An abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a...
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Abortion An abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus/embryo, resulting in or caused by its death.
An abortion is the termination of a pregnancy by the removal or expulsion from the uterus of a fetus/embryo, resulting in or caused by its death
An abortion is the termination of a pregnancy by the removal or
expulsion from the uterus of a fetus/embryo, resulting in or caused
by its death.
Slide 2
What is Abortion? An abortion can occur spontaneously due to
complications during pregnancy or can be induced, in humans and
other species. In the context of human pregnancies, an abortion
induced to preserve the health of the gravid (pregnant female) is
termed a therapeutic abortion, while an abortion induced for any
other reason is termed an elective abortion. The term abortion most
commonly refers to the induced abortion of a human pregnancy, while
spontaneous abortions are usually termed miscarriages.
Slide 3
Spontaneous abortion Spontaneous abortion (also known as
miscarriage) is the expulsion of an embryo or fetus due to
accidental trauma or natural causes before approximately the 20th
week of gestation; the definition by gestational age varies by
country. Most miscarriages are due to incorrect replication of
chromosomes; they can also be caused by environmental factors. A
pregnancy that ends before 37 weeks of gestation resulting in a
live-born infant is known as a "premature birth". When a fetus dies
in utero after about 20 weeks, or during delivery, it is usually
termed "stillborn". Premature births and stillbirths are generally
not considered to be miscarriages although usage of these terms can
sometimes overlap.
Slide 4
Miscarriage Between 10% and 50% of pregnancies end in
clinically apparent miscarriage, depending upon the age and health
of the pregnant woman. Most miscarriages occur very early in
pregnancy, in most cases, they occur so early in the pregnancy that
the woman is not even aware that she was pregnant. One study
testing hormones for ovulation and pregnancy found that 61.9% of
pregnancies were lost prior to 12 weeks, and 91.7% of these losses
occurred without the knowledge of the once pregnant woman. The risk
of spontaneous abortion decreases sharply after the 10th week from
the last menstrual period (LMP).One study of 232 pregnant women
showed "virtually complete [pregnancy loss] by the end of the
embryonic period" (10 weeks LMP) with a pregnancy loss rate of only
2 percent after 8.5 weeks LMP. The most common cause of spontaneous
abortion during the first trimester is chromosomal abnormalities of
the embryo/fetus, accounting for at least 50% of sampled early
pregnancy losses. Other causes include vascular disease (such as
lupus), diabetes, other hormonal problems, infection, and
abnormalities of the uterus. Advancing maternal age and a patient
history of previous spontaneous abortions are the two leading
factors associated with a greater risk of spontaneous abortion. A
spontaneous abortion can also be caused by accidental trauma;
intentional trauma or stress to cause miscarriage is considered
induced abortion or feticide.
Slide 5
Induced abortion A pregnancy can be intentionally aborted in
many ways. The manner selected depends chiefly upon the gestational
age of the embryo or fetus, which increases in size as it ages. [
Specific procedures may also be selected due to legality, regional
availability, and doctor-patient preference. Reasons for procuring
induced abortions are typically characterized as either therapeutic
or elective. An abortion is medically referred to as therapeutic
when it is performed to: save the life of the pregnant woman;
preserve the woman's physical or mental health; terminate pregnancy
that would result in a child born with a congenital disorder that
would be fatal or associated with significant morbidity; or
selectively reduce the number of fetuses to lessen health risks
associated with multiple pregnancy. An abortion is referred to as
elective when it is performed at the request of the woman "for
reasons other than maternal health or fetal disease."
Slide 6
Abortion methods Medical Surgical Other
Slide 7
Medical Abortions "Medical abortions" are non-surgical
abortions that use pharmaceutical drugs, and are only effective in
the first trimester of pregnancy. Medical abortions comprise 10% of
all abortions in the United States and Europe. Combined regimens
include methotraxate or mifepristone, followed by a prostaglandin
(either misoprostol or gemeprost: misoprostol is used in the U.S.;
gemeprost is used in the UK and Sweden.) When used within 49 days
gestation, approximately 92% of women undergoing medical abortion
with a combined regimen completed it without surgical
intervention.
