Induced abortion in the world: 1. Perception of abortion throughout the centuries and by religions

Abstract

Induced abortion has religious, moral, and cultural dimensions that place it at the center of major ethical debates. The interest of women caught in the middle of this never‐ending controversy requires that a dialogue replaces current confrontation. To promote such dialogue, we decided to write a mini‐series to review important aspects of abortion. First, we will turn to history to explore the root of the controversy, which may enable the disentangling of the complexity of the issue. In the second essay we describe how the 20th century witnessed the progressive legalization of abortion. In the third essay we will articulate how we see the possibility of a common ground between those favoring and those opposing abortion. Induced abortion has been attempted from the dawn of civilization and it is mentioned in Egyptian, Greek, and Roman writings, although the frequency of the practice and its success are not known. The world's principal religions did not view abortion favorably, but the strength of prohibition was not uniform. Within Christianity, the Roman Catholic and Orthodox Churches are currently totally opposed, whereas Protestant denominations are more nuanced in their disapproval. The anti‐abortion stance of Muslim countries seems to be at variance with the view of the majority of traditional scholars, who would allow abortion in the early stages of pregnancy (up to 4 months, or in the first 40 days). The Orthodox Jewish view bans abortion except when the life of the mother is at risk, whereas Reformed Judaism is more open. Hinduism is also opposed to abortion with few exceptions: severe fetal abnormalities, presence of a life‐threatening condition for the woman, in case of rape or incest. Confucianism stresses the importance of the family and reverence for life but also shows concern and compassion for the welfare of the pregnant woman; these positions are balanced when responding to the challenge of deciding about abortion.

1. INTRODUCTION

The World Health Organization estimates that 73 million induced abortions are performed in the world each year ¹ ; yet abortion remains the most controversial and contested procedure in the whole of medicine and is the cause of harsh disagreement and animosity in many societies.

Induced abortion entails the deliberate termination of human pregnancy. Most often the term is taken to refer to the practice undertaken before the fetus can survive outside the uterus, but it also applies to processes that entail fetal sacrifice before birth. Abortion has religious, moral, and cultural dimensions that are often misappropriated for political gains. ² Abortion is at the center of major ethical debates where advocates and opponents clash. A major tenet of the argument of those opposed to liberalizing access to abortion is that it desecrates the value or sanctity of human life and suppresses innocent human life, while advocates of free access to abortion emphasize a woman's right to self‐determination and right of control of her own body especially in cases that pose additional risk and for victims of rape. The language used in the exchanges is often highly emotive and reflects entrenched stances that leave no place for reconciliation. ³

The health dimensions of induced abortion are considerable. On the one hand, denial of abortion can result in personal, family, and social strife, and on the other hand, women undergoing abortion can suffer physical and psychological consequences. To some, the consequences of their choice can last a lifetime.

We, the authors, hold divergent views on the subject of induced abortion, but have agreed that a dialogue is useful and necessary for advancing the interest of those at the center of the controversy. It is for this reason that we decided to explore all aspects that may lead to a dialogue between persons holding divergent views on pregnancy termination.

But why does terminating an unwanted pregnancy continue to be the most hotly debated issue within modern bioethics?

In an attempt to answer this question, we decided to review the many aspects of induced abortion. Our work will be divided into three separate parts: first we will review attitudes on abortions over known historical times, believing that turning first to history, magistra vitae, can provide—if not an answer—at least the critical information that helps to disentangle the complexity of the issue. We believe that going back to what happened during millennia of human history will help in understanding why opposition to induced abortion is still widespread. We acknowledge that there are many publications dealing with a number of issues relevant to the history of induced abortion; however, usually they have concentrated on views and controversies in the western world. Here we will try to cover also the views of other ancient civilizations to show that, historically, most of them held critical positions on the topic. This will be followed by a second essay describing the “revolution” that occurred during the 20th century with the recognition of reproductive health and rights, leading to profound changes in many parts of the world in the perception of terminating an unwanted or untimely pregnancy, and the emergence of permissive legalization of abortion in many countries. Finally, in a third publication, we will summarize the two major opposing views of induced abortion, describing current tension between advocates and opponents that has led to the fact that abortion is treated differently from any other health matters, including in countries where it is legalized. In doing so, we will stress the need to open a constructive dialogue and indicate where such a dialogue may start.

