Voluntary Termination of Pregnancy Flashcards
Spontaneous Abortion
Involuntary expulsion of the unborn child before the 24th week
Voluntary Abortion
artificial interruption of pregnancy by medical or surgical means
Medical abortion
the woman gets a pharmacological lotion
What does the pharmacological lotion consist of?
- Mifepristone: stops the growth of the embryo and stimulates its disattachment
- Prostaglandin which consists of hormones that stimulate contractions
which was the first country to authorise medical abortion to be done at home?
The UK, however, the application of Mifepristone was to be done in the hospital to check for any side effects
What are the 3 methods to surgically abort a fetus?
- Suction
- Second trimester abortion
- Third trimester abortion
What is the suction method?
Using a hand/electric pump to withdraw the embryo
up to 15 weeks
What is involved in the second trimester abortion?
Enlarge the access to the uterus, scribe the fetus from the uterus and inspire
15-26 weeks
What is involved in the third trimester abortion?
The fetus is poisoned
When did abortion become legal in Italy? Why?
1978 becuase of the fact that abortion would happen illegally
What happens 1 week after conception?
Blastocyst implantation on the wall of the uterus
What happens 2 weeks after conception?
yolk sac is the first structure to provide nutrition, protection and gas exchange; placenta and amniotic sac are developing.
What happens 5 weeks after conception?
yolk sac can be viewed by ultrasound; yolk sac is replaced by an umbilical cord
What happens 6 weeks after conception?
Embryo viewed by ultrasound, heart beating
What happens 9 weeks after conception?
Growth of structures that ready to develop and differentiate
What happens 20 weeks after conception?
Full placenta development; movement perceived by mother
What happens 20-24 weeks after conception?
Pain manifested by flinching/withdrawing a limb; premature born-child can survive
When can you no longer practice abortion?
After 20-24 weeks of conception
List the methods for non-invasive screening
- Nuchal translucency (NT)
- Bi test
- Non-invasive prenatal test (NIPT)
What is Nuchal translucency (NT)?
anatomical ultrasound- can detect risk of chromosomal disease 75% positives and congenital malformations 90% positives
What is the Bi test?
Recommended in combination with NT
Serological test to identify 2 proteins in the mother’s blood associated with chromosomic alterations: 90% positives
What is the non-invasive prenatal test (NIPT)?
Serological test: mother’s blood to identify fetal cell-free DNA alterations: 99% positives
Sex can also be identified
Why is NIPT attractive in our society?
We can know every abnormality on our baby and we can know the sex 2 weeks in advance
List invasive diagnoses
- Villocentesis
- Amniocentesis
- Cordocentesis
What is villocentesis?
10-13 weeks
1-2% risk
aspiration of chronic villi from the placenta to diagnose genetic diseases
What is amniocentesis?
15-18 weeks
0.5% risk
aspiration of amniotic to identify genetic and chromosomic diseases
What is cordocentesis?
18-20 weeks
2% risk
injection/aspiration from umbilical cord blood to diagnose infections, genetic disease or to administer drugs
What is intra-amniotic infusion then labor induction?
Happens in the 3rd trimester; if the fetus cannot survive outside the mother’s womb a solution is injected into the amniotic sac to acheive abortion. THe fetus is delivered by Caesarian cut
What approach to life do Western countries follow?
A more individualistic: invidual> society
Main arguments supporting pro-choice
- Liberal objection: individualistic values
- feminist objection: the protection of the fetus is not more important than the mothers life
- Pragmatic approach of the lesser evil: abortions will still take place even if they are illegal; prevent risks
When was the Roe vs Wade landmark decision?
1973
Describe the trial of Roe vs Wade
- In 1969, Norma McCorvey was pregnant with her thrid child which was a product of rape
- She tried to seek a medical abortion but was denied the procedure because of the International Code of Medical Ethics (WHO 1949)
- McCorvey had to fight for case under the alias of Jane Roe against the conservative laws of Texas
- The opposition was represented by Henry Wade
- In 1973, McCorvey won her battle; 7 judges voted in favour of this woman by claiming that governments lack the power to ban abortions
Describe the state’s involvement in the first trimester
The state should have no interest or right to interfere with an individual choice
Describe the state’s involvement in the second trimester
Abortions may be performed when the act would save the mother’s life or when the fetus is sick
Describe the state’s involvement in the third trimester
Abortions are not allowed as the baby would be able to survive outside the mother’s womb; if the mother’s health is at risk the doctor must perform all possible procedures to save the baby
How were the abortion statutes modified in 1988-1989?
- Women seeking abortions now have to seek informed consent about the procedure
- Should wait 24 hours before proceeding
- Minor girls must eventually obtain parental consent to go through with an abortion
- Married women should notify their husband that she intends to have an abortion
How were the abortion statutes modified in 1992?
The planned parenthood southeastern pennsylvania brought suit against the proposals of 1989. In 1992, the court confirmed all acts to be introduced except for the point of spousal notification
What was the law that legalised abortions in Italy?
L. 194/1978
May 22 1978
When was the NHS introduced?
In 1978
When was the abortion pill introduced in Italy?
2009
The main points of abortion in Italy
- The embryo or fetus can be aborted for any reason within 90 days [voluntary abortion]
- The fetus can be aborted for medical reasons for almost another 90 days
- The mother;s safety prevails for the entire pregnancy
What is conscentious objection?
Entails the right of medical staff including nurses to refuse to take part in abortions based on their personal belief
What is the problematic aspect of conscentious objection?
Non-objecting doctors who do not want abortions to take up their whole profession
Change of Abortion Laws in the United States
The supreme court rules against the right to abortion, meaning that the single states had to decide for their own and repeat the votes individually
When was the change of Abortion Laws in the United States?
June 24 2022
Who was involved in the change of Abortion Laws in the United States?
Thomas.E Dobbs fought against the Jackson Women’s health organisation to reintroduce the ban of abortions after the 15th week
