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An abortion is the premature termination of a Pregnancy associated with the Death of an Embryo or a Fetus . This can occur spontaneously, in the form of a Miscarriage , or be intentionally induced through Chemical , Surgical , or other means. All Mammalian Pregnancies can be aborted; however, Human abortion receives the most focus in Biology and the Mass Media . There have been various methods of inducing an abortion Throughout The Centuries . In the 20th Century , the Ethics and Morality of abortion became the subject of intense Political Debate in many areas of the world. DEFINITIONS The following medical terms are used to define an abortion:
A pregnancy that ends earlier than 37 completed weeks of gestation, and where an Infant is born and survives, is termed a Premature Birth . A pregnancy that ends with an infant dead upon birth at any gestational stage, due to causes including spontaneous abortion or complications during delivery, is termed a Stillbirth . In common parlance, the term "abortion" is synonymous with induced abortion of a human fetus. However, in medical texts, the word 'abortion' can also refer to ''spontaneous abortion'' (miscarriage). INCIDENCE The incidence of and reasons for induced abortion vary in regions in which abortion is generally permitted. It has been estimated approximately 46 million induced abortions are performed globally each year. Of these, 26 million are said to occur in . A 1998 study aggregated data from studies in 27 countries on the reasons women seek to terminate their pregnancies. It concluded that common factors cited to have influenced the abortion decision were the desire to delay or end . Some abortions are undergone as the result of societal pressures. These might include the stigmatization of . See Social Issues for more information on these subjects. FORMS OF ABORTION Spontaneous abortion See Also: Miscarriage Spontaneous abortions, generally referred to as miscarriages, occur when an embryo or fetus is lost due to natural causes. A miscarriage is spontaneous loss of the embryo or fetus before the 20th week of development. Spontaneous abortions after the 20th week are generally considered to be preterm deliveries. Most miscarriages occur very early in a pregnancy. Approximately 10-50% of pregnancies end in miscarriage, depending upon the age and health of the pregnant woman. " Reproductive Endocrinology and Infertility: Recurrent Pregnancy Loss (Recurrent Miscarriage) ." (n.d.) Retrieved 2006-01-18 from Washington University School of Medicine, Department of Obstetrics and Gynecology web site. The risk for spontaneous abortion is greater in those with a history of more than three previous (known) spontaneous abortions, those who have had a previous induced abortion, those with systemic diseases, and in women over age 35. Other causes can be infection (of either the woman or the fetus), immune responses, or serious systemic diseases of the woman. A spontaneous abortion can also be caused by accidental Trauma ; intentional trauma to cause miscarriage is considered an induced abortion. Induced abortion A pregnancy can be intentionally aborted in a number of ways. The manner selected depends chiefly upon the Gestational Age of the Fetus , in addition to the legality, regional availability, and/or doctor-patient preference for specific procedures. Surgical abortion may determine which abortion methods are practiced.]] In the first fifteen weeks, (D & E) is used. D & E consists of opening the Cervix of the Uterus and emptying it using surgical instruments and suction. ''. The term "D and C", or perhaps ''suction curette'', etc, is sometimes used as a euphemism to refer to the first trimester abortion procedure, irrespective of the method used to perform the procedure. Other techniques must be used to induce abortion in the third Trimester . Premature delivery can be induced with Prostaglandin ; this can be coupled with injecting the Amniotic Fluid with caustic solutions containing Saline or Urea . Very late abortions can be brought about by Intact Dilation And Extraction (intact D & X) (also called Intrauterine Cranial Decompression ), which requires the surgical decompression of the fetus's head before evacuation, and is sometimes termed " Partial-birth Abortion ." A Hysterotomy Abortion , similar to a Caesarian Section but resulting in a terminated fetus, can also be used at late stages of pregnancy. It can be performed vaginally, with an incision just above the Cervix , in the late mid-trimester. From around gestational week 20-23 an injection to stop the fetal heart can be the first phase of the surgical abortion procedure. Vause S, Sands J, Johnston TA, Russell S, Rimmer S. (2002). PMID 12521492 Could some fetocides be avoided by more prompt referral after diagnosis of fetal abnormality? J Obstet Gynaecol. 