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What the data says about abortion in the U.S.

Pew Research Center has conducted many surveys about abortion over the years, providing a lens into Americans’ views on whether the procedure should be legal, among a host of other questions.

In a  Center survey  conducted nearly a year after the Supreme Court’s June 2022 decision that  ended the constitutional right to abortion , 62% of U.S. adults said the practice should be legal in all or most cases, while 36% said it should be illegal in all or most cases. Another survey conducted a few months before the decision showed that relatively few Americans take an absolutist view on the issue .

Find answers to common questions about abortion in America, based on data from the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute, which have tracked these patterns for several decades:

How many abortions are there in the U.S. each year?

How has the number of abortions in the u.s. changed over time, what is the abortion rate among women in the u.s. how has it changed over time, what are the most common types of abortion, how many abortion providers are there in the u.s., and how has that number changed, what percentage of abortions are for women who live in a different state from the abortion provider, what are the demographics of women who have had abortions, when during pregnancy do most abortions occur, how often are there medical complications from abortion.

This compilation of data on abortion in the United States draws mainly from two sources: the Centers for Disease Control and Prevention (CDC) and the Guttmacher Institute, both of which have regularly compiled national abortion data for approximately half a century, and which collect their data in different ways.

The CDC data that is highlighted in this post comes from the agency’s “abortion surveillance” reports, which have been published annually since 1974 (and which have included data from 1969). Its figures from 1973 through 1996 include data from all 50 states, the District of Columbia and New York City – 52 “reporting areas” in all. Since 1997, the CDC’s totals have lacked data from some states (most notably California) for the years that those states did not report data to the agency. The four reporting areas that did not submit data to the CDC in 2021 – California, Maryland, New Hampshire and New Jersey – accounted for approximately 25% of all legal induced abortions in the U.S. in 2020, according to Guttmacher’s data. Most states, though,  do  have data in the reports, and the figures for the vast majority of them came from each state’s central health agency, while for some states, the figures came from hospitals and other medical facilities.

Discussion of CDC abortion data involving women’s state of residence, marital status, race, ethnicity, age, abortion history and the number of previous live births excludes the low share of abortions where that information was not supplied. Read the methodology for the CDC’s latest abortion surveillance report , which includes data from 2021, for more details. Previous reports can be found at  stacks.cdc.gov  by entering “abortion surveillance” into the search box.

For the numbers of deaths caused by induced abortions in 1963 and 1965, this analysis looks at reports by the then-U.S. Department of Health, Education and Welfare, a precursor to the Department of Health and Human Services. In computing those figures, we excluded abortions listed in the report under the categories “spontaneous or unspecified” or as “other.” (“Spontaneous abortion” is another way of referring to miscarriages.)

Guttmacher data in this post comes from national surveys of abortion providers that Guttmacher has conducted 19 times since 1973. Guttmacher compiles its figures after contacting every known provider of abortions – clinics, hospitals and physicians’ offices – in the country. It uses questionnaires and health department data, and it provides estimates for abortion providers that don’t respond to its inquiries. (In 2020, the last year for which it has released data on the number of abortions in the U.S., it used estimates for 12% of abortions.) For most of the 2000s, Guttmacher has conducted these national surveys every three years, each time getting abortion data for the prior two years. For each interim year, Guttmacher has calculated estimates based on trends from its own figures and from other data.

The latest full summary of Guttmacher data came in the institute’s report titled “Abortion Incidence and Service Availability in the United States, 2020.” It includes figures for 2020 and 2019 and estimates for 2018. The report includes a methods section.

In addition, this post uses data from StatPearls, an online health care resource, on complications from abortion.

An exact answer is hard to come by. The CDC and the Guttmacher Institute have each tried to measure this for around half a century, but they use different methods and publish different figures.

The last year for which the CDC reported a yearly national total for abortions is 2021. It found there were 625,978 abortions in the District of Columbia and the 46 states with available data that year, up from 597,355 in those states and D.C. in 2020. The corresponding figure for 2019 was 607,720.

The last year for which Guttmacher reported a yearly national total was 2020. It said there were 930,160 abortions that year in all 50 states and the District of Columbia, compared with 916,460 in 2019.

• How the CDC gets its data: It compiles figures that are voluntarily reported by states’ central health agencies, including separate figures for New York City and the District of Columbia. Its latest totals do not include figures from California, Maryland, New Hampshire or New Jersey, which did not report data to the CDC. ( Read the methodology from the latest CDC report .)
• How Guttmacher gets its data: It compiles its figures after contacting every known abortion provider – clinics, hospitals and physicians’ offices – in the country. It uses questionnaires and health department data, then provides estimates for abortion providers that don’t respond. Guttmacher’s figures are higher than the CDC’s in part because they include data (and in some instances, estimates) from all 50 states. ( Read the institute’s latest full report and methodology .)

While the Guttmacher Institute supports abortion rights, its empirical data on abortions in the U.S. has been widely cited by  groups  and  publications  across the political spectrum, including by a  number of those  that  disagree with its positions .

These estimates from Guttmacher and the CDC are results of multiyear efforts to collect data on abortion across the U.S. Last year, Guttmacher also began publishing less precise estimates every few months , based on a much smaller sample of providers.

The figures reported by these organizations include only legal induced abortions conducted by clinics, hospitals or physicians’ offices, or those that make use of abortion pills dispensed from certified facilities such as clinics or physicians’ offices. They do not account for the use of abortion pills that were obtained  outside of clinical settings .

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The annual number of U.S. abortions rose for years after Roe v. Wade legalized the procedure in 1973, reaching its highest levels around the late 1980s and early 1990s, according to both the CDC and Guttmacher. Since then, abortions have generally decreased at what a CDC analysis called  “a slow yet steady pace.”

Guttmacher says the number of abortions occurring in the U.S. in 2020 was 40% lower than it was in 1991. According to the CDC, the number was 36% lower in 2021 than in 1991, looking just at the District of Columbia and the 46 states that reported both of those years.

(The corresponding line graph shows the long-term trend in the number of legal abortions reported by both organizations. To allow for consistent comparisons over time, the CDC figures in the chart have been adjusted to ensure that the same states are counted from one year to the next. Using that approach, the CDC figure for 2021 is 622,108 legal abortions.)

There have been occasional breaks in this long-term pattern of decline – during the middle of the first decade of the 2000s, and then again in the late 2010s. The CDC reported modest 1% and 2% increases in abortions in 2018 and 2019, and then, after a 2% decrease in 2020, a 5% increase in 2021. Guttmacher reported an 8% increase over the three-year period from 2017 to 2020.

As noted above, these figures do not include abortions that use pills obtained outside of clinical settings.

Guttmacher says that in 2020 there were 14.4 abortions in the U.S. per 1,000 women ages 15 to 44. Its data shows that the rate of abortions among women has generally been declining in the U.S. since 1981, when it reported there were 29.3 abortions per 1,000 women in that age range.

The CDC says that in 2021, there were 11.6 abortions in the U.S. per 1,000 women ages 15 to 44. (That figure excludes data from California, the District of Columbia, Maryland, New Hampshire and New Jersey.) Like Guttmacher’s data, the CDC’s figures also suggest a general decline in the abortion rate over time. In 1980, when the CDC reported on all 50 states and D.C., it said there were 25 abortions per 1,000 women ages 15 to 44.

That said, both Guttmacher and the CDC say there were slight increases in the rate of abortions during the late 2010s and early 2020s. Guttmacher says the abortion rate per 1,000 women ages 15 to 44 rose from 13.5 in 2017 to 14.4 in 2020. The CDC says it rose from 11.2 per 1,000 in 2017 to 11.4 in 2019, before falling back to 11.1 in 2020 and then rising again to 11.6 in 2021. (The CDC’s figures for those years exclude data from California, D.C., Maryland, New Hampshire and New Jersey.)

The CDC broadly divides abortions into two categories: surgical abortions and medication abortions, which involve pills. Since the Food and Drug Administration first approved abortion pills in 2000, their use has increased over time as a share of abortions nationally, according to both the CDC and Guttmacher.