To achieve our first goal, we will start with an overview of the stance of the main world religions on abortion. Such an overview will necessarily be limited to a small fraction of the 10 000 or so religions that exist in the world. However, the main religions covered in this article, claim three‐quarter of the world population. We are also conscious that scholars within each religion can, and do, have different interpretations and stances on the question of abortion. Religious stance also evolved overtime. Hence, the aim of our review is not to be an authoritative text of religious interpretation, but to provide a broad overview that places induced abortion within the religious context. Our approach also focused on the main ideas that helped shape current thinking about abortion. One limitation of this work is that it could not include a detailed account of the views of the various scholars of each religion. Such an account is outside the scope of this article.

2. A BRIEF HISTORY OF ABORTION

Induced abortions have been practiced from the dawn of civilization. The earliest reference to an abortifacient comes from ancient Egypt and is found in the Ebers Papyrus, which dates back about 1500 bc, believed to be a collection of folklore or knowledge available at the time, some of which may have been centuries older. This does not include reference to the reason(s) for abortion or how often it was practiced. The reported ancient abortifacients were made of dates, onions, and acanthus fruit, all crushed with honey and applied to the vulva. ⁴

Abortion was practiced in Ancient Greece and in Rome. In 1971, Enzo Nardi, an Italian historian, published a book on induced abortion in the Greek‐Roman world. ⁵ Unfortunately, we have not been able to access the book itself; what we have is an article, published in 1973, that provides a good summary. Its author, Sheila Dickson, ⁶ reports that Nardi dismissed as indemonstrable the existence of legislation against abortion by the Greek legislators Lycurgus and Solon, or the Roman kings Romulus and Numa Pompilius. Dickson reports that during the 5th and 4th centuries bc, abortion was practiced without either legal or religious sanctions and even commended as a means of population control. Twenty‐five centuries later, the need to control the population explosion was claimed as an important argument to make abortion compulsory in given cases.

The methods used in ancient Rome included extracts from the plant Silphium, which was also used as an aphrodisiac. ⁷

Although the number of abortions performed and the success of ancient methods are unknown, applying our current knowledge to available descriptions suggests that the methods were unlikely to have been effective.

Interestingly, the controversy over inducing an abortion seems to be as old as its practice: it has been reported that Imhotep, an Egyptian administrator and builder of the third millennium bc (third dynasty) to whom healing powers were ascribed through a gradual process of “deification,” instituted an oath to be taken by all practicing physicians prohibiting them from prescribing an abortifacient drug or pessary. Allegedly, this was used by Hippocrates, the great Greek physician of the 5th century bc, as the basis of the oath ascribed to him. ⁸ However, there is no documentary evidence of such an oath originating in ancient Egypt.

The English translation of the oath credited to Hippocrates (see the 16th century publication in which the Hippocratic Oath appears in Greek accompanied by a Latin translation by its side ⁹ ), contains a prohibition to perform an abortion (Moreover, I will give no sort of medicine to any pregnant woman, with a view to destroy the child). Traditionally, the Oath has been taken by every physician in the western world. The wording of the Oath has been amended several times to adjust it to evolving medical ethics.

Recently, the origin of the prohibition to induce an abortion that is found in the Latin and English versions of the Oath, has been questioned. In an essay Vintzileos and Mylonas, ¹⁰ argued that the original ancient Greek text reads: “I will not give to any woman a harming pessary”, and that the words “foetum (fetus) and abortu (abortion) were inserted in the Latin translations of the Oath, which then carried on in subsequent English versions”. They concluded that “because the original Hippocratic Oath did not contain language related to abortion, it should not be construed as prohibiting it.”

This conclusion, however, begs two questions.

