research paper outline on abortion

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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 Argumentative Essay: Definitive Guide

Academic writing

Abortion remains a debatable issue even today, especially in countries like the USA, where a controversial ban was upheld in 13 states at the point this article was written. That’s why an essay on abortion has become one of the most popular tasks in schools, colleges, and universities. When writing this kind of essay, students learn to express their opinion, find and draw arguments and examples, and conduct research.

It’s very easy to speculate on topics like this. However, this makes it harder to find credible and peer-reviewed information on the topic that isn’t merely someone’s opinion. If you were assigned this kind of academic task, do not lose heart. In this article, we will provide you with all the tips and tricks for writing about abortion.

Where to begin?

Conversations about abortion are always emotional. Complex stories, difficult decisions, bitter moments, and terrible diagnoses make this topic hard to cover. Some young people may be shocked by this assignment, while others would be happy to express their opinion on the matter.

One way or another, this topic doesn't leave anyone indifferent. However, it shouldn’t have an effect on the way you approach the research and writing process. What should you remember when working on an argumentative essay about abortion?

• Don’t let your emotions take over. As this is an academic paper, you have to stay impartial and operate with facts. The topic is indeed sore and burning, causing thousands of scandals on the Internet, but you are writing it for school, not a Quora thread.
• Try to balance your opinions. There are always two sides to one story, even if the story is so fragile. You need to present an issue from different angles. This is what your tutors seek to teach you.
• Be tolerant and mind your language. It is very important not to hurt anybody with the choice of words in your essay. So make sure you avoid any possible rough words. It is important to respect people with polar opinions, especially when it comes to academic writing. 
• Use facts, not claims. Your essay cannot be based solely on your personal ideas – your conclusions should be derived from facts. Roe v. Wade case, WHO or Mayo Clinic information, and CDC are some of the sources you can rely on.

Speaking of Outline

An argumentative essay on abortion outline is a must-have even for experienced writers. In general, each essay, irrespective of its kind or topic, has a strict outline. It may be brief or extended, but the major parts are always the same:

• Introduction. This is a relatively short paragraph that starts with a hook and presents the background information on the topic. It should end with a thesis statement telling your reader what your main goal or idea is.
• Body. This section usually consists of 2-4 paragraphs. Each one has its own structure: main argument + facts to support it + small conclusion and transition into the next paragraph.
• Conclusion. In this part, your task is to summarize all your thoughts and come to a general conclusive idea. You may have to restate some info from the body and your thesis statement and add a couple of conclusive statements without introducing new facts.

Why is it important to create an outline?

• You will structure your ideas. We bet you’ve got lots on your mind. Writing them down and seeing how one can flow logically into the other will help you create a consistent paper. Naturally, you will have to abandon some of the ideas if they don’t fit the overall narrative you’re building.
• You can get some inspiration. While creating your outline, which usually consists of some brief ideas, you can come up with many more to research. Some will add to your current ones or replace them with better options.
• You will find the most suitable sources. Argumentative essay writing requires you to use solid facts and trustworthy arguments built on them. When the topic is as controversial as abortion, these arguments should be taken from up-to-date, reliable sources. With an outline, you will see if you have enough to back up your ideas.
• You will write your text as professionals do. Most expert writers start with outlines to write the text faster and make it generally better. As you will have your ideas structured, the general flow of thoughts will be clear. And, of course, it will influence your overall grade positively.

Abortion Essay Introduction

The introduction is perhaps the most important part of the whole essay. In this relatively small part, you will have to present the issue under consideration and state your opinion on it. Here is a typical introduction outline:

• The first sentence is a hook grabbing readers' attention.
• A few sentences that go after elaborate on the hook. They give your readers some background and explain your research.
• The last sentence is a thesis statement showing the key idea you are building your text around.

Before writing an abortion essay intro, first thing first, you will need to define your position. If you are in favor of this procedure, what exactly made you think so? If you are an opponent of abortion, determine how to argue your position. In both cases, you may research the point of view in medicine, history, ethics, and other fields.

When writing an introduction, remember:

• Never repeat your title. First of all, it looks too obvious; secondly, it may be boring for your reader right from the start. Your first sentence should be a well-crafted hook. The topic of abortion worries many people, so it’s your chance to catch your audience’s attention with some facts or shocking figures.
• Do not make it too long. Your task here is to engage your audience and let them know what they are about to learn. The rest of the information will be disclosed in the main part. Nobody likes long introductions, so keep it short but informative.
• Pay due attention to the thesis statement. This is the central sentence of your introduction. A thesis statement in your abortion intro paragraph should show that you have a well-supported position and are ready to argue it. Therefore, it has to be strong and convey your idea as clearly as possible. We advise you to make several options for the thesis statement and choose the strongest one.

Hooks for an Abortion Essay

Writing a hook is a good way to catch the attention of your audience, as this is usually the first sentence in an essay. How to start an essay about abortion? You can begin with some shocking fact, question, statistics, or even a quote. However, always make sure that this piece is taken from a trusted resource.

Here are some examples of hooks you can use in your paper:

• As of July 1, 2022, 13 states banned abortion, depriving millions of women of control of their bodies.
• According to WHO, 125,000 abortions take place every day worldwide.
• Is abortion a woman’s right or a crime?
• Since 1994, more than 40 countries have liberalized their abortion laws.
• Around 48% of all abortions are unsafe, and 8% of them lead to women’s death.
• The right to an abortion is one of the reproductive and basic rights of a woman.
• Abortion is as old as the world itself – women have resorted to this method since ancient times.
• Only 60% of women in the world live in countries where pregnancy termination is allowed.

Body Paragraphs: Pros and Cons of Abortion

The body is the biggest part of your paper. Here, you have a chance to make your voice concerning the abortion issue heard. Not sure where to start? Facts about abortion pros and cons should give you a basic understanding of which direction to move in.

First things first, let’s review some brief tips for you on how to write the best essay body if you have already made up your mind.

Make a draft

It’s always a good idea to have a rough draft of your writing. Follow the outline and don’t bother with the word choice, grammar, or sentence structure much at first. You can polish it all later, as the initial draft will not likely be your final. You may see some omissions in your arguments, lack of factual basis, or repetitiveness that can be eliminated in the next versions.

Trust only reliable sources

This part of an essay includes loads of factual information, and you should be very careful with it. Otherwise, your paper may look unprofessional and cost you precious points. Never rely on sources like Wikipedia or tabloids – they lack veracity and preciseness.

Edit rigorously

It’s best to do it the next day after you finish writing so that you can spot even the smallest mistakes. Remember, this is the most important part of your paper, so it has to be flawless. You can also use editing tools like Grammarly.

Determine your weak points

Since you are writing an argumentative essay, your ideas should be backed up by strong facts so that you sound convincing. Sometimes it happens that one argument looks weaker than the other. Your task is to find it and strengthen it with more or better facts.

Add an opposing view

Sometimes, it’s not enough to present only one side of the discussion. Showing one of the common views from the opposing side might actually help you strengthen your main idea. Besides, making an attempt at refuting it with alternative facts can show your teacher or professor that you’ve researched and analyzed all viewpoints, not just the one you stand by.

If you have chosen a side but are struggling to find the arguments for or against it, we have complied abortion pro and cons list for you. You can use both sets if you are writing an abortion summary essay covering all the stances.

Why Should Abortion Be Legal

If you stick to the opinion that abortion is just a medical procedure, which should be a basic health care need for each woman, you will definitely want to write the pros of abortion essay. Here is some important information and a list of pros about abortion for you to use:

• Since the fetus is a set of cells – not an individual, it’s up to a pregnant woman to make a decision concerning her body. Only she can decide whether she wants to keep the pregnancy or have an abortion. The abortion ban is a violation of a woman’s right to have control over her own body.
• The fact that women and girls do not have access to effective contraception and safe abortion services has serious consequences for their own health and the health of their families.
• The criminalization of abortion usually leads to an increase in the number of clandestine abortions. Many years ago, fetuses were disposed of with improvised means, which included knitting needles and half-straightened metal hangers. 13% of women’s deaths are the result of unsafe abortions.
• Many women live in a difficult financial situation and cannot support their children financially. Having access to safe abortion takes this burden off their shoulders. This will also not decrease their quality of life as the birth and childcare would.
• In countries where abortion is prohibited, there is a phenomenon of abortion tourism to other countries where it can be done without obstacles. Giving access to this procedure can make the lives of women much easier.
• Women should not put their lives or health in danger because of the laws that were adopted by other people.
• Girls and women who do not have proper sex education may not understand pregnancy as a concept or determine that they are pregnant early on. Instead of educating them and giving them a choice, an abortion ban forces them to become mothers and expects them to be fit parents despite not knowing much about reproduction.
• There are women who have genetic disorders or severe mental health issues that will affect their children if they're born. Giving them an option to terminate ensures that there won't be a child with a low quality of life and that the woman will not have to suffer through pregnancy, birth, and raising a child with her condition.
• Being pro-choice is about the freedom to make decisions about your body so that women who are for termination can do it safely, and those who are against it can choose not to do it. It is an inclusive option that caters to everyone.
• Women and girls who were raped or abused by their partner, caregiver, or stranger and chose to terminate the pregnancy can now be imprisoned for longer than their abusers. This implies that the system values the life of a fetus with no or primitive brain function over the life of a living woman.
• People who lived in times when artificial termination of pregnancy was scarcely available remember clandestine abortions and how traumatic they were, not only for the physical but also for the mental health of women. Indeed, traditionally, in many countries, large families were a norm. However, the times have changed, and supervised abortion is a safe and accessible procedure these days. A ban on abortion will simply push humanity away from the achievements of the civilized world.

Types of abortion

There are 2 main types of abortions that can be performed at different pregnancy stages and for different reasons:

• Medical abortion. It is performed by taking a specially prescribed pill. It does not require any special manipulations and can even be done at home (however, after a doctor’s visit and under supervision). It is considered very safe and is usually done during the very first weeks of pregnancy.
• Surgical abortion. This is a medical operation that is done with the help of a suction tube. It then removes the fetus and any related material. Anesthesia is used for this procedure, and therefore, it can only be done in a hospital. The maximum time allowed for surgical abortion is determined in each country specifically.

Cases when abortion is needed

Center for Reproductive Rights singles out the following situations when abortion is required:

• When there is a risk to the life or physical/mental health of a pregnant woman.
• When a pregnant woman has social or economic reasons for it.
• Upon the woman's request.
• If a pregnant woman is mentally or cognitively disabled.
• In case of rape and/or incest.
• If there were congenital anomalies detected in the fetus.

Countries and their abortion laws

• Countries where abortion is legalized in any case: Australia, Albania, Bosnia and Herzegovina, Belgium, Canada, Denmark, Sweden, France, Germany, Greece, Italy, Hungary, the Netherlands, Norway, Ukraine, Moldova, Latvia, Lithuania, etc.
• Countries where abortion is completely prohibited: Angola, Venezuela, Egypt, Indonesia, Iraq, Lebanon, Nicaragua, Oman, Paraguay, Palau, Jamaica, Laos, Haiti, Honduras, Andorra, Aruba, El Salvador, Dominican Republic, Sierra Leone, Senegal, etc.
• Countries where abortion is allowed for medical reasons: Afghanistan, Israel, Argentina, Nigeria, Bangladesh, Bolivia, Ghana, Israel, Morocco, Mexico, Bahamas, Central African Republic, Ecuador, Ghana, Algeria, Monaco, Pakistan, Poland, etc. 
• Countries where abortion is allowed for both medical and socioeconomic reasons: England, India, Spain, Luxembourg, Japan, Finland, Taiwan, Zambia, Iceland, Fiji, Cyprus, Barbados, Belize, etc.