The majority of abortions in the U.S. now involve pills, according to both the CDC and Guttmacher. The CDC says 56% of U.S. abortions in 2021 involved pills, up from 53% in 2020 and 44% in 2019. Its figures for 2021 include the District of Columbia and 44 states that provided this data; its figures for 2020 include D.C. and 44 states (though not all of the same states as in 2021), and its figures for 2019 include D.C. and 45 states.

Guttmacher, which measures this every three years, says 53% of U.S. abortions involved pills in 2020, up from 39% in 2017.

Two pills commonly used together for medication abortions are mifepristone, which, taken first, blocks hormones that support a pregnancy, and misoprostol, which then causes the uterus to empty. According to the FDA, medication abortions are safe  until 10 weeks into pregnancy.

Surgical abortions conducted  during the first trimester  of pregnancy typically use a suction process, while the relatively few surgical abortions that occur  during the second trimester  of a pregnancy typically use a process called dilation and evacuation, according to the UCLA School of Medicine.

In 2020, there were 1,603 facilities in the U.S. that provided abortions,  according to Guttmacher . This included 807 clinics, 530 hospitals and 266 physicians’ offices.

While clinics make up half of the facilities that provide abortions, they are the sites where the vast majority (96%) of abortions are administered, either through procedures or the distribution of pills, according to Guttmacher’s 2020 data. (This includes 54% of abortions that are administered at specialized abortion clinics and 43% at nonspecialized clinics.) Hospitals made up 33% of the facilities that provided abortions in 2020 but accounted for only 3% of abortions that year, while just 1% of abortions were conducted by physicians’ offices.

Looking just at clinics – that is, the total number of specialized abortion clinics and nonspecialized clinics in the U.S. – Guttmacher found the total virtually unchanged between 2017 (808 clinics) and 2020 (807 clinics). However, there were regional differences. In the Midwest, the number of clinics that provide abortions increased by 11% during those years, and in the West by 6%. The number of clinics  decreased  during those years by 9% in the Northeast and 3% in the South.

The total number of abortion providers has declined dramatically since the 1980s. In 1982, according to Guttmacher, there were 2,908 facilities providing abortions in the U.S., including 789 clinics, 1,405 hospitals and 714 physicians’ offices.

The CDC does not track the number of abortion providers.

In the District of Columbia and the 46 states that provided abortion and residency information to the CDC in 2021, 10.9% of all abortions were performed on women known to live outside the state where the abortion occurred – slightly higher than the percentage in 2020 (9.7%). That year, D.C. and 46 states (though not the same ones as in 2021) reported abortion and residency data. (The total number of abortions used in these calculations included figures for women with both known and unknown residential status.)

The share of reported abortions performed on women outside their state of residence was much higher before the 1973 Roe decision that stopped states from banning abortion. In 1972, 41% of all abortions in D.C. and the 20 states that provided this information to the CDC that year were performed on women outside their state of residence. In 1973, the corresponding figure was 21% in the District of Columbia and the 41 states that provided this information, and in 1974 it was 11% in D.C. and the 43 states that provided data.

In the District of Columbia and the 46 states that reported age data to  the CDC in 2021, the majority of women who had abortions (57%) were in their 20s, while about three-in-ten (31%) were in their 30s. Teens ages 13 to 19 accounted for 8% of those who had abortions, while women ages 40 to 44 accounted for about 4%.

The vast majority of women who had abortions in 2021 were unmarried (87%), while married women accounted for 13%, according to  the CDC , which had data on this from 37 states.

In the District of Columbia, New York City (but not the rest of New York) and the 31 states that reported racial and ethnic data on abortion to  the CDC , 42% of all women who had abortions in 2021 were non-Hispanic Black, while 30% were non-Hispanic White, 22% were Hispanic and 6% were of other races.

Looking at abortion rates among those ages 15 to 44, there were 28.6 abortions per 1,000 non-Hispanic Black women in 2021; 12.3 abortions per 1,000 Hispanic women; 6.4 abortions per 1,000 non-Hispanic White women; and 9.2 abortions per 1,000 women of other races, the  CDC reported  from those same 31 states, D.C. and New York City.

For 57% of U.S. women who had induced abortions in 2021, it was the first time they had ever had one,  according to the CDC.  For nearly a quarter (24%), it was their second abortion. For 11% of women who had an abortion that year, it was their third, and for 8% it was their fourth or more. These CDC figures include data from 41 states and New York City, but not the rest of New York.

Nearly four-in-ten women who had abortions in 2021 (39%) had no previous live births at the time they had an abortion,  according to the CDC . Almost a quarter (24%) of women who had abortions in 2021 had one previous live birth, 20% had two previous live births, 10% had three, and 7% had four or more previous live births. These CDC figures include data from 41 states and New York City, but not the rest of New York.

The vast majority of abortions occur during the first trimester of a pregnancy. In 2021, 93% of abortions occurred during the first trimester – that is, at or before 13 weeks of gestation,  according to the CDC . An additional 6% occurred between 14 and 20 weeks of pregnancy, and about 1% were performed at 21 weeks or more of gestation. These CDC figures include data from 40 states and New York City, but not the rest of New York.

About 2% of all abortions in the U.S. involve some type of complication for the woman , according to an article in StatPearls, an online health care resource. “Most complications are considered minor such as pain, bleeding, infection and post-anesthesia complications,” according to the article.

The CDC calculates  case-fatality rates for women from induced abortions – that is, how many women die from abortion-related complications, for every 100,000 legal abortions that occur in the U.S .  The rate was lowest during the most recent period examined by the agency (2013 to 2020), when there were 0.45 deaths to women per 100,000 legal induced abortions. The case-fatality rate reported by the CDC was highest during the first period examined by the agency (1973 to 1977), when it was 2.09 deaths to women per 100,000 legal induced abortions. During the five-year periods in between, the figure ranged from 0.52 (from 1993 to 1997) to 0.78 (from 1978 to 1982).

The CDC calculates death rates by five-year and seven-year periods because of year-to-year fluctuation in the numbers and due to the relatively low number of women who die from legal induced abortions.

In 2020, the last year for which the CDC has information , six women in the U.S. died due to complications from induced abortions. Four women died in this way in 2019, two in 2018, and three in 2017. (These deaths all followed legal abortions.) Since 1990, the annual number of deaths among women due to legal induced abortion has ranged from two to 12.

The annual number of reported deaths from induced abortions (legal and illegal) tended to be higher in the 1980s, when it ranged from nine to 16, and from 1972 to 1979, when it ranged from 13 to 63. One driver of the decline was the drop in deaths from illegal abortions. There were 39 deaths from illegal abortions in 1972, the last full year before Roe v. Wade. The total fell to 19 in 1973 and to single digits or zero every year after that. (The number of deaths from legal abortions has also declined since then, though with some slight variation over time.)

The number of deaths from induced abortions was considerably higher in the 1960s than afterward. For instance, there were 119 deaths from induced abortions in  1963  and 99 in  1965 , according to reports by the then-U.S. Department of Health, Education and Welfare, a precursor to the Department of Health and Human Services. The CDC is a division of Health and Human Services.

Note: This is an update of a post originally published May 27, 2022, and first updated June 24, 2022.

Jeff Diamant is a senior writer/editor focusing on religion at Pew Research Center .

Besheer Mohamed is a senior researcher focusing on religion at Pew Research Center .

Rebecca Leppert is a copy editor at Pew Research Center .

Cultural Issues and the 2024 Election

Support for legal abortion is widespread in many places, especially in europe, public opinion on abortion, americans overwhelmingly say access to ivf is a good thing, broad public support for legal abortion persists 2 years after dobbs, most popular.

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Quintilian. Institutio Oratoria. Translated by H. E. Butler, vol. 2, Loeb-Harvard UP, 1980.

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Women's Health: Problems of the Digestive System . American College of Obstetricians and Gynecologists, 2006.

