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Abortion refers to pregnancy termination through expulsion or removal of an embryo or fetus before viability. Abortion can be deliberately induced or spontaneous. When it is spontaneous, it is referred to as a miscarriage. The term abortion is specifically used to refer to induced abortion by humans. When induced abortion done in the developed countries in accordance with the proper regulations, it is one among the best procedures conducted in medicine. Nevertheless, abortion conducted haphazardly results to massive deaths and hospital admissions around the world. Recently, abortion rates have reduced due to the increasing contraceptive supply and intensive family planning education. Today, most women can access justifiable legal abortions, performed within the acceptable gestational limits.
Types of Abortion
There are two types of abortion, induced and spontaneous abortion. The difference between the two types depends on how each occurs. Whereas induced abortion is optional and controllable, spontaneous abortion is mostly uncontrollable.
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Induced abortion has a very lengthy history and has been practiced over generations using different methods, such as herbal abortifacients, physical trauma, and sharpened tools among other traditional techniques. Contemporary practices use surgical procedures and medications to perform the same procedure. The prevalence, legality, as well as religious status of induced abortion, differ greatly around the world. Legality may depend on conditions such as rape, incest, risks of disability, fetal defects, mother being exposed to health risks, or socioeconomic factors. In almost all countries around the world, there are divisive controversies over the ethical, moral, and legal rightness of abortion. Those who condemn abortion argue that the fetus or embryo is already a human being with the right to life, hence equate abortion to homicide. On the other hand, those who support it claim that a woman has the right to make decisions that pertain to her own body.
Induced abortions mostly result from unintended pregnancies, but problems harbored by the fetus, alongside other factors stated earlier, may contribute to this type of abortion. Pregnancy termination can be performed through several ways. The selected method usually depends on the embryo’s gestational age, which increases as the pregnancy continues. Other factors that may lead to choosing specific procedures include legality, patient or doctor preference, and regional availability. Reasons for consenting to induced abortion are classified as either elective or therapeutic. Elective abortion occurs when a voluntary procedure is performed at a woman’s request without any medical reasons. On the other hand, the abortion procedure is referred to as therapeutic when it is conducted to save the life of the mother, prevent harm to her mental or physical health, or when it is established that the child will inevitably die after delivery.
This type of abortion is popularly referred to as miscarriage. It is the unintended expulsion of the fetus or embryo before the twenty-fourth week of gestation. Only a small percentage of pregnancies of about fifty progress beyond the first trimester while the other majority, which do not develop, are lost even before a woman realizes that she is pregnant. Others are lost before medical practitioners are aware of the embryo. However, some pregnancies are terminated in miscarriages that are clinically noticeable, depending on the health and age of the woman. Alongside other causes of spontaneous abortion, the most renowned cause of spontaneous abortion in the first trimester is embryo or fetus’ chromosomal abnormalities. Others include diabetes, vascular diseases, infection, hormonal problems, and uterus abnormalities.
Vacuum curettage, which is also known as uterine aspiration or suction curettage, is a very common procedure in the United States. Procedures that are performed before thirteen menstrual weeks are referred to as vacuum or suction, whereas the same procedures when performed after the same duration are referred to as dilation and evacuation. During vacuum curettage, use of antibiotics is very common. The manual vacuum aspiration (MVA) entails the removal of an embryo or fetus, membranes, and placenta by suction with a manual syringe. The electric vacuum aspiration (EVA), on the other hand, involves the use of an electric pump to perform the same procedure. The distinction between the two techniques lies in the mechanism used for applying suction, gestation stage, and necessity of cervical dilation (Lynn, Sacheen and Phillip 175). MVA can be used during the early stages of gestation without using cervical dilation.
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The other alternative procedure is dilation and curettage (D&C), which is used in surgical abortion for various reasons, including checking for abnormal bleeding, examining the uterine for any malignancy, as well as abortion itself. The word ‘curettage’ is derived from ‘curette’, which is an antibiotic used to clean the uterine walls. This procedure is recommended when the MVA procedure is unavailable (Lynn, Sacheen and Phillip 176). When pregnancy exceeds fifteen weeks, up to about the twenty-sixth week, other methods are used. An example is dilation and evacuation (D&E), which involves cervix opening and using suction and surgical instruments to empty it. After the sixteenth week of pregnancy, abortion can be induced through a procedure known as intact dilation and extraction (IDX), which calls for decompressing the fetus’s head surgically before evacuation. This method has been banned in the United States. Prostaglandin can be used to induce premature labor and delivery. This procedure can be done alongside injecting amniotic fluid that contains hypertonic solutions of urea or saline. In the third trimester, hysterotomy abortion is performed. This procedure is almost similar to a caesarean section and is only performed under general anesthesia (Swica 2).