Abortion Facts

In a medication abortion, sometimes called a medical or chemical abortion, a woman is administered an abortion-inducing compound called mifepristone (also called RU-486 or Mifeprex). Mifepristone blocks the action of progesterone, the natural hormone vital to maintaining the lining of the uterus. As the nutrient lining disintegrates, the embryo starves. Subsequently, the woman takes a dose of artificial prostaglandins which initiate uterine contractions and cause the embryo to be expelled from the uterus. Abortions by mifepristone are usually done prior to 49 days after the woman’s last menstrual period, but are sometimes done as late as 70 days.

In a prostaglandin abortion, a dose of prostaglandin hormones is injected into the uterine muscle, which induces violent labor resulting in the death of the fetus. Prostaglandin abortions, typically performed in the second and early third trimester, are rarely used today, due to the relatively high chance that the fetus will survive the abortion and be born alive.

In a saline abortion, amniotic fluid is removed from the uterus and replaced with a saline solution, which the fetus swallows. The fetus is killed by salt poisoning, dehydration, brain hemorrhage and convulsions. Saline abortions, typically performed in the second and early third trimester, are rarely used today, due to the risk of particularly serious health complications to the woman.

A D&X (dilation and extraction) or partial-birth abortion is typically performed in the late second or third trimester. As with a D&E abortion (see above), the cervix must first be dilated, usually with laminaria (dried seaweed sticks). Forceps are then inserted into the uterus to grasp the fetus’s legs. The fetus is delivered breech while the head remains inside the birth canal. Using blunt-tipped surgical scissors, the base of the skull is pierced, and a suction catheter is inserted to extract the contents of the skull. This causes the skull to collapse, and the dead fetus is then fully delivered.

Despite the fact that the United States Supreme Court upheld the federal Partial-Birth Abortion Ban Act in 2007, D&X abortions are still being performed. An abortionist can avoid violating the law by first injecting the fetus with a lethal intracardiac injection to ensure that the fetus will already be dead when it is partially delivered.

• See also How is an intracardiac injection abortion performed?

A D&E (dilation and evacuation) abortion is typically performed in the first half of the second trimester (13-20 weeks), but can be used up to approximately 28 weeks. At this stage of pregnancy, the fetus’s tendons, muscles, and bones are more developed. In a D&E abortion, forceps are inserted into the uterus to forcibly dismember the fetus, and the pieces are removed one by one. Larger fetuses must also have their skulls crushed so the pieces can pass through the cervix.

Typically, the cervix must be dilated for a period of one to three days prior to a D&E abortion. This is most often done by inserting laminaria (dried seaweed sticks) into the cervix. Therefore, a D&E abortion usually requires two visits to the abortion facility.

In an intracardiac abortion, a needle is guided into the fetus’s heart with the aid of ultrasound, and poison (often potassium chloride or digoxin) is injected, causing an immediate heart attack. Intracardiac injection is most commonly used for “pregnancy reduction” abortions following in vitro fertilization (IVF) procedures, if multiple embryos were implanted to increase the likelihood of pregnancy. In these cases, the procedure is typically performed between 10 and 12 weeks gestation.

Intracardiac injection is also used in late term abortions when there is likelihood of delivering a live baby, in order to avoid state laws that would require the baby to be resuscitated and given medical care.

In a D&C (dilation and curettage) abortion, typically performed in the first trimester, a curette (a sharp looped knife) is inserted into the uterus to scrape its walls. The curette is then used to dismember the fetus and placenta.

Suction aspiration, the most common abortion method, is typically performed at 6-12 weeks gestation, but can be used up to 16 weeks. The cervix is dilated, and a hollow plastic tube with a sharp tip is inserted into the cervix and then into the uterus. An aspirator attached to the tube tears the body of the fetus apart and suctions the pieces through the tube.