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“Hush.” Buffy the Vampire Slayer, created by Joss Whedon, performance by Sarah Michelle Gellar, season 4, episode 10, WB Television Network, 14 Dec. 1999 .

You should be as specific as possible in identifying a work’s location.

An essay in a book or an article in a journal should include page numbers.

Adiche, Chimamanda Ngozi. “On Monday of Last Week.” The Thing around Your Neck, Alfred A. Knopf, 2009, pp. 74-94 .

The location of an online work should include a URL.  Remove any "http://" or "https://" tag from the beginning of the URL.

Wheelis, Mark. "Investigating Disease Outbreaks Under a Protocol to the Biological and Toxin Weapons Convention." Emerging Infectious Diseases , vol. 6, no. 6, 2000, pp. 595-600, wwwnc.cdc.gov/eid/article/6/6/00-0607_article. Accessed 8 Feb. 2009.

When citing a physical object that you experienced firsthand, identify the place of location.

Matisse, Henri. The Swimming Pool. 1952, Museum of Modern Art, New York .

Optional elements

The ninth edition is designed to be as streamlined as possible. The author should include any information that helps readers easily identify the source, without including unnecessary information that may be distracting. The following is a list of optional elements that can be included in a documented source at the writer’s discretion.

Date of original publication:

If a source has been published on more than one date, the writer may want to include both dates if it will provide the reader with necessary or helpful information.

Erdrich, Louise. Love Medicine. 1984. Perennial-Harper, 1993.

City of publication:

The seventh edition handbook required the city in which a publisher is located, but the eighth edition states that this is only necessary in particular instances, such as in a work published before 1900. Since pre-1900 works were usually associated with the city in which they were published, your documentation may substitute the city name for the publisher’s name.

Thoreau, Henry David. Excursions . Boston, 1863.

Date of access:

When you cite an online source, the MLA Handbook recommends including a date of access on which you accessed the material, since an online work may change or move at any time.

Bernstein, Mark. "10 Tips on Writing the Living Web." A List Apart: For People Who Make Websites, 16 Aug. 2002, alistapart.com/article/writeliving. Accessed 4 May 2009.

As mentioned above, while the MLA handbook recommends including URLs when you cite online sources, you should always check with your instructor or editor and include URLs at their discretion.

A DOI, or digital object identifier, is a series of digits and letters that leads to the location of an online source. Articles in journals are often assigned DOIs to ensure that the source is locatable, even if the URL changes. If your source is listed with a DOI, use that instead of a URL.

Alonso, Alvaro, and Julio A. Camargo. "Toxicity of Nitrite to Three Species of Freshwater Invertebrates." Environmental Toxicology , vol. 21, no. 1, 3 Feb. 2006, pp. 90-94. Wiley Online Library, doi: 10.1002/tox.20155.

Creating in-text citations using the previous (eighth) edition

Although the MLA handbook is currently in its ninth edition, some information about citing in the text using the older (eighth) edition is being retained. The in-text citation is a brief reference within your text that indicates the source you consulted. It should properly attribute any ideas, paraphrases, or direct quotations to your source, and should direct readers to the entry in the Works Cited list. For the most part, an in-text citation is the  author’s name and the page number (or just the page number, if the author is named in the sentence) in parentheses :

When creating in-text citations for media that has a runtime, such as a movie or podcast, include the range of hours, minutes and seconds you plan to reference. For example: (00:02:15-00:02:35).

Again, your goal is to attribute your source and provide a reference without interrupting your text. Your readers should be able to follow the flow of your argument without becoming distracted by extra information.

How to Cite the Purdue OWL in MLA

Entire Website

The Purdue OWL . Purdue U Writing Lab, 2019.

Individual Resources

Contributors' names. "Title of Resource." The Purdue OWL , Purdue U Writing Lab, Last edited date.

The new OWL no longer lists most pages' authors or publication dates. Thus, in most cases, citations will begin with the title of the resource, rather than the developer's name.

"MLA Formatting and Style Guide." The Purdue OWL, Purdue U Writing Lab. Accessed 18 Jun. 2018.

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Research Paper Outline

Ai generator.

Apart from a report outline and a presentation outline , a research paper outline is one of the most common types of outlines you’re likely to encounter in any given field. This outline is incredibly useful in both business and education, as it serves as a guide for students and employees to further understand a certain topic. But before you begin creating the outline of your research paper, make sure you know how to structure it first. In this article, we shall discuss the basic elements of an outline with the help of a few examples.

Research outlines come with variety. To give you some visual representation of these tools, here are some examples of research paper outline in PDF file format you could rely on.

What is Research Paper?

Research Paper Format

Example of Research Paper

Basic Research Paper Outline

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Educational Research Paper Outline

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Simple Research Paper Outline

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Comprehensible Research Paper Outline

Plain Research Paper Outline

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 What Is a Research Paper Outline

Outlines are tools that are used by authors to chronologically arrange their written ideas about a central topic or thesis. Details in an outline are deductively written which means that it starts by mentioning the major topics, followed by subtopics and supporting details. Outlines are utilized by writers to provide themselves a plan or blueprint on what to include in their papers. Moreover, outlines vary from very general to very specific as well as formal to informal.

Similarly, a research paper outline also does the same. It also functions as a guide for the researchers to identify what pieces of information do they need to involve in their research document.

Essential Parts of a Research Paper Outline

The outline structure of a research paper is fairly similar to that of a book outline . The only difference is the actual content presented in the paper. For us to further understand the significant components of a research paper outline, let us discuss each part accordingly:

Introduction

The introduction is considered to be the most important part of your outline, as it gives readers a general overview of what your topic is about. Here, your thesis statement along with the purpose of your study must be stated clearly. You also have the option to include your reason for studying such a topic and its significance. The methodology and the aims for the investigation must also be emphasized in your introduction. To put it simply, the introduction of your outline should stress out the major points addressed in the research paper.

The body of your outline is where you will need to present every valid argument to support your topic or thesis statement. The best approach to follow would be the “Rule of 3”, in which you must find three supporting arguments to express your point. The body is also composed of several paragraphs or subparts, which include the background of the problem and other supporting data. You may also see a  speech outline .

The final part of an outline paper is the conclusion. This consists of a summary of all the major points mentioned to arrive at your final stand on the issue or subject tackled. Be sure to expound your thoughts briefly and concisely in this section, as you don’t want to end up adding a different argument to the outline. Remember to mention the thesis statement again to connect each point accordingly. It’s also advisable to state recommendations or formulate the prospect for future studies in your conclusion. You may also see a  chapter outline .

Listed below are examples of a research paper outline:

Topic: Asbestos Poisoning

I. Introduction

• Definition of the Topic
• Significance of the Study
• Definition of Terms
• Symptoms of Asbestos Poisoning
• Effects of Asbestos Poisoning
• Possible Treatments

III. Conclusion

• How to Deal with Asbestos Hazards

Thesis: Abortion: Main Causes and Effects

Introductory Clause

• Brief introduction of the issue
• Definition of terms
• The theoretical basis for the paper
• Methodology
• Thesis statement
• Review of related literature
• Significance of the study

a. Background of the problem

• The history of abortion and the primary causes that lead modern women to consider this method (possible causes such as religion, financial status, career issues, etc. must be expounded)
• Explain the position or stand of the church and the state regarding this problem
• General information about the possible consequences of abortion supported with valid facts, scientific articles and studies, examples, etc.

b. Available alternatives to abortion along with their pros and cons.

c. Advantages and disadvantages of abortion

• Explain all advantages of abortion, with supporting facts and examples
• Explain all disadvantages of abortion (both physical and mental), with supporting facts and examples

Final Clause/Conclusion

a. Conclusion

• A short analysis of all the facts provided in the paper
• Rephrased thesis statement

b. Recommendations for future studies

Based on the examples above, the structure of your outline must consist of a series of headings and subheadings of the said topic. Since an outline must only emphasize the primary points of your research, then you must keep it brief yet informative enough for readers to comprehend.