Slide 8
Surgical Abortions In the first 12 weeks, suction-aspiration or
vacuum abortion is the most common method. Manual Vacuum aspiration
(MVA) abortion consists of removing the fetus or embryo, placenta
and membranes by suction using a manual syringe, while electric
vacuum aspiration (EVA) abortion uses an electric pump. These
techniques are comparable, and differ in the mechanism used to
apply suction, how early in pregnancy they can be used, and whether
cervical dilation is necessary. MVA, also known as "mini-suction"
and "menstrual extraction", can be used in very early pregnancy,
and does not require cervical dilation. Surgical techniques are
sometimes referred to as 'Suction (or surgical) Termination Of
Pregnancy' (STOP). From the 15th week until approximately the 26th,
dilation and evacuation (D&E) is used. D&E consists of
opening the cervix of the uterus and emptying it using surgical
instruments and suction.
Slide 9
Vacuum Aspiration
Slide 10
Surgical Abortions Dilation and curettage (D&C), the second
most common method of abortion, is a standard gynecological
procedure performed for a variety of reasons, including examination
of the uterine lining for possible malignancy, investigation of
abnormal bleeding, and abortion. Curettage refers to cleaning the
walls of the uterus with a curette. The World Health Organization
recommends this procedure, also called sharp curettage, only when
MVA is unavailable. Other techniques must be used to induce
abortion in the second trimester. Premature delivery can be induced
with prostaglandin; this can be coupled with injecting the amniotic
fluid with hypertonic solutions containing saline or urea. After
the 16th week of gestation, abortions can be induced by intact
dilation and extraction (IDX) (also called intrauterine cranial
decompression), which requires surgical decompression of the fetus'
head before evacuation. IDX is sometimes called "partial-birth
abortion," which has been federally banned in the United States. A
hysterectomy abortion is a procedure similar to a caesarean section
and is performed under general anesthesia. It requires a smaller
incision than a caesarean section and is used during later stages
of pregnancy. From the 20th to 23rd week of gestation, an injection
to stop the fetal heart can be used as the first phase of the
surgical abortion procedure to ensure that the fetus is not born
alive.
Slide 11
Other Methods Historically, a number of herbs reputed to
possess abortion properties have been used in folk medicine: tansy,
pennyroyal, black cohosh. The use of herbs in such a manner can
cause seriouseven lethalside effects, such as multiple organ
failure, and is not recommended by physicians. Abortion is
sometimes attempted by causing trauma to the abdomen. The degree of
force, if severe, can cause serious internal injuries without
necessarily succeeding in inducing miscarriage. Both accidental and
deliberate abortions of this kind can be subject to criminal
liability in many countries. In Southeast Asia, there is an ancient
tradition of attempting abortion through forceful abdominal
massage. One of the bas reliefs decorating the temple of Angkor Wat
in Cambodia depicts a demon performing such an abortion upon a
woman who has been sent to the underworld. Reported methods of
unsafe, self-induced abortion include misuse of misoprostol, and
insertion of non-surgical implements such as knitting needles and
clothes hangers into the uterus. These methods are rarely seen in
developed countries where surgical abortion is legal and
available.
Slide 12
Slide 13
Health Risks and Considerations Early-term surgical abortion is
a simple procedure which is safer than childbirth when performed
before the 16th week. The APA revised and updated its findings in
August 2008 to account for the accumulation of new evidence, and
again concluded that induced abortion did not lead to increased
mental health problems. A 2008 review by a group from the Johns
Hopkins Bloomberg School of Public Health concluded that the
highest quality studies found few, if any, mental health
differences between women who had abortions and their comparison
groups, whereas studies with the most flaws reported negative
mental health consequences of abortion.al health is an area of
controversy.
