A: An abortion is the loss of a pregnancy prior to 20 weeks gestation

Abortion has been in the news a lot this week, and rightfully so. But I’ve seen a lot of miscommunication being thrown around, particularly around the idea of what an abortion is, and what it is used for. The purpose of this post is not to be political. Instead, my goal is to present the facts: how medical professionals define an abortion, and the clinical indications for why a woman would need one. Let’s start with definitions.

The embryonic stage is from 2-9 weeks gestation. At this stage, it is called an embryo.

The fetal stage is from 10 weeks gestation to birth. At this stage, it is called a fetus.

An abortion is the loss of a pregnancy prior to 20 weeks gestation.

A stillbirth is the loss of a pregnancy afte 20 weeks gestation.

As you can see, the medical definition of “abortion” is quite broad. For this reason, doctors further narrow abortions by specifying the type of abortion. Sometimes, these types can overlap. Subtypes of abortions include:

  • A spontaneous abortion occurs when the embryo/fetus dies and passes out of the uterus on its own.
  • A missed abortion occurs when the embryo/fetus dies but remains inside the uterus.
  • An incomplete abortion means that the embryo/fetus is dead and part of it – but not all – have passed out of the uterus.

A miscarriage – a colloquial term, not a medical one – could be any of the above types of abortions. Missed abortions and incomplete abortions are particularly dangerous. Since there are fetal parts still inside the uterus, the woman is at risk of getting an infection. If this happens, she now has a septic abortion. Septic abortions – infection of the uterus due to loss of pregnancy – are quite dangerous and can be severe enough to cause death.

An elective abortion is when a woman chooses to end a pregnancy. There are myriad reasons a woman might need an elective abortion, but most fall into one of 3 categories: the health of the mother, the health of the fetus, and socioeconomic factors. Maternal indications for an elective abortion for the health of the mother include cancer, heart disease, autoimmune disease (such as multiple sclerosis or lupus), kidney disease, lung disease, blood diseases (anemia, clotting disorders, etc.), rape/incest, and mental illness. Elective abortion might also be recommended if the fetus has drastic birth defects, including major heart defects, chromosomal abnormalities, congenital malformations, and disorders that are incompatible with life. I’m no expert in public health, so I’m not going to comment on the socioeconomic factors other than to say that there was a major, large-scale study that came out recently called the Turnaway Study. This prospective cohort study showed that women who were denied abortions were worse off in nearly every metric than women who were able to get abortions.

If your character needs an abortion, there are two main types. A medical abortion, also called the “abortion pill” is a medication that stimulates uterine contractions in order to pass the embryo/fetus. Medical abortions are more commonly prescribed early in the pregnancy, around twelve weeks or so. Surgical abortions are a surgical procedure, called a dilation and curettage, or “D&C, which physically removes the fetus from the uterus.

But elective abortions are not the only reason a woman might need an abortion. Medical and surgical abortions are also used to treat:

And finally, there’s the whole “late-term abortion thing.” I’m not going to get too in-depth here. Just like miscarriage isn’t a medical term, neither are “late-term abortion” or “partial birth abortion.” According to the CDC’s abortion surveillance data, the vast majority (more than 91%, ) of abortions occur by week 13. After that, abortions are named by the week (i.e. 18-week abortion). Less than 1% of abortions occur after week 20, and many of these were due to lethal fetal anomalies and/or significant health risks to the pregnant person.