Why Abortion Should Be Banned

Essays against abortions are popular in educational institutions since we all know that many people – many minds. So if you don’t want to support this procedure in your essay, here are some facts that may help you to argument why abortion is wrong:

• Abortion at an early age is especially dangerous because a young woman with an unstable hormonal system may no longer be able to have children throughout her life. Termination of pregnancy disrupts the hormonal development of the body.
• Health complications caused by abortion can occur many years after the procedure. Even if a woman feels fine in the short run, the situation may change in the future.
• Abortion clearly has a negative effect on reproductive function. Artificial dilation of the cervix during an abortion leads to weak uterus tonus, which can cause a miscarriage during the next pregnancy.
• Evidence shows that surgical termination of pregnancy significantly increases the risk of breast cancer.
• In December 1996, the session of the Council of Europe on bioethics concluded that a fetus is considered a human being on the 14th day after conception.

You are free to use each of these arguments for essays against abortions. Remember that each claim should not be supported by emotions but by facts, figures, and so on.

Health complications after abortion

One way or another, abortion is extremely stressful for a woman’s body. Apart from that, it can even lead to various health problems in the future. You can also cover them in your cons of an abortion essay:

• Continuation of pregnancy. If the dose of the drug is calculated by the doctor in the wrong way, the pregnancy will progress.
• Uterine bleeding, which requires immediate surgical intervention.
• Severe nausea or even vomiting occurs as a result of a sharp change in the hormonal background.
• Severe stomach pain. Medical abortion causes miscarriage and, as a result, strong contractions of the uterus.
• High blood pressure and allergic reactions to medicines.
• Depression or other mental problems after a difficult procedure.

Abortion Essay Conclusion

After you have finished working on the previous sections of your paper, you will have to end it with a strong conclusion. The last impression is no less important than the first one. Here is how you can make it perfect in your conclusion paragraph on abortion:

• It should be concise. The conclusion cannot be as long as your essay body and should not add anything that cannot be derived from the main section. Reiterate the key ideas, combine some of them, and end the paragraph with something for the readers to think about.
• It cannot repeat already stated information. Restate your thesis statement in completely other words and summarize your main points. Do not repeat anything word for word – rephrase and shorten the information instead.
• It should include a call to action or a cliffhanger. Writing experts believe that a rhetorical question works really great for an argumentative essay. Another good strategy is to leave your readers with some curious ideas to ponder upon.

Abortion Facts for Essay

Abortion is a topic that concerns most modern women. Thousands of books, research papers, and articles on abortion are written across the world. Even though pregnancy termination has become much safer and less stigmatized with time, it still worries millions. What can you cover in your paper so that it can really stand out among others? You may want to add some shocking abortion statistics and facts:

• 40-50 million abortions are done in the world every year (approximately 125,000 per day).
• According to UN statistics, women have 25 million unsafe abortions each year. Most of them (97%) are performed in the countries of Africa, Asia, and Latin America. 14% of them are especially unsafe because they are done by people without any medical knowledge.
• Since 2017, the United States has shown the highest abortion rate in the last 30 years.
• The biggest number of abortion procedures happen in the countries where they are officially banned. The lowest rate is demonstrated in the countries with high income and free access to contraception.
• Women in low-income regions are three times more susceptible to unplanned pregnancies than those in developed countries.
• In Argentina, more than 38,000 women face dreadful health consequences after unsafe abortions.
• The highest teen abortion rates in the world are seen in 3 countries: England, Wales, and Sweden.
• Only 31% of teenagers decide to terminate their pregnancy. However, the rate of early pregnancies is getting lower each year.
• Approximately 13 million children are born to mothers under the age of 20 each year.
• 5% of women of reproductive age live in countries where abortions are prohibited.

We hope that this abortion information was useful for you, and you can use some of these facts for your own argumentative essay. If you find some additional facts, make sure that they are not manipulative and are taken from official medical resources.

Abortion Essay Topics

Do you feel like you are lost in the abundance of information? Don’t know what topic to choose among the thousands available online? Check our short list of the best abortion argumentative essay topics:

• Why should abortion be legalized essay
• Abortion: a murder or a basic human right?
• Why we should all support abortion rights
• Is the abortion ban in the US a good initiative?
• The moral aspect of teen abortions
• Can the abortion ban solve birth control problems?
• Should all countries allow abortion?
• What consequences can abortion have in the long run?
• Is denying abortion sexist?
• Why is abortion a human right?
• Are there any ethical implications of abortion?
• Do you consider abortion a crime?
• Should women face charges for terminating a pregnancy?

Want to come up with your own? Here is how to create good titles for abortion essays:

• Write down the first associations. It can be something that swirls around in your head and comes to the surface when you think about the topic. These won’t necessarily be well-written headlines, but each word or phrase can be the first link in the chain of ideas that leads you to the best option.
• Irony and puns are not always a good idea. Especially when it comes to such difficult topics as abortion. Therefore, in your efforts to be original, remain sensitive to the issue you want to discuss.
• Never make a quote as your headline. First, a wordy quote makes the headline long. Secondly, readers do not understand whose words are given in the headline. Therefore, it may confuse them right from the start. If you have found a great quote, you can use it as your hook, but don’t forget to mention its author.
• Try to briefly summarize what is said in the essay. What is the focus of your paper? If the essence of your argumentative essay can be reduced to one sentence, it can be used as a title, paraphrased, or shortened.
• Write your title after you have finished your text. Before you just start writing, you might not yet have a catchy phrase in mind to use as a title. Don’t let it keep you from working on your essay – it might come along as you write.

Abortion Essay Example

We know that it is always easier to learn from a good example. For this reason, our writing experts have complied a detailed abortion essay outline for you. For your convenience, we have created two options with different opinions.

Topic: Why should abortion be legal?

Introduction – hook + thesis statement + short background information

Essay hook: More than 59% of women in the world do not have access to safe abortions, which leads to dreading health consequences or even death.

Thesis statement: Since banning abortions does not decrease their rates but only makes them unsafe, it is not logical to ban abortions.

Body – each paragraph should be devoted to one argument

Argument 1: Woman’s body – women’s rules. + example: basic human rights.

Argument 2: Banning abortion will only lead to more women’s death. + example: cases of Polish women.

Argument 3: Only women should decide on abortion. + example: many abortion laws are made by male politicians who lack knowledge and first-hand experience in pregnancies.

Conclusion – restated thesis statement + generalized conclusive statements + cliffhanger

Restated thesis: The abortion ban makes pregnancy terminations unsafe without decreasing the number of abortions, making it dangerous for women.

Cliffhanger: After all, who are we to decide a woman’s fate?

Topic: Why should abortion be banned?

Essay hook: Each year, over 40 million new babies are never born because their mothers decide to have an abortion.

Thesis statement: Abortions on request should be banned because we cannot decide for the baby whether it should live or die.

Argument 1: A fetus is considered a person almost as soon as it is conceived. Killing it should be regarded as murder. + example: Abortion bans in countries such as Poland, Egypt, etc.

Argument 2: Interrupting a baby’s life is morally wrong. + example: The Bible, the session of the Council of Europe on bioethics decision in 1996, etc.

Argument 3: Abortion may put the reproductive health of a woman at risk. + example: negative consequences of abortion.

Restated thesis: Women should not be allowed to have abortions without serious reason because a baby’s life is as priceless as their own.

Cliffhanger: Why is killing an adult considered a crime while killing an unborn baby is not?

Examples of Essays on Abortion

There are many great abortion essays examples on the Web. You can easily find an argumentative essay on abortion in pdf and save it as an example. Many students and scholars upload their pieces to specialized websites so that others can read them and continue the discussion in their own texts.

In a free argumentative essay on abortion, you can look at the structure of the paper, choice of the arguments, depth of research, and so on. Reading scientific papers on abortion or essays of famous activists is also a good idea. Here are the works of famous authors discussing abortion.

A Defense of Abortion by Judith Jarvis Thomson

Published in 1971, this essay by an American philosopher considers the moral permissibility of abortion. It is considered the most debated and famous essay on this topic, and it’s definitely worth reading no matter what your stance is.

Abortion and Infanticide by Michael Tooley

It was written in 1972 by an American philosopher known for his work in the field of metaphysics. In this essay, the author considers whether fetuses and infants have the same rights. Even though this work is quite complex, it presents some really interesting ideas on the matter.

Some Biological Insights into Abortion by Garret Hardin

This article by American ecologist Garret Hardin, who had focused on the issue of overpopulation during his scholarly activities, presents some insights into abortion from a scientific point of view. He also touches on non-biological issues, such as moral and economic. This essay will be of great interest to those who support the pro-choice stance.

H4 Hidden in Plain View: An Overview of Abortion in Rural Illinois and Around the Globe by Heather McIlvaine-Newsad 

In this study, McIlvaine-Newsad has researched the phenomenon of abortion since prehistoric times. She also finds an obvious link between the rate of abortions and the specifics of each individual country. Overall, this scientific work published in 2014 is extremely interesting and useful for those who want to base their essay on factual information.

H4 Reproduction, Politics, and John Irving’s The Cider House Rules: Women’s Rights or “Fetal Rights”? by Helena Wahlström

In her article of 2013, Wahlström considers John Irving’s novel The Cider House Rules published in 1985 and is regarded as a revolutionary work for that time, as it acknowledges abortion mostly as a political problem. This article will be a great option for those who want to investigate the roots of the abortion debate.

FAQs On Abortion Argumentative Essay

• Is abortion immoral?

This question is impossible to answer correctly because each person independently determines their own moral framework. One group of people will say that abortion is a woman’s right because only she has power over her body and can make decisions about it. Another group will argue that the embryo is also a person and has the right to birth and life.

In general, the attitude towards abortion is determined based on the political and religious views of each person. Religious people generally believe that abortion is immoral because it is murder, while secular people see it as a normal medical procedure. For example, in the US, the ban on abortion was introduced in red states where the vast majority have conservative views, while blue liberal states do not support this law. Overall, it’s up to a person to decide whether they consider abortion immoral based on their own values and beliefs.

• Is abortion legal?

The answer to this question depends on the country in which you live. There are countries in which pregnancy termination is a common medical procedure and is performed at the woman's request. There are also states in which there must be a serious reason for abortion: medical, social, or economic. Finally, there are nations in which abortion is prohibited and criminalized. For example, in Jamaica, a woman can get life imprisonment for abortion, while in Kenya, a medical worker who volunteers to perform an abortion can be imprisoned for up to 14 years.

• Is abortion safe?

In general, modern medicine has reached such a level that abortion has become a common (albeit difficult from various points of view) medical procedure. There are several types of abortion, as well as many medical devices and means that ensure the maximum safety of the pregnancy termination. Like all other medical procedures, abortion can have various consequences and complications.

