is poorly designed and falls far short of providing sufficient evidence to recommend this course of treatment.” He said the study “does not meet clinical or methodological standards.”

American Congress of Obstetricians and Gynecologists – Facts Are Important: Medication Abortion “Reversal” Is Not Supported by Science, August 2017

Vice.com – Medical community slams study pushing “abortion reversal” procedure. April 2018

Huffington Post – Proponents Of ‘Abortion Reversal’ Feel Vindicated By A New Study. They Shouldn’t.  April 2018

American Journal of Obstetrics & Gynecology – Medical abortion reversal: science and politics meet. March 2018