|
|
|
|||
| ||||
|
|
|
|||
| ||||
                                                                                     
|
What does the term 'abortion' mean?
Abortion means expulsion of a pregnancy before the fetus (baby) is viable (capable of survival outside the womb). This contrasts with the lay view, which usually assumes that an abortion means that the pregnancy has been deliberately terminated. A spontaneous abortion (Miscarriage) means that the pregnancy has been lost as a result of a natural process. Many of us find the terms 'miscarriage' or 'early pregnancy loss' to be more user friendly. In the UK there are strict legal criteria that permit a doctor to terminate a pregnancy. When a pregnancy is terminated by someone who is not medically qualified the termination is illegal (illegal abortion). What are the Legal criteria in the UK for pregnancy termination?
How can we screen for serious inherited disorders?Thirty years ago our ability to diagnose serious inherited disorders or anatomical abnormality (deformity) before birth was very limited. Technological advances, particularly the combination of blood screening tests and ultrasound now allow us to exclude many, but by no means all, of these problems. The question of screening for foetal abnormality is never an easy one. Some would find the thought of caring for a handicapped child intolerable whereas others believe the practice of pregnancy termination is unacceptable. It is only feasible to provide a brief account of the principles, benefits and risks here. When screening indicates that the fetus has a serious defect, there are two options. Many couples elect to continue the pregnancy and the obstetrician in collaboration with the paediatrician can counsel on what is to be expected and the treatment options for the baby. Other couples decide that they do not wish the pregnancy to continue and termination can be arranged. Counselling may be offered to provide support for you to come to terms with a decision to discontinue a planned pregnancy. You will also need advice on the chance of recurrence in another pregnancy. Your gynaecologist may be able to supply you with this information or otherwise arrange for you to see a clinical geneticist. The spina bifida group of defects, and heart and limb defects may be demonstrated by ultrasound. Some families are prone to inherited disorders and many of these can be detected by specific screening techniques.
Screening tests are discussed in screening tests How often is abortion performed?Legal abortion is the most frequently performed operation in the UK with about half these operations being undertaken within the NHS. Forty per cent of women in the UK will have had a pregnancy terminated by the age of 45 years. It has been estimated that worldwide 150,000 pregnancies are terminated each day (about one million each week and 350 million each year)! In some countries, such as Russia, more pregnancies are terminated than continue. Many Russian women will have between three and eight pregnancy terminations. There were 10 million terminations in China in 1987. Since the fall of communism in Romania, nearly four out of every five pregnancies are terminated. There are currently about six billion people in the world. This is increasing by 1 billion every ten years. Related Medical Abstracts - Click on the paper title:-
Why do unplanned pregnancies occur?
Start by confirming that you really are
pregnant. Pregnancy tests available from your
chemist are very accurate. The test may become
positive within eight days of conception or
about six days before your next period is due.
If your period is a few days late, arrange for a
test and if it is positive see your general
practitioner.
This must be one of the most difficult decisions a woman ever faces. When there is doubt careful counselling may help. The counsellor cannot make the decision for you. The purpose of counselling is to help you sort out the facts and decide for yourself the best option for you.
In the Related Medical Abstracts - Click on the paper title:-
You will need to take the Mifepristone tablets at the unit supervising the pregnancy termination. After a couple of hours, you may go home and continue with your usual activities. There is a 40% chance of bleeding during the next two days and a 2% chance that you will miscarry during this time. Thirty-six to 48 hours after taking the Mifepristone, you will be admitted and given a vaginal pessary. There is a 70% chance that you will miscarry during the following 4 hours. Should nothing happen within eight hours of the pessary, you may be allowed home and a scan arranged a few days later. Related Medical Abstracts - Click on the paper title:- Medical termination in the Related Medical Abstracts - Click on the paper title:- Usually the womb empties itself completely after medical termination. Once in every twenty five cases, the uterus may only partially empty; the doctors are likely to recommend an E.R.P.C (evacuation of retained products of conception – like a D and C but specific for miscarriage (Q12.8). Medical abortion only fails once in a hundred pregnancies. Related Medical Abstracts - Click on the paper title:- The general risks of surgical procedures are described in
surgery risks. A number of specific complications of pregnancy termination are quoted, but research has shown that the risks are low and not as worrying as the anti-abortion lobby tends to suggest. The risks increase as the pregnancy becomes more advanced. The concerns include the risk of reduced fertility, future miscarriage and depressive illness. There are a number of difficulties in evaluating the incidence of these complications. For example, a significant number of those seeking pregnancy termination are at increased risk of pelvic infection (Q 20.2). The uterus is soft during pregnancy and it can be perforated either during dilation of the cervix or during suction with the possibility of damaging other structures in the pelvis including the bowel and the bladder. The cervix may tear during dilatation. As instruments are introduced through the lower genital tract into the uterus there is a risk of pelvic infection (Q 20.2) which is increased if some pregnancy products are inadvertently retained. There is evidence that prophylactic (preventative) antibiotics reduce the risk. Some clinicians advocate taking swab tests from the neck of the womb and administering antibiotics only if bacteria are cultured. This protocol allows identification of sexually transmitted disease and facilitates contact tracing, thus reducing the incidence of sexually transmitted disease. The commonest cause of pregnancy related deaths worldwide remains pregnancy termination. The number of women dying each day from termination complications is about 500 (1 in 300 of all pregnancy terminations, including those undertaken without medical supervision). My generation of British gynaecologists has been spared the tragic sight of women dying due to illegal termination. It is pertinent to point out that in the three years before the Abortion Act of 1967, ninety-eight women died as a result of back-street abortions.
