Abortion Flashcards
What are the 2 different options for abortion?
Medical and surgical abortion
Describe the medical abortion procedure
A woman will take 2 tablets/pills.
What are the 2 drugs taken for a medical abortion?
Mifepristone first and then Misoprostol
Nowhere in Scotland currently offers late abortions above what number of weeks?
20 weeks
What changes were made in 2018 regarding Medical abortion?
A woman has to take the Mifepristone in clinic but could now take the 2nd tablet (misoprostol) home and take it there instead.
This reduces the number of clinic visits required.
Pros of at home medical abortion
Safe if under 10 weeks and some are done under 12 weeks.
Allows for more privacy, involvement of partner/friend, own food/entertainment
Cons of at home medical abortion
Causes painful, heavy bleeding (need another adult to make sure you are okay)– like the worst period you can imagine
Risk that procedure is not complete (need to take pregnancy test after)
GI upset common.
3 types of surgical abortion
Dilatation and evacuation – procedure done for those at higher gestation usually
Suction abortion (STOP) – uses vacuum as part of a machine
Manual vacuum aspiration (MVA) – done under local anaesthetic
Follow up after having an abortion
Medical abortions at home – need to take a follow up pregnancy test in case procedure was incomplete.
With all abortion treatment, if a woman runs into problems, she needs 24 hour access to advice and emergency admission if required.
1967 Abortion Act covers which countries?
Scotland
England
Wales
What are the clauses of the 1967 Abortion Act?
A. Continuing with the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated
B. The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman
C. The pregnancy has NOT exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if it were terminated, of injury to the physical or mental health of the pregnant woman
D. The pregnancy has NOT exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if it were terminated, of injury to the physical or mental health of any existing child(ren) of the family of the pregnant woman
E. There is substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.
According to the 1967 Abortion act, how many doctors must agree that one of the 5 clauses apply to a woman requesting an abortion?
2
In the UK what is the time limit for an abortion?
24 weeks
In the UK, an abortion can be carried out in emergency if…
If it saves the life of the pregnant woman.
If it prevents grave permanent injury to the physical or mental health of the pregnant woman.
What is the ‘conscientious clause’?
Any healthcare professional can refuse to participate in any treatment authorised by the Act if it conflicts with their religious or personal beliefs.
What are the exceptions to the ‘conscientious clause’?
If a woman is undergoing abortion treatment and is admitted due to bleeding a doctor would have to assist her.
A doctor also has to treat a pregnant woman who requires care even if they are considering abortion.
A doctor must ensure that a woman is still able to access care ie they must refer them, give them unbiased information about how to get another doctor/other help.
What is the law on abortion in Northern Ireland as of 2019?
Abortion is legal up to 28 weeks
Ethical questions raised by abortion
Right to life of the foetus
Religious grounds - sanctity of life
Rights of the woman - autonomy, her body/health
Legal restrictions result in more unsafe abortions and maternal death
Fraser Guidelines, Gillick Competence on contraception
Lord Fraser stated that a doctor could proceed to give contraceptive advice and treatment to a girl under 16, “provided he is satisfied on the following matters:
- That the girl (although under the age of 16 years of age) will understand his advice;
- That he cannot persuade her to inform her parents or to allow him to inform the parents that she is seeking contraceptive advice;
- That she is very likely to continue having sexual intercourse with or without contraceptive treatment;
- That unless she receives contraceptive advice or treatment her physical or mental health or both are likely to suffer;
- That her best interests require him to give her contraceptive advice, treatment or both without the parental consent.” (Gillick v West Norfolk, 1985)
Contraception options
Most effective - implant, intrauterine device (IUD) or sterilisation
Injectable, pill, patch, ring, diaphragm
Condoms, pull out, sponge, spermicide, fertility awareness based methods
