Abortion, termination of a pregnancy
before birth, resulting in the death of the fetus. Some abortions
occur naturally because a fetus does not develop normally or because the mother
has an injury or disorder that prevents her from carrying the pregnancy to term.
This type of spontaneous abortion is commonly known as a
miscarriage. Other abortions are induced—that is, intentionally
brought on—because a pregnancy is unwanted or presents a risk to a woman’s
health, or because the fetus is likely to have severe physical or mental health
problems
Induced abortion, the focus of this article, is one of today’s most intense and polarizing ethical and philosophical issues. Modern medical techniques have made induced abortions simpler and less dangerous. But in the United States, the debate over abortion has led to legal battles in the courts, in the Congress of the United States, and state legislatures. The debate has spilled over into confrontations, which are sometimes violent, at clinics where abortions are performed
Abortion Method
1. Drug-Based Abortion Methods
Legal surgical abortion, when done by a trained provider, is essentially 100 percent effective. A number of surgical methods can be used to induce abortions. To end a pregnancy before it reaches eight weeks, a doctor typically performs a preemptive abortion or an early uterine evacuation. In both procedures a narrow tube called a cannula is inserted through the cervix (the opening to the uterus) into the uterus. The cannula is attached to a suction device, such as a syringe, and the contents of the uterus, including the fetus, are extracted. Preemptive abortion uses a smaller cannula and is performed in the first four to six weeks of pregnancy. Early uterine evacuation, which uses a slightly larger cannula, is performed in the first six to eight weeks of pregnancy. Both types of abortions typically require no anesthesia and can be performed in a clinic or physician’s office. The entire procedure lasts for only several minutes. In preemptive abortions the most common complication is infection. Women who undergo early uterine evacuation may experience heavy bleeding for the first few days after the procedure.
Vacuum aspiration is a procedure used for abortions in the 6th to 14th week of pregnancy. It requires that the cervix be dilated, or enlarged, so that a cannula can be inserted into the uterus. Progressively larger, tapered instruments called dilators may be used to dilate the cervix. During the procedure, the cannula is attached to an electrically powered pump that removes the contents of the uterus. In some cases, the lining of the uterus must also be scraped with a spoonlike tool called a curette to loosen and remove tissue. This procedure is referred to as curettage. Vacuum aspiration may require local anesthesia and can be performed in a clinic or physician’s office. Minor bruising or injuries to the cervix may occur when the cannula is inserted
Dilation and curettage (D&C), performed during the 6th to 16th week of pregnancy, involves dilating the cervix and then scraping the uterine lining with a curette to remove the contents. A D&C often requires general anesthesia and must be performed in a clinic or hospital. Possible complications include a reaction to the anesthesia and cervical injuries. Since the development of vacuum aspiration, the use of D&C has declined
After the first 16 weeks of pregnancy, abortion becomes more difficult. One method that can be used during this period is dilation and evacuation (D&E), which requires greater dilation of the cervix than other methods. It also requires the use of suction, a large curette, and a grasping tool called a forceps to remove the fetus. D&E is a complicated procedure because of the larger size of the fetus and the thinner walls of the uterus, which stretch to accommodate a growing fetus. Bleeding in the uterus often occurs. D&E is often performed under general anesthesia in a clinic or hospital. It is typically used in the first weeks of the second trimester but can be performed up to the 24th week of pregnancy.
An induction abortion can also be performed in the second trimester, usually between the 16th and 24th week of pregnancy. In this type of abortion a small amount of amniotic fluid, the fluid that surrounds the fetus, is withdrawn and replaced with another fluid. About 24 to 48 hours later, the uterus begins to contract and the fetus is expelled. When this method was first developed, physicians used a strong saline (salt) solution to abort the fetus; today they may also use solutions containing prostaglandins or pitocin, a synthetic form of a chemical produced by the pituitary gland that induces labor. Heavy bleeding, infection, and injuries to the cervix can occur. This procedure is performed in the hospital and requires a stay of one or more days.