During my first weekend on call as a senior house officer in gynaecology, we were looking after a woman who had a surgical termination of pregnancy carefully performed by an accomplished consultant. The patient was married and the couple had no child. They had wished to delay parenthood for social reasons. During the operation there was bleeding and despite the team's best efforts, a life-saving hysterectomy was necessary. There has been a suggestion that pregnancy termination may be associated with an increased risk of breast cancer later in life.1996 Pregnancy termination does not appear to increase the risk of miscarriage in a subsequent pregnancy. Related Medical Abstracts - Click on the paper title:-
Before 1967, it was illegal to terminate (abort) a pregnancy in the UK. The case of a fourteen-year old girl who was raped by officers of the Royal Horse Guards in 1938 illustrates the difficulty. The parents sought an abortion for their daughter. Understandably, they argued that the baby would remind their daughter of her frightening experience. The girl was admitted to hospital under the care of Mr Aleck Bourne, a gynaecologist in London. He agreed that termination of the pregnancy was in the girl's best interest and undertook the procedure risking a twenty-year prison sentence. The judge at the Old Bailey accepted that, although the operation had not been performed to save life, it preserved the girls mental and physical health. The jury found in favour of the gynaecologist. This case was undoubtedly a big step on the road to the Abortion Act of 1967. It is noteworthy that Aleck Bourne eventually became a member of the Society for the Protection of the Unborn Child because of his concerns that the Abortion Act would lead to abortion on demand.
The Ethics of Abortion: Pro-Life Vs. Pro-Choice (Contemporary Issues)
Members of a support group, provide each other with various types of help
and information for a particular shared difficulty. The support may take the
form of providing relevant information, relating personal experiences,
listening to others' experiences, providing sympathetic understanding and
establishing social networks. A support group may also provide ancillary
support, such as serving as a voice for the public or engaging in advocacy.
Support groups maintain interpersonal contact among their members in a
variety of ways. Support groups also maintain contact through printed
information rich newsletters, telephone chains, internet forums, and mailing
lists.
Www.amnionet.com/contents.htm www.ascotrad.co.nz/prenatal/ www.hta.nhsweb.nhs.uk/execsumm/SUMM201.htm www.leeds.ac.uk/lass/index.htm www. Medforum.nl/gynfo/vol23.htm www.downs-syndrome.org.uk/ www.ntsad.org/ (Tay Sacs) www.bpas.org/ members. Tripod.com/~plpc/ pro-life
British Pregnancy Advisory Service
Austy Manor,
Wooten Warren,
Solihull,
West Midlands B95 6BX
Tel: 01564 793225
Marie Stopes Clinics
108 Whitfield Street
London W1pBE
Tel: 020 7388 2585
National Abortion Campaign
The Print House
18 Ashwin Street
London E8 3DL
Tel: 020 7923 4976
Pregnancy Advisory Service
Tel:- 0171 637 8962
ARC (Antenatal Results and Choices)
(Previously named - Support Around Termination for Abnormality)
73 Charlotte Street
London W1pLB
Tel 020 7631 0280.
Please click on the required question. DISCLAIMER The aim of this web site is to provide a general guide and it is not intended as a substitute for a consultation with an appropriate specialist in respect of individual care and treatment.
|
