Isabella Carter
Abortion is a healthcare intervention that can be safely and effectively managed by a wide range of health workers using medication or a surgical procedure. Medical abortions, which use a combination of drugs to end an early pregnancy, are often carried out when a congenital or inherited disease is detected, or when the pregnancy poses a risk to the mother's health. In some cases, abortion may be the only option to preserve a patient's health or save their life. This is especially true in cases of high-risk pregnancies, where the fetus has a condition that is incompatible with life, or the mother is suffering from a severe pregnancy complication or a medical condition that makes pregnancy dangerous.
| Characteristics | Values |
|---|---|
| Medical reasons for abortion | Severe congenital disorders, severe kidney disease, cancer, lupus, cystic fibrosis, pulmonary hypertension, cardiac disease, mental health, severe preeclampsia, ectopic pregnancy |
| Abortion procedure | Medication abortion, procedural abortion, surgical abortion |
| Abortion safety | Safe and effective up to 10 weeks of gestation, safe beyond 10 weeks of gestation, safe to self-manage in the first 12 weeks of pregnancy |
| Abortion access barriers | High costs, stigma, refusal of health workers, restrictive laws, criminalization of abortion, mandatory waiting periods, biased information, third-party authorization, restrictions on health care providers and facilities |
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What You'll Learn
High-risk pregnancies
A medical abortion uses a combination of drugs to end an early pregnancy. It is a safe procedure that works by stopping the growth of the pregnancy and causing the uterine lining to shed. In the first 12 weeks of pregnancy, a medical abortion can be self-managed outside of a healthcare facility.
> "It's not a decision that anybody takes lightly, especially in the context that I see it, in terms of high-risk pregnancies. Having that option is such an important part of being in control of your health and your life. I just wish people would know that and think about it from the perspective of someone who maybe never thought they would get an abortion."
Dr Limaye also notes that abortion could save the pregnant person's life. Medical reasons for abortion include pulmonary hypertension, ectopic pregnancy, severe preeclampsia, severe kidney disease, and cancer.
Pulmonary hypertension, for example, is when the pressure of the blood vessels connecting the heart and lungs is too high, putting a huge strain on the body. When pregnant, the heart is already working harder to pump blood to nourish a growing fetus. Limaye says:
> "You can go into really bad heart failure and there's a 50 percent rate of mortality — of dying in the pregnancy if you get pregnant with that condition."
In states with restrictive abortion laws, medical providers and their patients are feeling the unease that comes with fewer options. This is especially true in cases of high-risk pregnancies. Doctors may be reluctant to perform abortions in states with abortion bans out of fear of being prosecuted or losing their medical licenses.
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Severe congenital disorders
Abortion is a simple healthcare intervention that can be safely and effectively managed by a wide range of health workers using medication or a surgical procedure. In the first 12 weeks of pregnancy, a medical abortion can be safely self-managed by the pregnant person outside of a healthcare facility. However, abortion remains a highly contentious moral issue, with the debate often framed as a battle between the fetus's right to life and the woman's right to choose or autonomy.
One of the medical situations that constitute abortion is severe congenital disorders. Congenital disorders are also known as congenital abnormalities, congenital malformations, or birth defects. They are defined as structural or functional anomalies that occur during intrauterine life and can be identified prenatally, at birth, or later in infancy. The most common severe congenital disorders include heart defects, neural tube defects, and Down syndrome. Other severe congenital disorders include congenital cataract, metabolic, hematologic, and endocrine disorders.
Congenital disorders may be the result of one or more genetic, infectious, nutritional, or environmental factors. For example, maternal age is a risk factor for abnormal intrauterine fetal development, with advanced maternal age increasing the risk of chromosomal abnormalities, including Down syndrome. Other risk factors include exposure to infection, alcohol, radiation, certain pollutants, maternal nutritional deficiencies (such as iodine or folate deficiency), illness (such as maternal diabetes), and certain drugs.
Prenatal diagnosis, such as amniocentesis and ultrasound, can detect the presence of congenital disorders in the fetus before birth. Disability-selective abortion refers to the abortion of fetuses found to have non-fatal mental or physical defects detected through prenatal testing. For example, in Australia between 1983 and 1998, 98 out of 213 fetuses detected with Turner syndrome were aborted, and 39 out of 189 fetuses with sex chromosome anomalies were aborted.
The decision to abort a fetus with a severe congenital disorder can have severe financial, mental, or professional impacts on the mother. For example, a study found that 76% of surveyed mothers who did not have a child with Down syndrome were employed, compared to 56% of those who did. Additionally, families living below the poverty line with children with disabilities are more likely to experience food insecurity, housing instability, and lack of access to healthcare.
While abortion for severe congenital disorders can be a medically necessary and life-saving procedure, it is essential to consider the impact on the pregnant person's health, well-being, and circumstances.
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Life-threatening situations
Abortion is a simple healthcare intervention that can be safely and effectively managed by a wide range of health workers using medication or a surgical procedure. In the first 12 weeks of pregnancy, a medical abortion can be safely self-managed by the pregnant person outside of a healthcare facility.
Pregnancy can be life-threatening in some instances, and abortion could save the pregnant person's life. Medical reasons for abortion include pulmonary hypertension, ectopic pregnancy, severe preeclampsia, severe kidney disease, and cancer. Pulmonary hypertension, for example, is when the pressure of the blood vessels connecting the heart and lungs is too high, putting a huge strain on the body. When pregnant, the heart is already working harder to pump blood to nourish the fetus, and the combination of the two can lead to heart failure and a 50% mortality rate.