How to Create an Outline

A well-made outline is essential in locating significant information and keeping track of large amounts of data from a research paper. But an outline must be created properly for it to be understood by a reader, which is why the information should be organized in a logical or hierarchical order for everyone’s convenience. You may also see biography outline .

1. Begin with your thesis statement.  It’s important to start your research paper outline with your thesis statement, or at least a  topic sentence that supports your thesis statement. So when a person reads your outline, they can immediately identify what your research paper is all about.

2. List down the major points of your research paper.  Create a list of strong arguments that must be highlighted in your outline. It would be best to organize them properly by sectioning them into particular categories. You may even label each part in Roman Numerals (I, II, III, IV) to make it easier for readers to find what they are looking for in your outline. You may also see tentative outlines .

3. Note down supporting ideas or argument for each point listed.  For every major argument listed, there must be a series of supporting ideas to back up its claims. This usually consists of facts or examples that prove the credibility of such a claim. Similar to the central points of the paper, it is important to keep this section organized by labeling each idea in capital letters (A, B, C). You may also see a  resume outline .

4. Subdivide each supporting topic.  If necessary, you can continue to subdivide each point to fully expound the ideas presented. This will help make your outline even more informative for readers to grasp. You can then label them with numbers ( 1, 2, 3 ) and lowercase letters ( a, b, c ).

Creating an outline for your research paper isn’t as daunting as it may seem. It’s a step-by-step process that requires proper analysis and comprehension to carry out. If you’re having trouble writing your research paper outline, then it might be better to start off with a rough outline first. After which, you can then make the necessary adjustments to complete your final outline. By studying various outline samples , you’re sure to come up with the perfect research paper outline in no time.

MLA Research Paper Outline

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Air Quality Research Paper Outline

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Academic Research Paper Outline

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Psychology Research Paper Outline

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Students Research Paper Outline

Career Research Paper Outline

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Research Paper Outline Example

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Printable Research Paper Outline

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Sample Research Paper Outline

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Research Paper Outline Format

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Research Paper Outline Guide

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Research Paper Outline in PDF

Simple Research Paper Outline Example

Junior Research Paper Outline

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Sample Research for Outline Paper

A Step-by-Step Guide to Research Process

The research process is the act of identifying, locating, assessing and analyzing of different pieces of information that are needed to support your research question. Then, the collected data will help you derive a rational conclusion. The research process is systematic and is important for you to build your own paper. To help you construct your own research process, you may follow these steps:

1. Distinguish and select a research topic.

Choosing your research topic could be a very critical step to take. It is not just because it is the first move but also due to the fact that your whole research process revolves around this topic; thus, it should be done correctly. To explain further, here are some points you need to remember:

Stick with the parameters.  Whether you are making one for academic purposes in middle school or for your job, you need to be wary of the given criterion given by your instructor. Following these are really vital since it is the key to your next step. If you fail to obey the said parameter, it could disqualify or deem your paper proposal invalid. Most of the times, clear guidelines are given to help you take the first step; however, if there’s none, ask to clarify this issue.

Go for interesting topics.  Needless to say, composing your own research paper would more enjoyable if the topic is what you truly want to explore. Furthermore, doing your research will be easier since you are having fun on the process.

Go for topics with numerous possible information sources.  Assuming that there are numerous things that interest you then identify which of these has loads of various potential basis of information. To do this, you can conduct a preliminary searching of information in various sources such as books, journals, and the holy-grail internet. There’s no need on taking notes yet, simply ponder whether the available pieces of information are capable of meeting your needs and could support your study. If you find too many information, you may need to narrow your topic; if you find too few, you may need to widen your topic.

Never forget to be original.  The most probable reason for you to write your own research paper is for your academic completion. Hence, the most possible recipient of your work will be your instructor. Now, consider that your instructor already read thousands of research paper and the only way to stand out is to be rationally different. Think outside the mundane way of thinking, be creative and be innovative. In other words, be original.

Never hesitate to ask for help.  Though it may sound absurd, consulting your instructor about this issue would be a great help. Thinking that in most cases, your instructor would be one of the people that would give verdict on your paper, conducting research on ideas that came straight from him/her would be a great advantage.

If you already have a topic with you, it would also be helpful to turn it into a specific question. Doing this would surely make your research concepts and keywords identification a lot easier. For instance, if you are really into music then you can simply pinpoint a specific topic related to that such as:

• What are the effects of pop music to the performance level of students?
•  What makes us have different musical tastes?
• What makes a piece of music good to hear?

2. Search for in-depth information.

Now that you have a specific central topic to talk about, it is time to look for deeper information. Utilize the best form of source or material that is appropriate for your study. For example, if you are in search of objective information, you can use books, magazines, journals, and internet. However, there are some details that need a different approach such as responses. In these cases, conduct a survey, observation or interview instead. Moreover, take note of your sources in doing this step.

3. Examine your sources.

In research, there are certain criteria to consider your information valid and reliable. Check on your sources’ date of publication of the information you have gathered. The common acceptable range is 5 years from the present. If you are using the internet as your source, check on the top-level domain if it is either “.edu,” “.gov,” “.org,” etc.

4. Take note.

Making a note of the different data and sources are very important in your research process. This will serve as your guide on which of those are useful for your paper. Moreover, don’t forget to include the author, title, publisher, URL and other details that will be used in citing them.

5. Begin writing your paper.

You may start by constructing a research paper outline which we discussed earlier and follow it by writing a rough draft. Remember, there is no need to be perfect right away. The main purpose of making a rough draft is to organize your information and help you in forming your final paper. Afterward, review and edit your draft as many times as necessary.

6. Cite your sources.

It is important to recall that not all information in your research paper is not yours; thus, it is just appropriate to cite them in your bibliography or reference list. By doing this, you are able to give a polite credit to the authors of the different information you have used and also to avoid plagiarism. Moreover, these would allow your reader to locate the sources of your information for verification and duplication purposes. Remember, there are different styles and formats in citing your sources. MLA, APA, and Chicago are some of the most used citation formats.

7. Proofread your work

The last step before publishing your work is to proofread your work. Simply read over your research paper and see whether there are any grammatical, spelling or any other unnoticed technical and textual errors. Proofreading is also important to check if your paper is speaking of what you really want to imply and inspect if you are following the proper citing process. Before doing this step, it is recommendable to take a break or consult the help of a proficient friend.

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FACT FOCUS: A look at false claims around Kamala Harris and her campaign for the White House

Democrats are quickly rallying around Vice President Kamala Harris as their likely presidential nominee after President Joe Biden’s ground-shaking decision to bow out of the 2024 race.

Vice President Kamala Harris arrives to speak from the South Lawn of the White House in Washington, Monday, July 22, 2024, during an event with NCAA college athletes. This is her first public appearance since President Joe Biden endorsed her to be the next presidential nominee of the Democratic Party. (AP Photo/Alex Brandon)

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The announcement that Vice President Kamala Harris will seek the Democratic nomination for president is inspiring a wave of false claims about her eligibility and her background. Some first emerged years ago, while others only surfaced after President Joe Biden’s decision to end his bid for a second term.

Here’s a look at the facts.

CLAIM: Harris is not an American citizen and therefore cannot serve as commander in chief.

THE FACTS: Completely false . Harris is a natural born U.S. citizen. She was born on Oct. 20, 1964, in Oakland, California, according to a copy of her birth certificate, obtained by The Associated Press.

Her mother, a cancer researcher from India, and her father, an economist from Jamaica, met as graduate students at the University of California, Berkeley.

Under the 14th Amendment to the Constitution, anyone born on U.S. soil is considered a natural born U.S. citizen and eligible to serve as either the vice president or president.

“All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside,” reads the amendment.

There is no question or legitimate debate about whether a citizen like Harris is eligible to serve as president or vice president, said Jessica Levinson, a professor at Loyola Law School.

“So many legal questions are really nuanced — this isn’t one of those situations,” Levinson told the AP on Monday.

Still, social media posts making the debunked assertion that Harris cannot serve as president went viral soon after Biden announced Sunday that he was dropping out of the race and would back Harris for president.

