© 2012 McGraw-Hill Companies. All Rights Reserved. Chapter 7.

© 2012 McGraw-Hill Companies. All Rights Reserved.

Chapter 7


Abortion: The artificially induced 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 legal1900s: All states made abortion illegal1960s: Laws started to change to remedy

violations of the right to privacy

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1973 Roe v. Wade U.S. Supreme Court ruled:

Pregnancy divided into three trimesters 1st trimester - up to pregnant woman and her 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 barred use of federal Medicaid funds 17 states provide nonfederal public money Current issues

2007 Gonzales v. Carhart - Supreme Court upholding the Partial Birth

Abortion Ban Act 2008-2010

Several states pass legislation requiring women seeking an abortion to undergo ultrasound procedures and be given the chance to view the images

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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 to carry the pregnancy through

Women unable or unwilling to raise the children should consider placing them 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

an abortion and those who could not

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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 the question of when the right of the fetus takes precedence over the woman’s rights

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Legal arguments Moral arguments Short- and long-term ramifications What resources are available? Adoption options

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Two categories Surgical - 87% of all U.S. abortions in 2005 Medical – 13% of all U.S. abortions in 2005

Emergency contraception pills or IUD not abortifacients

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Also known as dilation and curettage or D&C Performed from the 6th to 12th weeks Used in about 90% of all abortions Cervix is cleansed, then gently and gradually

stretched over a 24-hour period After dilation, a tube connected to a suction machine

gently empties the uterus After suction, doctor uses a curette (narrow metal

loop) gently scrapes the walls of the uterus Entire curettage takes 5-10 minutes After a few hours in recovery, the woman can return

home

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Manual Vacuum Aspiration (MVA) Done up to 10 weeks of gestation Gentle suction of a syringe; no electric pump Significantly cheaper than suction curettage Can be performed by nurses or midwives Ideal for low-resource settings As safe as suction curettage

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Multi-Fetal Pregnancy Reduction (MFPR) Reduces the number of fetuses in a multiple

pregnancy Usually performed during first trimester Fetal heart injected with potassium chloride Improves maternal pregnancy outcomes

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One in ten abortions is performed after the 12th week of pregnancy

D&E used from 13 to 24 weeks of pregnancy

Dilation and Evacuation (D&E) Two steps:

1) Cervix is dilated overnight at home 2) Next day, uterus is emptied using surgical

instruments and an aspirating machine

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Intact dilation and extraction (known as partial birth abortion) Surgical procedure where intact fetus is removed

from the uterus; performed rarely (0.17% of all abortions)

Became illegal in 2007 by the Supreme Court ruling of Gonzales v. Carhart

Labor Induction Rarely performed; used for late abortion

Prostaglandins (chemicals) used to induce labor Causes contractions to begin Causes a stillbirth to occur within 6-24 hours

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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 mifepristoneTwo days later take dose of misoprostolEffective rate is 92-95%Side effectsFollow-up procedures

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Methotrexate with prostaglandinMethotrexate stops the embryonic or fetal

cells from dividingAbout 80-85% of women will abort within 2

weeksUp to 95% will abort within 30 days

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Possible physical effects Fever above 100º F Abdominal pain or swelling, cramping, or backache Abdominal tenderness Prolonged or heavy bleeding Foul-smelling vaginal discharge Vomiting or fainting

Incomplete abortion Unsafe abortions

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Possible feelings after having an abortion: Guilt New strength in having made and carried out an

important decision Relief Regret Depression Sense of loss Negative feelings about sex Relationship may end Anger Bitterness

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Chapter 7

© 2012 McGraw-Hill Companies. All Rights Reserved. Chapter 7.

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