Abortion Flashcards
Medical Abortion procedure
- Mifepristone p.o.
- 24-48 hours later Misoprostol vaginal/sublingual/buccal
- Misoprostol can be repeated every 3 hours
Medical abortion at home benefits
- More privacy
- Partner/friend involvement
- Own comforts
- Better pain management e.g. bath
Medical abortion at home risks
- Heavy bleeding
- Incomplete procedure
- GI upset common
Surgical Abortion options
- Manual vacuum aspiration (LA)
- Suction abortion (STOP)
- Dilatation and evacuation: higher gestations
Surgical Abortion benefits
- Less risk of retained tissue
- Short post-op bleeding
- Fit uterine contraception
- LA: shorter recovery
- GA: pain free
Surgical Abortion risks
- Uterine perforation
- Cervical damage
- Anaesthesia risks (GA)
- Pain but over less time (LA)
> 20 weeks
Nowhere in Scotland offers late abortion
Consequences of uncertainty of decision
- Depression
- Guilt
Ensure support network (family, friends, formal counselling)
Decision-making
- GMC: respect patient choice
- Final decision is woman’s
- Change mind right up until abortion
- Abortion in all religions
- Safer than childbirth
- Does not cause infertility
- Do not have to tell GP
Abortion legislation
- Scotland, England, Wales
UK 1967 Abortion Act
5 clauses
a) Risk to life
b) Grave permanent injury
c) <24 weeks and risk of injury to pregnant women (teenage)
d) ^ but to existing children
e) Abnormality risk of child if born
Northern Ireland
- No clauses, woman’s choice
- 2019: abortion was decriminalised up to 28 weeks
Conscientious Objection
- Staff do not have to participate in abortive act
- Obligation to ensure access to care
- Cannot refuse to treat acute medical care related to abortive treatment
Ethical arguments for (pro-choice)
- Women right to autonomy/self-determination
Ethical arguments against (pro-life)
- Woman’s right vs feotus’ right
- Physiologically damaging
- Religious grounds
More legal restrictions on abortions
Leads to increased unsafe abortions
Underage pregnancy: ethical/legal issues
- Consent
- Capacity to consent treatment (Fraser Guidelines, Gillock Competence)
- Exploitation risk?
Underage pregnancy: consultation questions
- Age of partner
- Forced/coercion
- Support network at home and school
Contraceptive options and ethical issues
- Implant, IUD
- Injection, pill, patch, ring
- Condom
Autonomy, beneficence and non-maleficence (e.g. combined therapy and migraines + aura)
