Defining ‘Abortion’: A Need for Clarity

Abstract: Following the Dobbs decision, some pregnant individuals have not received timely treatment for life-threatening conditions (e.g., in cases of ectopic pregnancy). This is partly due to clinicians’ confusion over what is allowed under the law. Calls to improve patient access to abortion (or related services) at the national level are unlikely to succeed, however, since there are substantial variations between states regarding the meaning of ‘abortion.’ Similarly, pronouncements by major medical organizations are unlikely to provide clarity, since terms like ‘abortion,’ ‘pregnancy,’ etc., mean different things in different jurisdictions. To promote clarity, we must identify points of disagreement between jurisdictions. Here, I identify six variables to consider when defining ‘abortion’ in public policy: (1) the definition of ‘pregnancy,’ (2) whether prescribing abortion-inducing medication counts as performing an abortion, (3) whether abortion terminates pregnancy or is merely an act done with ‘the intention to terminate pregnancy,’ (4) whether abortion has some characteristic intention(s), (5) whether providers must know that their actions are likely to cause fetal death, and (6) whether providers must know that patients receiving abortions are pregnant. After documenting how states’ statutes address each variable, I suggest how best to think about each variable (for the sake of developing abortion policy in a pluralistic context). I conclude by proposing a uniform definition of ‘abortion.’ Ultimately, this process creates a solid framework for providing greater clarity on abortion policy. Clarity is essential here, since widespread confusion will continue to put the health and lives of many pregnant individuals at risk.