Live births following abortion attempts refer to a rare phenomenon in which an infant is born alive during or after an attempted termination of pregnancy (induced abortion). These cases may occur in two contexts: when an attempted abortion fails and the pregnancy continues to term, resulting in a live birth; or when a late termination of pregnancy results in the expulsion or delivery of an infant exhibiting signs of life.
Abortion is largely effective at terminating a pregnancy and precluding live birth. For example, the efficacy of medication abortion via the mifepristone/misoprostol regimen early in pregnancy is over 98%, though the efficacy declines as pregnancy progresses. A live birth following an attempted abortion, while overall uncommon, is most likely to occur with the labor induction abortion method, an abortion procedure used in the later second and third trimesters of pregnancy. It is particularly likely to occur if a feticidal injection is omitted or unsuccessful.
The concept of live births following abortion attempts is a recurring topic in the abortion debate. Individuals born under these circumstances are sometimes referred to as “abortion survivors” in media and political contexts. In response, policymakers in several countries have proposed laws addressing the phenomenon of infants being born alive after attempted abortions. While most such infants do not survive long after birth, a small number have lived into later childhood or adulthood.
Medical overview Several clinical studies have examined the medical circumstances under which live births can occur following attempted abortion, particularly in the second and third trimesters when the fetus has approached or is approaching viability (typically around 20 to 24 weeks of gestation). Additionally, though extremely rare, a few first trimester failed abortion attempts have resulted in live births later on in pregnancy. Live birth outcomes are most likely to occur with the labor induction abortion method and when feticidal measures, such as intracardiac injection to stop the fetal heartbeat, are unsuccessful or omitted. In the context of abortion, feticide refers to the intentional killing of an embryo or fetus prior to expulsion from the uterus.
One of the most comprehensive studies on this phenomenon is a 2024 retrospective cohort study published in the American Journal of Obstetrics and Gynecology. Reviewing over 13,000 second-trimester abortions (15–29 weeks gestation) in a cohort indicated for fetal anomaly, maternal emergency, or other causes performed in Quebec, Canada, the study found that 11.2% of these procedures resulted in live births. This risk was especially pronounced at 20–24 weeks, where the likelihood of live birth was nearly five times higher compared to abortions performed at 15–19 weeks. Significantly, the use of feticidal injections, specifically intracardiac or intrathoracic administration, reduced this relative likelihood by 57%.
These findings are supported by other clinical studies and observations as well. A 2018 study published in Obstetrics & Gynecology, which focused specifically on second-trimester abortions performed without feticide for fetal anomalies or genetic abnormalities between 20 and 24 weeks gestation, found that 50.6% of fetuses were born alive. The median survival time in these cases was 32 minutes. Live birth following the attempted abortions was more likely in cases involving higher gestational age and the absence of severe anomalies. A smaller study, published in 2016 via The Journal of Reproductive Medicine, found that 15% of labor induction abortions performed between 16 and 22 weeks gestation resulted in unintended live births. Most of these infants exhibited cardiac activity for less than two hours. Consistent with most other research, the probability of live birth increased with gestational age. The study also found that attempted terminations due to prenatal diagnoses of Down syndrome (trisomy 21) were associated with a higher likelihood of live birth.
Further evidence from outside North America provides additional context. A 2012–2015 study conducted in Switzerland and published in BMJ Open examined extremely low gestational age neonates (ELGANs) delivered during attempted late terminations of pregnancy (LTOP). This study reported that 39% (76 of 195) of LTOP cases resulted in live births, with feticide having only occurred in three instances. Reflecting a more restrictive approach to proactive care for ELGANs in Switzerland, no attempts were made to resuscitate the infants who were born alive, and all died in the delivery room shortly after. Contrary to findings by other similar studies, the study found no clear correlation between gestational age and the likelihood of live birth within this specific group.
To reduce the likelihood of live births following procedures intended to terminate pregnancy, some clinical guidelines recommend the use of feticidal injections in later abortions. For instance, in the United Kingdom, the Royal College of Obstetricians and Gynaecologists advises that feticide be offered for abortions occurring after 21 weeks of gestation. A 2023 study on abortion in England and Wales further explains this practice, noting that "termination of pregnancy resulting in live birth is rare before 22 weeks of gestation. However, after this time, the chances of having a live birth following [termination] increase," and that feticide is carried out to "avoid this by inducing fetal demise in the uterus before [abortion]." Incidence National and regional data on live births following abortion attempts are limited, because few jurisdictions require separate reporting of live births after induced abortion, and because cases may be recorded under broader categories such as neonatal death or fetal anomaly. Available figures are therefore not directly comparable across countries and may reflect differences in registration rules, abortion methods, gestational age, use of feticide, and whether only deaths, rather than all live births, are counted.
