Notes - Ch. 19.1 Abortion.ppt

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 Abortion:

 the expulsion of an embryo or fetus from the uterus…

 Miscarriage:

 Spontaneous abortion that occurs naturally…

 The history of abortion in the U.S.

 Mid-1800’s: Prior to 20 weeks was legal

 1900’s: Physicians joined with other groups - stating

untrained people were performing them. All states made abortion illegal

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 In 2015, unmarried women accounted for 86%

of all abortions (CDC).

 Among married women, 4% of pregnancies

currently end in abortion.

Among unmarried women, 27% of pregnancies end in abortion (CDC).

 Women in their 20s accounted for the

majority of abortions in 2015 and had the highest abortion rates (CDC).

 Adolescents under 15 years obtained .03% of

all 2015 abortions; women aged 15–19 years accounted for less than 10% (CDC).

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 Percentage of 2015 Reported Abortions by

Age of Mother (CDC):

 Women living with a partner to whom they

are not married account for 25% of abortions but only about 10% of women in the

population (NAF).

 In 2015, women who had not aborted in the

past accounted for 56% of all abortions; women with one or two prior abortions

accounted for 35%, and women with three or more prior abortions accounted for 8% (CDC).

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 Among women who obtained abortions in

2015, 41% had no prior live births; 45% had one or two prior live births, and 14% had three or more prior live births (CDC).

 Among white women, 10% of pregnancies

currently end in abortion. Among black

women, 28% of pregnancies end in abortion (CDC).

 Black women were more than 3.5 times more

likely to have an abortion in 2015 than white women (CDC).

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 The abortion rate of non-metropolitan

women is about half that of women who live in metropolitan counties (NAF).

 The abortion rate of women with Medicaid

coverage is three times as high as that of other women (NAF).

 In 2014, 30% of aborting

women identified themselves as

Protestant and 24% identified themselves as Catholic (AGI).

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 Percentage and Reason

 <0.5% Victim of rape

 3% Fetal health problems

 4% Physical health problems

 4% Would interfere with education or career

 7% Not mature enough to raise a child

 8% Don't want to be a single mother

 19% Done having children

 23% Can't afford a baby

 25% Not ready for a child

 6% Other

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 40% of minors having an abortion report that

neither of their parents knew about the abortion (AGI).

 39 states require a parental consent form…

 California doesn’t

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 1973: Roe versus Wade

 Supreme Court ruled :

 Pregnancy divided into 3 trimesters  1st trimester - up to women & doctor  2nd trimester - state may regulate

 3rd trimester - state may regulate and bar all abortions that are not

life threatening to mother

 U.S. Congress and federal Medicaid funds

 17 states provide nonfederal public money

 Current issues

 2007

 Gonzales v. Carhart - Supreme Court upholding the Partial Birth

Abortion Ban Act.

 The Freedom of Choice Act is introduced to Senate

 2008

 Planned Parenthood – Abortion Access in the United State.

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 Pro-lifePro-life: The fertilized egg is a human being from

the moment of conception and therefore an abortion is murder.

 Any women having sex knows pregnancy is possible - she

has a moral obligation

 Women unable or unwilling to raise the children should

consider placing him/her up for adoption

 Abortion has destructive effects on our traditional morals

and values

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 Pro-Choice :Pro-Choice :There are distinct stages of fetal

development and that preserving the fetus early in pregnancy is not the ultimate moral concern.

 Women should have the right to make their own decisions

 If not legal then unsafe and unregulated practices would occur  Women would be divided into those who could afford and

those who could not.

 Some physicians would be forced to break the law

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 U.S. public opinion seems to change

depending on the situation

 Many approve legal abortion when health or

welfare consequences could result

 The issue in later pregnancy is when does the

right of the fetus take precedence over the woman’s rights

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 Legal arguments

 Moral arguments

 Short and long term ramifications

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 Two categories

 Surgical - 87% of all abortions in 2005  Medical – use of medication

 Emergency contraception pills or IUD

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 Vacuum aspiration

 Early abortion; about 6th to 12th week

 Used about 90% of all abortions

 Vagina is washes with antiseptic, Anesthetic is injected into

or near the cervix.

 Cervix is gently and gradually stretched over a 24 hour

period.

 After dilation a tube connected to a suction machine gently

empties the uterus

 After suction a Curette (narrow metal loop) gently scrapes

the walls of the uterus

 After a few hours in recovery the woman can return home

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 MVA

 Done within 4 or 5 weeks of last menstrual cycle

 More effective and safer if performed at least 6 or 7

weeks

 Gentle suction of a syringe

 Cervix is dilated with medication.

 Uterus is emptied with a handheld syringe

 If a definitive gestational sac is not identified then

women is tested for possible ectopic pregnancy

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 One in ten abortions is performed after the 12th

week of pregnancy.

 Abortion from 13 to 24 weeks of pregnancy

 Dilation and Evacuation: D & E  Two steps:

 1st: Vagina is cleaned with antiseptic

 Absorbent dilators are inserted

 2nd: Pain medications are administered

 Local anesthetic is injected into or near cervix  Fetus and other products are removed by surgical

instruments and curettage

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 Intact dilation and extraction (known as Partial birth

abortion)

 Rarely performed 0.17% of all abortions performed

 Became illegal in 2007 by the Supreme Court ruling of

Gonzales v. Carhart

 Labor Induction:

 Rarely performed

 Inserts a medication called prostaglandin or urea or salt

solution into vagina

 Causes contractions to begin

 Causes a stillbirth to occur

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 Medical Abortion

 Used very early in pregnancy within 49 days of the last

menstrual period.

 Choose to use a combination of drugs to end the

pregnancy

 Advantages and Disadvantages  Drugs used:

 Mifepristone

 Blocks the effect of progesterone

 Misoprostol

 Induces contractions

 Methotrexate

 Stops the embryonic or fetal cells from dividing

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 Mifepristone–Misoprostol method

 Initial dose of mifepristone

 Two days later take dose of misoprostol

 Effective rate is 92-95%

 Side effects

 Follow-up procedures

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

Mifepristone (RU-486)-Misoprostol Method

 Swallow a dose of Mifepristone at the doctors office

 Two days later insert Misoprostol into vagina

 Abortion happens from anywhere form a few hours to several

weeks

 50% occur within 4 hours

 75% within 24 hours

 After two weeks of taking mifepristone, a woman must

return for a follow-up

 Advantages

 Disadvantages

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 Methotrexate with prostaglandin

 Methotrexate stops the embryonic or fetal cells

from dividing.

 80-85% of women will abort within 2 weeks

 95% will abort within 30 days

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 Possible physical effects

 Fever above 100º F.

 Abdominal pain or tenderness  Swelling

 Backache

 Prolonged or Heavy bleeding  Foul smelling vaginal discharge  Vomiting

 Fainting

 Delay of 6 or more weeks in resuming menstruation

 Incomplete abortion

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 Possible feels after having an abortion

 Guilt

 New strength in having made and carried out an important

decision

 Depression  Sense of loss

 Negative feelings about sex  Relationship may end

 Anger

 Bitterness

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