Abortions – whether safe or not - exist in all countries of the world. The thing is that more than half of them are dangerous because women have them in unsuitable conditions and without professional help. Only universal access to abortion in all parts of the world can make it absolutely safe. In such a case, it will be performed only after a thorough assessment and under the control of a medical professional who can mitigate the potential risks.

• How safe is abortion?

If we do not talk about the ethical side of the issue related to abortion, it still has some risks. In fact, any medical procedure has them to a greater or lesser extent.

The effectiveness of the safe method in a medical setting is 80-99%. An illegal abortion (for example, the one without special indications after 12 weeks) can lead to a patient’s death, and the person who performed it will be criminally liable in this case.

Doctors do not have universal advice for all pregnant women on whether it is worth making this decision or not. However, many of them still tend to believe that any contraception - even one that may have negative side effects - is better than abortion. That’s why spreading awareness on means of contraception and free access to it is vital.

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• Open access
• Published: 17 July 2008

Experiences of abortion: A narrative review of qualitative studies

• Mabel LS Lie 1 ,
• Stephen C Robson 2 &
• Carl R May 3  

BMC Health Services Research volume  8 , Article number:  150 ( 2008 ) Cite this article

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Although abortion or termination of pregnancy (TOP) has become an increasingly normalized component of women's health care over the past forty years, insufficient attention has been paid to women's experiences of surgical or medical methods of TOP.

To undertake a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods.

Keyword searches of Medline, CINAHL, ISI, and IBSS databases. Manual searches of other relevant journals and reference lists of primary articles.

Qualitative studies (n = 18) on women's experiences of abortion were identified. Analysis of the results of studies reviewed revealed three main themes: experiential factors that promote or inhibit the choice to seek TOP; experiences of TOP; and experiential aspects of the environment in which TOP takes place.

Women's choices about TOP are mainly pragmatic ones that are related to negotiating finite personal and family and emotional resources. Women who are well informed and supported in their choices experience good psychosocial outcomes from TOP. Home TOP using mifepristone appears attractive to women who are concerned about professionals' negative attitudes and lack of privacy in formal healthcare settings but also leads to concerns about management and safety.

Peer Review reports

Although abortion or termination of pregnancy (TOP) by clinical means is politically contentious in some countries (notably the US), in most developed countries it has become a normalized [ 1 ] component of women's health care [ 2 ] over the past forty years. For most of this period, TOP was a surgical procedure but since the mid-1990s, pharmaceutical developments (i.e. RU-486 also known as mifepristone, and methotrexate [ 3 ]), have made medical TOP possible. Clinical trials have established that medical TOP provides a clinical and cost effective alternative to vacuum aspiration for the early termination of pregnancy [ 4 – 8 ]. While a Cochrane systematic review highlighted inadequate evidence [ 9 ], a more recent systematic review concluded that the incidence of side effects in medical abortion was low [ 10 ]. Even so, mifepristone has only been approved in the US since September 2000, whereas the UK and Sweden have had more than a decade of experience of its use and it is approved for use in 14 European countries [ 11 ].

The emphasis on establishing clinical and cost effectiveness of medical versus surgical TOP means that less attention has been paid to women's experiences of the two methods. This paper goes some way towards filling that gap by providing a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods. Given the importance of this topic to policy and clinical practice around reproductive health, this is a surprisingly small body of literature, but it is highly heterogeneous and contextually specific.

An initial scoping exercise established that the qualitative research literature was too heterogeneous to permit a systematic review of qualitative studies along the lines proposed by Dixon-Woods [ 12 ], or a theoretical qualitative meta-synthesis using the methods proposed by Sandelowski [ 13 ]. For this reason, a narrative review [ 14 ] was undertaken.

The review focused on the period 1998–2007 because it was during this period that medical TOP has become established in practice. The primary focus of the review is therefore on women's experiences of TOP, and this meant that other studies (for example qualitative studies of attitudes and moral considerations) were excluded. Studies included in the review were identified by keyword searches of Medline, Psychinfo, CINAHL, ISI, and IBSS databases. Keywords searched included 'abortion', 'terminat*, pregnan*', 'unplanned pregnancy', in combination with 'qualitative study', semi-structured, ethnograph* experiences', of which 'abortion experiences' yielded the most relevant material. Manual searches of other relevant journals ( Reproductive Health Matters ; Health Care for Women International ; Contraception ) and reference lists of primary articles found from initial searches were also conducted. These searches revealed four comparative qualitative studies of surgical versus medical TOP [ 15 – 18 ] of which three were conducted in the US and one in Latin America. A further 14 qualitative studies of women's experiences of TOP using either method were identified [ 19 – 32 ]. This is an extraordinarily small body of peer-reviewed research papers given the importance and contentiousness of the topic.

While many authors have observed that qualitative studies have important strengths in health policy and practice research [ 33 , 34 ] the studies included in this paper also have limitations that should be acknowledged. The most important of these are their small size and limited scope. Because this is not a systematic review and few articles were found, evaluations of methodological quality were not used to exclude papers from the study. However, it was accepted that non-probability sampling was employed and for ethical reasons, participants were self-selected. Even so, many studies provided insufficient socio-demographic information about their research participants and only nine acknowledged study limitations and recruitment biases [ 17 , 19 , 23 – 28 , 31 ]. In common with other narrative reviews of qualitative studies, this means that we do not seek to assess the ways that participant selection may have influenced results.

Discussion of ethnicity was virtually absent. Only one study [ 23 ], included participants who did not speak the dominant language in the country in which it was conducted, so that the views of migrant minority ethnic women were often not taken into account. While one study [ 28 ] recruited a significant proportion (two thirds) from minority ethnic communities, no attempt was made to explain their results on the basis of ethnicity.

Most studies recruited at clinical sites with the help of health professionals, others by advertising in public spaces (e.g. university, women's magazine) and snowballing [ 21 , 31 , 32 ] and the majority of studies interviewed single women from their late teens to their twenties. Only two studies interviewed participants prior to TOP [ 20 , 30 ]; two were longitudinal [ 24 , 35 ]; and two investigated the longer term effects of abortion [ 31 , 32 ]. Apart from two ethnographies [ 22 , 24 ] all studies collected data through semi-structured or in-depth interviews.

The review identified two groups of qualitative studies on TOP.

Studies that focused on experiences of medical TOP, (n = 4, summarised in table 1 ) mainly in comparison with experiences of surgical TOP. Three of these studies were conducted in the US. These included a study embedded in the 1994–95 pre-legalisation clinical trials of mifepristone [ 15 ], and two studies of the home administration of mifepristone within the Abortion Rights Mobilisation Trials [ 16 , 17 ]. A further study on Latin American women's perspectives on medical TOP was not connected with assessing mifepristone [ 18 ].

Studies that explored general experiences of TOP (n = 14, summarised in table 2 ). These focused on the process of arranging TOP [ 19 , 28 ], and the experience of undergoing it [ 21 , 22 , 26 , 30 ]. Two studies highlighted the influence of cultural and contextual features [ 23 , 24 ], with one looking more specifically at a sample of women involved in a clinical trial [ 25 ]. Other studies investigated the role of the male partner in TOP [ 35 , 36 ]; experiences of repeated TOP [ 20 ]; and recollections of abortion experiences years after undergoing the procedure [ 31 , 32 ]. Two studies specifically explored teenage TOP [ 24 , 29 ] and two the relationship between TOP and contraceptive service provision [ 29 , 37 ].

Analysis of the results of studies included in this paper revealed three main themes: experiential factors that promote or inhibit the choice to seek TOP; experiences of TOP; and experiential aspects of the environment in which TOP takes place.

The watchword of campaigners for abortion services has been that it is the woman's right to freely choose between abortion and pregnancy [ 38 ]. Studies reviewed for this paper suggest that although moral values are important [ 15 , 21 , 26 , 27 ], the choice to seek TOP is a pragmatic one that reflects the impact of pregnancy and childbearing on personal and household circumstances [ 17 , 18 , 21 , 26 , 27 , 29 ]. A number of studies described the role male partners played in women's decision of whether to undergo the procedure [ 16 , 20 – 22 , 24 , 30 ]. Lone mothers are often economically disadvantaged, but in Sweden, where universal childcare provision makes lone parenthood economically viable, one study showed that participants (n = 5) preferred not to bring up children on their own [ 26 ]. Partnered or married women were also concerned about planning their families well [ 27 ], taking into consideration their partners' attitudes and the needs of their children [ 18 ] and their quality of life [ 17 ]. However, a U.S. study reported that women were more likely to confide in their female friends about their pregnancy than family members or partners [ 25 ]. Women's childhood experiences such as growing up in a broken home could also affect women's decisions [ 26 ]. Studies conducted with women under the age of 21 revealed that other factors such as immaturity, parental attitudes, and education and employment prospects were more important than moral considerations [ 24 , 29 , 30 ]

Whatever women's circumstances, studies in this review suggest that the decision to seek TOP usually precedes any encounter with heath care professionals [ 17 , 28 , 29 ]. However, such decisions are moderated by the value systems and social norms of the society or community in question [ 15 , 19 , 22 – 24 , 29 ]. Feelings of ambivalence in the decision-making process were highlighted in a Swedish study [ 26 ], where women felt positive towards the right to abortion, but negative about their own decision to abort. It is argued that TOP allows women to return to 'normality' psychologically, physiologically and socially, and women appreciated being treated in a non-stigmatised way [ 19 ]. However, a study conducted in the UK found that the majority of teenage mothers who were interviewed did not associate motherhood with lack or loss of opportunity [ 29 ].

The range of services available also affects the choices of women. However, papers identified for review provided little about how the choice of TOP provider is framed, or even what choices are available. One study of young women in the UK [ 29 ] found that they preferred family planning services rather than general practitioners for their first point of contact and referral, for reasons of greater anonymity and specialised treatment. Anonymity and confidentiality are key issues in all settings where TOP is stigmatised [ 21 – 24 ]. For this reason, Israeli women tended to avoid publicly subsidised formal procedures opting instead for private abortion providers [ 23 ].

In the UK, expectations of better personal treatment and confidentiality were also reasons why some women chose private or voluntary sector clinics over National Health Service (NHS) clinics, although cost is an issue [ 19 ]. Those who had used independent providers reported more positive experiences than those who had used the NHS [ 29 ]. Further evidence of this comes from another British study [ 28 ], where participants (n = 21) reported difficulties in getting an urgent appointment with their family doctor, problems with the NHS telephone booking system and being asked by doctors to further consider their decision, thus delaying the process.

Finally, the choice of method is dependent not only on service availability but on medico-legal considerations such as the gestational age. Once again, data on this topic are very limited. Pragmatic reasons such as effectiveness and the side effects were found to over-ride women's moral and political considerations in one US study [ 17 ]. Previous experiences of surgical abortion may have led women to seek medical rather than surgical TOP in two other US studies [ 16 , 17 ]. The experiences of other family members or friends who had undergone abortion can also be influential [ 17 , 30 ].

2. Experiences

Studies that concentrated on women's experiences of the TOP procedure prefaced their findings with an account of the specific medical regimens in place at the time of the study. The US studies focused on women's perceptions of medical abortion as a new procedure, and often compared this with surgical TOP. In this context, women identified medical abortion as a way to avoid surgery, and anaesthesia and that permitted them privacy, autonomy and a greater sense of control [ 15 , 17 – 19 ]. Simonds et al [ 15 ], in particular, explored the idea of abortion being 'natural' describing this as 'not-really-abortion, but rather as a late period that finally comes' (p1316). As such, medical TOP was associated with reduced feelings of guilt for some participants in her study. This 'naturalness' (a subjective association with a miscarriage or menstruation without the insertion of instruments) seems to outweigh the pain and prolonged nature of the procedure, including the sight of fetus. Other women focused on the pain as a necessary part of the process [ 16 ].

