1. © 2012 McGraw-Hill Companies. All Rights Reserved. Chapter 7

2. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 legal  1900s: All states made abortion illegal  1960s: Laws started to change to remedy violations of the right to privacy 2

3. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 3

4. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 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 4

5. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 5

6. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 6

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

8.  Legal arguments  Moral arguments  Short- and long-term ramifications  What resources are available?  Adoption options 8

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11. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 11

12. © 2012 McGraw-Hill Companies. All Rights Reserved.  Also known as dilation and curettage or D&C  Performed from the 6 th to 12 th 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 12

13. © 2012 McGraw-Hill Companies. All Rights Reserved. 13

14. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 14

15. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 15

16. © 2012 McGraw-Hill Companies. All Rights Reserved.  One in ten abortions is performed after the 12 th 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 16

17. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 17

18. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 18

19. © 2012 McGraw-Hill Companies. All Rights Reserved.  Mifepristone–Misoprostol method  Initial dose of mifepristone  Two days later take dose of misoprostol  Effective rate is 92-95%  Side effects  Follow-up procedures 19

20. © 2012 McGraw-Hill Companies. All Rights Reserved.  Methotrexate with prostaglandin  Methotrexate stops the embryonic or fetal cells from dividing  About 80-85% of women will abort within 2 weeks  Up to 95% will abort within 30 days 20

21. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 21

22. © 2012 McGraw-Hill Companies. All Rights Reserved.  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 22

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24. © 2012 McGraw-Hill Companies. All Rights Reserved. Chapter 7