2002 May;22(3):243-5. Retrieved . Chemical abortion See Also: Chemical abortion Effective in the first trimester of pregnancy, chemical (also referred to as a medical abortion), or non-surgical abortions comprise 10% of all abortions in the United States and Europe . The process begins with the administration of either Methotrexate or Mifepristone , followed by Misoprostol . When appropriately used, 98% of women undergoing medical termination of pregnancy will experience completed abortion without surgical intervention. The Food And Drug Administration currently approves the use of mifepristone up to 49 days gestation (7 weeks), though evidence based regimens exist for its use up to 61 days gestation with similar success rates. Misoprostol alone can also be used, though it is not FDA approved for this purpose. Misoprostol (Cytotec) alone has the advantage of costing less than one dollar for an effective dose, as opposed to several hundred dollars for an effective dose of mifepristone. In cases of failure of medical abortion, vacuum or manual aspiration is used to complete the abortion surgically. Other means of abortion .]] Historically, a number of . Abortion is sometimes attempted through means of trauma to the . Reported methods of unsafe, Self-induced Abortion include the misuse of the Misoprostol Drug for ulcers, and the insertion of non-surgical implements such as Knitting Needle s and Clothes Hanger s into the Uterus . HEALTH EFFECTS Early-term surgical abortion is a simple procedure. When performed before the 16th week by competent . As with most surgical procedures, the most common surgical abortion methods carry a small risk of potentially serious complications. These risks include: a perforated Uterus , perforated Bowel or Bladder , Septic Shock , Sterility , and Death . The risk of complications occurring can increase depending on how far the Pregnancy has progressed, but remains less than Complications that may occur from carrying the pregnancy to term. Assessing the risks of induced abortion depend on a number of factors. Firstly, there are relative health risk of induced abortion and pregnancy, which are both affected by wide variation in the quality of health services in different Societies and among different Socio-economic groups, a lack of uniform Definition s of terms, and difficulties in patient follow-up and after-care. The degree of risk is also dependent upon the skill and experience of the practitioner; maternal age, health, and Parity ; Gestational Age ; pre-existing conditions; methods and instruments used; Medication s used; the skill and experience of those assisting the practitioner; and the quality of recovery and follow-up care. A highly-skilled practitioner of birth and abortion, operating under ideal conditions, will tend to have a low rate of complications; an inexperienced practitioner in an ill-equipped and ill-staffed facility, on the other hand, will often have a higher incidence of complications and could prove fatal in pregnancy, birth, or abortion. In the . Centers for Disease Control and Prevention. (. Some practitioners advocate using minimal Anesthesia so that the patient can alert them to possible complications. Others recommend General Anesthesia , in order to prevent patient movement, which might cause a perforation. General anesthesia carries its own risks, including death, which is why public health officials recommend against its routine use. Dilation of the Cervix carries the risk of cervical tears or perforations, including small tears that might not be apparent and might cause Cervical Incompetence in future pregnancies. Most practitioners recommend using the smallest possible dilators, and using Osmotic rather than Mechanical dilators after the first Trimester of pregnancy. Instruments are placed within the uterus to remove the fetus. These can, on rare occasions, cause Perforation or Laceration of the uterus, and damage to structures surrounding the uterus. Laceration or perforation of the uterus or cervix can, again on rare occasions, lead to even more serious complications. Incomplete emptying of the uterus can cause Hemorrhage and infection. Use of Ultrasound verification of the location and duration of the pregnancy prior to abortion, with immediate follow-up of patients reporting continuing pregnancy symptoms after the procedure, will virtually eliminate this risk. The sooner a complication is noted and properly treated, the lower the risk of permanent injury or death. In rare cases, the abortion will be unsuccessful and the pregnancy will continue. An unsuccessful abortion can also result in the delivery of a live . Unsafe Abortion methods (e.g.,use of certain drugs, herbs, or insertion of non-surgical