Unintended pregnancy/abortion Flashcards
Definition: unintended mistimed pregnancy
occurring earlier than desired
Definition: moderately mistimed
less than 2 years desired
Definition: seriously mistimed
more than 2 years earlier than desired
Definition: unintended unwanted
occurring when a woman wanted no children or no more children
Options (3)
1) carry and keep
2) carry and adopt
3) terminate pregnancy
4 general steps to pregnancy options counseling
- Explore how the woman feels about the pregnancy and her options
- Help identify support systems and assess risks
- Provide decision-making support or discuss a timetable for decision making
- Provide or refer the woman to the desired services
4 general approaches to abortion
- Aspiration (most common)
- Medication
- Labor induction
- Surgery
Are abortions safe?
They are more safe than pregnancy when performed correctly
What is an aspiration abortion?
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)
You can perform an MVA up until what point of pregnancy?
14 weeks
How common are medical abortions?
1/4 of all abortions are medical abortions
You can perform a medical abortion up until what point?
recommended before 10 weeks
What medication (s) are used in a medical abortion?
-Mifepristone and misoprostol
-Mifepristone alone
What is the regimen for mifepristone/misoprostol administration?
-Mifepristone 200 mg given on site
-Misoprostol 800 mcg home administration 24-48 hours after mifepristone
Mifepristone MOA
binds to progesterone receptors to block it —> this causes the endometrium to slough and the service to soften
When will bleeding occur after administration of misoprostol?
2-4 hours but can take up to 24 hours
What is dilation and curretage?
Practice of curetting the walls of the uterus after suctioning
Increased rates of complications
When is dilation and evacuation performed?
abortions > 14 weeks
What is commonly used during dilation and evacuation?
Forceps commonly used with suction to remove POC
What age groups/demographics do you mostly see unintended pregnancy?
-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
Trends related to unintended pregnancy:
-Unintended pregnancy is shown to have later entry into prenatal care
-low birth weight
-decreased likelihood of breastfeeding
What risks to women with unintended pregnancy face more than other pregnancies?
-Women with unintended pregnancy have higher risk of mental health outcomes and greater risk of physical abuse while pregnant
Questions to ask when discussing a positive pregnancy test:
- How do you feel about pregnancy?
- Do you know what your choices are?
- What are your thoughts about becoming a parent? Adoption? Abortion?
