Abortion Flashcards
What are the clinical aspects of termination of pregnancy?
1) < 14 weeks
a) Surgical:
- Manual
- Electric vacuum aspiration
b) Medical:
- Mifepristone (antiprogestogenic steroid) + misoprostrol (24-48 hours later) (≈ synthetic PGE)
2) > 14 weeks
a) Surgical:
- Vacuum aspiration
- Dilatation and evacuation (D+E)
b) Medical: Mifepristone + misoprostrol
What are the ethical issues with misoprostrol?
Administered at home ≈ is this ethical? However argued that going to clinic is a barrier + NHS costs + 4-6 hours cramping and bleeding if it happens at hospital ≈ not safe
List the benefits and drawbacks of medical abortion.
+ Avoid surgery
+ Mimics miscarriage
+ Controlled by woman
- Takes time + unpredictable
- May require more clinic visits than surgical abortion
List the benefits and drawbacks of surgical abortion.
+ Quick
+ Complete abortion verified by evaluation
+ Takes place in a healthcare facility
+ Insertion of IUD performed at same time as procedure
- Requires instrumentation of uterus
- Risk of cervical injury and
- Timing of abortion is controlled by facility and provider
What is the history of abortion?
History of Abortion Act 1967 ≈ Lord Steel ≈ created state of law where balance between right of foetus to develop full life and right of woman to have abundant life
Abortion Act 1967 (1990): Person shall not be guilty of an offence if performed by a medical practitioner: social grounds (24 weeks), grave permanent injury, risk to life and foetal abnormality
What are the social grounds of abortion?
Pregnancy not exceeded 24 weeks + continuation of pregnancy involve risk, greater than if pregnancy were terminated, of injury to the physical or mental health of the pregnant woman or any existing children of her family
What are the grave permanent injury grounds for abortion?
Termination ≈ prevent grave permanent injury to physical or mental health of pregnant woman
What are the risk to life grounds?
Continuance of pregnancy ≈ risk life of pregnant woman ≈ greater than if pregnancy were terminated
What is the foetal abnormality grounds for abortion?
Substantial risk if child were born ≈ suffer from physical or mental abnormalities ≈ seriously handicapped
List the four grounds for abortion.
1a) Social grounds
1b) Grave permanent injury
1c) Risk to life
1d) Foetal abnormality
List the key points in law regarding termination of pregnancy.
- Females u16 acquire ToP w/o parental consent ≈ competent + mature
- Doctor conscientiously object to direct participation in ToPs (but not associated tasks and patient care)
- Conscientious objection exists for some of the grounds - Abortion act does not give patients right to demand ToP
List are the key points in law regarding the foetus.
- Foetus has no legal right to life
- Once foetus is alive outside uterus, acquires legal protection of newborn
List the ethical concerns of abortion.
- Qualification of a handicap
- Foeticide (KCl to ensure born dead) - Potential father’s rights (none) - Responsibility of a woman to foetus
- Post-coital contraception ≠ abortion (needs to be fertilisation and implantation)