“Kamala Harris is not eligible to run for President,” read one post on X that was liked more than 34,000 times. “Neither of her parents were natural born American citizens when she was born.”

False assertions about Harris’ eligibility began circulating in 2019 when she launched her bid for the presidency. They got a boost, thanks in part to then-President Donald Trump, when Biden selected her as his running mate.

“I heard today that she doesn’t meet the requirements,” the Republican said of Harris in 2019.

CLAIM: Harris is not Black.

THE FACTS: This is false. Harris is Black and Indian . Her father, Donald Harris, is a Black man who was born in Jamaica. Shyamala Gopalan, her mother, was born in southern India. Harris has spoken publicly for many years, including in her 2019 autobiography , about how she identifies with the heritage of both her parents.

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Despite ample evidence to the contrary, social media users are making erroneous claims about Harris’ race.

“Just a reminder that Kamala Harris @KamalaHarris isn’t black,” reads one X post that had received approximately 42,000 likes and 20,400 shares as of Monday. “She Indian American. She pretends to be black as part of the delusional, Democrat DEI quota.”

But Harris is both Black and Indian. Indeed, she is the first woman, Black person and person of South Asian descent to serve as vice president. This fact is highlighted in her biography on WhiteHouse.gov and she has spoken about her ethnicity on many occasions.

Harris wrote in her autobiography, “The Truths We Hold: An American Journey,” that she identifies with the heritage of both her mother and father.

“My mother, grandparents, aunts, and uncle instilled us with pride in our South Asian roots,” she wrote. “Our classical Indian names harked back to our heritage, and we were raised with a strong awareness and appreciation for Indian culture.”

In the next paragraph, she adds, “My mother understood very well that she was raising two black daughters.” Harris again refers to herself as a “black woman” in the book’s next chapter.

CLAIM: Harris got her start by having an affair with a married man, California politician Willie Brown.

THE FACTS: This is missing some important context. Brown was separated from his wife during the relationship, which was not a secret.

Brown, 90, is a former mayor of San Francisco who was serving as speaker of the California State Assembly in the 1990s when he and Harris were in a relationship. Brown had separated from his wife in 1982.

“Yes, we dated. It was more than 20 years ago,” Brown wrote in 2020 in the San Francisco Chronicle under the article title, “Sure, I dated Kamala Harris. So what?”

He wrote that he supported Harris’ first race to be San Francisco district attorney — just as he has supported a long list of other California politicians, including former House Speaker Nancy Pelosi, former Sen. Dianne Feinstein and Gov. Gavin Newsom.

Harris, 59, was state attorney general from 2011-2017 and served in the Senate from 2017 until 2021, when she became vice president. She has been married to Doug Emhoff since 2014.

Harris’ critics have used the past relationship to question her qualifications, as Fox News personality Tomi Lahren did when she wrote on social media in 2019: “Kamala did you fight for ideals or did you sleep your way to the top with Willie Brown.” Lahren later apologized for the comment.

Trump and some of his supporters have also highlighted the nearly three-decade old relationship in recent attacks on Harris .

CLAIM: An Inside Edition clip of television host Montel Williams holding hands with Harris and another woman is proof that Harris was his “side piece.”

THE FACTS: The clip shows Montel with Harris and his daughter, Ashley Williams. Harris and Williams, a former marine who hosted “The Montel Williams Show” for more than a decade, dated briefly in the early 2000s.

In the clip, taken from a 2019 Inside Edition segment , Williams can be seen posing for photographs and holding hands with both women as they arrive at the 2001 Eighth Annual Race to Erase MS in Los Angeles.

But social media users are misrepresenting the clip, using it as alleged evidence that Harris was Montel’s “side piece” — a term used to describe a person, typically a woman, who has a sexual relationship with a man in a monogamous relationship.

Williams addressed the false claims in an X post on Monday, writing in reference to the Inside Edition clip, “as most of you know, that is my daughter to my right.” Getty Images photos from the Los Angeles gala identify the women as Harris and Ashley Williams.

In 2019, Williams described his relationship with Harris in a post on X, then known as Twitter.

“@KamalaHarris and I briefly dated about 20 years ago when we were both single,” he wrote in an X post at the time. “So what? I have great respect for Sen. Harris. I have to wonder if the same stories about her dating history would have been written if she were a male candidate?”

CLAIM: Harris promised to inflict the “vengeance of a nation” on Trump supporters.

THE FACTS: A fabricated quote attributed to Harris is spreading online five years after it first surfaced.

In the quote, Harris supposedly promises that if Trump is defeated in 2020, Trump supporters will be targeted by the federal government: “Once Trump’s gone and we have regained our rightful place in the White House, look out if you supported him and endorsed his actions, because we’ll be coming for you next. You will feel the vengeance of a nation.”

The quote was shared again on social media this week. One post on X containing an image of the quote was shared more than 22,000 times as of Monday afternoon.

The remarks didn’t come from Harris , but from a satirical article published online in August 2019. Shortly after, Trump supporters like musician Ted Nugent reposted the comments without noting they were fake.

CLAIM: A video shows Harris saying in a speech: “Today is today. And yesterday was today yesterday. Tomorrow will be today tomorrow. So live today, so the future today will be as the past today as it is tomorrow.”

THE FACTS: Harris never said this. Footage from a 2023 rally on reproductive rights at Howard University, her alma mater, was altered to make it seem as though she did.

In the days after Harris headlined the Washington rally, Republicans mocked a real clip of her speech, with one critic dubbing her remarks a “word salad,” the AP reported at the time .

Harris says in the clip: “So I think it’s very important — as you have heard from so many incredible leaders — for us, at every moment in time, and certainly this one, to see the moment in time in which we exist and are present, and to be able to contextualize it, to understand where we exist in the history and in the moment as it relates not only to the past, but the future.”

NARAL Pro-Choice America, an abortion rights nonprofit whose president also spoke at the rally, livestreamed the original footage. It shows Harris making the “moment in time” remark, but not the “today is today” comment.

The White House’s transcript of Harris’ remarks also does not include the statement from the altered video. Harris’ appearance at the event came the same day that Biden announced their reelection bid .

Find AP Fact Checks here: https://apnews.com/APFactCheck .

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The Morning

J.d. vance’s chance.

Why Donald Trump tapped Vance to be his successor.

By Michael C. Bender

Donald Trump did something yesterday that he’s never before done. He picked a successor.

Trump chose Senator J.D. Vance of Ohio as his running mate , a strategic move driven by the former president’s belief that he’ll win in November by recapturing the Midwestern states he lost in 2020. With Vance’s hardscrabble upbringing and Trump-aligned ideology, the senator is Trump’s attempt to appeal to those voters.

Selecting Vance also signals the party’s final commitment to Trumpism. Vance is one of the most aggressive and ideological disciples of the MAGA movement. Instead of balancing the ticket with someone who could expand Trump’s appeal to new voters, Trump has anointed the senator as the future of the Republican Party .

The party that Trump took over in 2016 — one guided by establishmentarians like Mitt Romney, Paul Ryan and John McCain — is now unrecognizable. Trump ushered in economic populism and pushed out the quest for limited government spending. He traded foreign interventionism for restrictive trade policies and downgraded the importance of country-club Republicans while prioritizing blue-collar workers.

The arrival of Vance on the ticket shows there is no going back.

At first blush, it may seem surprising that Trump would put the future of the party in the hands of a relatively new convert to his brand of conservatism. (As an author and private citizen, Vance said in 2016 that Trump might be “America’s Hitler.” Later, as he ran for office, the Ohioan embraced Trumpism.) But Trump is focused on winning, and he believes Vance is an asset.

An unusual path

There are several reasons Trump was drawn to Vance. The senator is an articulate communicator on television. Even his most ardent critics respect his expertise as a MAGA spokesman, a skill that Trump highly prizes. Vance also served in the Marines and deployed to Iraq, making him the only candidate on either party’s ticket with military experience.

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Factors Influencing Abortion Decision-Making Processes among Young Women

Mónica frederico.

