In 538's summary of the GOP debate, I was struck by this item:

In his closing statement, Ben Carson said that since the debate had started, 200 abortions had been performed. That stat caught our ear. Turns out, he’s right. In 2011, according to the Guttmacher Institute, the abortion rate in the U.S. was 121 per hour, or 242 over the course of the debate.

According to the CDC, there were 730,322 legal abortions in the U.S in 2011. That breaks down to about 83 per hour, or close to 170 for the two-hour debate.

Hillary has caught a lot of grief for her "safe, legal, and rare" formulation. Fortunately, abortion is currently rather safe - from Guttmaccher, " a first-trimester abortion is one of the safest medical procedures, with minimal risk—less than 0.05%—of major complications that might need hospital care."

Relatedly, "The risk of death associated with abortion increases with the length of pregnancy, from one death for every one million abortions at or before eight weeks to one per 29,000 at 16–20 weeks—and one per 11,000 at 21 weeks or later."

Causes of delay? "Fifty-eight percent of abortion patients say they would have liked to have had their abortion earlier. Nearly 60% of women who experienced a delay in obtaining an abortion cite the time it took to make arrangements and raise money. ...Teens are more likely than older women to delay having an abortion until after 15 weeks of pregnancy, when the medical risks associated with abortion are significantly higher."

The good news is medication abortions lower the delay to abortions - the bad news is after a dozen years or so, it's only 1/4: "early medication abortions have increased from 6% of all abortions in 2001 to 23% in 2011, even while the overall number of abortions continued to decline. Data from the CDC show abortions shifting earlier within the first trimester, likely due, in part, to the availability of medication abortion services."

Medication abortions probably are much safer & simpler as well, as indicated by: "Medication abortion accounted for 23% of all non-hospital abortions and 36% of abortions before nine weeks’ gestation, in 2011."

But Medication abortion services are less successful market-wise than Windows 7 (sorry, best analogy I had): "in 2011, 59% of abortion providers, or 1,023 facilities, provided one or more early medication abortions. At least 17% of providers offer only early medication abortion services."  I suppose 3/5th coverage isn't terrible, but it isn't fabulous on what should by now be a baseline.

And the decrease in abortions is likely not due to demand: "As of January 1, 2014, at least half of the states have imposed excessive and unnecessary regulations on abortion clinics, mandated counseling designed to dissuade a woman from obtaining an abortion, required a waiting period before an abortion, required parental involvement before a minor obtains an abortion, or prohibited the use of state Medicaid funds to pay for medically necessary abortions."  Cost for medical abortion ranges from $300-800, with mean about $500.

How are the restrictions on medicinal abortion?

The U.S. Food and Drug Administration (FDA) approved the use of mifepristone for early nonsurgical abortion in 2000.

Since then, states have enacted several types of restrictions targeting medication abortion.

Many states limit provision of medication abortion to physicians, despite recommendations from the World Health Organization and the National Abortion Federation that midlevel providers, such as physician assistants and advanced practice nurses, can safely provide medication abortion.

Several states have adopted laws that require mifepristone to be provided in accordance with the FDA-approved protocol, which is based on a regimen for mifepristone developed in Europe in the late 1980s. It has been surpassed by a newer regimen that, based on scientific studies, has been shown to be just as effective while using less medication, resulting in fewer side effects and requiring fewer visits to the provider.

Since health care providers are legally permitted to adapt FDA-approved protocols, and many medications are prescribed “off label,” including drugs for children and cancer patients, these protocol laws interfere with accepted medical practice.

In an effort to reach rural women, some providers began offering medication abortion services via telemedicine. However, some states require clinicians to be in the physical presence of the patient when prescribing abortion-inducing drugs. These laws therefore restrict the use of telemedicine in the case of abortion and reduce access to abortion services in rural areas.

So let's say that if medicinal abortions could be prescribed and provided by non-physician health care providers remotely, access to and use of safe abortion would likely approach Europe's 50%. (if you think we're backwards, Canada just approved Mifepristone this year).

What's it like? Here's a shot, not a pill, from Vice:

My best friend, a nurse, urged me to get an abortion shot. (A what? I thought.) She swore it would be the easiest and quickest option, and told me where I could find it. She even accompanied me on the visit — though I wasn’t required to bring a second party for the procedure, which was a simple injection in the hip.