Eight abortion methods are practiced in the U.S.:

Suction (Vacuum) Aspiration
Dilation and Curettage (D&C)
Intracardiac Injection Abortion
Dilation and Evacuation (D&E)
Dilation and Extraction (D&X or Partial-Birth Abortion)
Instillation (Saline) Abortion
Prostaglandin Abortion
Chemical (Medical) Abortion

Each of these methods is described in detail below.

Women often report that they feel pressured to get an abortion by others in their lives—boyfriends, parents, teachers, friends, employers and others. One survey found that 64% of American women who sought abortions felt coerced into doing so.

In 2012, a panel of physicians meeting in Ireland, a country with one of the world’s lowest rates of maternal mortality, concluded: “We affirm that direct abortion—the purposeful destruction of the unborn child—is not medically necessary to save the life of a woman.” They further stated: “The prohibition of abortion does not affect, in any way, the availability of optimal care to pregnant women.”

The three most frequently cited “hard cases” in which some argue abortion might be justified are rape, incest and protecting the life of the mother. However, women rarely report that they are seeking an abortion for any of these reasons:

Rape: 0.3%
Incest: 0.03%
Protection of mother’s life: 0.1%

In other words, out of 1,000 women procuring abortion, only three cite rape as the primary reason, and only one cites protecting her life as the reason for the abortion. Out of 10,000 women procuring abortion, only three cite incest as a reason.

• See also Shouldn’t abortion be legal in cases of rape and incest? and Is abortion ever necessary to save a woman’s life?

Forty-five percent of women procuring abortions have had at least one previous abortion.

Research indicates that 98% of all abortions are related to issues of  “personal choice.” The primary reasons women give for having an abortion include not feeling emotionally capable (32%) or financially capable (30%) of raising a child, and concern that having a child would drastically alter her life (16%).

The Guttmacher Institute found that more than half of women having abortions had been using contraception during the month they became pregnant.

• See also What percentage of all abortions are because of “hard cases”? and How often are women coerced into getting abortions?

According to the website AbortionDocs.org, there are 463 facilities specializing in abortion—commonly called “abortion clinics”—plus another 256 offering only medical abortions. The vast majority of abortions are performed at these facilities. Many abortions are also performed at hospitals and physicians’ offices, but a precise accounting of these locations is not available.

Based on the date of the mother’s last menstrual period, the breakdown of abortions is as follows:

This means approximately 88% of abortions occur in the first trimester (first 12 weeks) of pregnancy.

Women living below the federal poverty line abort at a higher rate than women living above the poverty line. The Guttmacher Institute reports that a single woman below the poverty line is six times more likely to abort than a woman who is not low-income.

According to the Guttmacher Institute, abortion breaks down along racial/ethnic lines as follows:

White: 39%

Hispanic: 25%

Black: 28%

Other: 9%

While blacks and Hispanics comprise only 32% of the population, they account for nearly 53% of all abortions. A black baby is four times as likely to be aborted as a white baby; a Hispanic baby is nearly twice as likely to be aborted than a white baby.

About 18% of all pregnancies end in abortion in the United States. There were approximately 862,000 abortions in 2017 compared to 3.86 million live births.

According to the Guttmacher Institute, the age breakdown of women having abortions is as follows (numbers rounded):

Less than 15 years: < 0.7%
Age 15-17: 3%
Age 18-19: 8%
Age 20-24: 34%
Age 25-29: 27%
Age 30+:  27%

This means that less than half of all abortions are performed on women 24 years old or younger.

According to the Guttmacher Institute, there were approximately 862,000 abortions performed in the United States in 2017, the most recent year for which data is available. This amounts to 2,363 abortions per day.

The number of abortions in 2017 is down from the number in 2014 (the next most recent year for which data is available):

Total abortions in 2017: 862,320
Total abortions in 2014: 926,190

This is a decrease of nearly 64,000 abortions from 2014 to 2017.

Since the legalization of abortion in 1973, there have been approximately 60 million abortions performed in the United States.