2. Social and ethical issues
Induced abortion, the focus of this article, is one of today’s most intense and polarizing ethical and philosophical issues. Modern medical techniques have made induced abortions simpler and less dangerous. But in the United States, the debate over abortion has led to legal battles in the courts, in the Congress of the United States, and state legislatures. The debate has spilled over into confrontations, which are sometimes violent, at clinics where abortions are performed
Abortion Method
1. Drug-Based Abortion Methods
Legal surgical abortion, when done by a trained provider, is essentially 100 percent effective. A number of surgical methods can be used to induce abortions. To end a pregnancy before it reaches eight weeks, a doctor typically performs a preemptive abortion or an early uterine evacuation. In both procedures a narrow tube called a cannula is inserted through the cervix (the opening to the uterus) into the uterus. The cannula is attached to a suction device, such as a syringe, and the contents of the uterus, including the fetus, are extracted. Preemptive abortion uses a smaller cannula and is performed in the first four to six weeks of pregnancy. Early uterine evacuation, which uses a slightly larger cannula, is performed in the first six to eight weeks of pregnancy. Both types of abortions typically require no anesthesia and can be performed in a clinic or physician’s office. The entire procedure lasts for only several minutes. In preemptive abortions the most common complication is infection. Women who undergo early uterine evacuation may experience heavy bleeding for the first few days after the procedure.
Vacuum aspiration is a procedure used for abortions in the 6th to 14th week of pregnancy. It requires that the cervix be dilated, or enlarged, so that a cannula can be inserted into the uterus. Progressively larger, tapered instruments called dilators may be used to dilate the cervix. During the procedure, the cannula is attached to an electrically powered pump that removes the contents of the uterus. In some cases, the lining of the uterus must also be scraped with a spoonlike tool called a curette to loosen and remove tissue. This procedure is referred to as curettage. Vacuum aspiration may require local anesthesia and can be performed in a clinic or physician’s office. Minor bruising or injuries to the cervix may occur when the cannula is inserted
Dilation and curettage (D&C), performed during the 6th to 16th week of pregnancy, involves dilating the cervix and then scraping the uterine lining with a curette to remove the contents. A D&C often requires general anesthesia and must be performed in a clinic or hospital. Possible complications include a reaction to the anesthesia and cervical injuries. Since the development of vacuum aspiration, the use of D&C has declined
After the first 16 weeks of pregnancy, abortion becomes more difficult. One method that can be used during this period is dilation and evacuation (D&E), which requires greater dilation of the cervix than other methods. It also requires the use of suction, a large curette, and a grasping tool called a forceps to remove the fetus. D&E is a complicated procedure because of the larger size of the fetus and the thinner walls of the uterus, which stretch to accommodate a growing fetus. Bleeding in the uterus often occurs. D&E is often performed under general anesthesia in a clinic or hospital. It is typically used in the first weeks of the second trimester but can be performed up to the 24th week of pregnancy.
An induction abortion can also be performed in the second trimester, usually between the 16th and 24th week of pregnancy. In this type of abortion a small amount of amniotic fluid, the fluid that surrounds the fetus, is withdrawn and replaced with another fluid. About 24 to 48 hours later, the uterus begins to contract and the fetus is expelled. When this method was first developed, physicians used a strong saline (salt) solution to abort the fetus; today they may also use solutions containing prostaglandins or pitocin, a synthetic form of a chemical produced by the pituitary gland that induces labor. Heavy bleeding, infection, and injuries to the cervix can occur. This procedure is performed in the hospital and requires a stay of one or more days.
2. Social and ethical issues
Abortion has become one of the most widely
debated ethical issues of our time. On one side are pro-choice
supporters—individuals who favor a woman’s reproductive rights, including the
right to choose to have an abortion. On the other side are the pro-life
advocates, who may oppose abortion for any reason or who may only accept
abortion in extreme circumstances, as when the mother’s life would be threatened
by carrying a pregnancy to term. At one end of this ethical spectrum are
pro-choice defenders who believe the fetus is only a potential human being when
it becomes viable, that is, able to survive outside its mother’s womb. Until
this time the fetus has no legal rights—the rights belong to the woman carrying
the fetus, who can decide whether or not to bring the pregnancy to full term. At
the other end of the spectrum are pro-life supporters who believe the fetus is a
human being from the time of conception. As such, the fetus has the legal right
to life from the moment the egg and sperm unite. Between these positions lies a
continuum of ethical, religious, and political positions.
A variety of ethical arguments have been
made on both sides of the abortion issue, but no consensus or compromise has
ever been reached because, in the public policy debate, the most vocal
pro-choice and pro-life champions have radically different views about the
status of a fetus. Embryology, the study of fetal development, offers
little insight about the fetus’s status at the time of conception, further
confounding the issue for both sides. In addition, the point during pregnancy
when a fetus becomes viable has changed over the years as medical advances have
made it possible to keep a premature baby alive at an earlier stage. The current
definition of viability is generally accepted at about 24 weeks gestation; a
small percentage of babies born at about 22 weeks gestation have been kept alive
with intensive medical care. Despite the most advanced medical care, however,
babies born prematurely are more at risk for long-term medical and developmental
problems.
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