• What was the use of a “pessary” in ancient times? The topic has been addressed by Oliver et al., ¹¹ who stated that the word “pessary” comes from a Greek word (pessos) meaning an oval stone used in a checkers‐like game. In other words, pessary “would have translated to apply to all intrauterine devices”. If this interpretation is correct, then inserting a pessary for Hippocrates would have been synonymous to inserting an intrauterine device, not an instrument to correct prolapse. This interpretation of the word pessary seems hardly adequate and, in fact, a pessary was probably something inserted in the vagina to block the descent of the uterus; this, however, does not preclude the possibility that it might have been used to somehow cause an abortion; after all, if we believe that Imhotep, in his oath, prohibited the use of “an abortifacient drug or pessary”, this implies that pessaries were used to induce an abortion. It is also possible that the pessaries were used as barriers to pregnancy.

• Why was the translation altered? By accident, or on purpose? The first option seems unlikely. If it was done on purpose, why did the author, acting alone or in liaison with others, consider this change necessary? A possible explanation is that, since the first Latin translation appeared in 1515, which may have been a time when there was a changing attitude towards abortion or to women generally, the altering of the text was made to comply with the prevailing sentiment of the time.

According to Nardi, ⁵ in the Hippocratic “corpus” (the compendium of his work), there is evidence that abortion was practiced in his time in the very early stages of pregnancy. This statement is subject to an important reservation: Until the beginning of the 20th century, there were no methods to identify an early pregnancy; therefore, it is doubtful that it would have been possible to practice abortion in the “very early stages”.

2.1. Abortion versus infanticide

Given the difficulty in safely inducing an abortion, there are indications that in past times (as well as in more recent times if legal abortion is not available) there was a trend to eliminate the newborn, rather than the fetus.

This topic is outside the scope of our review; therefore, here we will only report the views of Aristotle who wrote: “As to exposing or rearing the children born, let there be a law that no deformed child shall be reared; but on the ground of number of children, if the regular customs hinder any of those born being exposed, there must be a limit fixed to the procreation of offspring, and if any people have a child as a result of intercourse in contravention of these regulations, abortion must be practiced on it before it has developed sensation and life; for the line between lawful and unlawful abortion will be marked by the fact of having sensation and being alive”. ¹²

2.2. Ethical‐medical stance

As mentioned above, in the modern world, ethical objections center on the notion that performing an abortion entails the termination of human life, which should be prohibited either absolutely or with restrictions. In some characterizations, this has even been depicted as “murder” of innocent life. The opposing view gives primacy to a woman's autonomous choice, or right of control over her body or reproductive choices.

To fully understand the situation, it is very useful to explore how we reached this dualistic situation. As aptly reported by Albar, ¹³ the ban on doctors being involved in abortion, ubiquitous at least in the western world, began to change during the 20th century. However, the World Medical Association Declaration of Geneva of 1948, as amended in Sydney in 1968, ¹⁴ was still inspired by the Hippocratic Oath in its classically accepted meaning and pledged “to maintain the utmost respect for human life from the time of conception.” However, there was a shift with the Declaration of Oslo, where the existence of different, even opposing, opinions was formally accepted. ¹⁵ The Declaration of Oslo regards abortion as a matter of individual conviction and conscience that must be respected, while allowing for individual doctor's conscientious objection. Since then, attitudes continued to shift and almost all European countries accepted abortion for non‐medical indications during the 20th century. It is likely the case that the changes in medical declarations followed rather than drove the change in societal attitudes.

2.3. The doctrine of the sanctity of life

The anti‐abortion stance has at its core the doctrine of sanctity of human life. This notion is likely to have pre‐dated the Judeo‐Christian teaching that man is made in God's image, and that life is a gift from God. To strict religious advocates, the sanctity of life is absolute, although there is some debate on whether life becomes (or should be considered) sacred at conception, at a point during gestation, or at birth. There is also a consideration of which life is to be protected as a priority, that of the mother or the fetus. The concept of sanctity of human life is now widely recognized, including by persons who do not subscribe to any religion; this, however, does not necessarily mean that life should be preserved at all times, or at all cost. For instance, ancient and some modern societies still support capital punishment. At least to some, therefore, the notion of sanctity of human life is compatible with it being subjected to rules or customs, which means that it can be overridden in specific situations. Archeology has uncovered clear evidence of human sacrifice, including in the name of religion, in ancient societies. Infanticide was practiced in pre‐Christian Rome and pre‐Islamic Arabia. In both cases, the practice stopped because of the prohibitions imposed by religions, rather than by the influence of an innate predilection of human nature.

