Understanding Abortion

Quinn Gosselin

HE 210 OL

After Deciding to After Deciding to have an Abortion, have an Abortion,

What’s Next?What’s Next?

Finding a Provider Accessibility depends on the state you live in, how far

away you are from a clinic, financial situation, and how far along you are in the pregnancy

Planned Parenthood- clinics in almost every state; some provide

abortions

The National Abortion Federation hotline- provides referrals (1-800-772-9100)

Search for clinics online- www.gynpages.com

Search Yellow Pages- “Abortion Providers” or “Abortion Services”

What to look for when Choosing a Facility:

Ask Questions Concerning the Following Issues:

Medical Issues (ex: What methods are available?)

Financial Issues (ex: What does it cost? Will insurance cover the costs?)

State Laws (ex: What are the requirements? Do I need parental consent?)

Clinical Procedures (ex: How long will I be at the clinic? How will my privacy be

protected?)

What to Expect at the Clinic: Protesters may be present!

Providers will be prepared to properly handle any situation, such as escorting the patient into the facility if need be

Call ahead to ask about what you might encounter

Inside the Clinic: Medical history form will need to be filled out Vital signs will be taken Repeat urine pregnancy test Blood will be drawn to check for anemia and Rh factor Ultrasound may be performed to confirm how far along

the pregnancy is Counseling session may take place to discuss the choice

of having an abortion

What are the Different What are the Different Methods of Abortion Methods of Abortion that I can Choose that I can Choose

From?From?

Medication Abortion“Medical Abortion”

Two drugs administered

Mifepristone (most common; “abortion pill”) Taken orally Blocks progesterone; causes embryo to detach from uterine lining

Misoprostol (taken within 2 days of Mifepristone) Taken orally or inserted vaginally Prostaglandin; causes cervix to soften and uterus to cramp Embryo is expelled in the form of a “heavy period”

Method terminates pregnancy within first 9 weeks

(Medication Abortion Continued)

Safe; 95-98% Effective

Between September 2000 and fall 2004, 350,000 U.S. women used this type of abortion (FDA)

Possible side effects: bleeding, nausea, fatigue, cramping, diarrhea, chills

Discharge of blood clots is normal

Follow-up visit is necessary to ensure completion of abortion

My OpinionMy Opinion

I think that abortions I think that abortions should be legal, should be legal, especially in the first especially in the first trimester. Some people trimester. Some people do not have the financial do not have the financial support, personal support, personal support, or access to support, or access to health care that is health care that is necessary to having a necessary to having a child. I believe that an child. I believe that an individual should have the individual should have the ability to make the right ability to make the right choice according to their choice according to their personal situation and personal situation and beliefs.beliefs.

Vacuum Aspiration Abortion Uterine contents removed by suction (aspiration) Procedure:

Pelvic exam performed Speculum inserted into vagina to separate vaginal walls Cervix is washed with antiseptic solution Tenaculum placed on cervix (thin instrument with long

handle; lets clinician hold cervix in place) Anesthetic solution injected to numb cervix; cervix is

dilated Thin tube (cannula) inserted into uterus through cervix Cannula is connected to source of suction (electric

pump or handheld device) Cannula is moved back and forth to draw out

pregnancy tissue

(vacuum aspiration continued)

Used for most first-trimester abortions

Low risk of infection/injury

Risk of death is 1 in 160,000

May feel mild to intense cramping from uterus contracting and emptying

Cramps should lessen after cannula is removed

Second-Trimester Abortion 12% of abortions take place at 13 weeks or later

for many reasons Cost more Require longer period of recovery May need to travel farther distance to find

provider Carry greater risks; still low complication rate Two methods:

Dilation and Evacuation Induction Abortion

My Opinion

Although I do have reservations, I still believe second-trimester abortions should be allowed because some women do not even realize they are pregnant until this time. However, I do think that there should be a cut-off as to the number of weeks the woman is into the second-trimester.

Dilation and Evacuation (D&E) Most common method of second trimester

abortion Removal of fetal and placental tissue with

combination of suction and instruments Quicker method Does not require hospitalization Do not have to go through labor (physically

and emotionally stressful)

(Dilation and Evacuation Continued)

Procedure:Cervix dilated in process similar to vacuum

aspiration, but done in advance because pregnancy is farther along

Osmotic Dilators (thin rods inserted in cervical opening that absorb moisture and expands, stretching cervix) or Misoprostol is used

May be given pain medication or sedativesAfter dilation, clinician removes fetal and

placental tissue using vacuum aspiration, forceps, and a curette (small, spoonlike tool)

Strong cramping as uterus is emptied

Induction Abortion Medications used to cause uterus to contract and

expel pregnancy

Each woman’s experience is different

Painful contractions can last hours to days

May have to have it done in ward where other women are giving birth; bring support system

Preparation similar to D&E

Plan for overnight hospital stay

(Induction Abortion Continued)

Procedure:Medications used to induce labor given in

various ways: Prostaglandin suppositories/Misoprostol tablets

inserted vaginally every few hours Oxytocin given through IV line Prostaglandins may be injected into arm Saline and Urea may be injected in abdomen into

amniotic sac

May be given medication afterwards to manage pain

What Happens after the What Happens after the Abortion is Complete?Abortion is Complete?

