Abortion 08

What is abortion?

Abortion is the termination of pregnancy by removing the fetus or embryo from the uterus. It results to the death of the embryo.
There are two types of abortion:

1. spontaneous abortion
2. induced abortion.
   

Spontaneous abortion is the expulsion of the embryo due to accidental trauma and natural causes before the 20th week of pregnancy. In induced abortion, medicine uses surgical procedures and medications. In this case, the expulsion of the embryo is volontary.

What is the differences between spontaneous and induced abortion?

Sponaneous abortion is also called miscarriage, it occurs naturally. There is nothing we can do to avoid it whereas induced abortion is a choice we make.
The risk of spontaneous abortion is greater in those with a known history of several spontaneous abortions or an induced abortion, those with systemic diseases, and those over the age 35. Other causes can be infection (of either the woman or fetus), immune response, or serious systemic disease. A spontaneous abortion can also be caused by accidental trauma; intentional trauma or stress to cause miscarriage is considered induced abortion.

For induced abortion, pregnancy can be intentionally aborted in many ways. The manner selected depends upon the gestational age of the embryo or fetus, in addition to the legality, regional availability, and doctor-patient preference for specific procedures. 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;
• selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy.

How does spontaneous abortion occurs?

The first signs of an eventual miscarriage are:

• severe back pain
• Weight loss
• White-pink mucus
• True contractions (very painful happening every 5-20 minutes)
• Brown or bright red bleeding with or without cramps
• Tissue with clot like material passing from the vagina
• Sudden decrease in signs of pregnancy

There are many types of miscarriage:

• Threatened Miscarriage: It happens at the beginning of the pregnancy, there is a uterine bleeding accompanied by cramping or lower backache. The cervix remains closed. This bleeding is often the result of implantation.

• Inevitable or Incomplete Miscarriage: Abdominal or back pain accompanied by bleeding with an open cervix. It is inevitable when there is a dilation of the cervix and/or a rupture of the membranes. Bleeding and cramps may persist if the miscarriage is not complete.

• Complete Miscarriage: A completed miscarriage is when the embryo or products of conception have emptied out of the uterus. Bleeding should subside quickly, as should any pain or cramping. A completed miscarriage can be confirmed by an ultrasound or by having a surgical curettage performed.

• Missed Miscarriage: Women can experience a miscarriage without knowing it. A missed miscarriage is when embryonic death has occurred but there is any expulsion of the uterus. It is not known why this occurs. Signs of this would be a loss of pregnancy symptoms and the absence of fetal heart tones found on an ultrasound.

• Recurrent Miscarriage: Defined as 3 or more consecutive first trimester miscarriages. This can affect 1% of couples trying to have a child.

• Blighted Ovum: A fertilized egg implants into the uterine wall, but fetal development never begins. There is often a gestational sac with or without a yolk sac, but there is an absence of fetal growth.

• Ectopic Pregnancy: A fertilized egg implants itself in places other than the uterus, usually in the fallopian tube. Treatment is needed immediately to stop the development of the implanted egg. If it is not treated rapidly, this could end in serious complications for the mother.

• Molar Pregnancy: The result of a genetic error during the fertilization process that leads to growth of abnormal tissue within the uterus. Molar pregnancies rarely involve a developing embryo, but often entail the most common symptoms of pregnancy including a missed period, positive pregnancy test and severe nausea.

The earlier you are in the pregnancy, the more likely your body will expel all the fetal tissue by itself and will not require further medical procedures. If the body does not expel all the tissue, the most common procedure performed to stop bleeding and prevent infection is a dilation and curettage. Drugs may be prescribed to help control bleeding after the dilatation and curettage procedures are performed.

Most miscarriages are due to chromosomal abnormalities so there is nothing we can do about it. However, pregnant women can do some things to prevent other types of miscarriages such as:

• Keep the abdomen safe
• Not smoke or be around smoke
• Not drink alcohol
• Check with the doctor before taking any medications
• Limit or eliminate caffeine
• Avoid environmental hazards such as radiation, infectious disease and x-rays
• Avoid contact sports or activities that have risk of injury

How are induced abortions performed?

Abortion can be performed in many ways. The differents procedures depend on the stage of the pregnancy.

• The abortion pill: it is a form of early abortion caused by the combination of two medications, mifepristone and misoprostol that is an option for women who are 8 weeks pregnant or less. Also known as RU486 or medication abortion. Misoprostol causes contractions resulting in a miscarriage.