As will be discussed later, there are variations between religions and between branches within each religion in their approach to abortion and those stances have changed over time. Religions vary in their “structure”, some but not all have a living supreme reference authority and generally speaking, followers of religions are individuals who pursue faith within their given or assigned tradition. Hence, although followers of any particular religion or sect have a right to impose on themselves those practices that align to their belief system, it is less clear that they have a right to impose such practices on those who have a different set of beliefs.

The usual starting point for advocates of abortion is not that the life of embryos and fetuses has no intrinsic value; but rather that the practice should be considered with primary reference to the pregnant woman herself and that it should accommodate her circumstances and autonomy. This is often framed in terms of the right of the women to control over her body and her life. The difficulty here is that if the “unborn child” (as the opponents of induced abortion refer to the new life in the womb) has an intrinsic value, whether or not based on a religious concept of the sacred, then the question arises as to the magnitude of this value and, in turn, the corresponding level of control.

Hence, if the unborn is a living human with a distinct entity from the pregnant woman, the real question is whether it would be appropriate that its fate be left to the determination of the woman herself. In this respect, anti‐abortion advocates stress that issues of life and death are matters for legislation by the state rather than being left to individual autonomy.

The vexata questio is whether the value of intrauterine life should be one requiring an intervention by the state, or purely a private matter. Examining the status of ectopic pregnancies and miscarriages could also be informative.

2.4. The religious perspective

An important consideration is that, today, legislation on abortion in a number of countries runs contrary to the prevailing religion of its citizens and is more aligned to public views or medical considerations. Despite this, the role of religion remains highly influential in framing debates and sometime in creating tension, denial of care, or stigma.

As the stance regarding abortion varies within and between religious groups, it is useful to briefly outline the present position of the major religions.

Islam

For Islamic scholars, the position on abortion varied. Many Islamic scholars' interpretation of the Qur'an and of the Hadith (saying of the Prophet), is that abortion is permitted in the early stages of pregnancy (up to 4 months), which is believed to be the time when the spirit enters the body. Dissenting views that adopt a stricter interpretation regard abortion as permitted only in the first 40 days of pregnancy. Abortion is not allowed for pregnancy outside wedlock, which is itself prohibited. ¹³ , ¹⁶ , ¹⁷ In modern interpretations, it is opined that wanton abortion is prohibited and that abortion requires justification, such as when the continuation of pregnancy would endanger the life or health of the pregnant woman, or if there is proven serious congenital anomaly in the embryo or fetus. ¹⁸ Some scholars categorized abortion as disapproved (makruh) but not forbidden or unconditionally prohibited (haram). ¹⁹ Traditional Islam is unlikely to have developed a view about maternal or fetal risk given that these notions are the product of modern medical advances. It is perhaps important to recognize that (similar to the case of other religions) early Islamic scholars did not have any understanding of ovulation, conception, or implantation. As a result, these timescales would have been made with reference to readily recognized events, i.e. missed monthly cycle or fetal quickening (an expression meaning “when a pregnant woman starts to feel fetal movement in her uterus”).

As mentioned by Albar, ¹³ the position of Islamic scholars is not uniform. There are different interpretations of Hadith, as well as some discrepancies between different Hadiths. The veracity and interpretation of each Hadith is a matter for scholars, but what could be gleaned is that Islam advocates for protecting pregnancies after quickening and also that there is no absolute prohibition on abortion in early gestation. Albar ¹³ goes on to discuss whether the timeframe for abortion starts from the missed period or from the time of insemination. Clearly, this can have little practical relevance unless intercourse only occurs sporadically. What is also unclear is how abortion was performed in the Arab peninsula or the Muslim world in ancient times.