Complex emotional experiences appear to be integral to TOP. These include regret and guilt [ 17 , 22 ], distress and anxiety [ 17 , 22 , 27 ] and grief, loss, emptiness and suffering [ 21 ]. These experiences are related to gestational age, for example, in one study a medical termination before any symptoms of pregnancy were perceived was described as involving a 'loss' whereas a surgical termination was described as a 'death' [ 16 ]. Anxiety about sterility and death is also experienced by some women [ 16 , 18 , 26 ]. Women were also found to associate an abortion with taking responsibility [ 27 ] for the consequences of what they considered was an irresponsible act [ 19 ], especially in medical TOP where women were conscious during the procedure [ 15 ]. Another study [ 16 ] described the experience of a medical abortion as a chance to grieve, and the pain experienced was described by the authors as 'cathartic', one woman describing this as 'a personal investigation into your own pain' (p171).

Such perceptions are mediated by the moral context within which the women are located. In Indonesia, for example, women's perception of the fetus is influenced by the Islamic view that ensoulment takes place at 120 days of pregnancy [ 22 ]. In the US, Pro-Life argument against TOP is rich with images of a destructive, act, often explicitly called murder , leading some women to think that they 'killed a baby', but also realising 'it wasn't really a child' [ 17 ]. In a study by Fielding and Schaff [ 25 ], reservations about abortion in the second trimester onwards were unanimous except in relation to abnormalities. The language used to describe the fetus reflects the closeness or distance that women feel towards the life growing in their bodies and impacts on women's post-abortion emotional reactions [ 25 , 30 , 32 ]. In one trial, women were encouraged to look at the expelled fetus at home, but the authors say that 'dramatic' responses were rare [ 15 ]. Some women in this study described relief in not seeing a distinguishable human being when the fetus was expelled.

Feminist researchers provide insights into the interaction of TOP with notions of reproductive independence. A study [ 27 ] on the long term emotional effects of abortion found that more than half of the women who had reported both positive and painful feelings continued to report these feelings after 12 months. However, respondents reported they coped well, experiencing strengthened self-esteem, personal growth and maturity over the year. A study [ 30 ] of young Swedish women (n = 10) found that they encountered an understanding of themselves, their bodies, their fertility, and the meaning of adult motherhood. A study [ 24 ] of African-American adolescents (n = 12), aged between 15–18, highlighted their poor knowledge of reproductive processes and health and suggested that elective TOP was a 'positive, growth-enhancing experience' (p432), with participants being empowered by their experience of decision-making. However, Simonds et al [ 15 ] showed that in a clinical trial, medical abortion may have been perceived no less invasive as surgical abortion because of repeated insertions of pessaries, pelvic examinations, and ultrasound examinations, to ensure the success of the procedure.

Other studies highlight the isolation of women undergoing TOP and their concerns to conceal it from others [ 21 , 26 ]. In studies of the home use of misoprostol [ 17 , 18 ], there are accounts of women who undergo the abortion alone, or in secret with others such as family members around but unaware of the situation. In contrast, women in another clinical trial [ 16 ] described the active participation of partners or friends who helped to minimise their discomfort by rubbing their backs, bringing them tea, or monitoring their blood loss. Women with knowledge of how TOP works, and who have support from both their clinic and their partner seem more likely to experience a better outcome [ 18 ]. Women's cultural affiliations and beliefs also have a bearing on their emotional experiences [ 18 , 22 , 27 ]. For example, Israeli women tended to interpret abortion as a personal failure whereas Russian immigrants looked upon it as bad luck or a mistake [ 23 ]. In relation to the emotional impact of the abortion experience, a woman's preparedness and post-abortion support [ 32 ] as well as the emotional work required from nurses in family planning and abortion clinics [ 26 ] were important considerations.

3. Environment

The role of service providers is examined in most of the studies and British studies have focused especially on health services access and quality [ 19 , 28 , 29 ]. The process of seeking abortion in the UK is sometimes confusing because of inadequate information and extended because of delays in referrals. In three US studies [ 15 – 17 ] participants compared positive experiences of treatment by professionals providing medical TOP in clinical trials with professionals' negative attitudes and impersonal clinic settings in ordinary services. A Canadian study [ 21 ] identified a mismatch between women's normative expectations that health care providers should provide them with options and access to whatever medical services they might need, and what they perceived to be an unsympathetic reception from medical staff. The effect of such attitudes is assumed to discourage women from seeking abortion, but there is no systematic evidence to support this assumption. In an Israeli study, Russian immigrants objected to state interference into their choice to abort, but were impressed with the quality of publicly provided abortion services and sympathetic staff [ 23 ].

Women's experiences of patient care during an abortion are also affected by the method of termination. In US trials on medical TOP, women relied on health professionals to assure them about the safety of the new procedure and to determine if the termination had been successful [ 17 ]. Women needed more counselling from clinical staff about the procedure of medical termination [ 17 ]. This may reflect the need to assess if they were appropriate candidates for the procedure [ 15 ]. Women also had to be assured of ready access to medical information and help from clinical staff. In reports [ 15 ] of experiences with surgical TOP, treatment by medical staff figured more prominently than the actual physical experience of abortion.

In some contexts, the attitudes of health providers to abortion were relative to the marital status of the women [ 22 ]. In Indonesia for example, medical staff endorse abortions as a form of birth control for married women, but held disapproving attitudes towards pre-marital sex which impact on young women's feelings of guilt and shame. A study on teenage mothers in the UK [ 29 ] also reported doctors' disapproval. In the UK, clinical attitudes appear to be more negative towards the termination of pregnancies after the first trimester and some NHS clinics do not offer services for late abortions.

Studies that included primary care primary care professionals suggested that these were perceived as less sympathetic and supportive than professionals working in abortion services. The latter were perceived to be more caring and less judgemental [ 19 , 28 ]. This distinction was also found in one of the U.S. studies, although clinical trial staff were also perceived as more conscientious than women's usual health care providers.

Counselling is referred to in different ways in the studies but most particularly as counselling prior to the TOP to discuss the different methods, their benefits, what to expect, compliance and follow-up [ 17 ] and in relation to decision-making [ 28 ]. Other studies take a nursing perspective referring to the emotional work of nurses [ 26 ] and the importance of providing opportunities for women to express their suffering [ 27 ]. The importance of counselling is highlighted particularly where women had not told family or friends about their pregnancy [ 28 ]. However, unnecessary or superficial counselling has also been questioned [ 28 , 29 ]. In some parts of the non-Western world where women are more vulnerable, women's decision-making regarding abortion was influenced by the recommendations of the abortion provider and cost implications [ 18 , 22 , 23 ]. In most studies, information provision and knowledge were critical factors. An American study recommended that each patient be given a choice in the amount of information she receives, and information packs could be provided accordingly [ 17 ]. In relation to contraception however, knowledge needs to be integrated into practice for effective family planning [ 20 ]. The physical setting e.g. waiting rooms, and cold, unfamiliar wards was also referred to in some studies [ 19 , 26 ]. While some women appreciated the presence of other women in alleviating the loneliness of the experience, others were concerned about privacy and the risk of meeting someone they knew in the waiting room [ 21 ].

Some studies also investigated women's experiences of medical TOP at home rather than at a clinical facility [ 16 – 18 , 22 ]. In the US, Fielding [ 17 ] and Elul [ 16 ] identified familiar surroundings, privacy and not having to encounter strangers, as adding to women's appreciation of home TOP. However, there are situations in which home abortions are problematic, for example where the abortion needs to be kept hidden from the rest of the household because of shame [ 18 , 22 ]. This is particularly complicated where women are victims of domestic or sexual violence. Women also fear the risks of having an abortion at home where health professionals are not readily available to them.

Qualitative studies published on TOP within the time frame of this review have been limited in scope and detail. In this article, we have identified two main groups of studies; those that specifically address the issue of medical abortion, and those that explore the experiences of TOP more generally. Studies reviewed in this paper were influenced by a range of contextual factors such as political, ethical, social and legislative environments as well as health, economic and welfare systems. Research from the US, UK and Sweden dominated the literature, but these three countries have very different patterns of service provision. This review leads to four main conclusions.

Women's choices about whether, where, and how, TOP should be undertaken are mainly pragmatic ones that are related to negotiating finite household and psychosocial resources.

Rapid access to services characterised by supportive non-judgemental staff who delegate medical control over the process to women appear to characterise positive responses to medical TOP.

Home TOP using mifepristone appears attractive to women who are concerned about professionals' negative attitudes and lack of privacy in formal healthcare settings but also leads to concerns about management and safety.

Women who are well informed and supported in their choices experience good psychosocial outcomes from TOP.

These are broad conclusions derived from a very limited corpus of qualitative research. A recent review [ 39 ] of psychological studies of TOP identified discrepancies between societal and individual experiences, due to "theoretical and methodological deficiencies plaguing this area of study, with the available data often missing the complexity and depth of individuals' inner experiences" [37:238]. This is also true of many of the qualitative studies reviewed in this paper, suggesting that major opportunities to inform current policy and practice debates – utilizing the strengths of qualitative methods – have been missed.

Conflict of interests

The authors declare that they have no competing interests.

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MLSL's contribution to this paper was supported by funding from the NIHR HTA R&D Programme. (Grant 03/11/02: ISRCTN07823656 A randomised preference trial of medical versus surgical termination of pregnancy less then 14 weeks' gestation). CRM's contribution to this paper was partly supported by an ESRC personal research fellowship (RES 000270084). Funding agreements with these agencies ensured the authors' independence in designing the study, interpreting the data, writing, and publishing the report. This paper does not represent the views of the NIHR or ESRC.

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Mabel LS Lie

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CRM conducted an initial literature scoping exercise. MLSL conducted the literature searches, collected and collated articles, and drafted this paper. SCR and CRM commented in detail on drafts and contributed to the final version of the manuscript.

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Lie, M.L., Robson, S.C. & May, C.R. Experiences of abortion: A narrative review of qualitative studies. BMC Health Serv Res 8 , 150 (2008). https://doi.org/10.1186/1472-6963-8-150

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Abortion research that matters: Using core outcomes to enable systematic review

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• 1 Planned Parenthood League of Massachusetts, Boston, MA, United States.
• 2 Cochrane Fertility Regulation Review Group, Portland, OR, United States; Center for Health Research, Kaiser Permanente Evidence-based Practice Center, Portland, OR, United States.
• 3 Center for Health Research, Kaiser Permanente Evidence-based Practice Center, Portland, OR, United States; Department of OB/GYN, Oregon Health & Science University, Portland, OR, United States.
• 4 Center for Health Research, Kaiser Permanente Evidence-based Practice Center, Portland, OR, United States; Department of OB/GYN, Oregon Health & Science University, Portland, OR, United States. Electronic address: [email protected].
• PMID: 36055361
• DOI: 10.1016/j.contraception.2022.05.014

Keywords: Abortion; GRADE; Outcomes; Standard outcomes; Systematic reviews.

