What is abortion?
A Quick Guide to Abortion
Contents
Introduction and Purpose
Even before the US Supreme Court’s Dobbs decision, but especially afterwards, public discourse has been hampered by terminological fluidity. Ask five people to define abortion and you're likely to get four or five different answers. As a result, people often just talk past one another.
Regardless of where your beliefs fall along the spectrum of abortion policy positions, accuracy in communication is a vital skill set. Accuracy puts everyone on the same page and ensures "your message is clearly and accurately delivered," as well as "clearly and accurately received.”1
"Precision of language is essential to creating an expression that matches the intention of the writer [or speaker],”2 and "the possibility of misunderstandings, misinterpretations and even poor decisions, is radically reduced."3
Most importantly, the foundation of effective communication, always, is adherence to the meaning of words. This is especially true when discussing abortion and abortion policy.
The purpose of this post is to affect more fruitful public discourse by providing the reader with basic, factual information, answering the question, "What is abortion?" It is left to the reader to employ this information, modifying their sentences as necessary to provide clarification and specificity when engaged in interpersonal communication, whether in the private or public sphere.
Etymology and historical meaning
According to Grant Barrett, a linguist and lexicographer, the world abortion "comes into English from the Latin.”4 "In Latin," explained Barrett, the word "referred to a miscarriage, or the procuring of a miscarriage.”5 Both "'Abortio' — a miscarriage, induced or otherwise — and 'abortiuum' — an abortifacient, a substance that induces abortion — go back at least as far as the seventh century A.D., according to the Oxford Latin Dictionary.”6
Hence abortion, which came "into the English language around 1537," was the general, morally neutral "term for any pregnancy that didn't come to term — human intervention or no.”7 And the definition of abortion has changed very little since that time.
What is "abortion”?
Abortion is a medical term defined as the ending, both spontaneous and induced, of an established pregnancy before fetal viability,8910 though "some medical dictionaries mention 20 weeks' gestation or 500 g as the limit.”11
The definition of abortion does not include intent, as there can be different intentions for ending a pregnancy, or no intentions at all. For this reason, miscarriages are referred to as "spontaneous abortions," that is, the spontaneous, unintentional ending of a pregnancy.
Accordingly, major medical societies and medical billing codes reflect the intent-neutral/intent-free nature of the term abortion — the ending of a pregnancy, "whether that pregnancy is wanted or unwanted, whether a woman is seeking the procedure to clean out her uterus after a miscarriage, or because of a dire fetal diagnosis, or to terminate a pregnancy that she had not expected.”12
Some abortions are induced; here again, intent is irrelevant. According to the American College of Obstetricians and Gynecologists (ACOG), "Induced abortion ends a pregnancy with medication or a medical procedure”13 — this includes inducing labor.14 As Kaiser Health explains, Labor Induction Abortion “is ending a pregnancy by using medicines to start (induce) labor and delivery," a method sometimes "done because of a severe medical problem.”15
Because inducing labor and delivery ends a pregnancy prior to fetal viability, it is medically classified as abortion and, unfortunately, when labor induction abortion for an obstetric emergency involves the delivery of a living fetus, fetal demise is almost always inevitable due to fetal inviability.16
On occasion, spontaneous pregnancy loss requires treatment through an induced abortion,1718192021 such as in cases of inevitable abortion (inevitable miscarriage) or preterm premature rupture of membranes (pPROM), through the use of medications, through a procedure to evacuate the uterus, or by inducing labor.
Abortions are also performed to end pregnancies that are not viable, such as cesarean scar ectopic pregnancies, cervical ectopic pregnancies, and other ectopic pregnancies.222324
Whether an abortion is spontaneous or induced, the intent-free definition of the term abortion remains the same: the ending, both spontaneous and induced, of an established pregnancy before fetal viability or prior to 20 weeks.
The ⒶⒷⒸ's of Reproductive Health
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Three Categories of Abortion
Medication abortion:
Abortion primarily with medications, including mifepristone and misoprostol, misoprostol alone, and methotrexate, are medication abortions. Medication abortions are typically indicated up to 11.0 weeks LMP (last menstrual period), approximately 8 weeks after a person becomes pregnant.25
The most commonly used method for medication abortion in the United States involves a regimen of mifepristone and misoprostol "to terminate the pregnancy and expel it via vaginal bleeding, akin to a spontaneous miscarriage.”26 Methotrexate is used to terminate ectopic pregnancies that are diagnosed early, including cesarean scar and cervical pregnancies in which the fertilized egg implants into a dangerous location inside the uterus, as well as ectopic pregnancies that occur outside of the uterus.