Christianity

It has been reported that Christianity did not always condemn abortion; indeed, according to Callan, ²⁰ the miracles by which Brigid, a patron Saint of Ireland, was sanctified included a miracle that caused a fetus to disappear. Saint Ciarán of Saigir has also been credited with inducing an abortion on a raped nun. The existence of these stories suggests acceptance of abortion in early days, at least under specific circumstances.

In his historical review, Hovey ²¹ mentions that it was Pope Sixtus V who, around the end of the 16th century, officially classed all abortion as “homicide”, but this definition was rolled back by his successor Pope Gregory XIV. This means that between the beginning of the 17th and the end of the 19th centuries, abortion was tolerated by the Roman Catholic church until ensoulment (defined as more than 40 days for male fetuses and up to 80–90 days for females). It is hard to understand how the sex of the fetus could have been identified in those days.

Total prohibition was re‐imposed by Pope Pius IX who, in 1869, again equated all abortions with “murder”. ²¹ This stance remains the current position of the Catholic church and has been strongly reaffirmed by Pope Francis. ²²

As mentioned, the strict position against abortion by the Catholic church is relatively recent. In the past, the stance seems to have been more in line with that taken by Islam. The anti‐abortion stance has been repeatedly emphasized by the Catholic Church Magisterium. The Catechism promulgated by Pope John Paul II opposes all forms of abortion procedures and holds that “human life must be respected and protected absolutely from the moment of conception”. ²³ This position was upheld by both Pope Benedict XVI and Pope Francis (see, for example, ²⁴ , ²⁵ ).

In this connection, there are several Biblical texts suggesting that human life has value before birth. For example, the description of the creation of humans “in the image of God”, ²⁶ seems to indicate that human life has value even before birth. According to Potts and Diggory, ²⁷ the Old and New Testaments considered induced abortion to be a crime, but not murder, and allowed the husband of the offending woman to determine the punishment, which was a compensation to him. The Bible states that several important figures, including the prophets Jeremiah and Isaiah and the Christian Apostle Paul, were “called to their sacred tasks since their time in the womb”. Psalm 139 asserts that God “knit me together in my mother's womb”. ²⁷

The Catholic position on abortion is shared by Orthodox Churches. In a recent document that was mandated to be read in all Greek Orthodox Churches, the Permanent Holy Synod sent the clear message that the Church is against abortion and in favor of protecting life. ²⁸ The same stand has been taken by the Orthodox Church of America. ²⁹ The position of the Russian Orthodox Church is even more uncompromising, as it recently adopted a document equating abortion to murder amid growing ultra‐conservative calls for a nationwide ban and several regions restricting the procedure. ³⁰

Some of the Protestant denominations seem to be open to abortion, at least under specific circumstances. ³¹ The Church of England frames its position as one of strong opposition to abortion with a recognition that there are strictly limited circumstances where abortion may be morally preferable to any available alternatives. It takes the view that human life starts with conception. ³² In contrast, the Synod of the Church in Sweden does not formulate a single opinion on abortion, but instead emphasizes the church's pastoral task in relation to the practice while recognizing plurality of opinion and supporting Sweden's liberal laws.

However, as summarized by Blanchard, ³³ the admissibility of abortion is divisive even among Protestants because when it comes to ethics, they ostensibly agree on the centrality of Biblical Scripture. This, however, creates a problem because the meaning of a Scripture written thousands of years ago is definitely not self‐explanatory, with a number of factors, such as tradition, reason, and experience, conditioning any decision. Blanchard concludes that, “after decades of getting no closer to theological agreement, … perhaps it is time for Protestants to take a break from talking about abortion as such” and “focus our limited time and energy on creating systemic conditions for reproductive justice and engaging in concrete practices of hospitality and neighbor love.”

