Unintended pregnancy/abortion

Question 1

Definition: unintended mistimed pregnancy

Answer 1

occurring earlier than desired

Question 2

Definition: moderately mistimed

Answer 2

less than 2 years desired

Question 3

Definition: seriously mistimed

Answer 3

more than 2 years earlier than desired

Question 4

Definition: unintended unwanted

Answer 4

occurring when a woman wanted no children or no more children

Question 5

Options (3)

Answer 5

1) carry and keep
2) carry and adopt
3) terminate pregnancy

Question 6

4 general steps to pregnancy options counseling

Answer 6

1. Explore how the woman feels about the pregnancy and her options
2. Help identify support systems and assess risks
3. Provide decision-making support or discuss a timetable for decision making
4. Provide or refer the woman to the desired services

Question 7

4 general approaches to abortion

Answer 7

1. Aspiration (most common)
2. Medication
3. Labor induction
4. Surgery

Question 8

Are abortions safe?

Answer 8

They are more safe than pregnancy when performed correctly

Question 9

What is an aspiration abortion?

Answer 9

o Involves removal of the products of conception (POC)
o Cannula is introduced through the cervical os
 Cervical dilation: usually osmotic (laminaria) (v. mechanical) dilators
o Cannula is attached to a source of suction (either manual or electric vacuum aspirator)

Question 10

You can perform an MVA up until what point of pregnancy?

Answer 10

14 weeks

Question 11

How common are medical abortions?

Answer 11

1/4 of all abortions are medical abortions

Question 12

You can perform a medical abortion up until what point?

Answer 12

recommended before 10 weeks

Question 13

What medication (s) are used in a medical abortion?

Answer 13

-Mifepristone and misoprostol
-Mifepristone alone

Question 14

What is the regimen for mifepristone/misoprostol administration?

Answer 14

-Mifepristone 200 mg given on site
-Misoprostol 800 mcg home administration 24-48 hours after mifepristone

Question 15

Mifepristone MOA

Answer 15

binds to progesterone receptors to block it —> this causes the endometrium to slough and the service to soften

Question 16

When will bleeding occur after administration of misoprostol?

Answer 16

2-4 hours but can take up to 24 hours

Question 17

What is dilation and curretage?

Answer 17

 Practice of curetting the walls of the uterus after suctioning
 Increased rates of complications

Question 18

When is dilation and evacuation performed?

Answer 18

abortions > 14 weeks

Question 19

What is commonly used during dilation and evacuation?

Answer 19

Forceps commonly used with suction to remove POC

Question 20

What age groups/demographics do you mostly see unintended pregnancy?

Answer 20

-Unintended pregnancy: most frequent among women between age 18-24, unmarried, have incomes less than 200% of the federal poverty rate, are members of minority groups, or have not finished high school

Question 21

Trends related to unintended pregnancy:

Answer 21

-Unintended pregnancy is shown to have later entry into prenatal care
-low birth weight
-decreased likelihood of breastfeeding

Question 22

What risks to women with unintended pregnancy face more than other pregnancies?

Answer 22

-Women with unintended pregnancy have higher risk of mental health outcomes and greater risk of physical abuse while pregnant

Question 23

Questions to ask when discussing a positive pregnancy test:

Answer 23

• How do you feel about pregnancy?
• Do you know what your choices are?
• What are your thoughts about becoming a parent? Adoption? Abortion?