and those with more liberal access to abortion. restrictive abortion laws are associated with increases in the percentage of abortions performed unsafely. the unsafe abortion rate in developing countries is partly attributable to lack of access to modern contraceptives; according to the guttmacher institute, providing access to contraceptives would result in about 14.5 million fewer unsafe abortions and 38,000 fewer deaths from unsafe abortion annually worldwide. the rate of legal, induced abortion varies extensively worldwide. according to the report of employees of guttmacher institute it ranged from 7 per 1000 women per year (germany and switzerland) to 30 per 1000 women per year (estonia) in countries with complete statistics in 2008. the proportion of pregnancies that ended in induced abortion ranged from about 10% (israel, the netherlands and switzerland) to 30% (estonia) in the same group, though it might be as high as 36% in hungary and romania, whose statistics were deemed incomplete. an american study in 2002 concluded that about half of women having abortions were using a form of contraception at the time of becoming pregnant. inconsistent use was reported by half of those using condoms and three-quarters of those using the birth control pill; 42% of those using condoms reported failure through slipping or breakage. the guttmacher institute estimated that "most abortions in the united states are obtained by minority women" because minority women "have much higher rates of unintended pregnancy". in a 2022 analysis by the kaiser family foundation, while people of color comprise 44% of the population in mississippi, 59% of the population in texas, 42% of the population in louisiana (by the state health department), and 35% of the population in alabama, they comprise 80%, 74%, 72%, and 70% of those receiving abortions. the abortion rate may also be expressed as the average number of abortions a woman has during her reproductive years; this is referred to as total abortion rate (tar). gestational age and method histogram of abortions by gestational age in england and wales during 2019 (left). abortion in the united states by gestational age, 2016 (right). abortion rates also vary depending on the stage of pregnancy and the method practiced. in 2003, the centers for disease control and prevention (cdc) reported that 26% of reported legal induced abortions in the united states were known to have been obtained at less than 6 weeks' gestation, 18% at 7 weeks, 15% at 8 weeks, 18% at 9 through 10 weeks, 10% at 11 through 12 weeks, 6% at 13 through 15 weeks, 4% at 16 through 20 weeks and 1% at more than 21 weeks. 91% of these were classified as having been done by "curettage" (suction-aspiration, dilation and curettage, dilation and evacuation), 8% by "medical" means (mifepristone), >1% by "intrauterine instillation" (saline or prostaglandin), and 1% by "other" (including hysterotomy and hysterectomy). according to the cdc, due to data collection difficulties the data must be viewed as tentative and some fetal deaths reported beyond 20 weeks may be natural deaths erroneously classified as abortions if the removal of the dead fetus is accomplished by the same procedure as an induced abortion. the guttmacher institute estimated there were 2,200 intact dilation and extraction procedures in the us during 2000; this accounts for <0.2% of the total number of abortions performed that year. similarly, in england and wales in 2006, 89% of terminations occurred at or under 12 weeks, 9% between 13 and 19 weeks, and 2% at or over 20 weeks. 64% of those reported were by vacuum aspiration, 6% by d&e, and 30% were medical. there are more second trimester abortions in developing countries such as china, india and vietnam than in developed countries. motivation personal a bar chart depicting selected data from a 1998 agi meta-study on the reasons women stated for having an abortion the reasons why women have abortions are diverse and vary across the world. some of the reasons may include an inability to afford a child, domestic violence, lack of support, feeling they are too young, and the wish to complete education or advance a career. additional reasons include not being able or willing to raise a child conceived as a result of rape or incest. societal some abortions are undergone as the result of societal pressures. these might include the preference for children of a specific sex or race, disapproval of single or early motherhood, stigmatization of people with disabilities, insufficient economic support for families, lack of access to or rejection of contraceptive methods, or efforts toward population control (such as china's one-child policy). these factors can sometimes result in compulsory abortion or sex-selective abortion. maternal and fetal health an additional factor is maternal health which was listed as the main reason by about a third of women in 3 of 27 countries and about 7% of women in a further 7 of these 27 countries. in the u.s., the supreme court decisions in roe v. wade and doe v. bolton: "ruled that the state's interest in the life of the fetus became compelling only at the point of viability, defined as the point at which the fetus can survive independently of its mother. even after the point of viability, the state cannot favor the life of the fetus over the life or health of the pregnant woman. under the right of privacy, physicians must be free to use their "medical judgment for the preservation of the life or health of the mother." on the same day that the court decided roe, it also decided doe v. bolton, in which the court defined health very broadly: "the medical judgment may be exercised in the light of all factors—physical, emotional, psychological, familial, and the woman's age—relevant to the well-being of the patient. all these factors may relate to health. this allows the attending physician the room he needs to make his best medical judgment.": 1200–1201 public opinion shifted in america following television personality sherri finkbine's discovery during her fifth month of pregnancy that she had been exposed to thalidomide. unable to obtain a legal abortion in the united states, she traveled to sweden. from 1962 to 1965, an outbreak of german measles left 15,000 babies with severe birth defects. in 1967, the