2. Abortion
This presentation is intended for anyone
after puberty to the start of menopause.
*Roughly ages 12- early 40s*
It is intended to inform students about the
options of abortion, if they should choose to
have one.
3. What is Abortion and elective abortion?
“Abortion is the medical term for any
interruption of a pregnancy before a fetus is
viable (able to survive outside of the uterus
if born at that time)”
“Elective abortion is the planned medical
termination of a pregnancy”
-(Pillitteri, pp. 555, 2010)
4. Pro-Choice
A Pro-Choicer would say that the decision to abort
a pregnancy is to be made only by the woman
herself and that the government has no right to
interfere
Abstinence
Contraception use
Emergency contraception
Abortion
Childbirth
5. Pro-Life
A Pro-Lifer would say that from the
moment of conception, the embryo
or fetus is alive and that the
government has a moral obligation
to preserve it, and that abortion is
equivalent to murder
Prohibits:
Abortion
Assisted suicide
Death penalty
6. Roe vs.Wade
Roe vs. Wade occurred in 1973 in the Supreme
Court
Norma McCorvey’s alias was Jane Roe
Henry B. Wade was the district attorney of
Dallas, TX
Norma argued that the Texas Abortion Law
violated her constitutional rights and rights of
other women
Roe v. Wade legalized abortion in the United
States, which was not legal in many
states and was limited by law in others.
The Roe v. Wade decision held
that a woman, with her doctor, could
choose abortion in earlier months of pregnancy
without legal restriction, and with restrictions
in later months.
7. Facts about abortion
19% of teens who have had sexual intercourse become
pregnant each year. 78% of these pregnancies are
unplanned. 6 in 10 teen pregnancies occur among 18-19
year olds.
Each year, 2 out of every 100 women of childbearing
age have an abortion. 47% have had at least one previous
abortion, and 55% have had a previous birth.
An estimated 43% of women will have at least one abortion
by the time they are 45 years old.
Worldwide, the lifetime average is about 1 abortion per
woman.
8. How old are women having abortions?
0.50%
16.40%
32.60%
23.40%
14.50%
8.70%
3.20%
>15 15-19 20-24 25-29 30-34 35-39 40+
Age
9. What is the Race/Ethnicity of the Women
having Abortions?
34%
37%
22%
7%
Race
White
Black
Hispanic
Other
10. How Many Abortions are Performed at each
Stage of Pregnancy?
61.30%
17.80%
9.60%
6.70%
3.50%
1.10%
<9 weeks 9-10 weeks 11-12 weeks 13-15 weeks 16-20 weeks 21+ weeks
Gestational Age
11. Why do Women have abortions?
98% of all abortions are related to
issues of “personal choice”
Not feeling emotionally capable: 32%
Financially incapable of raising a child: 25%
Concern about the drastic change: 16%
12. What percentage of all abortions are because
of “hard cases”?
Rape: 0.3%
Incest: 0.03%
Protection of the mother’s life:
0.2%
14. First Trimester Abortions
Generally, first trimester abortions are very safe.
Steps:
1) Counseling
Options counseling: for those who are undecided about their
decision.
Abortion-specific: Tells about the different options.
2) Informed consent: must be obtained to move forward.
3) Obtain a medical and surgical history: to determine high-
risk patients
4) Lab work: to ensure the pregnancy, make sure there is no
infection present.
5) Clinical exam or ultrasound: estimate gestational age
6) Pain control: to control pain during the procedure
15. Mifepristone
What does mifepristone do?
Given orally or vaginally
Blocks the effects of progesterone
Uterine lining thins and the pregnancy detaches
Cervix softens and dilates
Increased production of prostaglandins which makes the uterine
contract
On the first visit, the woman is given pills (mifepristone) that
cause the death of the embryo. Two days later, if the abortion
has not occurred, she is given a second drug (misoprostol)
which causes cramping that expels the embryo. The last visit
is to determine if the procedure has been completed.
Misoprostol is either orally or inserted vaginally and is given a
few days after mifepristone and increases it’s effectiveness by
95-98%
16. Advantages of Mifepristone
Avoids surgical instruments
No anesthesia required
High success rate (95-98%)
Resembles a “natural miscarriage”
More privacy for the women
Both drugs administered orally
Early in pregnancy
Procedure completion within 24 hours of
misoprostol administration in 90% of women
Approved for the FDA for early abortion
17. Disadvantages of Mifepristone
Requires at least 2 visits
Effectiveness decreases with use after 7 weeks in
regimens using oral misoprostol. Efficacy remains
high up to 9 weeks with vaginal misoprostol.
