Abortion Flashcards
What is an abortion?
It is an elective procedure to end a pregnancy
What is another term for abortion?
Termination of pregnancy
What is the legal framework for abortions?
1967 Abortion Act
What is the 1967 Abortion Act?
It involves two registered medical practitioners supporting the woman’s request under the following circumstances…
- The pregnancy is likely to risk the life of the pregnant woman, greater than if the pregnancy is terminated
-The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman - There is substantial risk that if the child was born it would suffer from physical or mental abnormalities as to be seriously handicapped
Which regions of the UK does the the 1967 Abortion Act cover?
Scotland
England
Wales
What is the legal status of abortions in Northern Ireland?
It is permitted if under 28 weeks gestation and it is completely the women’s choice - not the doctors
How should clinicians manage patients who wish to have an abortion - however they have a conscientious objection?
They don’t need to provide this treatment - instead they refer the patient onto another colleague
However, this does not include provided care who are currently undergoing abortion (post-operative complications - bleeding) or pregnant women who are considering abortion
How do we manage the confidentiality of patients under the age of 16, who have an abortion?
If they have capacity the clinicians will not tell their parents or carers
Are GPs informed if individuals have an abortion?
No, individuals can refer themselves to an abortion clinic
What are the four main arguments for abortion (pro-choice)?
It acknowledges the sexual and reproductive rights of the women
An unwanted pregnancy can harm physical and mental health
A safe abortion saves lives globally
A potential human does not have the same rights as a child
What are the three main arguments against abortion (pro-life)?
It denies the rights of the embryo/foetus
It eliminates potential for life
There is contraception that can be sued as an alternative
When can individuals take a pregnancy test after sexual intercourse?
A pregnancy test may not be accurate until they have missed a period or three weeks after unprotected sex
When should abortion ideally take place?
Before 24 weeks gestation
When can surgical abortion be conducted?
Between 5 to 24 weeks gestation
What do we induce before surgical abortions?
Cervical priming
How do we induce cervical priming before conducting a surgical abortion?
We misoprostol three hours prior to surgery
Why do we induce cervical priming before surgical abortion?
It reduces the risk of perforation and haemorrhage
What surgical procedure is conducted in pregnancies under 14 weeks gestation?
Cervical dilatation and suction of the uterus contents
What surgical procedure is conducted in pregnancies between 14 and 24 weeks gestation?
Cervical dilatation and evacuation using forceps
What are the three advantages of surgical abortion over medical abortion?
There is less risk of retained tissue
There is shorter post-procedure bleeding
They can fit intrauterine contraception immediately
What is the disadvantage of surgical abortion over medical abortion?
There is a risk of uterine perforation and cervical damage
What is the most common complication following surgical abortion?
Infection
What is the follow up treatment provided after surgical abortions?
24 hour access to advice and emergency admission
When do we generally conduct medical abortions?
Earlier in pregnancy
When can we conduct medical abortions?
It can be used at any time from a positive pregnancy test to 23+5 weeks gestation
What are two abortion drugs?
Mifepristone
Misoprostol
What is the class of the mifepristone drug?
Anti-progesterone
What is the function of mifepristone?
It blocks the action of progesterone, halting the pregnancy and relaxing the cervix
What is the class of misoprostol?
Prostaglandin analogue
What is the function of misoprostol?
It initiates uterine contractions and softens the cervix
When is misoprostol taken? Which route is administered via?
One to two days after mifepristone
Vaginal route
At what gestational age is medical abortion safe at home?
< 10 weeks
How long can it take to pass the pregnancy, if it is under 12 weeks gestation?
4 - 6 hours
What are the two common side effects of medical abortion?
Heavy bleeding
GI upset (vomiting, diarrhoea)
What is the follow up treatment provided after medical abortions?
Pregnancy test
24 hour access to advice and emergency admission
How long following abortions may a urine pregnancy test remain positive for?
4 weeks
Do abortions increase the risk of infertility?
No