Judaism

The position of the Jewish faith is not univocal either ³⁴ : traditionally, for Orthodox Jews abortion is banned except when the life of the mother is at risk, since the third Noahide Law contains the admonition, “He who spills the blood of a man in a man, his blood will be spilt” and the Talmud defines “a man in a man” as a preborn fetus in his mother's womb. In this connection, Maimonides in his 12th‐century interpretation of Jewish law, wrote: “A descendant of Noah who kills any human being, even a fetus in its mother's womb, is to be put to death”. ³⁵

Reformed Judaism is definitely more open to abortion, ³⁶ starting from the fact that the Talmud states that the preborn baby is “one of the living limbs of the mother”. In addition, two statements in the Talmud affirm that for the first 40 days of pregnancy the fetus is “mere water” and has no status at all, which incidentally is the same according to some Islamic scholars. For the first 40 days, the fetus has zero status and is merely a part of the woman's body.

Hinduism

According to Kumar, ³⁷ Hinduism being a non‐dogmatic religion, does not explicitly proscribe abortion. However, it considers abortion “himsa” (violence) and “hatya” (murder). In 2019, Aramesh ³⁸ compared the perspectives of Hinduism and Zoroastrianism, two ancient religions with strong historical bonds and similar value‐systems on abortion. He explains that, according to Zoroastrian moral teachings, abortion is evil for two reasons: “killing an innocent and intrinsically good person, and the contamination caused by the dead body (Nashu).” In Hinduism, moral deliberations on abortion are “Ahimsa, Karma and reincarnation”. Killing an innocent human being is not only in contrast with the concept of Ahimsa but also places a serious karmic burden on its agent; finally, induced abortion deliberately disrupts the process of reincarnation to either punish or forgive sins.

An outline of what the Hindu Smriti and Shruti texts have to contribute to the abortion debate has been provided by Koley ³⁹ who explained that Hinduism is opposed to abortion, with few and well‐defined exceptions: severe congenital fetal abnormalities, when continuing the pregnancy presents a life‐threatening condition for the woman, and in case of rape and incest.

Confucianism

The Confucian approach to abortion has been presented in detail by Ivanhoe. ⁴⁰ Briefly, in Confucian ethics there are two important and related sets of ethical concerns: “on the one hand, the importance of the family and a general reverence for life; on the other, concern and compassion for the welfare of the pregnant woman.” The peculiarity of this position is that rather than seeing these two aspects as fundamentally opposed, Confucians regard them as important where abortion is concerned, refusing to choose one, appreciating the full range of ethical concerns, balancing the competing goods in responding to the challenge of deciding about abortion. Because of these two equally important issues, modern Confucians categorically reject the liberal principle of “abortion on demand”, because there is no right to an abortion given that the procedure is morally bad as it ends a potential human life and so is at odds with the general Confucian reverence for life. At the same time, this reverence is not grounded in a “right to life”. Rather in “an all‐things‐considered” moral judgment about what is best under difficult circumstances. ⁴⁰

Perhaps because of this balanced ethical view, in feudal China, there was no law prohibiting women from obtaining abortion and it was only during the Late Qing period (1636–1912)—under the influence of the western legal tradition and with China's priority on modernization—that legal sanction on abortion was first introduced. ⁴¹ Abortion continued to be banned during the Republican era and the early years of the People's Republic of China and was only changed in the 1950s with the first family planning program.

The extent by which the views held by religious scholars influence their followers is an interesting question. Surveys have shown that individuals affiliated to different religions do not hold uniform views on the question of legalization. ⁴² Expressed preferences are not necessarily an indication of the actual choices individuals themselves make.

3. CONCLUSION

Given the multi‐faceted reality herewith described, it is important to emphasize that the question of whether abortion is, or is not, morally acceptable could not be answered through reference to ancient texts, or to the authority of Hippocrates, or ancient Egyptian, Greek, or Roman physicians or leaders, because both knowledge of the early stages of life and the way societies addressed the problem as well as the status of women in society varied over time. It is also important to mention that—in practical terms—various cultures are likely to have practically addressed the issue differently from the stance taken by religious or other authorities.

