SEX WITHOUT PROBLEMS

Unplanned Pregnancy - Abortion

What is abortion?

Conception consists of two parts, fertilisation and implantation. Abortion is a medical procedure that terminates pregnancy by removing the implanted fetus before it can survive outside the uterus.

Is abortion legal?

Abortions are generally legal but this can vary from country to country and state to state. Age limits are often placed on when you can have an abortion, so it is wise to check on the local laws before you make any decisions.

Moral issues of abortion

There are moral issues surrounding abortion. Anti-abortion lobbies exist worldwide and they continue to pressure governments and society in general against abortion. Their protests are based on the belief that the fetus is a living person from the moment of conception. These people believe abortion is murder. 'Pro-choice' groups believe that one of a woman's most fundamental rights is to choose whether or not to have children, and when to have them. The fetus is totally dependent on the mother, it is part of her body and they say she should have the right to choose whether to continue with a pregnancy.

Emotional issues

If you intend to go through with an abortion you need to be sure you are happy with your decision. Weigh up how you feel about the pregnancy and how you feel about abortion. The operation is not reversible and if you are not happy you will live with the consequences. Abortion has a number of advantages. If you are over the legal age you can contain the number of people who know you were pregnant and your life can go on. The procedure is relatively quick and safe.

In terms of medical risks, abortion is much less dangerous than giving birth. The main disadvantage of abortion is that some women feel guilty and depressed after the abortion and this feeling can stay with the woman for years. However, most women do not suffer from any long term consequences.

Methods of abortion

There are a number of methods of abortion, which differ according to the stage of pregnancy.

Abortion in the first 14 days after conception

It is difficult to be certain of pregnancy so soon after conception, but if suspected, a menstrual extraction or menstrual regulation can be performed. This is also called interception. The procedure involves the use of a hand syringe and a plastic tube known as a cannula, which removes the contents of the uterus. It is a quick and reasonably safe method, but as pregnancy has often not been established, some women can experience the emotional trauma often associated with abortion unnecessarily.

Up to 14 weeks after conception

Vacuum aspiration is the most common abortion procedure. A thin flexible tube is inserted into the vagina, through the cervix and into the womb. It is attached to a suction machine at the other end which draws out the contents of the uterus. This method can be carried out under local or general anesthetic.

14 to 18 weeks after conception

A dilatation and evacuation or D&E is performed at this stage. A D&E involves the stretching or dilation of the cervix and the removal of the contents of the uterus. The operation is carried out under local and general anesthetic in a two-stage procedure of dilation and operation. An overnight stay in hospital is usually recommended.

18 to 20 weeks after conception

Terminations at this stage are rare, usually being performed for an urgent or psychological reason. The later a termination occurs, the more difficult and potentially dangerous it becomes. When late termination of an abnormal foetus is required, injections of salt solutions or drugs, such as prostaglandin, can be used to cause contractions of the womb to push out the contents. These solutions or drugs cause contractions like a mini-labour and a sedative may be given to ease the discomfort. A stay of 2-3 days in hospital is recommended. This procedure is not recommended for termination of normal foetuses as the experience of going through labour can be traumatic for the woman. D&E is the preferred and safest method for the late termination of pregnancy. Hysterotomy may also be used to terminate a late pregnancy. However, it is a dangerous procedure and should only be used when the pregnancy is life threatening and other options aren't available. This involves cutting through the abdomen and the wall of the uterus to remove the contents. Hysterotomy should not be confused with a hysterectomy, which is the removal of the womb. The procedure leaves a scar and can only be performed at a late stage of pregnancy. The scar does not heal well and may not be strong enough to prevent ruptures of the uterus during further pregnancies, causing serious internal bleeding. A hysterotomy is performed under a general anesthetic with a one-week stay in hospital and 2-3 weeks' further convalescence.

Recovery from abortion

Recovery from an abortion is usually fast. Bleeding and cramping can occur for the first few days after. If the bleeding is very heavy or the cramps severe, a doctor should be consulted. Also watch for other danger signs which include fever and chills, foul vaginal discharge and muscle aches and pains.

Other advice

The first menstrual bleed should occur 4-6 weeks after the abortion. Only sanitary napkins should be used — not a tampon — for the first two weeks after an abortion as the risk of infection may increase if anything is inserted into the vagina. Intercourse, swimming and strenuous exercise should be avoided for at least two weeks. It is important to have a checkup after two weeks to ensure there are no complications. Some women feel relieved after an abortion, some feel sad or depressed. Both reactions are normal. The hormones associated with pregnancy are still present in the body and any depression experienced is similar to post-natal depression. Whatever emotion is experienced, talk to a friend, mother, doctor or counsellor for advice on how to cope.

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