Abortion

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Understanding the issue

Abortion is a very controversial topic. Some believe it to be an act of murder, while others simply believe it's a woman's right. The two sides of this debate are ambiguously named, pro-choice and pro-life. If people wouldn't hide behind ambiguous terms, they would call themselves what they really are, pro-legalizing abortion, and pro-outlawing abortion. Another loosely used term is "reproductive freedom." The name implies the freedom to reproduce when in actuality the freedom to reproduce has never been threatened in America and is not what this term stands for. A more accurate name would be "freedom to have an abortion," or "abortion freedom." With ambiguous terms such as these, the issue can become clouded and confusing. Hard truths are painted in misleading, more easily digested words. The full reality of what's being discussed can easily be ignored. To best address this issue you have to look at the facts. You also have to take into account all possible situations. A strong pro-choice argument addresses the possibility of an unplanned pregnancy as the result of rape or incest. In other situations the fetus may have severe abnormalities that may cause it to die or prevent it from having any sort of sustainable or tolerable existence. These are hard truths that are difficult to swallow but need to be addressed.

Once a girl does become pregnant, she can avoid the controversy and the difficult decisions about abortion by taking the morning after pill within 72 hours of having unprotected sex. The morning after pill does not terminate a pregnancy. It actually prevents the pregnancy from occurring.

Things like unwanted pregnancies don't just happen. They happen because people let them happen. The only guaranteed way to avoid them is to abstain from sex. The next best way to avoid unwanted pregnancies is by using two reliable forms of birth control, (the pill and a condom, spermicidal foam and a condom, a diaphragm and the condom, etc.) A less effective but very easy and practical way to reduce the chance of an unwanted pregnancy is by using a condom alone. Under no circumstances should you ever fail to use at least a condom. If you do, you are flirting with other people's lives, and with your own death. Finally, if your prophylactics fail, or if you're raped, you can use the morning after pill (emergency contraception) to prevent pregnancy within 72 hours after intercourse.

Visit http://ec.princeton.edu/providers/index.html to find your nearest provider of emergency contraception and more information on the morning after pill.

There are so many ways to easily protect against unwanted pregnancies. The tragic problem is, not everyone knows about them, and not everyone realizes the tragic realty of an unwanted pregnancy, which is a human's life unwanted by its parents.

When deciding whether or not to have an abortion, people must consider the full reality of their situation. An embryo or fetus is a human. It carries all the genetic material to qualify it as human. It is the offspring of the father and the mother. Deciding to have an abortion is not only a choice made by a woman about her own body. It is a choice to deny another human's right to choose whether or not to live. It's making a choice on behalf of the mother, father, and child. Anyone denying this fact is in denial of the truth. Some argue that the life of the child has not begun because it has not yet been born, thus abortion does not terminate a life. This is another example of denial and a twisting of the truth. The embryo or fetus is a living thing. Its heart is pumping blood through its body from the time it's four weeks old. It has started growing into an adult human the moment the egg is fertilized. It cannot survive without the nutrients supplied by the mother. But it is alive and abortion does terminate this life.

When considering the effects of abortion, you must obviously also consider the effects it will have on you. Many women suffer from depression, feelings of anger and/or guilt while others feel relieved, depending on their beliefs or their reason for having an abortion. Depending on special conditions you may have, carrying a baby to term could put your health or that of your baby at risk. We strongly urge you to educate yourself on this issue, and look deep into your heart, in order to make the best decisions for both you, the father and for the future of the living embryo or fetus within the womb. Be completely honest with yourself and how you will feel, or cope with either decision. Decide for yourself what is morally right and wrong. Don't let others do that for you. If you don't address it now, your mind will probably force you to face it again and again, after the decision has been made. To help you face the naked truth of this dilemma, contemplate the following: Imagine a loved one standing in front of you. Think of all the things they've experienced, and all the ways they've contributed to your life. Now imagine them vanishing out of existence. If you think that a woman's right to choose to have an abortion is more important than the life of that person, and all the people you know who were put up for adoption instead of the alternative, than you are "pro-choice". If not, than you are in some respect pro-life. Either way you now understand the magnitude of this issue. You understand how important it is to avoid putting yourself in a position that requires you to make this awful decision. Use birth control each and every time you have sex. If you don't have birth control and you're not married and planning to have children, don't have sex. Wait until you can swing by the nearest pharmacy and buy birth control.

Laws concerning parental consent and the importance of having an abortion as soon as possible

If you decide to have an abortion, you must do it as soon as possible. The earlier an abortion is performed the safer it is. The following 31 states currently enforce parental consent or notification laws for minors seeking an abortion:

  • Alabama
  • Arizona
  • Delaware
  • Georgia
  • Iowa
  • Idaho
  • Indiana
  • Kansas
  • Kentucky
  • Louisiana
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Missouri
  • Mississippi
  • North Carolina
  • North Dakota
  • Nebraska
  • Ohio
  • Pennsylvania
  • Rhode island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Virginia
  • West Virginia
  • Wisconsin
  • Wyoming

The Supreme Court ruled that minors must have the alternative of seeking a court order authorizing the procedure. However, the more time you waist in court, the more risky the abortion becomes and the more developed the embryo will be, so if you need consent, we recommend talking to your parent immediately. Although your parents might not support your actions that led to the pregnancy, the great majority of parents support their child's decision to have an abortion. You also may need their help and emotional support after the abortion.

