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8/2/2019 Insel11e Ppt07 Abortion
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Chapter 7
8/2/2019 Insel11e Ppt07 Abortion
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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-1800s: Prior to 20 weeks was legal
1900s: Physicians joined with other groups - stating
untrained people were performing them. All statesmade abortion illegal
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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 notlife 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-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 - shehas 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 :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 changedepending on the situation
Many approve legal abortion when health orwelfare consequences could result
The issue in later pregnancy is when does theright of the fetus take precedence over thewomans 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 intoor near the cervix.
Cervix is gently and gradually stretched over a 24 hourperiod.
After dilation a tube connected to a suction machine gentlyempties 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 12thweek 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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MifepristoneMisoprostol 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 100 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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Chapter 7