United States National data on live births following abortion attempts in the United States are limited. In 2019, FactCheck.org summarized a Centers for Disease Control and Prevention review of infant death certificates from 2003 to 2014, which identified 143 deaths involving induced terminations of pregnancy where the infant had been born alive. The CDC data included only deaths of infants born alive, not fetal deaths or stillbirths. PolitiFact reported that the 143 cases occurred during a twelve-year period in which more than 9.3 million abortion procedures were performed in the United States. Of the 143 deaths, about 42% occurred within one hour of birth, 54% occurred between one and 23 hours after birth, and about 4% occurred after one day.
The available figures are not comprehensive national incidence data. FactCheck.org reported that the CDC considered the figure of 143 deaths a possible underestimate, because in cases where it was unclear whether the pregnancy termination was induced or spontaneous, the CDC classified cases involving congenital anomalies or maternal complications as spontaneous terminations rather than induced terminations. As of 2019, FactCheck.org and PolitiFact reported that six states—Arizona, Florida, Michigan, Minnesota, Oklahoma, and Texas—had some form of reporting requirement for abortions resulting in live birth.
Canada Canadian national data have been the subject of political dispute because some figures use broad infant-death classifications rather than a dedicated born-alive-abortion reporting system. In 2013, Maisonneuve reported that three Conservative Members of Parliament had called for an RCMP investigation into 491 deaths between 2000 and 2009 classified by Statistics Canada as "Termination of pregnancy, affecting fetus and newborn." The article noted that Statistics Canada described the classification as referring to a fetus that showed any sign of life after an abortion and complete removal from the mother, regardless of gestational age; such a sign of life could be as minor as umbilical cord pulsation, and the fetus could be many weeks from viability.
A 2024 retrospective cohort study in the American Journal of Obstetrics and Gynecology examined 13,777 second-trimester abortions performed in hospital settings in Quebec between 1989 and 2021. The study found that 1,541 abortions, or 11.2%, led to live birth. Most procedures were labor-induction abortions, and the risk of live birth was highest at 20 to 24 weeks of gestation. The study also found that feticidal injection reduced the risk of live birth, with intracardiac or intrathoracic injection being especially effective.
United Kingdom In the United Kingdom, data is available mainly from regional studies and older perinatal mortality reports rather than a single national reporting system for all live births after attempted abortions. A population-based study in BJOG examined terminations of pregnancy for fetal anomaly in the West Midlands from 1995 to 2004. Among 3,189 terminations for fetal anomaly, 102 cases, or 3.2%, were live births.
A 2023 study on feticide before termination of pregnancy in England and Wales stated that live birth following termination is rare before 22 weeks of gestation, but that the likelihood increases after that point. The same study noted that feticide is used before some later terminations to induce fetal demise before abortion and thereby avoid live birth.
Australia Although Australia does not have centralized national reporting on abortion outcomes, data from several states indicate that infants are occasionally born alive during abortion procedures. Between 2010 and 2020, Queensland reported 328 neonatal deaths (15.1% of all neonatal deaths) following live births during abortions, while Victoria reported 396 such deaths (17.1%).
In 2024, The Guardian reported that Australian health experts and professional organizations had told parliamentary inquiries that, on rare occasions, a non-viable baby may be born alive after an abortion. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists described the scenario as uncommon and stated that only about 1% of abortions in Australia are performed after 20 weeks of gestation. According to the report, professional bodies disputed claims that large numbers of viable infants were being born alive and denied care.
Switzerland A 2020 study in Swiss Medical Weekly examined delivery-room deaths after late termination of pregnancy at nine Swiss level III perinatal centers from July 2012 to June 2015. Among 195 late terminations of pregnancy at 22 to 27 weeks of gestation, 76 cases, or 39%, resulted in live birth. All infants born alive after late termination died in the delivery room without resuscitation attempts. The authors stated that late terminations of pregnancy should be included in perinatal registries and that uniform reporting should be established.
Law and policy Infants born alive during or after attempted abortion procedures are recognized as legal persons in most jurisdictions, entitled de jure to the same rights and protections as other live-born individuals. However, the consistency of enforcement can vary between countries and legal systems. While international definitions, such as that of the World Health Organization, offer standardized criteria for what constitutes a live birth, legal obligations regarding resuscitation or postnatal care are often governed by regional law or left to clinical discretion.World Health Organization. (2004). International statistical classification of diseases and related health problems: Tenth revision, Volume 2: Instruction manual. (2nd ed., p. 95). Geneva: World Health Organization. https://iris.who.int/bitstream/handle/10665/42980/9241546530_eng.pdf
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