Medication abortion treatment is often used to complete miscarriages (spontaneous abortions), and cesarean scar ectopic pregnancies diagnosed early.
Procedural abortion:
Abortion primarily with instrumentation, including uterine aspiration (manual or electric), dilation and curettage, dilation and evacuation, or dilation and extraction, is referred to as procedural abortion.27 The most commonly used method of procedural abortion is aspiration which uses a suction device to empty the uterus. Procedural abortions in the first trimester take only about 5 minutes.28
Procedural abortion treatment are frequently used to complete instances of spontaneous pregnancy loss such as in cases of PPROM. Procedural abortion such as D&C, is also “recommended when patients are bleeding heavily, are anemic, have blood-clotting issues or certain conditions that make them medically fragile.”
Induction abortion:
“The other medically proven abortion method is induction abortion, where a physician uses medication to induce labor and delivery of a non-viable fetus. Induction of labor accounts for only about 2% of second-trimester abortions nationally. Induction abortions are usually performed in a hospital or similar facility that has the capacity to closely monitor a patient and provide adequate pain management (e.g., intravenous pain medication or an epidural). Induction abortions can last anywhere from five hours to three days; are extremely expensive; entail more pain, discomfort, medical risks, and recovery time for the patient—similar to giving birth—than procedural abortion.”29 Labor induction abortion is sometimes "done because of a severe medical problem.”30
Conclusion
"Accuracy in communication is one of the most critical communication skills. It sounds so obvious and simple! Yet this essential aspect of communication is often overlooked. The impact can be massive. For better or worse. This applies to both verbal and written communications”31 Accuracy in communication begins with adherence to the meaning of words, in this case abortion. "An initial misunderstanding can quickly and easily escalate into" the total breakdown of dialog.32 It is up to you to employ terminology accurately and utilize linguistic specificity on the subject of abortion and abortion policy.
Matters, Margi. “Accuracy in Communication - Brisbane Psychologist Margi Matters: Ashgrove and North Brisbane.” Brisbane Psychologist Margi Matters | Ashgrove and North Brisbane, 14 June 2020, https://margimattersbrisbanepsychologist.com/2018/06/25/communication-and-accuracy/.
Hollander, Brooklyn. “Precision of Language.” Los Angeles Times, Los Angeles Times, 1 Dec. 2017, https://highschool.latimes.com/corona-del-mar-high-school/precision-of-language/.
Matters, Margi. “Accuracy in Communication - Brisbane Psychologist Margi Matters: Ashgrove and North Brisbane.” Brisbane Psychologist Margi Matters | Ashgrove and North Brisbane, 14 June 2020, https://margimattersbrisbanepsychologist.com/2018/06/25/communication-and-accuracy/.
Beckerman, Jim. “Abortion Is the Word of the Hour. but Where Did It Come from?” North Jersey Media Group, NorthJersey.com, 10 May 2022, https://www.northjersey.com/story/news/2022/05/06/abortion-definition-history-word-roe-v-wade-law/9646606002/.
Beckerman, Jim. “Abortion Is the Word of the Hour. but Where Did It Come from?” North Jersey Media Group, NorthJersey.com, 10 May 2022, https://www.northjersey.com/story/news/2022/05/06/abortion-definition-history-word-roe-v-wade-law/9646606002/.
Beckerman, Jim. “Abortion Is the Word of the Hour. but Where Did It Come from?” North Jersey Media Group, NorthJersey.com, 10 May 2022, https://www.northjersey.com/story/news/2022/05/06/abortion-definition-history-word-roe-v-wade-law/9646606002/.
Beckerman, Jim. “Abortion Is the Word of the Hour. but Where Did It Come from?” North Jersey Media Group, NorthJersey.com, 10 May 2022, https://www.northjersey.com/story/news/2022/05/06/abortion-definition-history-word-roe-v-wade-law/9646606002/.
WILLIAMS OBSTETRICS ch. 11 at 198 (F. Gary Cunningham, Kenneth J. Leveno, Jodi S. Dashe, Barbara L. Hoffman, Catherine Y. Spong & Brian M. Casey eds., 26th ed. 2022).
“Abortion: Taber's Medical Dictionary.” Abortion | Taber's Medical Dictionary, https://www.tabers.com/tabersonline/view/Tabers-Dictionary/766365/all/abortion.
“Chapter 11: First- and Second-Trimester Pregnancy Loss.” AccessMedicine, https://accessmedicine.mhmedical.com/content.aspx?sectionid=263815963&bookid=2977#263816185.
