Abortion

   

Abortion, in its most common usage, refers to the destruction of an embryo and its removal from the uterus. Medically, the term also refers to the early termination of a pregnancy by natural causes ("spontaneous abortion" or miscarriage, which ends one in five of all pregnancies, usually within the first thirteen weeks) or to the cessation of normal growth of a body part or organ. What follows is a discussion of the issues related to deliberately induced abortion.

Since 1972, the medical definition of pregnancy in the U.S. requires that implantation has already occurred so, technically, emergency contraceptives do not interfere with pregnancy. The controversy arises when one considers that conception occurs before implantation. Some believe the zygote is a human being with the same moral standing of an implanted embryo before pregnancy technically starts.

"Morning after" or "emergency" contraceptive drugs that are taken within 72 hours of sex interfere with the release of eggs from the ovary or with fertilization, and so are not generally considered to be forms of abortion. However, in some cases eggs will be released anyway; in these cases, if conceptions occurs the zygote will implant successfully regardless of emergency contraception use. There is no fetotoxic 'backup chemical' found in current formulations of emergency contraception: if ovulation occurs, conception will probably follow and the emergency contraceptive will have failed. Some studies suggest that emergency conceptives can thicken the uterine mucus and thus interfere with implantation of a zygote, but, if true, this also happens with normal birth control pills taken regularly as well. Some institutions or individuals mistakenly consider use of emergency contraceptives to be abortions (notably the Roman Catholic Church) because they confuse emergency contraception with true fetotoxic abortion pills.


Methods of abortion

Depending on the stage of pregnancy, an abortion is performed by a number of different methods. Chemical abortion (or Medical Abortion as opposed to Surgical Abortion) is the usual method when it is induced before the first nine weeks. The procedure consists of administering either methotrexate or mifepristone (RU-486) followed by administration of misoprostol. Approximately eight per cent of these abortions require surgical followup, usually by vacuume aspiration (See below).

In the first fifteen weeks, suction-aspiration or vacuum abortion is one of the most common methods, replacing the more risky dilation and curettage (D & C). Manual vacuum aspiration or MVA abortion consists of removing the embryo by suction using a manual syringe, while Electric vacuum aspiration or EVA abortion uses suction produced by an electric pump to remove the embryo. From the fifteenth week up until around the eighteenth week a surgical 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.

Dilation and suction curettage consists of emptying the uterus by suction using a special apparatus. Curettage is cleaning the walls of uterus with a curette. Dilation and curettage (D & C) is a standard gynaecological procedure performed for a variety of reasons, such as examination.

As the fetus size increases, other techniques must be used to induce abortion in the third trimester. Premature expulsion of the fetus can be induced with prostaglandin; this can be coupled with injecting the amniotic fluid with saline or urea solution. Very late abortions can be brought about by the controversial intact dilation and extraction (D & X) or a hysterotomy abortion, similar to a caesarian section, and requiring the surgical decompression of the fetus's head before evacuation. (This is the procedure controversially termed "partial-birth abortion").

Possible side effects

Postabortion psychological issues

Abortion has been associated with increased risk of depression. According to a study of 1,884 women conducted by the National Longitudinal Survey of Youth, women who did not carry their first pregnancies to term are 65% more likely to be diagnosed with clinical depression around eight years later. However, other studies did not support that depression may be caused by abortion. For example, a study of 2,525 women revealed that women who had an abortion were more likely to report depression or lower satisfaction with their lives. However, they also often reported rape, childhood physical and sexual abuse, and violent partners. After controlling for the history of abuse, partner characteristics, and background variables, abortion was not related to poorer mental health (Denious, J. & Russo, N. F. (2000). The Socio-Political Context of Abortion and its Relationship to Women's Mental Health. In J. Ussher (Ed.). Women's Health: Contemporary International Perspectives (pp. 431-439). London: British Psychological Society.).

Postabortion physical issues

  • The exact risk and type of complications depend on the abortion method as well as the clinical and hygienic conditions. Studies found that the risk of serious physical complications of an abortion is less than 1%. In countries where abortion is illegal and women are forced to go to back-street abortionists serious physical complications such as infections, bleeding, and even deaths are much higher.
  • The question whether Breast cancer is tied to abortion is controversially disussed in the medical science. A meta-analysis of 53 epidemological studies undertaken in 16 countries did not find evidence of a relationship between abortion and breast cancer (Breast cancer and abortion. The Lancet, 2004;363;pg 1007). For an argument from the opposing perspective, see Breast Cancer : Its Link to Abortion and the Birth Control Pill by Chris Kahlenborn, MD (ISBN 0966977734). As of November 2004, women seeking abortions in Mississippi must first sign a form indicating they've been told abortion can increase their risk of breast cancer. In Texas, Louisiana, and Kansas, state law requires women receive a pamphlet that suggests a cancer link with abortion. Similar legislation requiring notification has also been introduced, and is pending, in 14 other states. However, these laws do not rely on conclusive scientific evidence.

Abortion law

Main Article: abortion law

Abortion has long been a controversial subject throughout history due to its moral and ethical implications. It has been regularly banned and otherwise limited, though illegal abortions have continued to be commonplace in many areas regardless of the legal status. Almost 2/3 of the world’s women currently reside in countries where abortion may be obtained on request or for a broad range of social, economic or personal reasons. Abortion laws vary widely by country, with some countries allowing nearly total liberalization, and others banning abortion under any circumstances. There are also countries that do not have any laws restricting abortion, such as Canada.

Related topics

External links

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