objects into the Uterus ) is potentially dangerous, carrying a significantly elevated risk for permanent injury or death, as compared to abortions done by Physician s. Suggested effects There is controversy over a number of proposed risks and effects of abortion. Evidence, whether in support of or against such claims, might in part be influenced by the political and religious beliefs of the parties behind it. Breast cancer The ''abortion-breast cancer (ABC) hypothesis'' (a.k.a. ABC link) posits a Causal Relationship between induced Abortion and an increased risk of developing Breast Cancer . The hypothesis has not been verified and abortion is not considered an actual breast cancer risk by any major cancer organization. In early Pregnancy the level of Estrogen s increase and initiates Breast Growth in preparation for Lactation . The ABC hypothesis proposes that if this process is interrupted with an abortion – before full differentiation in the third Trimester – then more relatively vulnerable undifferentiated cells could be left than there were prior to the pregnancy, resulting in a greater potential risk of breast cancer. A large from PubMed. Of over 100 experts at the NCI workshop, . Fetal pain See Also: Fetal pain The existence or absence of fetal sensation during abortion is a matter of medical, ethical and public policy interest. Evidence is conflicting, with some authorities holding that the fetus is capable of feeling pain from the first Trimester , and others maintaining that the Neuro-anatomical requirements for such experience do not exist until the second or third trimester. . Researchers have observed changes in the heart rates and , cannot be measured in such Reflexive responses. Mental health Some women will experience negative feelings as a result of their reproduction choices. In the case of abortion, however, whether this phenomenon warrants a general diagnosis, or even classification as an independent Syndrome , is debated. Post-abortion Syndrome is listed in neither the DSM-IV-TR nor the ICD-10 . Studies have suggested a link between the elective termination of an unwanted from the National Electronic Library For Health website. Data on the incidence of . ). Retrieved 2006-01-11 . Childbirth can also sometimes result in Maternity Blues or Postpartum Depression . HISTORY OF ABORTION See Also: History of abortion The practice of induced abortion, according to some Anthropologists , can be traced to ancient times. There is evidence to suggest that, historically, pregnancies were terminated through a number of methods, including the administration of Abortifacient herbs, the use of sharpened implements, the application of abdominal pressure, and other techniques. . It is also known that the ancient Greeks relied upon the herb Silphium as both a Contraceptive and an Abortifacient . The plant, as the chief export of Cyrene , was driven to Extinction , but it is suggested that it might have possessed the same abortive properties as some of its closest extant relatives in the Apiaceae Family . Such folk remedies, however, varied in effectiveness and were not without risk. Tansy and Pennyroyal , for example, are two Poison ous Herbs with serious Side Effects that have at times been used to terminate pregnancy. Abortion in the 19th century continued, despite bans in both the . SOCIAL ISSUES A number of complex issues exist in the debate over abortion. These, like the suggested effects upon health listed above, are a focus of research and a fixture of discussion among members on all sides the controversy. Effect upon crime rate See Also: legalized abortion and crime effect A controversial theory attempts to draw a Correlation between the unprecedented nationwide decline of the overall Crime Rate witnessed in the United States during the 1990s and the decriminalization of abortion 20 years prior. The suggestion was brought to widespread attention by a 1999 . Fellow economists , from University of Chicago, Initiative on Chicago Price Theory web site: http://pricetheory.uchicago.edu/levitt/Papers/ResponseToFooteGoetz2006.pdf . Such research has been criticized by some as being . Levitt states in his book, '' Freakonomics '', that they are neither promoting nor negating any course of action – merely reporting data as economists. Sex-selective abortion See Also: sex-selective abortion and infanticide The advent of both Ultrasound and Amniocentesis has allowed Parent s to determine Sex before Birth . This has lead to the occurrence of Sex-selective Abortion or the targeted termination of a Fetus based upon its gender. It is suggested that sex-selective abortion might be partially responsible for the noticeable disparities between the . In . In the ). ''Xinhua News Agency.'' Retrieved 2006-01-12 . Unsafe abortion See Also: Unsafe abortions