Grimes, David A., and Gretchen Stuart. “Abortion Jabberwocky: The Need for Better Terminology.” Contraception, Elsevier, 21 Oct. 2009, https://www.contraceptionjournal.org/article/S0010-7824%2809%2900415-6/fulltext.
Zernike, Kate. “What Does 'Abortion' Mean? Even the Word Itself Is up for Debate.” The New York Times, The New York Times, 18 Oct. 2022, https://www.nytimes.com/2022/10/18/us/abortion-roe-debate.html.
“Abortion Care.” ACOG, https://www.acog.org/womens-health/faqs/induced-abortion.
Casey, Frances E. “Induced Abortion - Gynecology and Obstetrics.” Merck Manuals Professional Edition, Merck Manuals, 14 Dec. 2022, https://www.merckmanuals.com/professional/gynecology-and-obstetrics/family-planning/induced-abortion.
“Induction Abortion.” Induction Abortion | Kaiser Permanente, https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.induction-abortion.tw2562.
Borgatta, Lynn, and Nathalie Kapp. “Labor Induction Abortion in the Second Trimester.” Contraception, Elsevier, 31 Mar. 2011, https://www.contraceptionjournal.org/article/S0010-7824(11)00057-6/fulltext.
TeachMe OBGYN. (2022, July 11). Miscarriage - threatened - missed - complete - septic. TeachMeObGyn. https://teachmeobgyn.com/pregnancy/early/miscarriages/
Joshua Broder, Chapter 12 - Imaging the Genitourinary Tract, Editor(s): Joshua Broder, Diagnostic Imaging for the Emergency Physician, W.B. Saunders, 2011, Pages 650-705, ISBN 9781416061137, .
Hitzeman, N., & Albin, K. (2014, April 1). Misoprostol for incomplete first trimester miscarriage. American Family Physician.
Coplon, Leah, et al. “Society of Family Planning Committee Statement: Abortion Nomenclature.” Contraception, Elsevier, 16 June 2023, .
MacNaughton, H., Nothnagle, M., & Early, J. (2021a, April 15). Mifepristone and Misoprostol for early pregnancy loss and medication abortion. American Family Physician.
Masten, M., & Alston, M. (2023, March 15). Treatment of recurrent cesarean scar pregnancy with oral mifepristone, Systemic Methotrexate, and ultrasound-guided suction dilation and curettage. Cureus.
Arey, W., Lerna, K., Beasley , A., Harper, L., Moayedi, G., & White, K. (2022, June 22). A Preview of the Dangerous Future of Abortion Bans — Texas Senate Bill 8. New England Journal of Medicine .
Évora, F., Hundarova, K., Águas, F., & Carvalho, G. (2021, October 29). Cervical ectopic pregnancy: A multidisciplinary approach. Cureus.
Coplon, Leah, et al. “Society of Family Planning Committee Statement: Abortion Nomenclature.” Contraception, Elsevier, 16 June 2023, www.sciencedirect.com/science/article/pii/S0010782423001786.
Center for Reproductive Rights, Blackman v. State of Tennessee. Retrieved at: https://reproductiverights.org/wp-content/uploads/2023/09/TN-Complaint-Final-9-12.pdf
Coplon, Leah, et al. “Society of Family Planning Committee Statement: Abortion Nomenclature.” Contraception, Elsevier, 16 June 2023, www.sciencedirect.com/science/article/pii/S0010782423001786.
Center for Reproductive Rights, Blackman v. State of Tennessee. Retrieved at: https://reproductiverights.org/wp-content/uploads/2023/09/TN-Complaint-Final-9-12.pdf
Center for Reproductive Rights, Blackman v. State of Tennessee. Retrieved at: https://reproductiverights.org/wp-content/uploads/2023/09/TN-Complaint-Final-9-12.pdf
“Induction Abortion.” Induction Abortion | Kaiser Permanente, https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.induction-abortion.tw2562.
Matters, Margi. “Accuracy in Communication - Brisbane Psychologist Margi Matters: Ashgrove and North Brisbane.” Brisbane Psychologist Margi Matters | Ashgrove and North Brisbane, 14 June 2020, https://margimattersbrisbanepsychologist.com/2018/06/25/communication-and-accuracy/.
Matters, Margi. “Accuracy in Communication - Brisbane Psychologist Margi Matters: Ashgrove and North Brisbane.” Brisbane Psychologist Margi Matters | Ashgrove and North Brisbane, 14 June 2020, https://margimattersbrisbanepsychologist.com/2018/06/25/communication-and-accuracy/.
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