Takes days or, rarely, weeks to complete.
Post-procedure bleeding may last longer than with
surgical abortion.
Women may see blood clots and pregnancy tissue.
18. Vacuum Aspiration
Cervix is opened with tapered rods
A cannula (straw-like tube) is attached
to a suction apparatus and is inserted
through the cervix into the uterus
Contents are emptied by suction
99% effective!
19.
20. Advantages of Vacuum Aspiration
Typically one requires 1 visit to the
provider
Completed within minutes
Allows for sedation
High success rate
Early pregnancy
21. Disadvantages of Vacuum Aspiration
Involves a surgical procedure
Less private
Although risks do exist, they are very low.
• Hemorrhage (<1%)
• Infection (<2%)
• Missed abortion (<1/2 of 1%)
• Retained tissue (<1%)
• Perforation/cervical tear (<1%)
22. Dilation and curettage (D&C)
In this procedure, the abortionist uses a loop
shaped knife to cut the baby into pieces and scrape
the uterine wall. The baby's body parts are then
removed and checked to make sure that no pieces
were left in the mother's womb.
Done when you are less than 13 weeks pregnant
Uterine is scrapped clean with a curette
Women remain in clinic 1-4 hours after procedure
Potential risk for uterine perforation
23. Why do people get abortions after the first
trimester?
Some of the main reasons for later abortions include:
o Fetal anomalies discovered by genetic testing or ultrasound that are
performed after 15 weeks
o Maternal medical problems that would worsen with full term
pregnancy, such as heart disease
o Late detection of pregnancy
o Difficulty getting money to pay for service
o Exposure to intimate partner violence.
o Lack of financial and/or emotional support from partner.
o Psychological denial of pregnancy, as may occur in cases of rape or
incest
25. Dilation and evacuation (D&E)
Preformed from 12 to 16 weeks pregnant
Typically performed over a two-day period but doesn't require an
overnight stay in the hospital
Inpatient or ambulatory procedure
Dilation is done with either Misoprostol or laminaria tent (seaweed that
is dried and sterilized and placed into the vagina)
Suction the uterine contents or the abortionist will use forceps to grab
parts of the baby (arms and legs) and then tears the baby apart. The
baby's head must be crushed in order to remove it because the skull
bone has hardened by this stage in the baby's growth.
Takes about 15 minutes
Remain flat after the procedure to prevent hypotension (low blood
pressure)
Remain in the hospital for 4 hours after procedure to monitor vital
signs
26. Prostaglandin or saline induction
16 to 24 weeks
Inpatient or ambulatory basis
Given Prostaglandin F2α injection or
prostaglandin E3 suppository which cause cervical
dilation and uterine cramping which expels the
products of conception.
After, the products of conception should be
examined to determine whether all the fetus,
placenta, and membranes are expelled.
27. Hysterotomy
More than 16 to 18 weeks
Removal of the fetus surgically
Resembles a cesarean section
>1%
29. “Partial Birth Abortion”
During the last 3 months of pregnancy
Fetus had a congenital anomaly that
would be incompatible with life or
severe compromised child
Labor was induced by oxytocin and
cervical ripening
No longer legal in the United States
30. References
Abortion: MedlinePlus. (n.d.). U.S National Library of Medicine. Retrieved September 29, 2015 , from
http://www.nlm.nih.gov/medlineplus/abortion.htm
Abortion - surgical: MedlinePlus Medical Encyclopedia. (n.d.). U.S National Library of Medicine.
Retrieved September 29,2 015, from http://
www.nlm.nih.gov/medlineplus/ency/article/002912.htm
Facts on Induced Abortion in the United States. (n.d.). Facts on Induced Abortion in the United States.
Retrieved September29,2015, from http:// www.guttmacher.org/pubs/fb_induced_abortion.html
Jones RK, Zolna M, Henshaw SK, Finer LB. Abortion in the United States: Incidence and access to
services, 2005. Perspectives on Sexual and Reproductive Health, 2008, 40 (1):6-16.
Lipp, A. (2008). Supporting the significant other in women undergoing abortion. British Journal Of
Nursing (Mark Allen Publishing), 17(19), 1232-1236.
Pillitteri, A. (2010). Maternal & child health nursing: care of the childbearing & childrearing family
(6th ed.). Philadelphia: Wolters Kluwer Health/ Lippincott Williams & Wilkins.
Roehrs, C., Masterson, A., Alles, R., Witt, C., & Rutt, P. (2008). Caring for families coping with perinatal
loss. Journal Of Obstetric, Gynecologic, And Neonatal Nursing: JOGNN / NAACOG, 37(6), 631-639.