Having said this, in the overall panorama of induced abortion, religion will continue to have an important, although probably not a decisive, role in debates about ethics and law. This stems from the place that the “sacred” has in human life or imagination and the place of religion in relation to the sacred. Current interpretation of the main world religions—in terms of the number of followers—is often framed as having a negative stance towards abortion. It is clear that abortion occupies a prominent place in modern ethical and politico‐legal debate; this, however, should not be taken to indicate equivalent prominence throughout history. Technically, safe termination of pregnancy has not been easy until recently. Until the advent of the 21st century, it required surgical intervention and technology that was not available at the dawn of modern times, as attempts at surgical (manual) pregnancy termination would have been accompanied by serious morbidity and mortality. On the other hand, descriptions of ancient potions suggest that these were unlikely to have been effective or were toxic also to the woman. However, those with money and connections have been able to obtain safe treatment at least since the 19th century.

In a book dedicated to contraception and abortion in world religions, Maguire ⁴³ argues that framing religions as being inflexible or unresponsive to societal reality perhaps stems from a stereotypical depiction that juxtaposes religion against science. Exploring the religious stance finds evidence that this has shifted over time, which is not unexpected because religions encompass scripture or traditions handed down through the generations and interpretations can evolve. Because of its nature, it should not come as a surprise that religious stance does not change at the same rapid pace as science. Currently, religious stance leans towards a more conservative interpretation than what could be gleaned from the possibly more permissive interpretations. This runs contrary to the societal shift as reflected in legislation. Maguire ⁴³ characterizes almost all world religions to admit both the “pro‐choice” and the “no‐choice” options and that, rather than being seamless garments, world religions are more like rich patchwork quilts that have a space for valid moral pluralism.

Sharma ⁴⁴ argues that the current stance of religion should be seen as a “result” of the religious method in the same way as current understanding of science is the result of scientific method. This separation of the result from the method enables religion and science to continue even as the outcome changes, evolves, or is proven to be inaccurate. It is possible that the religious stance is a rebound against liberalization. On the other hand, religious views may not be the primary or the dominant drivers of the anti‐abortion sentiment. Ultimately, religion influences but does not control individual or political choice. The distinction seen in some religious teachings based on the stage of pregnancy may have also been weakened by modern embryology and medical advances, such as ultrasound, which demonstrated signs of “life” in very early embryos. Despite general prohibition, some religions are willing to make exceptions for extreme cases such as where the life of the mother is at risk. But the interpretation of this is difficult, especially with the advances in medicine. On the other hand, the concept of pregnancy as a risk to the mother's health is itself modern and, therefore, it is difficult to conceive how it could have been appreciated or addressed by early religious scholars.

Followers of religions that do not have a hierarchal “ultimate” authority need to navigate uncertainty themselves. Individuals also vary in the degree by which they adhere to authoritative teaching and those who do not subscribe to a religion need to make their choices in a religious vacuum. Particularly for the latter group, the notion of “sanctity” of human life may or may not be helpful.

It is important that the reader is not left with the conclusion that all religions have been monolithically standing against abortion. At the same time, there is no doubt that throughout written human history, various major cultures of the world have held a negative position towards terminating an unwanted pregnancy. However, it is clear from regions with available statistics that women belonging to various regions or anti‐choice groups have at least as high (or higher) rates of abortion than the pro‐choice groups. However, for those belonging to more anti‐choice groups, the stigma and feelings of guilt may contribute to very negative health outcomes.

AUTHOR CONTRIBUTIONS

GB and SM conceived the overall plan; GB, KG‐D, HB, SM, and SS‐K contributed to writing. GP conceived the idea. MH and GP led the writing and literature review and are the lead authors. KG‐D, SM, and SS‐K contributed to the manuscript. All authors read and reviewed the final draft.

CONFLICT OF INTEREST STATEMENT

The authors have no conflicts of interest.

Benagiano G, Gemzell‐Danielsson K, Habiba M, Mancuso S, Shantha‐Kumari S. Induced abortion in the world: 1. Perception of abortion throughout the centuries and by religions. Int J Gynecol Obstet. 2025;171:1148‐1155. doi: 10.1002/ijgo.70318

DATA AVAILABILITY STATEMENT

Data sharing is not applicable to this article as no new data were created or analyzed in this study.