Where and when access to safe abortion has been barred, due to explicit sanctions or general unavailability, women seeking to terminate their pregnancies have sometimes resorted to unsafe methods. ". This can include a person without medical training, a professional health provider operating in sub-standard conditions, or the woman herself. Unsafe abortion remains a . ABORTION DEBATE .]] at the March For Women's Lives .]] See Also: Abortion debate Over the course of the History Of Abortion , induced abortions have been a source of considerable Debate and Controversy regarding the morality and legality of this practice. An individual's position on the complex Ethical , Moral , Philosophical , Biological , and Legal issues have a strong relationship with that individual's Value System . A person's position on abortion may be best described as a combination of their personal beliefs on the morality of abortion, and that person's beliefs on the ethical scope and responsibility of legitimate Government al and legal Authority . Another factor for many individuals is Religious doctrine (see Religion And Abortion ). Abortion debates, especially pertaining to Abortion Law s, are often spearheaded by Advocacy Groups belonging to one of two camps. Most often those in favor of legal prohibition of abortion describe themselves as Pro-life while those against legal restrictions on abortion describe themselves as Pro-choice . Both are used to indicate the central principles in arguments for and against abortion: "Is the fetus a human being with a fundamental right to ''life''?" for pro-life advocates, and, for those who are pro-choice, "Does a woman have the right to ''choose'' whether or not to have an abortion?" In both public and private debate, arguments presented in favor of or against abortion focus on either the moral permissibility of an induced abortion, or justification of Laws permitting or restricting abortion. Arguments on morality and legality tend to collide and combine, complicating the issue at hand. Debate also focuses on whether the . Public opinion Political sides have largely been divided into Absolutes . The abortion debate, as such, tends to center around individuals who hold strong positions. However, public opinion varies from poll to poll, country to country, and region to region:
ABORTION LAW George W. Bush signs the ''Partial-Birth Abortion Ban Act of 2003'']] Before the scientific discovery that human development began at fertilization, British common law allowed abortions performed before quickening, the earliest perception of fetal movement by a woman during the second trimester of pregnancy. In 1861, the British Parliament passed the Offences Against The Person Act , which outlawed abortion throughout the British Empire . The Soviet Union , with legislation in 1920, and Iceland with legislation in 1935 were some of the first countries to generally allow abortion. The second half of the 20th century saw the liberalization of abortion laws in other countries. The Abortion Act 1967 allowed abortion for limited reasons in the United Kingdom. In the 1973 case, '' Roe V. Wade '', the United States Supreme Court struck down state laws banning abortion in the first trimester, ruling that such laws violated an implied Right To Privacy in the United States Constitution . The Supreme Court Of Canada , similarly, in the case of '' R. V. Morgentaler '', discarded its criminal code regarding abortion in 1988, after ruling that such restrictions violated the security of person guaranteed to women under the Canadian Charter Of Rights And Freedoms Canada later struck down provincial regulations of abortion in the case of '' R. V. Morgentaler (1993) .'' Abortion In Ireland , on the other hand has been affected by the addition of an Amendment to its Constitution in 1983 by popular Referendum , recognizing "the right to life of the unborn". Current laws pertaining to abortion are diverse. Religious, moral, and cultural sensibilities continue to influence abortion laws throughout the world. The Right To Life , the right to Liberty , and the right to Security Of Person are major issues of Human Rights that are sometimes used as justification for the existence or the absence of laws controlling abortion. Many countries in which abortion is legal require that certain criteria be met in order for an abortion to be obtained, often, but not always, using a Trimester -based system to regulate the window in which abortion is still legal to perform:
Other countries, in which abortion is illegal, will allow one to be performed in the case of Rape , Incest , or danger to the pregnant woman's life or health. A handful of nations ban abortion entirely, such as Chile , El Salvador , and Malta . SEE ALSO
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