Slide 14
Health Risks and Considerations Pain and/or cramping Nausea
Vomiting Diarrhea Reaction to local anesthetic Infection many
physicians prescribe antibiotics to prevent infections, serious
infection occurs in 3% of women Heavy Bleeding 1-2% of women will
have serious bleeding (more than a normal menstrual period)
Continued Pregnancy may occur if pregnancy is tubal or ectopic (a
fertilized egg has implanted outside the uterus), requires major
surgery Retained Tissue requires a repeat of the suction procedure
Perforation or puncture of the uterus rare, but requires surgical
repair Sterility very rare, may occur due to serious infection,
bleeding, or damage to the uterus Death extremely rare
Slide 15
Abortion Laws- Pennsylvania ILLEGAL: 1) Failure to obtain
informed consent of woman; (2) failure to meet standards for legal
abortion; (3) using any means to cause the death of an unborn child
but not meaning use of intrauterine device or the birth control
pill; (4) solely for the reason of the child's sex; (5) without
making diagnosis of gestational age; (6) use of public funds,
facilities, or officials
Slide 16
PA LAWS Except for medical emergency, physician must give
information to mother at least 24 hours before abortion; if mother
under 18 years and not emancipated, both mother's and one
parent/guardian's informed consent required-court may authorize
M.D. to perform abortion. If the woman is married, she must provide
signed statement that she has notified her spouse of the abortion
(Spousal consent found unconstitutional in Planned Parenthood of
Southeastern Pennsylvania V. Casey, but remain in PA's statute
nonetheless)
Slide 17
Federal Abortion Law Roe v. Wade The 1973 Supreme Court
decision in Roe v. Wade made it possible for women to get safe,
legal abortions from well-trained medical practitioners. This led
to dramatic decreases in pregnancy-related injury and death. The
Roe case arose out of a Texas law that prohibited legal abortion
except to save a woman's life. At that time, most other states had
laws similar to the one in Texas. Those laws forced large numbers
of women to resort to illegal abortions. Jane Roe, a 21-year-old
pregnant woman, represented all women who wanted abortions but
could not get them legally and safely. Henry Wade was the Texas
Attorney General who defended the law that made abortions illegal.
After hearing the case, the Supreme Court ruled that Americans'
right to privacy included the right of a woman to decide whether to
have children, and the right of a woman and her doctor to make that
decision without state interference.
Slide 18
Abortion laws in the United States prior to Roe vs. Wade RED
Illegal. PURPLE Legal in cases of rape. BLUE Legal in cases of
danger to woman's health. GREEN Legal in cases of danger to woman's
health, rape or incest, or likely damaged fetus. YELLOW Legal
Slide 19
The U.S. Supreme Court has ruled that the term "partial-birth
abortion" in the act pertains to a procedure that is medically
called intact dilation and extraction. Under this law, "Any
physician who, in or affecting interstate or foreign commerce,
knowingly performs a partial-birth abortion and thereby kills a
human fetus shall be fined under this title or imprisoned not more
than 2 years, or both." The law was enacted in 2003, and in 2007
its constitutionality was upheld by the U.S. Supreme Court.
Slide 20
Reasons for abortions In 2000, cases of rape or incest
accounted for 1% of abortions. Another study, in 1998, revealed
that in 1987-1988 women reported the following reasons for choosing
an abortion: 25.5% Want to postpone childbearing 21.3% Cannot
afford a baby 14.1% Has relationship problem or partner does not
want pregnancy 12.2% Too young; parent(s) or other(s) object to
pregnancy 10.8% Having a child will disrupt education or job 7.9%
Want no (more) children 3.3% Risk to fetal health 2.8% Risk to
maternal health 2.1% Other
Slide 21
Reasons for LATE abortions According to a study that included
specific data about late abortions (i.e. abortions at 16 or more
weeks' gestation), women reported that various reasons contributed
to their having a late abortion: 71% Woman didn't recognize she was
pregnant or misjudged gestation 48% Woman found it hard to make
arrangements for abortion 33% Woman was afraid to tell her partner
or parents 24% Woman took time to decide to have an abortion 8%
Woman waited for her relationship to change 8% Someone pressured
woman not to have abortion 6% Something changed after woman became
pregnant 6% Woman didn't know timing is important 5% Woman didn't
know she could get an abortion 2% A fetal problem was diagnosed
late in pregnancy 11% Other
Slide 22
POLLS
Slide 23
COSTS The cost of an abortion varies depending on factors such
as location, facility, timing, and type of procedure. In 2005, a
nonhospital abortion at 10 weeks gestation ranged from $90 to
$1,800 (average: $430), whereas an abortion at 20 weeks gestation
ranged from $350 to $4,520 (average: $1,260). Costs are higher for
a medical abortion than a first-trimester surgical abortion.
Slide 24
Abortion Clinics Found through
www.plannedparenthood.comwww.plannedparenthood.com Pittsburgh
Allentown Philadelphia Buffalo, NY Cleveland, OH
Slide 25
Pro Life http://www.youtube.com/watch?v=BYRpIf2F9NA
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