May 16, 2011 Nursing 330 Human Reproductive Health

IMPORTANT DATES Mon, May 23, 2011 Guest Speaker, American Cancer Society Mon, May 30, 2011 – Holiday Mon, June 6, 2011 – Final Exam 7:00pm – 10pm Cumulative 100 questions, 2 points each Study Guide will be posted by Fri, May 27, 2011

Abortion

Spontaneous abortion aka miscarriage Loss of baby before 20 weeks of pregnancy Induced abortion Surgical Drug-based

Surgical Method Vacuum Aspiration First trimester method Dilation and Extraction (D & X) Late surgical method

Drug-Based Methods Mifepristone (RU 486) –Injection, 0rally An anti-progesterone prevents progesterone from making uterine lining hospitable for implantation If fetus is already implanted, causes the uterus to shed its lining and, along with it, the fertilized fetus Approved by FDA in September 2000 for abortion As an alternative to surgical procedure Effectiveness is increased if used with another drug, Misoprostol (95-98%) Most effective within 7 weeks of fertilization

Drug-Based Methods (cont) Methotrexate –Injection; orally (rarely) Prevents cell division and multiplication Can be used to induce an abortion Effectiveness is increased if used with another drug, Misoprostol (95%) Approved by FDA for treatment of cancer, arthritis and psoriasis Most effective within 7 weeks of fertilization Misoprostol – orally or vaginally Legal Drug used in conjunction with above drugs The second drug used to complete the abortion procedure Taken a day or two after administration of the first drug Causes the uterus to contract and expel its contents Approved in the US for coating the stomach of people who take stomach-irritating anti-inflammatory drugs.

Abortifacient A method or substance that causes a fertilized egg that has implanted in the uterine wall or fetus to be expelled. Which of the drug-based methods is an abortifacient?

Source: Perspectives on Sexual and Reproductive Health Incidence of Abortions Nearly half of pregnancies among American women are unintended, and four in 10 of these are terminated by abortion. Twenty-two percent of all pregnancies (excluding miscarriages) end in abortion. In 2005, 1.21 million abortions were performed, down from 1.31 million in From 1973 through 2005, more than 45 million legal abortions occurred. Each year, about two percent of women aged have an abortion; 47% of them have had at least one previous abortion.

Source: Guttmacher Institute When women have abortions

Cost Surgical In 2005, the cost of a non-hospital abortion with local anesthesia at 10 weeks gestation ranged from $90 to $1,800; the average amount paid was $413 (Source: Perspectives on Sexual and Reproductive Health) Drug-based most providers do charge more for this method

Abortion and the Law Roe v. Wade 1973 Supreme Court decision stating 1st trimester abortions cannot be regulated by states and the decision to abort is between woman and physician 2nd trimester abortions permitted when mental or physical health of mother at risk 3rd trimester abortions allowed when life of mother at risk

Source: Alan Guttmacher Institute California Law California does not have any of the major types of abortion restrictions – such as waiting period, mandated parental involvement or limitations on publicly funded abortions – often found in other states.

The Pro-Life and Pro-Choice Controversy Anti-abortion (Pro-life) position Pro-choice position