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Abortion

Stephanie I. Garcia

Pickens Technical College

Foundations for Healthcare Professionals

HPR 106 Laws & Ethics for Healthcare

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Abortion can be a very emotional situation to talk about and to even actually have to go

through. Just because abortion is not widely discussed, does not mean it is not controversial,

because’ it honestly is, extremely, especially in American politics. There are many people on

both ends of this issue, positive and negative. Frequency of occurrence, legal issues, cultural,

religious status, etc, of the individual varies widely in all different people throughout the world.

I’m pretty sure that everyone should know what an abortion is, but I cannot make that

assumption. “Abortion is the intentional termination of a pregnancy after conception. It allows

women to put an end to their pregnancies, but involves killing the undeveloped embryo or fetus.

(Head, n.d.)“ But according to my knowledge, an abortion doesn’t have to be at all intentional. It

is said that a miscarriage, is also considered an abortion and blunt-force trauma can also cause

termination to a womans pregnancy; this can include the act of violence by anyone, not just the

woman herself, but a spouse also. The procedure SHOULD be done by a licensed healthcare

professional in a professional manner and environment. The abortion can either be medically or

surgically done. It all depends on the woman. When a woman is in her first trimester, a medical

abortion is available for up to about nine weeks of gestation.1 There are about eight different

procedures to make an abort possible. “Methotrexate & Misoprostol (MTX): a medical

abortion procedure used up to the first seven weeks of pregnancy. This medication combination

is not as commonly used in the U.S. with the availability of mifepristone, which works more

effectively for this use. Mifepristone and Misoprostol: a medical abortion procedure used up to

the first seven to nine weeks of pregnancy. It can also be referred to as RU-486, the abortion pill

and Mifeprex. Manual Vacuum Aspiration (MVA): a procedure used as early as 3 -12 weeks

since the last period. It’s considered less invasive with only a local anesthesia being used on the

cervix. Aspiration: a surgical abortion procedure used to terminate pregnancy up to 16 weeks

1 The process of carrying or being carried in the womb between conception and birth.

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from the last period. It can also be referred to as suction curettage2, dilation and curettage (D &

C) or vacuum aspiration. Dilation & Curettage (D & C): a surgical abortion procedure used to

terminate a pregnancy up to 16 weeks gestation. It is also referred to as suction curettage or

vacuum aspiration. Dilation & Evacuation (D & E): a surgical abortion procedure used to

terminate a pregnancy after 16 weeks gestation. Dilation and Extraction: a surgical abortion

procedure used to terminate a pregnancy after 21 weeks of gestation. This procedure is also

known as D & X, Intact D & X, Intrauterine Cranial Decompression and Partial Birth Abortion.

*This procedure is now considered against the law in the U.S. according to the Partial Birth

Abortion Ban Act of 1995* Induction Abortion: a rarely performed surgical procedure where

salt water, urea, or potassium chloride is injected into the amniotic sac3; prostaglandins4 are

inserted into the vagina and pitocin is injected intravenously. (Abortion Procedures, 11/2011).”

The procedure in which will be performed, has to and will determined by the medical

professional by how many weeks the woman is far along. This is many of the reasons why it

should be done by a professional correctly.

“Abortion has been legal in every U.S. state since 1973, when the Supreme Court ruled in

Roe v. Wade(1973) that women have the right to make medical decisions about their own bodies

(Head, n.d.).” Seeming that abortion has been around for many years, there are many, many

negatives and positives to it. Worldwide there are different views about abortion which still are

very much unresolved. Many people oppose to having abortion legal in the United States

because, the first, most discussed is that women who are not ready to conceive a child and know

it should simply use a contraceptive. There are 15 types of contraceptives available, in which all

fall into categories: male and female condoms, diaphragms and caps, contraceptive pill, long-

2 The use of a curette that is used to scrape or scoop the lining of the uterus.3 The thin innermost membranous sac enclosing the developing embryo of a mammal, bird, or reptile.4 Any of a group of cyclic fatty acids with hormone like effects, notably the promotion of uterine contractions.

