Abortion, Therapeutic Health Article

Definition

Therapeutic abortion is the intentional termination of a pregnancy before the fetus can live independently. Abortion has been a legal procedure in the United States since 1973.

Purpose

An abortion may be performed whenever there is some compelling reason to end a pregnancy. Women have abortions because continuing the pregnancy would cause them hardship, endanger their life or health, or because prenatal testing has shown that the fetus will be born with severe abnormalities.

Abortions are safest when performed within the first six to 10 weeks after the last menstrual period. The calculation of this date is referred to as the gestational age and is used in determining the stage of pregnancy. For example, a woman who is two weeks late having her period is said to be six weeks pregnant, because it is six weeks since she last menstruated.

About 90% of women who have abortions do so before 13 weeks and experience few complications. Abortions performed between 13-24 weeks have a higher rate of complications. Abortions after 24 weeks are extremely rare and are usually limited to situations where the life of the mother is in danger.

Precautions

Most women are able to have abortions at clinics or outpatient facilities if the procedure is performed early in pregnancy. Women who have stable diabetes, controlled epilepsy, mild to moderate high blood pressure, or who are HIV positive can often have abortions as outpatients if precautions are taken. Women with heart disease, previous endocarditis, asthma, lupus erythematosus, uterine fibroid tumors, blood clotting disorders, poorly controlled epilepsy, or some psychological disorders usually need to be hospitalized in order to receive special monitoring and medications during the procedure.

Very early abortions

Between five and seven weeks, a pregnancy can be ended by a procedure called menstrual extraction. This procedure is also sometimes called menstrual regulation, mini-suction, or preemptive abortion. The contents of the uterus are suctioned out through a thin (3-4 mm) plastic tube that is inserted through the undilated cervix. Suction is applied either by a bulb syringe or a small pump.

Another method is called the "morning after" pill, or emergency contraception. Basically, it involves taking high doses of birth control pills within 24 to 48 hours of having unprotected sex. The high doses of hormones causes the uterine lining to change so that it will not support a pregnancy. Thus, if the egg has been fertilized, it is simply expelled from the body.

There are two types of emergency contraception. One type is identical to ordinary birth control pills, and uses the hormones estrogen and progestin). This type is available with a prescription under the brand name Preven. But women can even use their regular birth control pills for emergency contraception, after they check with their doctor about the proper dose. About half of women who use birth control pills for emergency contraception get nauseated and 20 percent vomit. This method cuts the risk of pregnancy 75 percent.

The other type of morning-after pill contains only one hormone: progestin, and is available under the brand name Plan B. It is more effective than the first type with a lower risk of nausea and vomiting. It reduces the risk of pregnancy 89 percent.

Women should check with their physicians regarding the proper dose of pills to take, as it depends on the

brand of birth control pill. Not all birth control pills will work for emergency contraception.

Menstrual extractions are safe, but because the amount of fetal material is so small at this stage of development, it is easy to miss. This results in an incomplete abortion that means the pregnancy continues.