american medical association publicly supported liberalization of abortion laws. a national opinion research center poll in 1965 showed 73% supported abortion when the mother's life was at risk, 57% when birth defects were present and 59% for pregnancies resulting from rape or incest. cancer the rate of cancer during pregnancy is 0.02–1%, and in many cases, cancer of the mother leads to consideration of abortion to protect the life of the mother, or in response to the potential damage that may occur to the fetus during treatment. this is particularly true for cervical cancer, the most common type of which occurs in 1 of every 2,000–13,000 pregnancies, for which initiation of treatment "cannot co-exist with preservation of fetal life (unless neoadjuvant chemotherapy is chosen)". very early stage cervical cancers (i and iia) may be treated by radical hysterectomy and pelvic lymph node dissection, radiation therapy, or both, while later stages are treated by radiotherapy. chemotherapy may be used simultaneously. treatment of breast cancer during pregnancy also involves fetal considerations, because lumpectomy is discouraged in favor of modified radical mastectomy unless late-term pregnancy allows follow-up radiation therapy to be administered after the birth. exposure to a single chemotherapy drug is estimated to cause a 7.5–17% risk of teratogenic effects on the fetus, with higher risks for multiple drug treatments. treatment with more than 40 gy of radiation usually causes spontaneous abortion. exposure to much lower doses during the first trimester, especially 8 to 15 weeks of development, can cause intellectual disability or microcephaly, and exposure at this or subsequent stages can cause reduced intrauterine growth and birth weight. exposures above 0.005–0.025 gy cause a dose-dependent reduction in iq. it is possible to greatly reduce exposure to radiation with abdominal shielding, depending on how far the area to be irradiated is from the fetus. the process of birth itself may also put the mother at risk. according to li et al., "aginal delivery may result in dissemination of neoplastic cells into lymphovascular channels, haemorrhage, cervical laceration and implantation of malignant cells in the episiotomy site, while abdominal delivery may delay the initiation of non-surgical treatment." history and religion bas-relief at angkor wat, cambodia, c. 1150, depicting a demon inducing an abortion by pounding the abdomen of a pregnant woman with a pestle since ancient times, abortions have been done using a number of methods, including herbal medicines acting as abortifacients, sharp tools through the use of force, or through other traditional medicine methods. induced abortion has a long history and can be traced back to civilizations as varied as ancient china (abortifacient knowledge is often attributed to the mythological ruler shennong), ancient india since its vedic age, ancient egypt with its ebers papyrus (c. 1550 bce), and the roman empire in the time of juvenal (c. 200 ce). one of the earliest known artistic representations of abortion is in a bas relief at angkor wat (c. 1150). found in a series of friezes that represent judgment after death in hindu and buddhist culture, it depicts the technique of abdominal abortion. in judaism (genesis 2:7), the fetus is not considered to have a human soul until it is safely outside of the woman, is viable, and has taken its first breath. the fetus is considered valuable property of the woman and not a human life while in the womb (exodus 21:22–23). while judaism encourages people to be fruitful and multiply by having children, abortion is allowed and is deemed necessary when a pregnant woman's life is in danger. several religions, including judaism, which disagree that human life begins at conception, support the legality of abortion on religious freedom grounds. in islam, abortion is traditionally permitted until a point in time when muslims believe the soul enters the fetus, considered by various theologians to be at conception, 40 days after conception, 120 days after conception, or quickening. abortion is largely heavily restricted or forbidden in areas of high islamic faith such as the middle east and north africa. some medical scholars and abortion opponents have suggested that the hippocratic oath forbade physicians in ancient greece from performing abortions; other scholars disagree with this interpretation, and state that the medical texts of hippocratic corpus contain descriptions of abortive techniques right alongside the oath. the physician scribonius largus wrote in 43 ce that the hippocratic oath prohibits abortion, as did soranus of ephesus, although apparently not all doctors adhered to it strictly at the time. according to soranus' 1st or 2nd century ce work gynaecology, one party of medical practitioners banished all abortives as required by the hippocratic oath; the other party to which he belonged was willing to prescribe abortions only for the sake of the mother's health. in politics (350 bce), aristotle condemned infanticide as a means of population control. he preferred abortion in such cases, with the restriction that it "must be practised 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." in the catholic church, opinion was divided on how serious abortion was in comparison with such acts as contraception, oral sex, and sex in marriage for pleasure rather than procreation.: 155–167 the catholic church did not begin vigorously opposing abortion until the 19th century. as early as ~100 ce, the didache taught that abortion was sinful. several historians argue that prior to the 19th century most catholic authors did not regard termination of pregnancy before quickening or ensoulment as an abortion. among these authors were the doctors of the church, such as st. augustine, st. thomas aquinas, and st. alphonsus liguori. in 1588, pope sixtus v (r. 1585–1590) was the only pope before pope pius ix (in his 1869 bull, apostolicae sedis) to institute a church policy labeling all abortion as homicide and condemning abortion regardless of the stage of pregnancy.: 362–364 : 157–158 sixtus v's pronouncement was reversed in 1591 by pope gregory xiv. in the recodification of 1917 code of canon law, apostolicae sedis was strengthened, in part to remove a possible