The subsequent abortion felt mercifully easyThe subsequent abortion felt mercifully easy. It was quick and entailed almost no pain. Giddy with relief, I hugged the doctor on my follow-up visit, when successful termination was confirmed.

A far cry from backroom abortions of the past (in the west, present elsewhere). In general, medical abortion is safer than antibiotics, much safer than pregnancy and the various complications surround than pregnancy. Chance of death less than 1 per 100,000 (<0.001%), about the same as for miscarriage. ABORTION CLINICS ARE LARGELY NOT NEEDED FOR EARLY MEDICAL ABORTIONS, up to 9 weeks because of US regs - at least 12-13 weeks in Europe (possible complications after 12-13 weeks). Some figures show 2-3% of women need further medical care up to using RU-486 in the first 11 weeks.

So let's get on to the "rare" part - what will make abortion more rare? Better access to simpler & effective contraception (though the side-effects of long-term use of the pill should be acknowledge, vs. a medical abortion even up to 5-10 times during more sexually active ages). Will guys ever use contraceptives effectively? Fairly unlikely, and the "male pill" is still a myth.

So should abortion be "rare"? I'm just one opinion, but as I think about the evolving facts and methods around abortion in writing this piece, I've come to not think so, though as I can't experience pregnancy, I'm sure I'm not quite clued in on all the feelings it entails.

But if it's safe, easy, not too expensive, and is a natural solution for our need and desire to have sex, why not?

We're talking about a socially and medically evolving situation, where many of the repercussions that were unavoidable before are no longer required. We don't have "till death do you part" marriages, we don't have saving yourself for marriage outside of strict religious circles. We also know that much of the horror and dread about both getting pregnant and getting an abortion is about the pain involved - fairly negligible in this day & age. And we know that the first weeks of pregnancy are pretty unnoticeable, and we've just established that most of the ickyness takes place within those first 9-10 weeks, and are more likely to if the medical procedure is simpler so less to contemplate. And if the abortion itself isn't a painful horrid physical and psychological mess, the negatives have largely gone away - we're pretty much talking about going to a dentist twice a year vs. running away to a monastary.

The contentious part for some is the state of the foetus, which is without a central nervous system, e.g. non-functioning brain or feelings, so not a functioning human being by most measures through the allowed period of abortion. Short of that, our concept of "rare" is affected less by the dangers and discomfort of the past, and the fact that it's no longer such a big deal. Yes, we will likely expect our children to have some kind of control of their sexual lives, but it's also closer to "don't rut in public" and "don't pull your pud in the street" than a sin against God or a major affront to society. Abortion or unwanted pregnancy as a sign of infidelity is likely the major remaining shame, and 1) as it gets safer and simpler to deal with before discovery, and 2) since pregnancy - especially one easily not brought to term - is no longer a life-changing event unless you want it to be, even the negative connotations and the somewhat regressive attitudes of owning someone else's body will change somewhat.

I'd expect in 20 years a somewhat evolved attitude on all this, but I wouldn't walk into a general presidential debate spouting actual facts and figures this year - I don't think intellectually and emotionally a majority are able to handle this quite yet. Any society that can have a Trump or Carson taken as seriously as they've been is pretty stunted. Leave it for the kids (irony intended). Just as the biggest danger from marijuana is police incarceration, not medical harm,the biggest danger from sex and pregnancy is now Republicans, not abortion or miscarriage. So I'll leave you with some stats.

INCIDENCE OF ABORTION

• Half of pregnancies among American women are unintended, and four in 10 of these are terminated by abortion.[1]

•Twenty-one percent of all pregnancies (excluding miscarriages) end in abortion.[2]

• In 2011, 1.06 million abortions were performed, down 13% from 1.21 million in 2008. From 1973 through 2011, nearly 53 million legal abortions occurred.[2]

• Each year, 1.7% of women aged 15–44 have an abortion [2]. Half have had at least one previous abortion.[3]

• At least half of American women will experience an unintended pregnancy by age 45, and at 2008 abortion rates, one in 10 women will have an abortion by age 20, one in four by age 30 and three in 10 by age 45.[4,5]

Abortion Drone carrying Mifepristone into Poland