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Abortion Experiences, Knowledge, and Attitudes Among Women in the U.S.: Findings from the 2024 KFF Women’s Health Survey

Ivette Gomez , Karen Diep , Brittni Frederiksen , Usha Ranji , and Alina Salganicoff Published: Aug 14, 2024

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Key Takeaways

• Among women of reproductive age, one in seven (14%) have had an abortion at some point in their life. Larger shares of Black (21%) and Hispanic (19%) women report having had an abortion compared to 11% of White women. Across partisanship, similar shares of Republican women, Democratic women, and independents report having had an abortion.
• Nearly one in ten (8%) women of reproductive age personally know someone who has had difficulty getting an abortion since Roe v. Wade was overturned, including 11% of Hispanic women and 13% of women living in states with abortion bans.
• Among women of reproductive age who report knowing someone personally who has had difficulty getting an abortion since Roe v. Wade was overturned, many say they had to travel out of state for care (68%), did not know where to go (40%), and/or did not have the money to cover the cost (35%).
• More than six in ten women of reproductive age are concerned that they, or someone close to them, would not be able to get an abortion if it was needed to preserve their life or health (63%) and that abortion bans may affect the safety of a potential future pregnancy for themselves or someone close to them (64%).
• Less than half of reproductive age women in the United States are aware of the current status of abortion policy in their state (45%). Nearly a quarter describe the status incorrectly (23%) and a third are unsure about the status of abortion in their state (32%).
• One in four (26%) reproductive age women say if they needed or wanted an abortion they would not know where to go nor where to find information.
• Nearly one in five women (17%) of reproductive age report they have changed their contraceptive practices as a result of Roe being overturned. Actions taken include starting birth control, getting a sterilization procedure, switching to a more effective method, or purchasing emergency contraceptive pills to have on hand.
• While two-thirds of women have heard about medication abortion pills, only 19% of women say people in their state can get medication abortion pills online.
• Three in four reproductive age women in the United States think abortion should be legal in most or all cases (74%). The majority support a nationwide right to abortion (70%), oppose a nationwide abortion ban at 15 weeks (64%), and oppose leaving it up to the states to determine the legality of abortion (74%). This is the case for the majority of women who are Democrats and independents as well as smaller but still substantial shares of Republicans.

Introduction

In the two years since the Dobbs decision, which overturned Roe and eliminated the federal standards that had protected the right to abortion for almost 50 years, the abortion landscape in the United States has drastically changed. Abortion is banned in 14 states and an additional six states have implemented early gestational limits between 6 and 15 weeks.

Abortion will likely be a key issue in the upcoming 2024 election . The Democratic and Republican parties have starkly different visions of what access to abortion in the U.S. should look like. Vice President and Democratic Nominee Kamala Harris has been an outspoken advocate of abortion rights and has thrown her support behind efforts to restore Roe v. Wade’ s abortion standards in all states. Former President Donald Trump endorses leaving abortion policy up to states, allowing full bans to stay in effect, although he has also previously said he would consider a 15 or 16-week national ban on abortion. At the state level, voters in up to 11 states will vote on abortion-related ballot initiatives that will shape access to abortion in their states.

This brief provides new information about women’s experiences with abortion, the fallout of overturning Roe v. Wade , women’s knowledge about abortion laws in their states including medication abortion, as well as their opinions on the legality of abortion. The 2024 KFF Women’s Health Survey was fielded from May 15 to June 18, 2024, before President Biden withdrew from the 2024 Presidential race, and was developed and analyzed by KFF staff. It is a nationally representative survey of 5,055 women and 1,191 men ages 18 to 64, and the findings in this brief are based on a sample of 3,901 women ages 18 to 49. See the methodology section for detailed definitions, sampling design, and margins of sampling error.

Women’s Experiences With Abortion

Among women of reproductive age, one in seven (14%) report having had an abortion at some point in their life. Larger shares of Black (21%) and Hispanic (19%) women report having had an abortion compared to 11% of White women ( Figure 1 ). A higher share of women with lower incomes had an abortion (17%) compared to women with higher incomes (13%).

Smaller shares of women living in rural areas report having had an abortion compared to those living in urban/suburban areas (7% vs. 15%, respectively). Many rural women face long travel distances to access abortion services.

Similar shares of Republican women (12%), independent women (15%), and Democratic women (14%) say they have had an abortion. Throughout this brief, partisans include independents who lean to either party, while independents are individuals who say they do not lean toward either political party. Nearly one in 10 women (8%) who currently identify as pro-life say they have had an abortion compared to almost one in five (17%) who currently identify as pro-choice.

Smaller shares of women living in states with abortion bans or gestational limits between 15 and 22 weeks have had an abortion compared to women living in states with gestational limits at or after 24 weeks or without any gestational limits. Even before the Dobbs decision, abortion access was very limited in many of the states that currently ban abortion or have gestational limits before viability. Most of these states had laws restricting access to abortion, including waiting periods, counseling and ultrasound requirements, and insurance coverage restrictions which resulted in the closure of many abortion clinics in the years preceding the Dobbs decision.

Among women who say they have ever wanted or needed an abortion, 15% (2% of all reproductive age women) report that at some point in their lives, they have wanted or needed an abortion that they did not get ( Figure 2 ). A larger share of Black women (24%) (5% of all Black women of reproductive age) who have ever been pregnant and have wanted or needed an abortion report that they have wanted or needed an abortion they did not get compared to White women (12%) (1% of all White women of reproductive age). When asked why they did not get a wanted or needed abortion, a third (33%) report access and affordability issues, with affordability issues making up the majority of the category. One in five women also identify religious, moral, or societal pressures as the reason why they did not get the abortion, and another 16% say they changed their mind or couldn’t go through with the abortion. One in 10 women say they were too far along to end the pregnancy. Among the women who report ever wanting or needing an abortion they did not get, 31% say they had an abortion at some other time (data not shown).

In their own words: There are many reasons why someone may not get an abortion. What was the reason you did not get the abortion(s)?

“Unable to afford the procedure and would be reaching [the] point where it would be too late to complete if able.”

“Was a day over the amount of days in order to have an abortion. I waited too long to get it.”

“Changed my mind. Decided to keep the baby but was initially scared and unsure of what to do.”

“I decided I wanted to keep and raise my child despite societal pressures that would advise against it (I was a minor).”

“My family made me feel like I couldn’t and I was scared so I followed through with my pregnancy.”

“I was intimidated by the child’s father showing up at the clinic.”

“I could not afford to go out of state and had no way out of [the] state.”

“Ended up miscarrying before proceeding with appointment.”

“I was too far along in the pregnancy when I found out I was pregnant”

“Religious reasons. We are Catholic and it’s not an option for us.”

“The service wasn’t easily accessible to me, and my partner’s family pressured me into having the child.”

“Guilt, moral compass”

“Nurse convinced me not to get it.”

“I could not afford it at the time and unsure if I really wanted to do it.”

“Family pressure, difficulty finding a place to perform an abortion.”

“I lived an hour and a half from the location and my ride didn’t show up.”

The Impact of Overturning Roe

Two years after the Supreme Court overturned the constitutional right to abortion, 14 states have banned abortion, and 11 states have implemented gestational restrictions between 6 and 22 weeks LMP (last menstrual period). Nationally, 8% of reproductive age women say they personally know someone, including themselves, who has had difficulty getting abortion care since Roe was overturned due to the restrictions in their state ( Figure 3 ). Larger shares of Hispanic women (11%) than White women (8%) report knowing someone who has experienced difficulty getting an abortion. Similarly, larger shares of women living in states with abortion bans (13%) and women living in states with gestational limits between 6 and 12 weeks (11%) report knowing someone who has experienced difficulty compared to women living in states with gestational limits at or after 24 weeks or without gestational limits (6%). Even in states with few abortion restrictions, access to abortion services can be limited by lack of providers, poor coverage, and other factors.

Among those who say they know someone (including themselves) who had difficulty getting abortion care since Roe was overturned, the majority report they (or the person they knew) had to travel out of state (68%) ( Figure 4 ). Women with higher incomes who say they or someone they know had difficulty accessing abortion care are more likely to report that they or the person they know had to travel out of state compared to women with lower incomes (75% vs. 62%). Many abortion patients living in states with abortion bans or restrictions have to travel to neighboring states to get abortion care, while others may need to travel farther .

Among women who say they or someone they know had difficulty accessing abortion, four in ten women say they or a person they know did not know where to go when trying to get an abortion (40%), three in ten women say they could not afford the cost (35%), and nearly three in ten say they had to take time off work (28%).

When asked about women’s ability to get abortion services in their state, more than half of women residing in states with abortion bans (57%) and over four in ten women in states with gestational limits say it is difficult to access abortion care in their state (Figure 5). Notably, one in five (21%) women residing in states with gestational limits at or after 24 weeks or without gestational limits say it is difficult to get abortion services in their state. While abortion may not be restricted, limitations on Medicaid and insurance coverage of abortion, the scarcity of abortion providers in rural communities, stigma, and other factors (such as the need to take time off from work and childcare costs) are still barriers to abortion.

O ver six in ten reproductive age women in the U.S. (63%) are concerned that they or someone close to them would not be able to get an abortion if it was needed to preserve their life or health (Figure 6). While all states with abortion bans and abortion restrictions have an exception in their law to “prevent the death” or “preserve the life” of the pregnant person, six states with abortion bans or early gestational restrictions do not have health exceptions. In general, health exceptions have often proven to be unworkable except in the most extreme circumstances. The abortion policies in these states are generally unclear about how ill or close to death a pregnant person would have to be to qualify for the exception.

With the exception of Republican women, a majority of reproductive age women in all subgroups report that they are very or somewhat concerned about access to abortion if it was needed to preserve their life or health. Larger shares of Asian or Pacific Islander women (75%) than White women (61%) are concerned, and smaller shares of women residing in rural areas (52%) are concerned compared to those residing in urban/suburban areas (65%). Compared to Democratic women (78%), smaller shares of women who identify as independent (61%) are concerned that they or someone close to them would not be able to get an abortion if it was needed to preserve their life or health; however, less than half of Republican women report being somewhat or very concerned (41%).

Similarly, over 6 in 10 (64%) reproductive age women say they are concerned that abortion bans may affect the safety of a potential future pregnancy for themselves or someone close to them ( Figure 7 ). Across most subgroups—except across party affiliation— majorities of women say that they are somewhat or very concerned. Four in ten (39%) Republican women say they are concerned about the impact of abortion bans on the safety of potential pregnancies for themselves or someone close to them, compared to almost eight in 10 Democratic women and six in 10 independent women.

Nearly one in five women (17%) of reproductive age report they have changed their contraceptive practices as a result of Roe being overturned. Larger shares of Asian or Pacific Islander, Black, and Hispanic women report they started to use birth control (9%, 10%, and 7%, respectively) compared to White women (3%) ( Table 1 ). A higher share of Asian or Pacific Islander women report that they have switched to a more effective method of birth control compared to White women (6% vs. 3%), and 7% of Hispanic women report that they have gotten emergency contraception to have on hand compared to 4% of White women.