1 International Centre for Reproductive Health (ICRH), Ghent University, 9000 Gent, Belgium; [email protected]

2 Centro de Estudos Africanos, Universidade Eduardo Mondlane, C. P. 1993, Maputo, Mozambique; [email protected]

Kristien Michielsen

Carlos arnaldo, peter decat.

3 Department of Family Medicine and primary health care, Ghent University, 9000 Gent, Belgium; [email protected]

Background: Decision-making about if and how to terminate a pregnancy is a dilemma for young women experiencing an unwanted pregnancy. Those women are subject to sociocultural and economic barriers that limit their autonomy and make them vulnerable to pressures that influence or force decisions about abortion. Objective : The objective of this study was to explore the individual, interpersonal and environmental factors behind the abortion decision-making process among young Mozambican women. Methods : A qualitative study was conducted in Maputo and Quelimane. Participants were identified during a cross-sectional survey with women in the reproductive age (15–49). In total, 14 women aged 15 to 24 who had had an abortion participated in in-depth interviews. A thematic analysis was used. Results : The study found determinants at different levels, including the low degree of autonomy for women, the limited availability of health facilities providing abortion services and a lack of patient-centeredness of health services. Conclusions : Based on the results of the study, the authors suggest strategies to increase knowledge of abortion rights and services and to improve the quality and accessibility of abortion services in Mozambique.

1. Introduction

Abortion among adolescents and youth is a major public health issue, especially in developing countries. Estimates indicate that 2.2 million unplanned pregnancies and 25% (2.5 million) unsafe abortions occur each year, in sub-Saharan Africa, among adolescents [ 1 ]. In 2008, of the 43.8 million induced abortions, 21.6 million were estimated to be unsafe, and nearly all of them (98%) took place in developing countries, with 41% (8.7 million) being performed on women aged 15 to 24 [ 2 ].

The consequences of abortion, especially unsafe abortion, are well documented and include physical complications (e.g., sepsis, hemorrhage, genital trauma), and even death [ 3 , 4 , 5 , 6 ]. The physical complications are more severe among adolescents than older women and increase the risk of morbidity and mortality [ 6 , 7 ]. However, the detrimental effects of unsafe abortion are not limited to the individual but also affect the entire healthcare system, with the treatment of complications consuming a significant share of resources (e.g., including hospital beds, blood supply, drugs) [ 5 , 8 ].

The decision if and how to terminate a pregnancy is influenced by a variety of factors at different levels [ 9 ]. At the individual level these factors include: their marital status, whether they were the victim of rape or incest [ 10 , 11 ], their economic independence and their education level [ 10 , 12 ]. Interpersonally factors include support from one’s partner and parental support [ 12 ]. Societal determinants include social norms, religion [ 9 , 13 ], the stigma of premarital and extra-marital sex [ 14 ], adolescents’ status, and autonomy within society [ 12 ]. At the organizational level, the existence of sex education [ 10 , 14 ], the health care system, and abortion laws influence the decisions if and where to have an abortion.

Those factors are related to power and (gender) inequalities. They limit young women’s autonomy and make them vulnerable to pressure. Additionally, the situation is exacerbated when there is a lack of clarity and information on abortion status, despite the existence of a progressive law in this regard.

For example, Mozambican law has allowed abortion if the woman’s health is at risk since the 1980s [ 15 , 16 , 17 , 18 ]. In 2014, a new abortion law was established that broadened the scope of the original law: women are now also allowed to terminate their pregnancy: (1) if they requested it and it is performed during the first 12 weeks; (2) in the first 16 weeks if it was the result of rape or incest, or (3) in the first 24 weeks if the mother’s physical or mental health was in danger or in cases of fetus disease or anomaly. Women younger than 16 or psychically incapable of deciding need parental consent [ 19 , 20 ].

Notwithstanding the progressive abortion laws in Mozambique, hospital-based studies report that unsafe abortion remains one of the main causes of maternal death in Mozambique [ 3 ]. However, hospital cases are only a small share of unsafe abortions in the country. Many women undergo an abortion in illegal and unsafe circumstances for a variety of reasons [ 3 ], such as legal restrictions, the fear of stigma [ 21 , 22 , 23 ], and a lack of knowledge of the availability of abortion services [ 3 , 9 , 23 ].

According to the 2011 Mozambican Demographic Health Survey (DHS), at least 4.5% of all adolescents reported having terminated a pregnancy [ 24 ]. Unpublished data from the records of Mozambican Association for Family Development (AMODEFA) which has a clinic that offers sexual and reproductive health services, including safe abortion, indicate that from 2010 to 2016 a total of 70,895 women had an induced abortion in this clinic, of which 43% were aged 15 to 24. Of the 1500 women that had an induced abortion in the AMODEFA clinic in the first three months of 2017, 27.9% were also in this age group [ 25 ]. These data show the high demand for (safe) abortion among young women.

For all this described above, Mozambique is an interesting place to study this decision-making process; given the changing legal framework, women may have to navigate gray areas in terms of legality, safety, and access when seeking abortion, which is stigmatized but necessary for the health, well-being, and social position of many young women.

The objective of this study is to explore the individual, interpersonal and environmental factors behind the abortion decision-making process. This entails both the decision to have an abortion and the decision on how to have the abortion. By examining fourteen stories of young women with an episode of induced abortion, we contribute to the documentation of the circumstances around the abortion decision making, and also to inform the policymakers on complexity of this issue for, which in turn can contribute to improve the strategies designed to reduce the cases of maternal morbidity and mortality in Mozambique.

2. Materials and Methods

This is an exploratory study using in-depth interview to explore factors related to abortion decision-making in a changing context. As research on this topic is limited, we opted for a qualitative research framework that aims to identify factors influencing this decision-making process.

2.1. Location of the Study

The study was conducted in two Mozambican cities, Maputo and Quelimane. These cities were selected because they registered more abortions than other cities in the same region. According to the 2014 data from the Direcção Nacional de Planificação, 629 and 698 women, respectively, were admitted to the hospital due to induced abortion complications in Maputo and Quelimane [ 26 ]. Furthermore, the two differ radically in terms of culture, with Maputo in the South being patrilineal and Quelimane in the Central Region matrilineal, which could influence the abortion decision-making process. The fieldwork took place between July–August 2016 and January–February 2017.

2.2. Data Collection

The data were collected through in-depth interviews, asking participants about their experiences with induced abortion and what motivated them to get an abortion. To approach and recruit participants ( Figure 1 ), we used the information collected during a cross-sectional survey with women in the reproductive age (15–49), These women were selected randomly applying multistage cluster based on household registers. The survey was designed to understand women’s sexual and reproductive health and included filter questions that allowed us to identify participants who had undergone an abortion. The information sheet and informed consent form for this household survey included information about a possible follow-up study.

The process of recruitment of the participants.

Participants who were within the age-range 15–24 years and who reported having had an abortion were contacted by phone. In this contact, the researcher (MF) introduced herself, reminded the participant of the study she took part in, explained the follow-up study and asked whether she was willing to participate in this. If she did, an appointment was made at a convenient location. Before each interview, we explained to each participant why she was invited to the second interview. Participants were also informed of interview procedures, confidentiality and anonymity in the management of the data, and the possibility to withdraw from the interview at any time. In total 14, young women (15–24) agreed to participate: nine in Maputo and five in Quelimane. Six of them were interviewed twice to explore further aspects that remained unclear after the first interview. The interviews were conducted in Portuguese.

To start the interview, the participant was invited to tell her life history from puberty until the moment when the abortion occurred. During the conversation, we used probing questions to elicit more details. Gradually, we added questions related to the abortion and factors that influenced the decision process. The main questions were related to the pregnancy history, abortion decision-making, and help-seeking behaviour. The guideline was adapted from WHO tools [ 27 , 28 ]. Before the implementation of the guideline, it was discussed first with another Mozambican researcher to see how they fell regarding the question. After those questions were revised or removed from the guideline.

