1. Abortion Chapter 7

2. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 2 The Abortion Issue  The history of abortion in the U.S. Mid-1800’s: Prior to 20 weeks was legal 1900’s: Physicians joined with other groups - stating untrained people were performing them. All states made abortion illegal

3. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 3 Current Legal Status  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 not life threatening to mother  U.S. Congress and federal Medicaid funds  17 states provide nonfederal public money  Current issues 2000 Nebraska ban on partial birth 2006 Supreme Court reconsideration of Partial Birth Abortion Ban Act

4. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 4 Moral Considerations  Pro-life  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 - she has 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

5. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 5 Moral Considerations  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 and those who could not. Some physicians would be forced to break the law

6. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 6 Public Opinion  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 when does the right of the fetus take precedence over the woman’s rights

7. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 7 Public opinion about abortion

8. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 8 Personal Considerations  Legal arguments  Moral arguments  Short and long term ramifications

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10. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 10 Reasons why women choose abortions

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12. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 12 Methods of Abortion  Two categories Surgical - 98% of all abortions Medical  Ends a pregnancy before birth takes place Miscarriage/Spontaneous abortion - embryo or fetus dies in the uterus and is expelled by the body Ending a pregnancy voluntarily - induced abortion Approx. 88 % of all abortions are performed during the first trimester Typically performed at a clinic, health center, or in a doctors office. Women are usually able to return home an hour or so later

13. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 13 Abortion Around the World

14. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 14 Suction Curettage  Vacuum aspiration  Early abortion; about 6 th to 12 th week  Used about 90% of all abortions  Vagina is washes with antiseptic, Anesthetic is injected into or near the cervix.  Cervix is gently and gradually stretched over a 24 hour period.  After dilation a tube connected to a suction machine gently empties 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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16. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 16 Manual Vacuum Aspiration  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 meds. Uterus is emptied with a handheld syringe If a definitive gestational sac is not identified then women is tested for possible ectopic pregnancy

17. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 17 Abortion After the First Trimester  After 13 th to 24 th 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

18. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 18 Abortion After the First Trimester  Partial birth abortion  Induction: Rarely performed  Inserts a medication called prostaglandin or urea or salt solution into vagina  Causes contractions to begin  Causes a stillbirth to occur

19. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 19 Abortion After the First Trimester  Medical Abortion  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

20. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 20 Medical Abortion  Mifepristone–Misoprostol method Initial dose of mifepristone Two days later take dose of misoprostol Effective rate is 92-95% Side effects Follow-up procedures

21. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 21 Medical Abortion Mifepristone (RU-486)-Misoprostol Method  Swallow a dose of Mife at the doctors office  Two days later insert Miso into vagina  Pregnancy usually ends within 4 hours  Advantages  Disadvantages

22. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 22 Complications of Abortion  Possible physical effects Fever above 100º 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

23. chapter 7 ©2008 McGraw-Hill Companies. All Rights Reserved. 23 Possible Psychological Effects  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

24. Abortion Chapter 7