Mifepristone blocks the hormone progesterone needed to maintain the pregnancy. Because this hormone is blocked, the cervix begins to soften and bleeding may occur. With the later addition of the second medication, misoprostol, the uterus contracts and the pregnancy is usually expelled within 6 to 8 hours. This method can only be used if the woman isn't pregnant more than 8 weeks.

• Suction abortion: It is the most common technique used. In this procedure a suction tube is inserted through the dilated cervix into the womb. A powerful vacuum tears the placenta from the uterus and dismembers the body of the developing child. It can be used until 12 weeks.

• Dilatation and curettage: In this technique, the doctor inserts a curette, a steel knife, into the womb through the dilated cervix. As the curette scrapes the wall of the uterus, the baby is cut into pieces.

• salt poisoning: This technique is used after sixteen weeks,The doctor inserts injects a saline solution into the sac of amniotic fluid surrounding the baby. The baby is poisoned by swallowing the salt and his skin is completely burned away. After the child dies, the mother goes into labor and expels the dead baby.

• Hysterotomy: This abortion procedure is essentially the same as a caesarian section birth, the mother's abdomen is cut open and the child is removed from the womb.

Abortion law

In some countries abortion is totally forbidden (Chile,El Salvador, Nicaragua, Malta, Vatican city), the laws are most of the time linked with the religion of the country, where the laws can be very strict. In other, it is forbidden with exceptions, depending on the mother's health, the maternal health, social reasons or if the woman was raped. Most countries in Europe, Switzerland included, allow abortion but the deadline varies.
In Switzerland, a new law was prescribed in 2002, the woman can chose wether or not she wants to pursue the pregnancy within 12 weeks.

In the Penal Code, it says abortion is punishable unless:

1) there is a danger of severe physical damage or severe psychological distress for the woman. The danger has to be one that would increase in severity as the pregnancy progresses.

2) it is carried out by a doctor within the first 12 weeks of the woman's last menstrual period, on written request of the woman in which she says she is in a situation of distress. The doctor has to discuss her decision with her and inform her of possible risks, and give her a list of counseling centers and services offering help, as well as information about adoption.

Why are abortions forbidden after three months?

The earlier an abortion is performed, the safer it is. Mainly because early abortions are less complicated than the ones performed when the pregnancy is already quite advanced. This is why most abortions, in the United States, are made within 12 to 13 weeks after the last menstrual period. However, some abortions can be performed later than the first trimester. This can be due to the fact that some woman don't realize they are pregnant, or the fact that woman wait to get enough money to pay the procedure.

What are the ethical problems

There are many ethical problems and questions on this topic. The main question on which people disagree and debate is: When does human personhood begin? Does it begin at the conception of the child, as prolife think or does it begin after the delivering as prochoice affirm?

But we could also ask ourselves if the life of the fetus is more important than the choice of the mother or on the other way. An other ethical problem is the way the abortion can be performed, is the value of life really respected during the procedure?

Can abortion be appropriate? If yes,when? This is another ethical aspect which can be discussed. In some cases people believe abortion can be advised for example if a woman has been raped or if the health of the mother is in danger.

All these questions cannot be answered because people have different point of vues. This is why governments have actual difficulties to prescribe laws about abortion, and that people are demonstrating against or in favour of abortion.

What is the difference between Pro-Life and Pro-Choice people?

Pro-Life and Pro-choice are extremist movements which have opposed opinions about abortion.

ProLife: Pro-life activists focus on life. They consider the embryon or the fetus as human beings, any actions against it is described, from their point of vue as a crime. They support the fetal rights in every kind of situation. The child of a woman who has been raped should not be punished for the way it was concieved.

Pro-Choice: Pro-Choice people are in favor of abortion. For them, the fetus is not a human being, it is just a mass of tissue. Thus, abortion is not considered as a crime. They also think that every child should be wanted, and that a woman should be able to control her own body. A woman should not be forced to give birth to a child that is the result from a rape. Pro-Choice activists also say that we are overpopulating the planet, so reducing the number of unwanted children by abortion could have an influence on the world's increasing population.

Sources

• wikipedia Abortion [1]
• ProLife [2]
• ProChoice [3]
• BBC abortion [4]
• Ethics matters [5]
• American pregnancy association [6]
• WHO abortion [7]
• Abortion facts [8]

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