2.3. Data Analysis

The analysis consisted of three steps: transcription, reading, and codification with NVivo version 11(QSR International Pty Ltd., Doncaster, Australia). After an initial reading, one of the authors (MF) developed a coding tree on factors determining the decision-making. A structured thematic analysis was used to make inferences and elicit key emerging themes from the text-based data [ 29 , 30 ]. The coding tree was based on the ecological model, which is a comprehensive framework that emphasizes the interaction between, and interdependence of factors within and across all levels of a health problem since it considers that the behaviour affects and is affected by multiple levels of influence [ 31 , 32 ].

Next, the codes and the classification were discussed among the researchers (Mónica Frederico, Kristien Michielsen, Carlos Arnaldo and Peter Decat). Finally, the data was interpreted, and conclusions were drawn [ 33 ].

2.4. Ethical Consideration

Before the implementation of this research, we obtained ethical approval from the Institutional Committee of the Faculty of Medicine and Nacional Bioethical Committee for Health (IRB00002657). We also asked for the institutional approval of the Minister of Health and authorities at the provincial and community levels. The participants gave their informed consent after the objectives and interview procedures had been explained to them. The participants were informed that they might be contacted and invited, within six months, to participate in another interview.

2.5. Concepts

The providers are the people who carried out the abortion procedure. These may be categorized into skilled and unskilled providers: the former refers to a professional (i.e., nurse or doctor) offering abortion services to a client, while the latter is someone without any medical training. Another concept that requires further explanation is the legal procedure. This corresponds to a set of steps to be followed to comply with the law [ 19 , 20 ]. Specifically, this means that a committee should authorize the induced abortion and an identification document should be available, as well as an informed consent form from the pregnant woman. If the woman is a minor, consent is given by her legal guardian. An ultrasound exam is required to determine the gestational age.

3.1. Characteristics of the Participants

The characteristics of the interviewees are summarized in Table 1 . The 14 participants were aged 17 to 24 years. Eight had completed secondary school, four had achieved the second level of primary school, and two were university students. Almost all (13) were Christian. Five participants were studying, eight were unemployed, and one was working. The median age of their first sexual intercourse was 15.5 years. Participants reported living with one or both parents (12), with their uncle (1) or alone (1). They lived in suburban areas of Maputo and Quelimane, which are slums with poor living conditions. In these areas, most households earn their income through small businesses that also involve child labour (e.g., selling food or drinks).

Socio-demographic characteristics and abortion procedure.

Among the participants, five reported more than one pregnancy. One interviewee first had a stillbirth and then two abortions. Another woman gave birth to a girl and afterward terminated two pregnancies. Two interviewees reported two pregnancies, the first of which was brought to full term and the second one terminated. One woman first had an abortion and afterward gave birth to a child. In short, 14 interviewees in total reported on the experiences and decision-making of 16 abortions. One participant stated that the pregnancy was the consequence of rape. Of the 16 reported abortions, seven were performed after the new law came into force at the end of 2014, and nine were carried out before this time.

3.2. Abortions Stories

In this study, 12 abortions were done by skilled providers and two by unskilled providers. The unskilled providers were a mother and a husband, respectively. None of the cases, whose abortion was done by a skilled provider, included in this study followed the legal procedure.

In the analysis of the interviews, we studied the personal, interpersonal and environmental factors that influenced six different types of abortion stories, see Table 2 : (1) an abortion was performed because the pregnancy was unwanted; (2) an abortion was carried out although the pregnancy was wanted; (3) the abortion was done by an unskilled provider at home; (4) an abortion was carried out by a skilled provider outside the hospital; (5) a particular abortion procedure (medical or chirurgical) was chosen, and (6) the legal procedure was not followed in the hospital. Factors influencing the choice for a particular technical procedure were also examined.

Summary of induced abortion stories. (We changed the table format, please confirm.)

* The result of rape; ** Seven participants; *** six participants.

3.3. Abortion Following an Unwanted Pregnancy

In the stories about unwanted pregnancies, mostly personal factors were mentioned as reasons, with some interviewees stating that they felt unable to be a mother at the time of the pregnancy: “ (It) was at the time that I was taking pills that I got pregnant, and I induced abortion because I was not prepared (for motherhood). ” (24 years)

Some had had a bad experience in the past: “ Maybe I would be abandoned and it would be the same. (Sigh)... I learned with my first pregnancy. ” (23 years)

Also, the existence of another child was mentioned as a reason to have an abortion: “ I got pregnant when I was 20, and I had a baby. When I became pregnant again, my daughter was a child, and I could not have another child. ” (23 years)

For other participants, studies were the main reason why the pregnancy was not wanted: “ He was informed about it, and he said that I should keep it. However, as I wanted to continue my studies, I told him no, no (I) do not. ” (17 years)

At the interpersonal level, a lack of support from the partner was often mentioned as a reason for not wanting the baby: “ He said that he recognizes the paternity, but it is not to keep that pregnancy. ” (22 years)

Women frequently mentioned environmental circumstances related to their poor socio-economic situation: “ I am staying at Mom's house; it is not okay to still be having babies there.” (23 years)

“ At home, we do not have any resources to take care of this child! ” (20 years)

3.4. Abortion Following a Wanted Pregnancy

In these cases, the decision to abort the pregnancy was not made by the woman herself but imposed by others or by the circumstances.

Some participants reported that their parents/family had decided what had to be done: “ They decided while I was at school. If (it) was my decision I would keep it because I wanted it. ” (18 years).

Other young women indicated the refusal of paternity as a reason to terminate the pregnancy.

“ Because my son’s father did not accept the (second) pregnancy. There was a time, we argued with each other, and we terminated the relationship. Later, we started dating again, and I got pregnant. He said it was not possible. ” (21 years)

“ (he) impregnated me and after that, he dumped me, (smiles)… I went to him, and I said that I was pregnant. He said eee: I do not know, that is not my child. ” (20 years).

Some women told the interviewers that they were convinced by their boyfriend to have an abortion: “ I talked to him, and he said okay we are going to have an abortion and I accepted. ” (22 years)

Others mentioned their partner’s indecision and changing attitude as a reason to get an abortion, even though they did want the baby:

“ I told him I was pregnant. First, he said to keep it. (Next) He was different. Sometimes he was calling me, and other times not. I understood that he did not want me. ” (20 years)

The fear of being excluded from their family due to their pregnancy was another reason reported by participants: “ So I went to talk with my older sister, and she said eee, you must abort because daddy will kick you out of our home. ” (20 years)

“ As I am an orphan, and I live with my uncle, they were going to kick me out. No one would assist me. ” (20 years)

3.5. Location of the Abortion: Home-Based Versus Hospital-Based

Two young women reported having had the abortion at home by an unskilled provider. It seems that these unskilled providers than the women (i.e. family members, partner) made the decisions.

“ It was mammy and my sister (who provided the induced abortion services). My sister knows these things. ” (18 years)

“ He (the father of the child) came to my house and took me back to his house. It was that moment when I aborted. ” (21 years)

Of the 16 abortions, seven were performed through health services, by a skilled provider. For some of them, the choice for a health service was influenced by the fact of knowing someone at the health facility.

“ I went to talk to her (friend), and she said that “I have an aunt who works at the hospital, she can help you. Just take money”. ” (20 years)

“ I Already knew who could induce it (abortion). No, I knew that person. I went to the hospital, and I talked to her, (and) she helped me. ” (22 years)

Other participants went to the health facility, but due to the lack of money to pay for an abortion at the facilities they sought help out of the health facility: “ They charged us money that we did not have. The ladies did not want to negotiate anything. I think they wanted 1200 mt (17.1 euros) if I am not wrong. He had a job, but he (boyfriend) did not have that amount of money. ” (22 years)

Some participants reported that they had an abortion outside regular facilities because the health provider recommended going to his house: “ She (mother) was the one who accompanied me. She is the one who knows the doctor. We went to the central hospital, but he (the doctor) was very busy, and he told us to go to his house. ” (17 years)

Others reported the fear of signing a document as a reason to seek help outside of official channels: “ I heard that to induce abortion at the hospital it is necessary for an adult to sign a consent form. I was afraid because I did not know who could accompany me. Because at that time I only wanted to hide it from others. ” (22 years).

