Abortion

Miguel A. Villanueva Jr.

Sociology

Dr. Slade

Abortion

An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. This can occur spontaneously or accidentally as with a miscarriage, or be artificially induced by medical, surgical or other means. "Abortion" can refer to an induced procedure at any point during human pregnancy; it is sometimes medically defined as either miscarriage or induced termination before the point of viability.Throughout history, abortion has been induced by various methods and the moral and legal aspects of abortion are subject to intense debate in many parts of the world.

The incidence and reasons for induced abortion vary regionally. It has been estimated that approximately 46 million abortions are performed worldwide every year. Of these, 26 million are said to occur in places where abortion is legal; the other 20 million happen where the procedure is illegal. Some countries, such as Belgium (11.2 per 100 known pregnancies) and the Netherlands (10.6 per 100), have a low rate of induced abortion, while others like Russia (62.6 per 100) and Vietnam (43.7 per 100) have a comparatively high rate. The world ratio is 26 induced abortions per 100 known pregnancies.

Spontaneous abortion

Spontaneous abortions, generally referred to as miscarriages, occur when an embryo or fetus is lost due to natural causes before the 20th week of gestation. A pregnancy that ends earlier than 37 weeks of gestation, if it results in a live-born infant, is known as a "premature birth". When a fetus dies in the uterus at some point late in gestation, beginning at about 20 weeks, or during delivery, it is termed a "stillbirth". Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.

Most miscarriages occur very early in pregnancy. Between 10% and 50% of pregnancies end in miscarriage, depending upon the age and health of the pregnant woman. In most cases, they occur so early in the pregnancy that the woman is not even aware that she was pregnant.

The risk of spontaneous abortion decreases sharply after the 8th week. This risk is greater in those with a known history of several spontaneous abortions or an induced abortion, those with systemic diseases, and those over age 35. Other causes can be infection (of either the woman or fetus), immune response, or serious systemic disease. A spontaneous abortion can also be caused by accidental trauma; intentional trauma to cause miscarriage is considered induced abortion or feticide.

Induced abortion

A pregnancy can be intentionally aborted in many ways. The manner selected depends chiefly upon the gestational age of the embryo or fetus, in addition to the legality, regional availability, and doctor-patient preference for specific procedures.

Surgical abortion

Gestational age may determine which abortion methods are practiced.

In the first twelve weeks, suction-aspiration or vacuum abortion is the most common method. Manual vacuum aspiration, or MVA abortion, consists of removing the fetus or embryo by suction using a manual syringe, while the Electric vacuum aspiration or EVA abortion method uses an electric pump. These techniques are comparable, differing in the mechanism used to apply suction, how early in pregnancy they can be used, and whether cervical dilation is necessary. MVA, also known as "mini-suction" and menstrual extraction, can be used in very early pregnancy, and does not require cervical dilation. Surgical techniques are sometimes referred to as STOP: 'Suction (or surgical) Termination Of Pregnancy'. From the fifteenth week until approximately the twenty-sixth week, a dilation and evacuation (D & E) is used. D & E consists of opening the cervix of the uterus and emptying it using surgical instruments and suction.

Dilation and curettage (D & C) is a standard gynecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion. Curettage refers to cleaning the walls of the uterus with a curette. The World Health Organization recommends this procedure, also called sharp curettage, only when MVA is unavailable. The term "D and C", or sometimes suction curette, is used as a euphemism for the first trimester abortion procedure, whichever the method used.

Other techniques must be used to induce abortion in the third trimester. Premature delivery can be induced with prostaglandin; this can be coupled with injecting the amniotic fluid with caustic solutions containing saline or urea. After the 16th week of gestation, abortions can be induced by intact dilation and extraction (IDX) (also called intrauterine cranial decompression), which requires surgical decompression of the fetus's head before evacuation. IDX is sometimes termed "partial-birth abortion," which has been federally banned in the United States. A hysterotomy abortion is an abortion procedure