Unplanned pregnancy

For lots of reasons, teens may have an unplanned pregnancy. Depending on a young woman’s beliefs and resources, she may choose to carry the pregnancy to term and keep her baby, place her baby up for adoption, or have an abortion (before 20 weeks). 

According to Planned Parenthood, millions of women face unplanned pregnancies every year, and about 4 out of 10 will decide to have an abortion. 

Terminating a pregnancy is often an emotional and complex decision for a woman at any age. If a young woman has an unplanned pregnancy in the US (or many other countries) she has a legal right to decide to have a safe termination of the pregnancy, an abortion. Since 1973 abortion has been an option in the US for women of all ages. 

However, if she is under 18, depending on the laws in her state, she may need to obtain one or both of her parents’ or legal guardian’s permission or a judge’s approval. In some states she may be excused, if she was the victim of sexual assault

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Intact dilation and extraction

Intact dilation and extraction (IDX, intact D&E) is a surgical procedure that removes an intact fetus from the uterus. The procedure is used both after late-term miscarriages and in late-term abortions.

It is also known as intact dilation and evacuation, dilation and extraction (D&X, or DNX, disfavored term), and, in United States federal law, as partial-birth abortion.

However, partial-birth abortion is not an accepted medical term, and is not used by abortion practitioners or the medical community at large.

In 2000, although only 0.17% (2,232 of 1,313,000) of all abortions in the United States were performed using this procedure, it developed into a focal point of the abortion debate. It was outlawed in most cases by the 2003 Partial-Birth Abortion Ban Act, which was upheld in the case of Gonzales v. Carhart.

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Labor induction

Labor induction is the process or treatment that stimulates childbirth and delivery. Inducing labor can be accomplished with pharmaceutical or non-pharmaceutical methods.

In Western countries, it is estimated that one-quarter of pregnant women have their labor medically induced with drug treatment.

Inductions are most often performed either with prostaglandin drug treatment alone, or with a combination of prostaglandin and intravenous oxytocin treatment.

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Partial-Birth Abortion Ban Act

The Partial-Birth Abortion Ban Act of 2003 (Pub.L. 108–105, 117 Stat. 1201, enacted November 5, 2003, 18 U.S.C. § 1531, PBA Ban) is a United States law prohibiting a form of late termination of pregnancy called "partial-birth abortion", referred to in medical literature as intact dilation and extraction.

Under this law, any physician "who, in or affecting interstate or foreign commerce, knowingly performs a partial-birth abortion and thereby kills a human fetus shall be fined under this title or imprisoned not more than 2 years, or both".

The law was enacted in 2003, and in 2007 its constitutionality was upheld by the U.S. Supreme Court in the case of Gonzales v. Carhart.

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Pregnancy

Pregnancy, also known as gestation, is the time during which one or more offspring develops inside a woman.[4] A multiple pregnancy involves more than one offspring, such as with twins.

Pregnancy can occur by sexual intercourse or assisted reproductive technology.[6] Childbirth typically occurs around 40 weeks from the start of the last menstrual period (LMP).

This is just over nine months, where each month averages 31 days. When measured from fertilization it is about 38 weeks. An embryo is the developing offspring during the first eight weeks following fertilization, after which, the term fetus is used until birth.

Symptoms of early pregnancy may include missed periods, tender breasts, nausea and vomiting, hunger, and frequent urination. Pregnancy may be confirmed with a pregnancy test.

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Gestational age

Gestational age is a measure of the age of a pregnancy which is taken from the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method if available.

Such methods include adding 14 days to a known duration since fertilization (as is possible in in vitro fertilization), or by obstetric ultrasonography.

The popularity of using such a definition of gestational age is that menstrual periods are essentially always noticed, while there is usually a lack of a convenient way to discern when fertilization occurred.

The initiation of pregnancy for the calculation of gestational age can be different from definitions of initiation of pregnancy in context of the abortion debate or beginning of human personhood.

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Reasons for abortions

Reasons for late terminations of pregnancy include when a pregnant woman's health is at risk or when lethal fetal abnormalities have been detected.

A study from 2013 found after excluding abortion "on grounds of fetal anomaly or life endangerment", that women seeking late abortions "fit at least one of five profiles:

They were raising children alone, were depressed or using illicit substances, were in conflict with a male partner or experiencing domestic violence, had trouble deciding and then had access problems, or were young and nulliparous".

They concluded that "bans on abortion after 20 weeks will disproportionately affect young women and women with limited financial resources"

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Mental health and abortion

A wanted abortion in any trimester is not associated with mental health harms. Overall, abortion does not increase the risk of experiencing symptoms of depression, anxiety or stress in the short term or over five years.

A previous history of mental health conditions, sexual assault, and intimate partner violence were strongly associated with experiencing negative mental health outcomes after the abortion.

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What is late termination

A late termination of pregnancy often refers to an induced ending of pregnancy after the 20th week of gestation, i.e. after a fetal age (time since conception) of about 18 weeks.

The exact point when a pregnancy becomes late-term, however, is not clearly defined. Some sources define an abortion after 16 weeks as "late".

In three articles published in 1998 in the same issue of the Journal of the American Medical Association (JAMA) two chose the 20th week of gestation and one chose the 28th week of gestation as the point where an abortion procedure would be considered late-term.

The point at which an abortion becomes late-term is often related to the "viability" (ability to survive outside the uterus) of the fetus. Sometimes late-term abortions are referred to as post-viability abortions, though this is not a medical term.

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Late termination of pregnancy

Late termination of pregnancy (also referred to as late-term abortion)[2] describes the termination of pregnancy by induced abortion during a late stage of gestation.

"Late", in this context, is not precisely defined, and different medical publications use varying gestational age thresholds.

In 2015 in the United States, about 1.3% of abortions took place after the 21st week,[4] and less than 1% occur after 24 weeks.

Reasons for late terminations of pregnancy include when a pregnant woman's health is at risk or when lethal fetal abnormalities have been detected.

These anomalies may include anencephaly or limb-body wall complex where death occurs almost immediately after birth.

Later abortion is not associated with any negative physical or mental health outcomes, and the risk of death following a surgical abortion after 20 weeks is less than that of typical full-term childbirth in the United States

Late termination of pregnancy is more politically controversial than abortion in general. Most countries in Europe permit abortion in later stages of pregnancy if specific circumstances are present.

The American College of Obstetricians and Gynecologists states with respect to abortion that "politicians should never interfere in the patient-physician relationship".

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