Aftercare You will be brought to “recovery area” to rest

Vital signs and bleeding will be checked periodically

You will be provided with information about what toexpect next and what anysigns of complication may be

May receive antibiotics to prevent infection or excessive bleeding

Normal to feel tired and cramp for a few days

(Aftercare Continued)

Can get pregnant shortly after abortion; use of reliable birth control is important Ask provider about different forms of birth control

Follow-up appointment will be made for 2-3 weeks post-abortion

Emotions may be a mix of negative feelings and feelings of relief

May be told to avoid heavy lifting, exercise, baths, swimming, tampons and vaginal intercourse

The History of AbortionThe History of Abortion Practiced legally in U.S. until 1880Practiced legally in U.S. until 1880

Banned at this time unless necessary to save a lifeBanned at this time unless necessary to save a life Part of backlash to suffrage movement; an effort to Part of backlash to suffrage movement; an effort to

control womencontrol women Way for medical profession to control women’s health Way for medical profession to control women’s health

carecare Declining birth rate among whites concerned Declining birth rate among whites concerned

government about “race suicide”government about “race suicide”

Still widely practiced illegallyStill widely practiced illegally

Economic status, race, and location heavily Economic status, race, and location heavily effected safety of illegal abortioneffected safety of illegal abortion The poor were at the mercy of incompetent doctors or The poor were at the mercy of incompetent doctors or

dangerous self abortion methods were used (insertion of dangerous self abortion methods were used (insertion of coat hangers into the vagina, etc.)coat hangers into the vagina, etc.)

(History of Abortion Continued)

Groups formed to help women obtain abortions Jane Collective; Clergy Consultation

In the 1960’s following Civil Rights Movement, women began to organize

Abortion was major issue in movement

Activism led to several states allowing abortion New York was first state to legalize abortions up until

the 24th week of pregnancy Government allowed states to issue individual

restrictions

Legality of AbortionLegality of Abortion

Roe v. WadeRoe v. Wade decision decision Ended illegal status of clinical abortionsEnded illegal status of clinical abortions Court found it to be a woman’s decision to terminate Court found it to be a woman’s decision to terminate

pregnancy in first trimester pregnancy in first trimester Positive impact of Roe v. Wade:Positive impact of Roe v. Wade:

Fatal infections and hemorrhaging due to Fatal infections and hemorrhaging due to complications were no longer an issuecomplications were no longer an issue

Anti-abortionists still campaigned to intimidate abortion seekers and Anti-abortionists still campaigned to intimidate abortion seekers and providersproviders

Still a controversial issue todayStill a controversial issue today ““Pro-life” (label for abortion opponents)Pro-life” (label for abortion opponents) ““Pro-choice” (label for abortion supporters)Pro-choice” (label for abortion supporters)

Abortion WorldwideAbortion Worldwide

1)1) About 46 million abortions occur yearly; about half About 46 million abortions occur yearly; about half are unsafeare unsafe

2)2) 95% unsafe abortions occur in developing 95% unsafe abortions occur in developing countriescountries

3)3) 20 million unsafe abortions performed annually20 million unsafe abortions performed annually

4)4) Approximately 13% preventable maternal deaths Approximately 13% preventable maternal deaths are due to complications of unsafe abortionsare due to complications of unsafe abortions

5)5) 25% world’s population lives in countries where 25% world’s population lives in countries where abortion is highly restricted (Latin America, Asia, abortion is highly restricted (Latin America, Asia, Africa)Africa)

“’ “’I had an illegal abortion, which led to I had an illegal abortion, which led to infection, and I was close to death. I ended infection, and I was close to death. I ended up in a legal hospital with a real doctor who up in a legal hospital with a real doctor who managed to pull me through. Thank god the managed to pull me through. Thank god the pregnancy was terminated. All this rubbish pregnancy was terminated. All this rubbish about guilt feelings is just that. Ask me if I about guilt feelings is just that. Ask me if I would do it again knowing the risks- YES- would do it again knowing the risks- YES- absolutely. Thank heaven it’s legal now, so absolutely. Thank heaven it’s legal now, so women don’t have to endure life-threatening women don’t have to endure life-threatening situations,’” (Abortion 407)situations,’” (Abortion 407)

Are you pro-life or pro-choice? What is your Are you pro-life or pro-choice? What is your reasoning?reasoning?