Awareness of Abortion Availability and Policy

Nationally, most women of reproductive age are unaware of the status of abortion legality in the state they live in. While 45% can correctly describe the status of abortion in their state, 23% of reproductive age women could not answer correctly and another third (33%) say they are not sure ( Figure 8 ). Awareness is highest among women who live in states where abortion is fully banned (51%) or in states with gestational limits at or after 24 weeks or without bans (47%). Smaller shares of women living in states with gestational limits at 15 to 22 weeks (33%) and limits at 6 to 12 weeks (38%) are aware of the status of abortion in their state. Consistently across state abortion groupings, about a third of women say they are not sure on the status of abortion in their state.

One in four (26%) women of reproductive age in the U.S. report that if they needed or wanted an abortion in the near future they would not know where to go or where to find the information (Figure 9). A quarter of women say they would know where to go for an abortion and half (49%) say they would not know where to go, but would know where to find that information. Since the Dobbs decision, websites like abortionfinder.org and ineedana.com provide individuals seeking abortion services with directories of abortion clinics and services that provide medication abortion via telehealth.

Over a third of Hispanic women (37%) and a third of Black women (33%) report that if they wanted or needed an abortion in the near future, they wouldn’t know where to find information compared to 23% of White women. More women with lower incomes (37%) and women living in rural areas (35%) report they wouldn’t know where to go or find that information compared to women with higher incomes (19%) and women living in urban/suburban areas (25%). Over four in 10 (43%) women living in states where abortion is banned say they wouldn’t know where to find information compared to 17% of women in states with gestational limits at or after 24 weeks or without gestational limits. Women living in banned states seeking abortion services must either travel out of state or obtain medication abortion drugs from companies that will ship pills without requiring a clinician visit or from clinicians practicing in states with shield-laws, which offer clinicians a measure of legal protection from attempts by law authorities in abortion ban states to enforce bans in states that support abortion access.

In the United States, medication abortion is the most common abortion method. It involves taking two different medications, mifepristone and misoprostol, and it has been approved by the FDA to end pregnancies up to 10 weeks gestation. Two-thirds (67%) of women of reproductive age report that they have heard about medication abortion ( Figure 10 ). While still majorities, relatively smaller shares of Asian or Pacific Islander (62%), Black (64%), and Hispanic (59%) women report having heard about medication abortion compared to White women (72%). Similarly, smaller shares of women with lower incomes (60%) have heard about medication abortion compared to women with higher incomes (74%). Compared to women who identify as pro-choice (72%) and women who are Democrats (77%), smaller shares of women who identify as pro-life (56%) or are Republican/Republican leaning (62%) or independents (60%) report hearing of medication abortion.

The majority of women are unsure of the legal status of abortion in their state. While neither mifepristone nor misoprostol are explicitly banned in any state and the drugs can still be used for miscarriage management treatment, their use for abortion is banned in the 14 states with abortion bans. Medication abortion, for the purposes of abortion, is legal in all states with gestational restrictions as well as states without any limits, but is not legal to use for abortion after the state’s gestational limit (for example, after 6 weeks LMP in Iowa, Florida, Georgia, and South Carolina).

The majority of women of reproductive age are unclear about the legal status of medication abortion in their state, regardless of the legal status of abortion in their state ( Figure 11 ). A larger share of women living in states with gestational limits at 24 weeks or without gestational limits (43%) report that medication abortion is legal in their state compared to women living in states with gestational limits between 6 to 12 weeks (19%) and gestational limits between 15 to 22 weeks (18%). Among women living in states where abortion is banned, 6% say medication abortion is legal in their state and 27% say it is illegal. Regardless of the status of abortion in their state of residence, majorities of women of reproductive age are not aware of the legal status of medication abortion in their state or have never heard of medication abortion.

Overall, only one in five (19%) women of reproductive age are aware that medication abortion pills are available online. Since state abortion bans and restrictions have gone into effect, new online services have been created that sell medication abortion pills through online organizations. Among women of reproductive age, 10% say individuals in their state cannot get medication abortion pills online and about three-quarter (71%) were unsure or had never heard of medication abortion ( Figure 12 ). Small shares of women living in states where abortion is banned or states with gestational limits know that people in their states can get medication abortion pills online compared to women living in states without any gestational limits or limits after 24 weeks.

Opinions on Abortion Policy

Three in four (75%) women of reproductive age in the United States, the age group that is most directly impacted by state abortion policies, think that abortion should be legal in most or all cases—38% say legal in all cases and 37% legal in most cases. Only 8% of women say that abortion should be illegal in all cases. This trend is consistent with prior polls which have found that the majority of Americans believe that abortion should be legal.

Across various subgroups, except those who identify as Republican or pro-life, majorities of reproductive age women think abortion should be legal in all or most cases. Among those ages 18 to 49, over eight in 10 Black women (83%) and Asian or Pacific Islander women (83%), and almost three-quarters of Hispanic women (73%) and White women (72%) think abortion should be legal ( Figure 13 ). In contrast, slightly less than half (48%) of Republican women of reproductive age think abortion should be legal, 36% say abortion should be illegal in most cases and 17% say abortion should be illegal in all cases. Not surprisingly, among women who identify as pro-life, 74% say that abortion should be illegal in all or most cases, but one in four (25%) believe that abortion should be legal in all or most cases.

Seven in ten reproductive age women (70%) support a law guaranteeing a federal right to abortion, with half (50%) saying they strongly support this (Figure 17) . While similar shares of Asian, Black, Hispanic, and White reproductive age women support a nationwide right to abortion, support varies widely by income, urbanicity, and party affiliation ( Figure 14 ). Though still a majority, smaller shares of reproductive age women with lower incomes (64%) and women who live in rural communities (62%) support a nationwide right to abortion compared to their urban/suburban (71%) and higher income counterparts (74%). Support is strongest among Democratic (84%) women, but two thirds (64%) of women who identify as independents and nearly half of Republican women (48%) strongly or somewhat support establishing a federal right to abortion. More than three times as many Democrats (71%) than Republicans (22%) strongly support a law that would guarantee this right.

More than half of all women of reproductive age support a law establishing a nationwide right to abortion, regardless of the abortion status in their state of residence. While there are smaller shares of support among women who reside in states with bans and gestational limits before viability, over four in 10 women in these states strongly support a law guaranteeing a federal right to abortion.

On the issue of abortion, former President Trump has previously said he would consider a national ban at 15 or 16 weeks, a position also proposed by other Republican elected officials. Overall, six in ten women of reproductive age (63%) oppose a law that would establish a nationwide ban on abortion at 15 weeks ( Figure 15 ). While still a majority, smaller shares of those with lower incomes (58%) and those who reside in rural areas (55%) oppose a national abortion ban at 15 weeks. Six in ten women in states with abortion bans and gestational limits before viability oppose a national ban on abortion at 15 weeks.

Most recently, former President Trump announced he supports leaving abortion policy up to the individual states, allowing the current bans and restrictions to stay in effect across half the country. Overall, nearly three in four women of reproductive age (74%) oppose this approach ( Figure 16 ). Similar shares of Asian (72%), Black (75%), Hispanic (75%), and White (72%) reproductive age women oppose leaving abortion policy up to the states. Compared to their counterparts, larger shares of women with higher incomes (76%) and those who live in urban/suburban communities (74%) oppose having states decide whether abortion should be legal or illegal in their states.

At least half of all women oppose this approach regardless of party affiliation, but opposition is highest among Democratic women (88%). While there is slight variation in support/opposition by abortion status in a woman’s state of residence, over two thirds of those in states with abortion bans and gestational limits oppose leaving the legality of abortion up to individual states.

• Women's Health Policy
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Also of Interest

• Women and Abortion in Florida: Findings from the 2024 KFF Women’s Health Survey
• Women and Abortion in Arizona: Findings from the 2024 KFF Women’s Health Survey
• Abortion in the United States Dashboard
• 2024 Women’s Health Survey

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• Research Highlights

Abortion and health care

Research Highlights Featured Chart

August 21, 2024

Does legal abortion reduce maternal mortality?

Tyler Smith

Activists protest the overturning of Roe v. Wade by Supreme Court.

Source: LyonStock

In 2022, the US Supreme Court overturned Roe v. Wade , revoking the constitutional right to abortion. The landmark Dobbs decision has reignited debates about legal abortion and in particular its status as an essential health care service.

In a  paper in the American Economic Journal: Economic Policy , authors Sherajum Monira Farin , Lauren Hoehn-Velasco , and Michael F. Pesko analyzed maternal mortality between 1959 and 1980, as abortions became legal first at the state level and then at the federal level with Roe v. Wade in 1973. Using an event study that compared maternal mortality rates at the state level before and after abortion decriminalization, they found that legalization at the state level over the period 1969–73 substantially lowered non-White maternal mortality.

Panel C of Figure 3 shows the estimates from that analysis for non-White females between the ages of 15 and 44.

Panel C of Figure 3 from Farin et al. (2024)

The solid lines in the left graph indicate maternal mortality overall, and the solid lines in the right graph indicate abortion-related mortality. The gray diamonds represent the results for all US states in the sample; the colored circles represent estimates that control for state policies, such as access to contraception; and the colored squares are estimates for states that legalized abortion voluntarily prior to Roe v. Wade . The dashed lines show the 95 percent confidence intervals. The red vertical lines indicate the year before legalization. 

In both graphs, mortality rates begin flat in the years leading up to legalization. But soon after abortion becomes legal, mortality declines across each type of estimate. Overall, non-White maternal mortality fell by 30 to 50 percent one year after legalization, averting approximately 134 non-White maternal deaths nationally. For non-White abortion-related mortality, the reduction was between 30 and 80 percent. Most of the mortality decline was concentrated around early state-level legalizations rather than Roe v. Wade .

The findings suggest that restricted access to legal abortion is likely to affect the health of non-White women the most, a group that already suffers from maternal mortality rates that are much higher than they are for their White counterparts.

“ The Impact of Legal Abortion on Maternal Mortality ” appears in the August 2024 issue of the American Economic Journal: Economic Policy .

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Factors Influencing Abortion Decision-Making Processes among Young Women

Mónica frederico.

1 International Centre for Reproductive Health (ICRH), Ghent University, 9000 Gent, Belgium; [email protected]

2 Centro de Estudos Africanos, Universidade Eduardo Mondlane, C. P. 1993, Maputo, Mozambique; [email protected]

Kristien Michielsen

Carlos arnaldo, peter decat.

3 Department of Family Medicine and primary health care, Ghent University, 9000 Gent, Belgium; [email protected]

Background: Decision-making about if and how to terminate a pregnancy is a dilemma for young women experiencing an unwanted pregnancy. Those women are subject to sociocultural and economic barriers that limit their autonomy and make them vulnerable to pressures that influence or force decisions about abortion. Objective : The objective of this study was to explore the individual, interpersonal and environmental factors behind the abortion decision-making process among young Mozambican women. Methods : A qualitative study was conducted in Maputo and Quelimane. Participants were identified during a cross-sectional survey with women in the reproductive age (15–49). In total, 14 women aged 15 to 24 who had had an abortion participated in in-depth interviews. A thematic analysis was used. Results : The study found determinants at different levels, including the low degree of autonomy for women, the limited availability of health facilities providing abortion services and a lack of patient-centeredness of health services. Conclusions : Based on the results of the study, the authors suggest strategies to increase knowledge of abortion rights and services and to improve the quality and accessibility of abortion services in Mozambique.

