Chapter Seven Abortion

What is Abortion? Expulsion of an embryo or fetus from the uterus before it sufficiently developsExpulsion of an embryo or fetus from the uterus before it sufficiently develops Can also be referred to as those expulsions that are artificially induced by mechanical means or drugsCan also be referred to as those expulsions that are artificially induced by mechanical means or drugs Miscarriage is generally used as a natural form of expulsion without any causal interventionMiscarriage is generally used as a natural form of expulsion without any causal intervention

Current Legal Status In 1973, the U.S. Supreme Court made abortion legal in the landmark case, Roe vs. WadeIn 1973, the U.S. Supreme Court made abortion legal in the landmark case, Roe vs. Wade First Trimester: decision left to pregnant woman and physicianFirst Trimester: decision left to pregnant woman and physician Second Trimester: similar rights but state may dictate regulatory factorsSecond Trimester: similar rights but state may dictate regulatory factors Third Trimester: State regulates and can bar abortions, unless it is to preserve the life of the womanThird Trimester: State regulates and can bar abortions, unless it is to preserve the life of the woman U.S. Congress has barred the use of federal Medicaid funds to pay for abortions, except in cases of incest, rape, or immediate life- threatening dangerU.S. Congress has barred the use of federal Medicaid funds to pay for abortions, except in cases of incest, rape, or immediate life- threatening danger

Current Trends 43% of a decline of abortions was due to the use of emergency contraception43% of a decline of abortions was due to the use of emergency contraception Many states are imposing additional restrictions on abortion i.e. waiting period, counseling, age of consent, and type of procedureMany states are imposing additional restrictions on abortion i.e. waiting period, counseling, age of consent, and type of procedure The typical woman having an abortion is:The typical woman having an abortion is: Age 20Age 20 Has a previous birth historyHas a previous birth history Has never marriedHas never married From a lower socio-economic backgroundFrom a lower socio-economic background Lives in a metropolitan areaLives in a metropolitan area Is considered “Christian”Is considered “Christian”

Methods of Abortion Suction CurettageSuction Curettage Developed in China (1958)Developed in China (1958) Performed during the 6 th to 12 week of pregnancyPerformed during the 6 th to 12 week of pregnancy Cervix is dilated and a suction curette empties the uterine contentsCervix is dilated and a suction curette empties the uterine contents A metal curette is used to scrape any remaining tissuesA metal curette is used to scrape any remaining tissues Manual Vacuum AspirationManual Vacuum Aspiration MVA is considered a new option not available at all clinicsMVA is considered a new option not available at all clinics Cervix is dilated and a plastic tube attached to a syringe is insertedCervix is dilated and a plastic tube attached to a syringe is inserted Gestational sac is removed by suction forceGestational sac is removed by suction force

Abortions after the First Trimester Dilation and Evacuation (D&E)Dilation and Evacuation (D&E) Method most commonly used after the 12 th week of pregnancyMethod most commonly used after the 12 th week of pregnancy Cervix is opened using dilators and surgical instruments are used to remove the uterine contents, along with an aspiratorCervix is opened using dilators and surgical instruments are used to remove the uterine contents, along with an aspirator Induction of LaborInduction of Labor Prostaglandins are used to induce laborProstaglandins are used to induce labor Delivery of fetus usually occurs in 6-24 hours laterDelivery of fetus usually occurs in 6-24 hours later Fewer than 1% use this methodFewer than 1% use this method Medical AbortionMedical Abortion Combination of drugs causes the embryo to be passed out (miscarriage)Combination of drugs causes the embryo to be passed out (miscarriage) Drugs commonly used for this are Mifepristone, Misoprostol, and MethotrexateDrugs commonly used for this are Mifepristone, Misoprostol, and Methotrexate

Complications of Abortion Fever >100 degree FFever >100 degree F Abdominal pain or swelling, cramping, or backacheAbdominal pain or swelling, cramping, or backache Prolonged or heavy bleedingProlonged or heavy bleeding Foul-smelling vaginal dischargeFoul-smelling vaginal discharge Vomiting or fainting Abdominal tenderness (to pressure) Delay in resuming menstrual periods (6 weeks or more) These are possible physical effects due to an abortion

Psychological After-effects of Abortion These aftereffects vary with the individualThese aftereffects vary with the individual Many women go through a period of ambivalenceMany women go through a period of ambivalence Stronger feelings are felt immediately after the abortionStronger feelings are felt immediately after the abortion Support from a partner, friend, and/or family member can be helpfulSupport from a partner, friend, and/or family member can be helpful

Chapter Seven Abortion