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active reversible contraceptive methods (LARC), patch and ring, sterilization5, and natural family

planning. Women should research information on each and see which is more suitable for them.

Contraceptives aren’t 100% effective; they aren’t perfect but when used properly, can be very

helpful. Unfortunately, not many can afford any of these so to be 100% sure you won’t conceive

without wanting to, is abstinence. If you are not emotionally and financially ready and do not

want to conceive a child at any moment in your life, then stay abstinent, period. Many people

also argue that abortion is of that killing a human being that it “defies a commandment from

God. The Sixth Commandment of the Bible's Old Testament (Exodus 20:13) is "Thou shall not

kill"(Should Abortion Be Legal?,05/08/2013).”, in which goes into ones personal religious

beliefs. “According to Kanwaljeet J. S. Anand, MBBS, DPhil, Professor of Pediatrics,

Anesthesiology and Neurobiology at the University of Tennessee Health Science Center, "If the

fetus is beyond 20 weeks of gestation, I would assume that there will be pain caused to the fetus.

And I believe it will be severe and excruciating pain." This statement can be seen and can be

grouped with those who say aborting an unborn baby is still killing an unborn human being no

matter under any circumstances. “A 2002 peer-reviewed study published by the Southern

Medical Journal of more than 173,000 American women, found that women who aborted were

154% more likely to commit suicide than women who carried to term. An Apr. 1998 Journal of

Social and Clinical Psychology study of men whose partners had abortions, found that 51.6% of

the men reported regret, 45.2% felt sadness, and 25.8% experienced depression (Should Abortion

Be Legal?, 05/08/2013).” These psychological damages cannot be reversed completely, however

there are medications to help with the sadness and depression, though no medication can reverse

the memories one has of the aborted child, as well as any conflicts one might have gone through

5 Female sterilization is done by cutting, sealing or blocking the fallopian tubes. Male sterilisation is done by cutting and sealing or tying the vas deferens.

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getting to the decision made. Having an induced abortion can really give a woman many

complications on the next conception of a child that is actually to ones intention. Many of the

type of abortions that I mentioned can weaken the uterus and cervix in which can affect the

ability of the embryo to be implanted on the uterus correctly and/or the ability for a woman’s

cervix to support a pregnancy to full-term without complications, to conceive without

miscarriage and/or not conceive prematurely. This risk increases when multiple abortions are

performed on a woman regardless of age, race, and ethnicity, etc. “A June 2003 study published

by the peer-reviewed International Journal of Epidemiology estimated that about 15% of first-

trimester miscarriages are attributed to a prior history of induced abortion (Should Abortion Be

Legal?, 05/08/2013)” and “Women who have had more than one abortion and get pregnant again

later on, may find that they have what's known as an incompetent cervix6. (Abortion and

Infertility, (n.d.)“ Going through this issue because of a decision made early in life can very

much also cause psychological disorders. Having an induced abortion gives the woman more of

a chance to develop breast cancer and this is because when an abortion is performed it causes a

sudden drop in estrogen levels that may make breast cells more susceptible to cancer. But having

the decision to abort an unborn fetus that is inside of a woman’s body is in fact the woman’s

decision on what should be done.

As cons to abortions, there are also pros to keeping abortion legal isn’t bad as people

make it seem. The positive views on abortion in fact being legal are that a woman does have the

right to choose to abort, because that is a ‘fundamental right’ that, as said above, was recognized

by the Supreme Court. It is said that personhood begins until birth, not at conception. Also

having abortion banned is giving the government the right to have pretty much total control of a

womans’ body. This is why many people say that an abortion isn’t all that bad, it’s not murder.

6 a cervix that starts dilating prematurely

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With this said people continue arguing that these unborn fetuses are incapable of feeling any type

of pain. Also a positive effect of keeping abortion legal is that professional performed abortions

reduce injury and deaths caused by unsafe illegal aborts. ““Back-alley" abortions cause 68,000

maternal deaths each year in the 33 countries where abortion is not legal or available, according

to the World Health Organization in Oct. 2006 (Should Abortion Be Legal?, 05/08/2013).”