1. Introduction

Abortion among adolescents and youth is a major public health issue, especially in developing countries. Estimates indicate that 2.2 million unplanned pregnancies and 25% (2.5 million) unsafe abortions occur each year, in sub-Saharan Africa, among adolescents [ 1 ]. In 2008, of the 43.8 million induced abortions, 21.6 million were estimated to be unsafe, and nearly all of them (98%) took place in developing countries, with 41% (8.7 million) being performed on women aged 15 to 24 [ 2 ].

The consequences of abortion, especially unsafe abortion, are well documented and include physical complications (e.g., sepsis, hemorrhage, genital trauma), and even death [ 3 , 4 , 5 , 6 ]. The physical complications are more severe among adolescents than older women and increase the risk of morbidity and mortality [ 6 , 7 ]. However, the detrimental effects of unsafe abortion are not limited to the individual but also affect the entire healthcare system, with the treatment of complications consuming a significant share of resources (e.g., including hospital beds, blood supply, drugs) [ 5 , 8 ].

The decision if and how to terminate a pregnancy is influenced by a variety of factors at different levels [ 9 ]. At the individual level these factors include: their marital status, whether they were the victim of rape or incest [ 10 , 11 ], their economic independence and their education level [ 10 , 12 ]. Interpersonally factors include support from one’s partner and parental support [ 12 ]. Societal determinants include social norms, religion [ 9 , 13 ], the stigma of premarital and extra-marital sex [ 14 ], adolescents’ status, and autonomy within society [ 12 ]. At the organizational level, the existence of sex education [ 10 , 14 ], the health care system, and abortion laws influence the decisions if and where to have an abortion.

Those factors are related to power and (gender) inequalities. They limit young women’s autonomy and make them vulnerable to pressure. Additionally, the situation is exacerbated when there is a lack of clarity and information on abortion status, despite the existence of a progressive law in this regard.

For example, Mozambican law has allowed abortion if the woman’s health is at risk since the 1980s [ 15 , 16 , 17 , 18 ]. In 2014, a new abortion law was established that broadened the scope of the original law: women are now also allowed to terminate their pregnancy: (1) if they requested it and it is performed during the first 12 weeks; (2) in the first 16 weeks if it was the result of rape or incest, or (3) in the first 24 weeks if the mother’s physical or mental health was in danger or in cases of fetus disease or anomaly. Women younger than 16 or psychically incapable of deciding need parental consent [ 19 , 20 ].

Notwithstanding the progressive abortion laws in Mozambique, hospital-based studies report that unsafe abortion remains one of the main causes of maternal death in Mozambique [ 3 ]. However, hospital cases are only a small share of unsafe abortions in the country. Many women undergo an abortion in illegal and unsafe circumstances for a variety of reasons [ 3 ], such as legal restrictions, the fear of stigma [ 21 , 22 , 23 ], and a lack of knowledge of the availability of abortion services [ 3 , 9 , 23 ].

According to the 2011 Mozambican Demographic Health Survey (DHS), at least 4.5% of all adolescents reported having terminated a pregnancy [ 24 ]. Unpublished data from the records of Mozambican Association for Family Development (AMODEFA) which has a clinic that offers sexual and reproductive health services, including safe abortion, indicate that from 2010 to 2016 a total of 70,895 women had an induced abortion in this clinic, of which 43% were aged 15 to 24. Of the 1500 women that had an induced abortion in the AMODEFA clinic in the first three months of 2017, 27.9% were also in this age group [ 25 ]. These data show the high demand for (safe) abortion among young women.

For all this described above, Mozambique is an interesting place to study this decision-making process; given the changing legal framework, women may have to navigate gray areas in terms of legality, safety, and access when seeking abortion, which is stigmatized but necessary for the health, well-being, and social position of many young women.

The objective of this study is to explore the individual, interpersonal and environmental factors behind the abortion decision-making process. This entails both the decision to have an abortion and the decision on how to have the abortion. By examining fourteen stories of young women with an episode of induced abortion, we contribute to the documentation of the circumstances around the abortion decision making, and also to inform the policymakers on complexity of this issue for, which in turn can contribute to improve the strategies designed to reduce the cases of maternal morbidity and mortality in Mozambique.

2. Materials and Methods

This is an exploratory study using in-depth interview to explore factors related to abortion decision-making in a changing context. As research on this topic is limited, we opted for a qualitative research framework that aims to identify factors influencing this decision-making process.

2.1. Location of the Study

The study was conducted in two Mozambican cities, Maputo and Quelimane. These cities were selected because they registered more abortions than other cities in the same region. According to the 2014 data from the Direcção Nacional de Planificação, 629 and 698 women, respectively, were admitted to the hospital due to induced abortion complications in Maputo and Quelimane [ 26 ]. Furthermore, the two differ radically in terms of culture, with Maputo in the South being patrilineal and Quelimane in the Central Region matrilineal, which could influence the abortion decision-making process. The fieldwork took place between July–August 2016 and January–February 2017.

2.2. Data Collection

The data were collected through in-depth interviews, asking participants about their experiences with induced abortion and what motivated them to get an abortion. To approach and recruit participants ( Figure 1 ), we used the information collected during a cross-sectional survey with women in the reproductive age (15–49), These women were selected randomly applying multistage cluster based on household registers. The survey was designed to understand women’s sexual and reproductive health and included filter questions that allowed us to identify participants who had undergone an abortion. The information sheet and informed consent form for this household survey included information about a possible follow-up study.

The process of recruitment of the participants.

Participants who were within the age-range 15–24 years and who reported having had an abortion were contacted by phone. In this contact, the researcher (MF) introduced herself, reminded the participant of the study she took part in, explained the follow-up study and asked whether she was willing to participate in this. If she did, an appointment was made at a convenient location. Before each interview, we explained to each participant why she was invited to the second interview. Participants were also informed of interview procedures, confidentiality and anonymity in the management of the data, and the possibility to withdraw from the interview at any time. In total 14, young women (15–24) agreed to participate: nine in Maputo and five in Quelimane. Six of them were interviewed twice to explore further aspects that remained unclear after the first interview. The interviews were conducted in Portuguese.

To start the interview, the participant was invited to tell her life history from puberty until the moment when the abortion occurred. During the conversation, we used probing questions to elicit more details. Gradually, we added questions related to the abortion and factors that influenced the decision process. The main questions were related to the pregnancy history, abortion decision-making, and help-seeking behaviour. The guideline was adapted from WHO tools [ 27 , 28 ]. Before the implementation of the guideline, it was discussed first with another Mozambican researcher to see how they fell regarding the question. After those questions were revised or removed from the guideline.

2.3. Data Analysis

The analysis consisted of three steps: transcription, reading, and codification with NVivo version 11(QSR International Pty Ltd., Doncaster, Australia). After an initial reading, one of the authors (MF) developed a coding tree on factors determining the decision-making. A structured thematic analysis was used to make inferences and elicit key emerging themes from the text-based data [ 29 , 30 ]. The coding tree was based on the ecological model, which is a comprehensive framework that emphasizes the interaction between, and interdependence of factors within and across all levels of a health problem since it considers that the behaviour affects and is affected by multiple levels of influence [ 31 , 32 ].

Next, the codes and the classification were discussed among the researchers (Mónica Frederico, Kristien Michielsen, Carlos Arnaldo and Peter Decat). Finally, the data was interpreted, and conclusions were drawn [ 33 ].

2.4. Ethical Consideration

Before the implementation of this research, we obtained ethical approval from the Institutional Committee of the Faculty of Medicine and Nacional Bioethical Committee for Health (IRB00002657). We also asked for the institutional approval of the Minister of Health and authorities at the provincial and community levels. The participants gave their informed consent after the objectives and interview procedures had been explained to them. The participants were informed that they might be contacted and invited, within six months, to participate in another interview.

2.5. Concepts

The providers are the people who carried out the abortion procedure. These may be categorized into skilled and unskilled providers: the former refers to a professional (i.e., nurse or doctor) offering abortion services to a client, while the latter is someone without any medical training. Another concept that requires further explanation is the legal procedure. This corresponds to a set of steps to be followed to comply with the law [ 19 , 20 ]. Specifically, this means that a committee should authorize the induced abortion and an identification document should be available, as well as an informed consent form from the pregnant woman. If the woman is a minor, consent is given by her legal guardian. An ultrasound exam is required to determine the gestational age.

3.1. Characteristics of the Participants

The characteristics of the interviewees are summarized in Table 1 . The 14 participants were aged 17 to 24 years. Eight had completed secondary school, four had achieved the second level of primary school, and two were university students. Almost all (13) were Christian. Five participants were studying, eight were unemployed, and one was working. The median age of their first sexual intercourse was 15.5 years. Participants reported living with one or both parents (12), with their uncle (1) or alone (1). They lived in suburban areas of Maputo and Quelimane, which are slums with poor living conditions. In these areas, most households earn their income through small businesses that also involve child labour (e.g., selling food or drinks).

Socio-demographic characteristics and abortion procedure.

Among the participants, five reported more than one pregnancy. One interviewee first had a stillbirth and then two abortions. Another woman gave birth to a girl and afterward terminated two pregnancies. Two interviewees reported two pregnancies, the first of which was brought to full term and the second one terminated. One woman first had an abortion and afterward gave birth to a child. In short, 14 interviewees in total reported on the experiences and decision-making of 16 abortions. One participant stated that the pregnancy was the consequence of rape. Of the 16 reported abortions, seven were performed after the new law came into force at the end of 2014, and nine were carried out before this time.

3.2. Abortions Stories

In this study, 12 abortions were done by skilled providers and two by unskilled providers. The unskilled providers were a mother and a husband, respectively. None of the cases, whose abortion was done by a skilled provider, included in this study followed the legal procedure.

In the analysis of the interviews, we studied the personal, interpersonal and environmental factors that influenced six different types of abortion stories, see Table 2 : (1) an abortion was performed because the pregnancy was unwanted; (2) an abortion was carried out although the pregnancy was wanted; (3) the abortion was done by an unskilled provider at home; (4) an abortion was carried out by a skilled provider outside the hospital; (5) a particular abortion procedure (medical or chirurgical) was chosen, and (6) the legal procedure was not followed in the hospital. Factors influencing the choice for a particular technical procedure were also examined.

Summary of induced abortion stories. (We changed the table format, please confirm.)

* The result of rape; ** Seven participants; *** six participants.

3.3. Abortion Following an Unwanted Pregnancy

In the stories about unwanted pregnancies, mostly personal factors were mentioned as reasons, with some interviewees stating that they felt unable to be a mother at the time of the pregnancy: “ (It) was at the time that I was taking pills that I got pregnant, and I induced abortion because I was not prepared (for motherhood). ” (24 years)

Some had had a bad experience in the past: “ Maybe I would be abandoned and it would be the same. (Sigh)... I learned with my first pregnancy. ” (23 years)

Also, the existence of another child was mentioned as a reason to have an abortion: “ I got pregnant when I was 20, and I had a baby. When I became pregnant again, my daughter was a child, and I could not have another child. ” (23 years)

For other participants, studies were the main reason why the pregnancy was not wanted: “ He was informed about it, and he said that I should keep it. However, as I wanted to continue my studies, I told him no, no (I) do not. ” (17 years)

At the interpersonal level, a lack of support from the partner was often mentioned as a reason for not wanting the baby: “ He said that he recognizes the paternity, but it is not to keep that pregnancy. ” (22 years)

Women frequently mentioned environmental circumstances related to their poor socio-economic situation: “ I am staying at Mom's house; it is not okay to still be having babies there.” (23 years)

“ At home, we do not have any resources to take care of this child! ” (20 years)

3.4. Abortion Following a Wanted Pregnancy

In these cases, the decision to abort the pregnancy was not made by the woman herself but imposed by others or by the circumstances.

