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What You Should Know About Abortion

May 21, 2008
An abortion is the removal or expulsion of an embryo or fetus from the uterus, resulting in or caused by its death. The spontaneous expulsion of a fetus or embryo before the 20th week of gestational age is commonly known as a miscarriage.

Induced abortion is the removal or expulsion of an embryo or fetus by medical, surgical, or other means at any point during human pregnancy for therapeutic or elective reasons. The approximate number of induced abortions performed worldwide in 2003 was 42 million.

The history of modern Western abortion laws can be traced back to English common law, which allowed abortion before the "quickening" of the fetus. Currently, abortion law varies from country to country, with regard to religious, moral, and cultural sensibilities.

Throughout recorded history, abortion has been induced by various traditional medicine methods, including botanical abortifacients, the use of sharpened tools, and abdominal pressure.

The moral and legal aspects of abortion are subject to intense social debate in many parts of the world. Aspects of this debate can include the public health impact of unsafe or illegal abortion as well as legal abortion's effect upon crime rates, and the ramifications of sex-selective practices. Other debates include the abortion-breast cancer hypothesis, post-abortion syndrome, and fetal pain. Moral arguments often equate abortion to murder, or denial of abortion to oppression of women.

Most places will only do a medical abortion using methotrexate and misoprostol up to seven weeks from the start of your last period. Where the mifepristone and misoprostol combination is available, it may be used slightly longer, up to nine weeks after your last period.

A medical abortion uses drugs to empty the contents of the uterus. Medical abortions can be done only early in pregnancy. There are two drug combinations used to cause abortions. One, methotrexate and misoprostol. Two, mifepristone (RU 486) and misoprostol.

Only the first combination is currently available in Canada. The second combination mifepristone (RU 486) and misoprostol is not currently approved for sale in Canada.

Methotrexate is a drug used to treat psoriasis, and cancer. It also stops the growth of the pregnancy when given to a woman very early in pregnancy. Methotrexate is usually given by injection.

Misoprostol is a drug used to treat stomach ulcers. It causes the muscles of the uterus to contract, pushing out the contents. Tablets of misoprostol are placed in the vagina five to seven days after the methotrexate injection is given.

In most cases the uterus will be emptied within 24 hours, but in about 35 percent of cases, it can take several days or weeks. Pain medication is used to ease the pain of the cramps, which occur when the pregnancy tissue comes out of the uterus.

The drugs that induce medical abortions cause birth defects. A woman who takes these drugs must be prepared to have a surgical abortion if the medical abortion is unsuccessful. A follow-up exam is done one or two weeks after the methotrexate injection to make sure that the abortion has happened.

Manual Vacuum Aspiration is a simple procedure done early in pregnancy, which uses the suction of a syringe to remove the pregnancy tissue from the uterus. A local anaesthetic is used to numb the cervix and medicines to reduce pain and anxiety may also be offered.

A thin tube is guided through the cervical opening into the uterus. The syringe is attached to the tube and used to remove the contents of the uterus. It takes less than ten minutes.

This procedure is done early in pregnancy in the first seven to eight weeks from the start of your last period. You should have a follow-up exam three weeks later to make sure it was a success.

Furthermore, suction and curettage is a surgical procedure that uses a mechanical suction machine to remove the pregnancy tissue from the uterus. It can be done with a general anesthetic, where you will be asleep, or a local anaesthetic is used to freeze the cervix. The cervical opening is dilated (widened) by inserting and removing a series of narrow, tapered rods, each slightly wider in diameter than the last.

The doctor inserts a hollow tube into the uterus which is attached to an aspirator machine (similar to the one dentists use to clear the mouth of saliva). The suction is turned on and the doctor moves the tube back and forth for a short time. When the uterus is empty, the suction is stopped. The walls of the uterus are then gently felt with a loop-shaped instrument (called a curette) to make sure no tissue remains.

A suction and curettage abortion is done later in the first trimester from 6 to 14 weeks from the start of your last period. Women having suction and curettage abortions should have someone accompany them to the clinic or hospital and help them get home. Normal activities can be resumed in the next day or two. However, it may take up to a week for a full recovery. A follow-up exam is done a week or two later to make sure the procedure is complete.

However, with this procedure abdominal cramping and pain are common; most women recover quickly but cramps may continue for up to a week following the procedure. Menstrual like bleeding is possible for up to two weeks after procedure. Full recovery may take up to a week. Also, serious complications, like infection or damage to the uterus, are possible but rare; the risk of complications increases with more advanced pregnancies
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