Shan Boodram: Abortion is a charged topic, with strong opinions all around  And it also involves complex personal decisions. 

But knowing what abortion is is a key part of any comprehensive sex ed course. 

We won't get too deep into the politics or legal situation surrounding abortion today, because those factors are ever-changing. But we will shine a light on what's trie about abortions, and whi gets them. 

Hi! I'm Shan Boodram and this is Crash Course: Sex Ed.

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Heads up: in today's episode, we'll be talking about sensitive topics, including miscarriages, and why people get abortions. So please keep that in mind and take care when watching. 

When people talk about abortion, they're usually referring to the medical process that ends a pregnancy. That's called an induced abortion, and that's our focus today. 

But there's also spontaneous abortions. That's the medical term for a miscarriage, when someone's body terminates a pregnancy on its own before the 20th week. 

A spontaneous abortion might require some of the same medical care used in induced abortions, but it depends on the specific case. 

A healthcare provider can share more information if you need it, and you can learn more about why miscarriages happen in Episode 9.

We'll be referring to cisgender women a lot in this episode, since that's who most of the research and discussion focuses on, but trans folk may also need pregnancy and reproductive healthcare services, including abortions. 

Now when it comes to induced abortions, there are two main ways they can happen. 

The first is by taking medication: two kinds of pills over two days, that are prescribed by a doctor or another licensed healthcare provider. 

The first pill stops a pregnancy from developing further, and the second pill empties the uterus. A medical abortion can happen entirely at home or partially at a doctor's office, and it can happen up to 10 or 11 weeks after the first day of someone's last period. 

The second kind is an in-clinic abortion, when a doctor uses light suction to empty the uterus. While the clinic visit may take longer, the procedure itself usually lasts 10 minutes or less, and can happen up to 14 to 16 weeks after someone's last period.

There's also another version of in-clinic abortion that can happen up to 24 weeks after someone's last period, which can be a little more involved and take a bit longer. 

These kinds of abortions are significantly less common, though. 

In 2021, about 93% of abortions in the US happened in the first 13 weeks of pregnancy, according to the CDC. And less than 1% happened after 21 weeks. 

As far as safety goes, surveys have found that when abortions are done under the care of a trained medical provider, they rarely have complications. 

A 2015 study that looked at data from more than 50,000 patients reported that complications happen in about 2% of cases. 

Like we'll say many times during this episode, though, every pregnancy and every person is unique. And if you'd like to learn more about any of these procedures, you can find more information in the description. 

Teen Shan: So who gets abortions? And why?

Shan: Good questions! The short answer is... well, there is no short answer. 

The Guttmacher Institute, which has been tracking this kind of data since the late 1960s, estimates that just under a quarter of women in the US will have an abortion before they're 45. 

The number is lower than it was in the past, and researchers point to a variety of reasons for that, like better contraception use and fewer teenagers having sex. 

But that estimate of just under 1/4 of US women represents millions of people. And when you ask that big of a group of people why they might do anything, you're gonna get a huge variety of answers. 

One of the most widely-referenced studies that's been done about abortion is called the Turnaway Study. It started collecting data in 2008, and surveyed hundreds of women about their experiences with abortion, over multiple years. 

As part of that study, about 950 women shared why they were seeking abortions.

And 40% of them said it was at least partly for financial reasons — either in general, or because of specific reasons like unemployment 

Meanwhile, about 20% of study participants said they were seeking an abortion because having a child would interfere with their school, work, or other life opportunities. 

And just under 30% said it was because they had to focus on their other children. 

And when it comes to that last point, about already having kids — a 2021 review by the CDC looked at data from over half a million abortions, and found that 60% of those patients were already parents.

Someone might also have multiple reasons for getting an abortion. And some of them might have nothing to do with finances, family, or their living situation. 

Notably, some people — including about 110 women from that Turnaway Study — sought abortions for medical reasons. They might have a health condition that makes pregnancy dangerous for them, or problems might come up during the pregnancy that affect them, the fetus, or both. 

So, there are a lot of variables here — and there can be a lot of emotions.

These are often complicated, heavy decisions. And while the data shows that most abortions are to end unintended pregnancies,  that isn't always the case. 

One 2015 study reported that about 4% of abortions in the US end a pregnancy that was intentional but had medical complications. 

Teen Shan: I see what you mean about the whole "there's no short answer" thing. 

Shan: Mmhmm, exactly. 

When it comes to mental health, surveys have found that getting an abortion affects different people in different ways. (You might notice a trend happening here.)

And this is also something that researchers from the Turnaway Study have looked into. As part of that larger project, they recruited more than 600 women who'd received abortions. 

And with their permission, they called them twice a year for 5 years, to ask what emotions they were feeling about their decision.

Overall, the team found that no matter how the women felt at first, nearly everyone's emotions — both positive and negative — were less intense after two years.

And after half a decade, at least 97% of women reported that getting an abortion was the right decision for them, even if they also said it had been a hard decision to make at the time. 

As a reminder, though, while data can shed some light on how a group of people can feel, and can be great for understanding the big picture  it also can't tell you how everyone will feel. 

Like, in the Turnaway Study, about half of the women said that decided to have an abortion was very or somewhat difficult — and the other half reported that it wasn't a hard decision. 

Like we've said, every pregnancy, and every person, is unique. 

Now, when it comes to abortion access — at the time we're filming this, in October 2024 — the legal situation in US is complicated. 

With a case called Roe v. Wade, the Supreme Court ruled in the 1970s that the Constitution protected a person's right to an abortion. 

But that ruling was overturned in 2022, and now, abortion access is largely up to the individual states. 

And even when laws aren't in limbo, it's also something activists — and your local politicians, and your neighbours, and your 3rd cousin on Instagram — are often vocal about. 

With these beliefs swirling around, you might've heard that there's two camps when it comes to abortion: those who argue that abortion should be banned, and those who argue that legal abortion should be available. 

But if you dig into the research, what people actually think about abortion is much more complex, because it sits right at the crossroads of law, philosophy, religion, and science. 

Kind of like how cats find a way to sit right in the middle of whatever you're doing. 

Since 1995, the Pew Research Centre has kept track of data on what Americans think about abortion.

And while those numbers have varied a bit over the years, the number of Americans who think abortion should be legal in all or most cases is usually above 50%. As of 2024, it was 63%.

Teen Shan: Wait, what does "all or some cases" mean? 

Shan: Way to critically about data, Teen Shan!

So in 2022, the folks at Pew dug a little deeper into this, and found there's a lot going on under that "all or some cases" umbrella. 

Things like how long a woman has been pregnant, whether the pregnancy threatens her health, and the circumstances of how she got pregnant — like, whether or not the sex was consensual or not — affected a lot of people's answers. 

Overall, only about 19% of participants supported the idea that abortion should be legal in all cases, and 8% said it should be illegal in all cases. But a whopping 71% answered with some version of "it depends." 

Here's where that leaves us today. Abortion will continue to be debated, and attitudes and laws will keep evolving, too. We hope this data about what happens and why helps you understand this big, complex topic a little better. 

Next time, we're talking about consent. See you then. 

This episode of Crash Course: Sex Ed was produced in partnership with the Kinsey Institute at Indiana University. If you are interested in learning more, visit their website for resources that explore the topics we discussed in the video today. 

Thank you for watching this episode, which was filmed at our studio in Indianapolis, and was made with the help of all of these nice people. If you want to help keep Crash Course free for everyone forever, you can join our community on Patreon.