Reproductive Health Concerns: Defining Terms

Reproductive health concerns are top of mind for many clinicians and patients.

This is the second part in our series exploring the potential changes to patient care and reproductive health concerns stemming from the 2022 Supreme Court decision Dobbs v. Jackson Women’s Health. Learn more about the history and background of the case in part one here.  

Related podcast: Women’s Reproductive Health Issues in the Face of Changing Legislation 

Medical and legislative definitions  

The word ‘abortion’ is a medical term, referring to any pregnancy that ends prior to viability. This can happen naturally, via medication, or procedure. In cases of the former, many people prefer terms like ‘miscarriage’ or ‘spontaneous loss’ rather than ‘abortion’ to avoid association with elective termination of pregnancy. 

‘Spontaneous abortion’ is the unprompted passage of a pregnancy. In these cases, the patient usually presents with bleeding, cramping, and passing of tissue. About 80% of these occur before 12 weeks’ gestation, and the majority are caused by chromosomal abnormalities. Sadly, this is a common occurrence. 

A ‘missed abortion’ is an intrauterine pregnancy that will not result in a live birth. The embryo or a fetus stops growing and does not have cardiac activity. 

A ‘therapeutic abortion’ occurs when a pregnancy is terminated because of a medical indication, either with the fetus or the parent. Some laws expand this term to include terminations of pregnancies that are the result of rape or incest. 

Therapeutic abortions may also be considered ‘induced abortions,’ which Williams Obstetrics defines as the “surgical or medical termination of a live fetus that has not reached viability” (25th ed.). 

‘Elective abortion,’ sometimes also referred to as ‘voluntary abortion,’ is a termination of a pregnancy prior to viability at the request of the patient but not because of a medical complication. 

Legal induced and early medication abortions 

The Centers for Disease Control and Prevention define a ‘legal induced abortion’ as “an intervention performed by a licensed clinician, e.g. a physician, nurse-midwife, nurse practitioner, physician assistant, within the limits of state regulations, that is intended to terminate a suspected or known ongoing intrauterine pregnancy and that does not result in a live birth” (CDC, 2021). 

In contrast, the CDC defines an ‘early medical abortion’ as “the administration of medications(s) [sic] to induce an abortion at ≤9 completed weeks’ gestation, consistent with the current Food and Drug Administration labeling for mifepristone (implemented in 2016)” (CDC, 2021). 

Global and domestic statistics 

Approximately 73 million abortions are induced annually across the globe. According to the World Health Organization, about 60% of unintended pregnancies and about 30% of all pregnancies worldwide are terminated via abortion.

Approximately 45% of those abortions are unsafe, of which about 97 out of 100 occur in developing countries. Unsafe abortions are a significant source of maternal morbidity and mortality globally.  

In the United States, the CDC began collecting information about legally induced abortions in 1969 (pre-Roe v. Wade). However, states do not have to report data to the CDC. There is also no data available for illegal and unreported abortions.  

In 2019, the CDC reported 629,898 legal induced abortions in the United States, translating to at least 195 abortions for every 1000 live births. 


Women from ages 20-29 received over 55% of legal induced abortions. The breakdown of the timing for gestational age is as follows: 

  • Nearly 92% occurred at or under 13 weeks 
  • Nearly 6% occurred between 14 and 20 weeks 
  • Less than 1% occurred at 21 weeks or more 

From 2018-2019, the U.S. saw a 10% increase in early medical abortions. Over the full decade (2010-2019), there was a 123% increase in early medical abortions. 

Emergency care and EMTALA 

On July 11, 2022, the U.S. Department of Health and Human Services issued guidance clarifying that women who are pregnant and those experiencing loss of pregnancy should have access to emergency care. The Emergency Medical Treatment and Active Labor Act (EMTALA) also protects those healthcare providers administering legal lifesaving care. 

EMTALA provides rights to any individual who comes to a hospital emergency department and requests examination or treatment. It assures pregnant patients facing severe complications that necessary healthcare measures, including abortion, cannot be withheld because of state laws.

Examples include “ectopic pregnancy, complications of pregnancy loss, or emergent hypertensive disorders, such as preeclampsia with severe features.” Treatments may include surgical removal of one or both tubes, administering methotrexate (a medication that causes harm to the pregnancy), antihypertensive therapy, and/or abortion. (U.S. Department of Health & Human Services, 2022).