3.6. Abortion Procedure

The women were not able to explain why a particular abortion procedure (i.e., pills or aspiration, curettage) was used. It appears that they were not given the opportunity to choose and that they submitted themselves to the procedure proposed by the provider.

“ The abortion was done here at home. They just went to the pharmacy, bought pills and gave them to me. ” (18 years)

3.7. Legal Procedure

None of those treated at the hospital stated that legal procedures were followed. They also mentioned that they had to pay without receiving any official receipt.

“ First we got there and talked to a servant (a helper of the hospital). The servant asked for money for a refreshment so he could talk to a doctor. After we spoke (with servant), he went to the doctor, and the doctor came, and we arranged everything with him. ” (22 years)

“ We went to the health center, and we talked to those doctors or nurses I mean, they said that they could provide that service. It was 1200 mt (17.1 euros), and they were going to deal with everything. They did not give us the chance to sign a document and follow those procedures. ” (20 years)

4. Discussion

The objective of this study was to describe abortion procedures and to explore factors influencing the abortion decision-making process among young women in Maputo and Quelimane.

The study pointed out determinants at the personal, interpersonal and environmental level. Analysing the results, we were confronted with four recurring factors that negatively impacted on the decision-making process: (1) women’s lack of autonomy to make their own decisions regarding the termination of the pregnancy, (2) their general lack of knowledge, (3) the poor availability of local abortion services, and (4) the overpowering influence of providers on the decisions made.

The first factor involves women’s lack of autonomy. In our study, most women indicate that decisions regarding the termination of a pregnancy are mostly taken by others, sometimes against their will. Parents, family members, partners, and providers decide what should happen. As shown in the literature, this lack of autonomy in abortion decision-making is linked to power and gender inequality [ 34 , 35 , 36 , 37 , 38 ]. On the one hand, power reflects the degree to which individuals or groups can impose their will on others, with or without the consent of those others [ 34 , 37 , 38 ]. In this case, the power of the parent/family is observed when they, directly or indirectly, influence their daughters to induce an abortion, for instance by threatening to kick them out of their home. On the other hand, gender inequality is also a factor. This refers to the power imbalance between men and women and is reflected by cases in which the partner makes the decision to terminate the pregnancy [ 38 ]. Besides this, the contextual environment of male chauvinism in Mozambique also makes it more socially acceptable for men to reject responsibility for a pregnancy [ 34 , 35 , 37 , 39 , 40 ]. Finally, women’s economic dependence makes them more vulnerable, dependent and subordinated. For economic reasons, women, have no other choice but to obey and follow the family or partner’s decisions. Closely linked with women’s lack of autonomy is their lack of knowledge. Interviewees report that they do not know where abortion services are provided. They are not acquainted with the legal procedures and do not know their sexual rights. This lack of knowledge among women contributes to the high prevalence of pregnancy termination outside of health facilities and not in accordance with legal procedures.

Our participants often report that abortion services are absent at a local level, as has also been pointed out by Ngwena [ 41 ]. This is a particular problem in Mozambique. Not all tertiary or quaternary health facilities are authorized to perform abortions. The fact that only some tertiary and quaternary facilities are allowed to do so creates a shortage of abortion centres to cover the demand. In fact, only people with a certain level of education and a sufficiently large social network have access to legal and proper abortion procedures.

Finally, our study shows that providers mostly decide on the location, the methods used and the legality of abortion procedures. Patients are highly dependent on the health providers’ commitment, professionality and accuracy and the selected procedures are not mutually decided by the provider and the patient. Providers often do not refer the client to the reference health facility or do not inform them of the legal procedures, creating a gap between law and practice that stimulates illegal and unsafe procedures. The reasons for this are unclear. It might be due to a lack of knowledge among health providers too, and, perhaps, provider saw here an opportunity to supplement the low salary [ 42 ]. Participants who seek help at the health facility they do so contacting the provider in particular, as indication given by someone.

This corroborates with studies conducted by Ngwena [ 41 , 43 ], Doran et al. [ 44 ], Pickles [ 45 ], Mantshi [ 46 ], and Ngwena [ 47 ], which pointed out the obstacles related to the availability of services and providers’ attitudes towards safe abortion, although the law grants the population this right [ 41 , 43 , 44 , 45 , 46 , 47 ]. As Ngwena [ 41 , 43 ] argues, the liberalization of abortion laws is not always put into practice and abortion rights merely exist on paper. Braam’ study [ 48 ] therefore highlights the necessity of clarifying and informing women and providers of the current legislation and ensuring that abortion services are available in all circumstances described in the law.

Finally, despite cultural differences between Maputo and Quelimane, the result did not suggest differences between two areas studied regarding factors influencing the decision to terminate and how the abortion is done. However, the Figure 1 suggests that there was trend to have more participants from Maputo reporting abortion episode in her life than Quelimane. This difference maybe be because Maputo is much more multicultural and the people of this city have more access to information that gives them the opportunity to learn about matter of reproductive health including abortion, than Quelimane. So, due to this there is trend decrease the taboo relation to abortion in Maputo than in Quelimane.

These abortion stories illustrate the lack of autonomy in decision-making process given the power and gender inequalities between adults and young women, and also between man and women . They also show the lack of knowledge not only on the availability of abortion services at some health facilities, as well as, on the new law on abortion. All these lacks that women have are reinforced by poor availability of abortion services and the fact that the providers we not taking their role to help those women, as it is exposed in the next sections.

This study interviewed young women who had an induced abortion at some point in their lives (15 years up to their age at interview date). As such, it does not provide any information on the factors behind the decisions of those who did not terminate their pregnancy.

The results presented in this paper only reflect the perceptions of the young women who had an induced abortion, not those of their parents or partners. The paper is based on qualitative data that provides insights into factors influencing abortion decision-making. Since the sample included in the study is not representative for the population of young women in Mozambique, the results cannot be generalized.

5. Conclusions

Based on the results of the study, we recommend the following measures to improve the abortion decision-making process among young women:

First, strategies should be implemented to increase women's autonomy in decision-making: The study highlighted that gender and power inequalities obstructed young women to make their decision with autonomy. We reiterate the Chandra-Mouli and colleges [ 49 ] message. There is a need to address gender and power inequalities. Addressing gender inequality, and promotion of more equitable power relations leads to improved health outcomes. The interventions to promote gender-equitable and power relationships, as well as human rights, need to be central to all future programming and policies [ 49 ].

Second, patients and the whole population should be better informed about national abortion laws, the recommended and legal procedures and the location of abortion services, since, despite the decision to terminate pregnancy resulted to the imposition, if they were well informed on that, maybe they could be decide on safe and legal abortion, avoiding double autonomy deprivation. At the same time, providers must be informed about the status of national abortion laws. Additionally, they should be trained in communication skills to promote shared decision-making and patient orientation in abortion counseling.

Third, the number of health facilities providing abortions services should be increased, particularly in remote areas.

Finally, health providers should be trained in communication skills to promote shared decision-making and patient orientation in abortion counseling.

The abortion decision-making by young women is an important topic because it refers the decision made during the transitional period from childhood to adulthood. The decision may have life-long consequences, compromising the individual health, career, psychological well-being, and social acceptance. This paper, on abortion decision-making, calls attention to some attitudes that lead to the illegality of abortion despite it was done at a health facility.

Acknowledgments

Authors gratefully acknowledge the support, contribution, and comments from all those who collaborated direct or indirectly, especially Olivier Degomme, Eunice Remane Jethá, Emilia Gonçalves, Cátia Taibo, Beatriz Chongo, Hélio Maúngue and Rehana Capruchand.

Author Contributions

All authors contributed significantly to the manuscript. Mónica Frederico collected data and developed the first analysis. The themes were intensively discussed with Kristien Michielsen, Carlos Arnaldo and Peter Decat. The subsequent versions of the article were written with the active participation of all authors.

Conflicts of Interest

The authors declare no conflicts of interest.