Other life-threatening situations that may require abortion include severe congenital disorders or genetic abnormalities that can affect the child's well-being, such as trisomy 13, trisomy 18, Down syndrome, Turner syndrome, Tay-Sachs disease, DiGeorge syndrome, severe neural tube defects, and heart defects with a poor prognosis.
Additionally, pregnancy can exacerbate underlying or pre-existing conditions such as cardiac or renal disease, severely compromising health or even causing death. In such cases, abortion can be the only medical intervention to preserve a patient's health or life.
It is important to note that laws governing abortion vary by state, and state laws determine whether it is legal to receive a medical abortion. In states with restrictive abortion laws, medical providers and patients face challenges due to limited options, and doctors may be reluctant to perform abortions out of fear of prosecution or losing their medical licenses.
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Mental health concerns
Abortion is a simple healthcare intervention that can be safely and effectively managed by a wide range of health workers using medication or a surgical procedure. In the first 12 weeks of pregnancy, a medical abortion can be safely self-managed by the pregnant person outside of a healthcare facility. However, abortion laws vary by state, and state laws determine whether it is legal for a person to receive a medical abortion in that state.
On the other hand, a well-known survey of women who sought abortions beyond legal gestational age limits (the "Turnaway Study") reported that women who were unable to obtain abortions experienced slightly more anxiety and lower self-esteem one week later. However, these differences diminished over time, and no other mental health differences were identified over the five-year study period. The APA's 1989 review concluded that legal abortion of an unwanted pregnancy "does not pose a psychological hazard for most women." While women who terminate wanted pregnancies or lack support may feel a greater sense of loss, anxiety, and distress, the APA found that most women experience relief and happiness after an abortion.
Restrictive abortion regulations can contribute to distress and stigma, potentially violating the human rights of women and girls. These restrictions can lead to financial burdens and make abortion inaccessible to those with limited resources. The debate surrounding abortion and mental health is ongoing, with antiabortion researchers continuing to try and prove the harmful mental health effects of abortion. However, it is essential to consider the fundamental question of whether women who have abortions experience more adverse reactions than those who carry unwanted pregnancies to term, as confounding factors may influence both the unintended pregnancy and the mental health problem.
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Chronic health conditions
Abortion is a simple healthcare intervention that can be safely and effectively managed by a wide range of health workers using medication or a surgical procedure. In the first 12 weeks of pregnancy, a medical abortion can also be safely self-managed outside of a healthcare facility. This requires access to accurate information, quality medicines, and support from a trained health worker.
There are several chronic health conditions that may constitute a medical abortion. Firstly, pulmonary hypertension, where the pressure in the blood vessels connecting the heart and lungs is too high, putting a strain on the body. When pregnant, the heart works harder to pump blood to nourish the growing fetus, and pulmonary hypertension can lead to a 50% mortality rate during pregnancy.
Secondly, severe preeclampsia, which can be continued up to 34 weeks with very close monitoring, but it poses risks for both the mother and fetus. Pregnancy increases the workload for the kidneys, so people with kidney disease are at a higher risk of pregnancy complications and kidney failure. While mild kidney disease may not be an issue, severe kidney disease may require ending the pregnancy to protect the mother and fetus.
Another condition is cancer. While the health consequences of continuing a pregnancy with cancer may not be immediately obvious, the prognosis could worsen over time. Additionally, some fetuses develop life-threatening abnormalities, such as anencephaly, where babies are born without fully developed brains or skulls and die shortly after birth. In such cases, abortion is medically necessary as it is much safer than delivery.
Lastly, ectopic pregnancy, where the pregnancy occurs outside of the uterus, is a condition that may require a medical abortion. This is because it can be life-threatening for the mother. It is important to note that abortion laws and access vary by state, and some states with strict abortion bans may have vague exceptions for "medical emergencies," leading to uncertainty and delays in care.
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Frequently asked questions
Abortion is a simple healthcare intervention that can be safely and effectively managed by a wide range of health workers using medication or a surgical procedure. Abortion is often considered in the following medical situations:
- Severe congenital disorders or genetic abnormalities that can affect the child's well-being, like trisomy 13, trisomy 18, Down syndrome, Turner syndrome, Tay-Sachs disease, and DiGeorge syndrome.
- Birth defects including severe neural tube defects such as anencephaly (lack of brain or skull development), kidney abnormalities resulting in a lack of amniotic fluid, and heart defects with poor post-birth prognosis.
- Chronic health conditions such as cancer, lupus, cystic fibrosis, pulmonary hypertension, cardiac disease, or kidney disease.
- Mental health concerns.
- Ectopic pregnancy.
- Severe preeclampsia.
- When carrying the pregnancy could be life-threatening.
It's important to note that abortion laws vary by state and country, and access to abortion services may be restricted in certain regions.
A medical abortion, also known as a medication abortion, is a procedure that uses prescription pills to end a pregnancy in its early stages, usually up to 10-12 weeks of gestation. It involves taking two pills, mifepristone and misoprostol, which work together to stop the growth of the pregnancy and cause the uterine lining to shed.
A spontaneous abortion, on the other hand, refers to the natural loss of a pregnancy before the 20th week, often called a miscarriage.
Abortion is considered medically necessary when it is the only intervention that can preserve a patient's health or save their life. This could be due to severe health conditions or risks associated with continuing the pregnancy.
Lack of access to safe abortion care can lead to physical and mental health risks for pregnant individuals. It can also result in financial burdens and restrict individuals' human rights, including the right to privacy, non-discrimination, and equality.