Methods of Abortion

Within 7 weeks of your last period
RU-486, The Abortion Pill

(Not to be confused with the morning after pill which prevents implantation of the fertilized egg)
A series of two pills taken to induce an abortion. The abortion pill must be taken within 7 weeks (49 days) of having sex.

The first pill contains Mifepristone, a hormone that prevents the high production of sexual hormones required for the pregnancy to persist. As a result the uterine lining is shed, dislodging the embryo within it.

The second pill must be taken two days after the first. This pill contains Misoprostol, a drug that induces contractions of the uterus, thus expelling the embryo in 95% of cases. Understand that the flow resulting from this medication, is usually more than that resulting from a regular period. Pregnancy causes the uterine lining to swell. Thus there is more tissue to shed. The embryo within the flow is unrecognizable.

The patient is required to make 3 visits to the doctor. During the first visit, an ultrasound is used to determine if the pregnancy is within the required 7 week period, and to make sure the pregnancy is not ectopic (located in the fallopian tubes). During the second visit, the patient takes the second pill to induce contractions. This way medical facilities are available if the patient needs assistance. During the third visit an ultrasound is used to make sure the abortion is complete.

Side effects of the drugs include excessive bleeding in 2% of users, very sharp stabbing pains, nausea and diarrhea. Nausea passes soon after expulsion. People with bleeding disorders and people who smoke more than 10 cigarettes a day should not use the pill.

Surgical Abortions

Before week 12 of pregnancy
Vacuum aspiration

This procedure has to occur during the first trimester.

It is the most common method of surgical abortion.

Local anesthetic

The physician carefully dilates the cervix with metal rods called dilators.

The physician inserts a small flexible tube through the cervix.

Contents of the uterus are sucked out.

In some cases the physician may perform curettage to ensure all embryonic and placental tissues are removed. To do this the physician uses a spoon-shaped instrument to scrape away part of the endometrium (uterine lining). Often a hysteroscope is used to monitor the inside of the uterus.

The uterine tissue along with the embryo is then disposed.

The patient remains in the recovery room for one hour. During this time she may experience strong contractions of the uterus as it returns to its original size.

She may also experience temporary fatigue, shakiness and nausea

After an hour, if she has fully recovered, she is released


Methotrexate Injection

This procedure must be done during the first trimester (by week 12) as well. It is 90% effective within 7 weeks of your last period.

Methotrexate is a drug which has been used to treat some cancers, arthritis, psoriasis and to terminate ectopic pregnancies (pregnancies occurring outside the uterus ).

The physician injects methotrexate into the muscle of the patients arm.

The drug stops cells from dividing and multiplying, thus stopping development of the placenta and embryo, and causing a miscarriage.

If a pregnancy continues after injection, the fetus could have severe deformities.

The physician therefore must make sure the abortion is completed.

Mild temporary side effects of methotrexate may include nausea, diarrhea, abdominal cramps, hot flashes and sores inside the mouth.

Less common side effects include vomiting, headache, dizziness, insomnia and vaginal bleeding.

5 to 7 days after the injection, four pills containing misoprostol (one of the same drugs used in the abortion pill) are inserted into the vagina.

Within a few hours, misoprostol causes the uterus to contract, inducing strong cramps and heavy bleeding possibly containing large blood clots, as if you were having a miscarriage. Bleeding and cramps may last for several hours.

Side effects of misoprostol include cramping and bleeding, necessary during the miscarriage. Additional side effects include nausea, vomiting, diarrhea, abdominal pain, dizziness, fever or chills.

If the abortion has not completed within 48 hours, a second set of four misoprostol pills may be inserted into the vagina.

The entire process from injection to the end of the abortion can take anywhere from 6 days to a month. Women who are still pregnant after a month must have a surgical abortion.

The worst side effect of medical abortions such as methotrexate injection or the abortion pill is heavy bleeding. If severe bleeding occurs, emergency dilation of the cervix and curettage (using a spoon-shaped instrument to scrape away part of the uterine lining) may be necessary. In rare cases, the patient may need a blood transfusion.


Abortions between weeks 12 and 22 of pregnancy

Abortions occurring in the second trimester (after 13 weeks of pregnancy) are much more complicated. Fewer doctors are willing to perform the procedure. An overnight stay in a hospital is required. There is a higher risk of complications. There is an increased risk for the mother to have problems with further pregnancies. They are also more expensive and cause the mother more physical and emotional pain. In some areas these types of abortions are only performed when the mother's health is at risk. Some states require the fetus to be no more than 20 to 24 weeks old.


Dilation and evacuation

This is the most common method during the second trimester

Dilation of the cervix

Physician uses a curette (spoon-shaped instrument for scraping uterine walls), forceps for grabbing the fetus and a suction (flexible tube attached to a vacuum) to remove the uterine contents and lining.

Patient stays in the hospital over night.


After 16 weeks of abortion
Induction abortion

Injection of saline or prostaglandin solution into the uterus replacing the amniotic fluid.

The resulting death of the fetus.

The prostaglandin causes the uterus to contract.

There may be a long period of many hours to wait.

Labor and delivery of the dead fetus and placenta.

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