Some participants reported that their parents/family had decided what had to be done: “ They decided while I was at school. If (it) was my decision I would keep it because I wanted it. ” (18 years).

Other young women indicated the refusal of paternity as a reason to terminate the pregnancy.

“ Because my son’s father did not accept the (second) pregnancy. There was a time, we argued with each other, and we terminated the relationship. Later, we started dating again, and I got pregnant. He said it was not possible. ” (21 years)

“ (he) impregnated me and after that, he dumped me, (smiles)… I went to him, and I said that I was pregnant. He said eee: I do not know, that is not my child. ” (20 years).

Some women told the interviewers that they were convinced by their boyfriend to have an abortion: “ I talked to him, and he said okay we are going to have an abortion and I accepted. ” (22 years)

Others mentioned their partner’s indecision and changing attitude as a reason to get an abortion, even though they did want the baby:

“ I told him I was pregnant. First, he said to keep it. (Next) He was different. Sometimes he was calling me, and other times not. I understood that he did not want me. ” (20 years)

The fear of being excluded from their family due to their pregnancy was another reason reported by participants: “ So I went to talk with my older sister, and she said eee, you must abort because daddy will kick you out of our home. ” (20 years)

“ As I am an orphan, and I live with my uncle, they were going to kick me out. No one would assist me. ” (20 years)

3.5. Location of the Abortion: Home-Based Versus Hospital-Based

Two young women reported having had the abortion at home by an unskilled provider. It seems that these unskilled providers than the women (i.e. family members, partner) made the decisions.

“ It was mammy and my sister (who provided the induced abortion services). My sister knows these things. ” (18 years)

“ He (the father of the child) came to my house and took me back to his house. It was that moment when I aborted. ” (21 years)

Of the 16 abortions, seven were performed through health services, by a skilled provider. For some of them, the choice for a health service was influenced by the fact of knowing someone at the health facility.

“ I went to talk to her (friend), and she said that “I have an aunt who works at the hospital, she can help you. Just take money”. ” (20 years)

“ I Already knew who could induce it (abortion). No, I knew that person. I went to the hospital, and I talked to her, (and) she helped me. ” (22 years)

Other participants went to the health facility, but due to the lack of money to pay for an abortion at the facilities they sought help out of the health facility: “ They charged us money that we did not have. The ladies did not want to negotiate anything. I think they wanted 1200 mt (17.1 euros) if I am not wrong. He had a job, but he (boyfriend) did not have that amount of money. ” (22 years)

Some participants reported that they had an abortion outside regular facilities because the health provider recommended going to his house: “ She (mother) was the one who accompanied me. She is the one who knows the doctor. We went to the central hospital, but he (the doctor) was very busy, and he told us to go to his house. ” (17 years)

Others reported the fear of signing a document as a reason to seek help outside of official channels: “ I heard that to induce abortion at the hospital it is necessary for an adult to sign a consent form. I was afraid because I did not know who could accompany me. Because at that time I only wanted to hide it from others. ” (22 years).

3.6. Abortion Procedure

The women were not able to explain why a particular abortion procedure (i.e., pills or aspiration, curettage) was used. It appears that they were not given the opportunity to choose and that they submitted themselves to the procedure proposed by the provider.

“ The abortion was done here at home. They just went to the pharmacy, bought pills and gave them to me. ” (18 years)

3.7. Legal Procedure

None of those treated at the hospital stated that legal procedures were followed. They also mentioned that they had to pay without receiving any official receipt.

“ First we got there and talked to a servant (a helper of the hospital). The servant asked for money for a refreshment so he could talk to a doctor. After we spoke (with servant), he went to the doctor, and the doctor came, and we arranged everything with him. ” (22 years)

“ We went to the health center, and we talked to those doctors or nurses I mean, they said that they could provide that service. It was 1200 mt (17.1 euros), and they were going to deal with everything. They did not give us the chance to sign a document and follow those procedures. ” (20 years)

4. Discussion

The objective of this study was to describe abortion procedures and to explore factors influencing the abortion decision-making process among young women in Maputo and Quelimane.

The study pointed out determinants at the personal, interpersonal and environmental level. Analysing the results, we were confronted with four recurring factors that negatively impacted on the decision-making process: (1) women’s lack of autonomy to make their own decisions regarding the termination of the pregnancy, (2) their general lack of knowledge, (3) the poor availability of local abortion services, and (4) the overpowering influence of providers on the decisions made.

The first factor involves women’s lack of autonomy. In our study, most women indicate that decisions regarding the termination of a pregnancy are mostly taken by others, sometimes against their will. Parents, family members, partners, and providers decide what should happen. As shown in the literature, this lack of autonomy in abortion decision-making is linked to power and gender inequality [ 34 , 35 , 36 , 37 , 38 ]. On the one hand, power reflects the degree to which individuals or groups can impose their will on others, with or without the consent of those others [ 34 , 37 , 38 ]. In this case, the power of the parent/family is observed when they, directly or indirectly, influence their daughters to induce an abortion, for instance by threatening to kick them out of their home. On the other hand, gender inequality is also a factor. This refers to the power imbalance between men and women and is reflected by cases in which the partner makes the decision to terminate the pregnancy [ 38 ]. Besides this, the contextual environment of male chauvinism in Mozambique also makes it more socially acceptable for men to reject responsibility for a pregnancy [ 34 , 35 , 37 , 39 , 40 ]. Finally, women’s economic dependence makes them more vulnerable, dependent and subordinated. For economic reasons, women, have no other choice but to obey and follow the family or partner’s decisions. Closely linked with women’s lack of autonomy is their lack of knowledge. Interviewees report that they do not know where abortion services are provided. They are not acquainted with the legal procedures and do not know their sexual rights. This lack of knowledge among women contributes to the high prevalence of pregnancy termination outside of health facilities and not in accordance with legal procedures.

Our participants often report that abortion services are absent at a local level, as has also been pointed out by Ngwena [ 41 ]. This is a particular problem in Mozambique. Not all tertiary or quaternary health facilities are authorized to perform abortions. The fact that only some tertiary and quaternary facilities are allowed to do so creates a shortage of abortion centres to cover the demand. In fact, only people with a certain level of education and a sufficiently large social network have access to legal and proper abortion procedures.

Finally, our study shows that providers mostly decide on the location, the methods used and the legality of abortion procedures. Patients are highly dependent on the health providers’ commitment, professionality and accuracy and the selected procedures are not mutually decided by the provider and the patient. Providers often do not refer the client to the reference health facility or do not inform them of the legal procedures, creating a gap between law and practice that stimulates illegal and unsafe procedures. The reasons for this are unclear. It might be due to a lack of knowledge among health providers too, and, perhaps, provider saw here an opportunity to supplement the low salary [ 42 ]. Participants who seek help at the health facility they do so contacting the provider in particular, as indication given by someone.

This corroborates with studies conducted by Ngwena [ 41 , 43 ], Doran et al. [ 44 ], Pickles [ 45 ], Mantshi [ 46 ], and Ngwena [ 47 ], which pointed out the obstacles related to the availability of services and providers’ attitudes towards safe abortion, although the law grants the population this right [ 41 , 43 , 44 , 45 , 46 , 47 ]. As Ngwena [ 41 , 43 ] argues, the liberalization of abortion laws is not always put into practice and abortion rights merely exist on paper. Braam’ study [ 48 ] therefore highlights the necessity of clarifying and informing women and providers of the current legislation and ensuring that abortion services are available in all circumstances described in the law.

Finally, despite cultural differences between Maputo and Quelimane, the result did not suggest differences between two areas studied regarding factors influencing the decision to terminate and how the abortion is done. However, the Figure 1 suggests that there was trend to have more participants from Maputo reporting abortion episode in her life than Quelimane. This difference maybe be because Maputo is much more multicultural and the people of this city have more access to information that gives them the opportunity to learn about matter of reproductive health including abortion, than Quelimane. So, due to this there is trend decrease the taboo relation to abortion in Maputo than in Quelimane.

These abortion stories illustrate the lack of autonomy in decision-making process given the power and gender inequalities between adults and young women, and also between man and women . They also show the lack of knowledge not only on the availability of abortion services at some health facilities, as well as, on the new law on abortion. All these lacks that women have are reinforced by poor availability of abortion services and the fact that the providers we not taking their role to help those women, as it is exposed in the next sections.

This study interviewed young women who had an induced abortion at some point in their lives (15 years up to their age at interview date). As such, it does not provide any information on the factors behind the decisions of those who did not terminate their pregnancy.

The results presented in this paper only reflect the perceptions of the young women who had an induced abortion, not those of their parents or partners. The paper is based on qualitative data that provides insights into factors influencing abortion decision-making. Since the sample included in the study is not representative for the population of young women in Mozambique, the results cannot be generalized.

5. Conclusions

Based on the results of the study, we recommend the following measures to improve the abortion decision-making process among young women:

First, strategies should be implemented to increase women's autonomy in decision-making: The study highlighted that gender and power inequalities obstructed young women to make their decision with autonomy. We reiterate the Chandra-Mouli and colleges [ 49 ] message. There is a need to address gender and power inequalities. Addressing gender inequality, and promotion of more equitable power relations leads to improved health outcomes. The interventions to promote gender-equitable and power relationships, as well as human rights, need to be central to all future programming and policies [ 49 ].

Second, patients and the whole population should be better informed about national abortion laws, the recommended and legal procedures and the location of abortion services, since, despite the decision to terminate pregnancy resulted to the imposition, if they were well informed on that, maybe they could be decide on safe and legal abortion, avoiding double autonomy deprivation. At the same time, providers must be informed about the status of national abortion laws. Additionally, they should be trained in communication skills to promote shared decision-making and patient orientation in abortion counseling.

Third, the number of health facilities providing abortions services should be increased, particularly in remote areas.

Finally, health providers should be trained in communication skills to promote shared decision-making and patient orientation in abortion counseling.

The abortion decision-making by young women is an important topic because it refers the decision made during the transitional period from childhood to adulthood. The decision may have life-long consequences, compromising the individual health, career, psychological well-being, and social acceptance. This paper, on abortion decision-making, calls attention to some attitudes that lead to the illegality of abortion despite it was done at a health facility.

Acknowledgments

Authors gratefully acknowledge the support, contribution, and comments from all those who collaborated direct or indirectly, especially Olivier Degomme, Eunice Remane Jethá, Emilia Gonçalves, Cátia Taibo, Beatriz Chongo, Hélio Maúngue and Rehana Capruchand.

Author Contributions

All authors contributed significantly to the manuscript. Mónica Frederico collected data and developed the first analysis. The themes were intensively discussed with Kristien Michielsen, Carlos Arnaldo and Peter Decat. The subsequent versions of the article were written with the active participation of all authors.

Conflicts of Interest

The authors declare no conflicts of interest.