Having this available gives women a chance to have a safe procedure done by someone who is

qualified to do such a risky procedure. Another positive saying that goes around is that having

the access to safe performed abortions is quite necessary seeming that contraceptives aren’t

always readily ‘available’ at the moment or simply because of finances. “About half of all large

group insurance plans do not cover any form of prescription contraception, and only a third cover

the birth control pill. A July/Aug. 2001 Guttmacher Institute study of health care insurers found

that 75% of insured women lacked coverage for contraceptive services. As of 2009, 17 million

US women were completely uninsured. An abortion can cost anywhere from around $350 to

more than $1,000. In 2009, it was estimated that a total of $831 million is spent on abortions

annually (Should Abortion Be Legal?,05/08/2013).” This shows that many women do indeed

perform abortions, even if they cannot afford. They believe that it will cost less to abort than to

give birth to a child. “A Sep. 2005 survey in the peer-reviewed journal Perspectives on Sexual

and Reproductive Health asked women why they had an abortion, found that 73% of respondents

said they could not afford to have a baby, and 38% said giving birth would interfere with their

education and career goals(Should Abortion Be Legal?,05/08/2013).” This shows that these

women prefer to abort at no matter what cost to continue living their life how they were before

conception occurred. They state that a baby should not come into this world unwanted, and about

49% of all pregnancies that occur among these American women are actually very unintentional.

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And having a baby does not just come with conception, waiting nine months, giving birth and

that’s it, no, the woman’s decision requires many consideration, preparation, and planning on

how she’ll support her child and herself. This introduces the statement that having abortion be

legal will reduce the number of theft crimes by those who cannot afford to support themselves

with this child, as said.

“Proponents, identifying themselves as pro-choice, contend that abortion is a right that

should not be limited by governmental or religious authority, and which outweighs any right

claimed for an embryo or fetus. They argue that pregnant women will resort to unsafe illegal

abortions if there is no legal option. Opponents, identifying themselves as pro-life, assert that

personhood begins at conception, and therefore abortion is the immoral killing of an innocent

human being. They say abortion inflicts suffering on the unborn child, and that it is unfair to

allow abortion when couples who cannot biologically conceive are waiting to adopt. Variations

exist in arguments on both sides of the debate. Some pro-choice proponents believe abortion

should only be used as a last resort, while others advocate unrestricted access to abortion services

under any circumstance. Pro-life positions range from opposing abortion under any circumstance

to accepting it for situations of rape, incest, or when a woman's life is at risk. (Should Abortion

Be Legal?, (05/08/2013).” The side that one is for or against as has much to do in ones beliefs,

and their families can also influence that greatly. But either you’re for it or opposing it, values

still are at stake that a variety of people don’t pay much attention to at the moment of decision

making. Of course it’s ones choice to make the decision, but have you thought about how you

would be affected by the certain decision? Think of someone whose moral judgment you

immensely respect. What would that person do about this? How will your decision affect others?

Have you taken a look at the facts to your decision? Would your decision be taken as unethical

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by others? How would your decision look if it were reported on the news or in another public

place according to your honest reasoning? Would you be proud of your choice if your child were

to find out? Would you want them to make the same choice as you did? Could you honestly

defend your choice, rationally? Will you be able to sleep tonight comfortably? These questions

can give you an estimate image about what values would be at stake according to you and your

loved ones. Privacy issues can also be a value at stake because making a decision can involve

many others’ input, support, trust, etc to help deal with this dilemma.

By what I read and the many arguments, society has no straight forward conclusion on

what they want to do to resolve this controversial dilemma because of the fact that everyone has

many different religious and cultural beliefs, morals, views, etc, on how they feel about

terminating an unwanted pregnancy intentionally. I personally think abortion should be legal but

should in fact have very strict considerations/regulations/laws on whom and why the woman

should actually take action in performing such procedure. So in other words, not everyone and

anyone can abort a child just because the woman herself and her spouse decided not to use a

contraceptive, this is not a rational reason why. The reasoning should be very much rational, not

just because the woman decided to make a ‘stupid decision’ and not protect herself in any of the

many ways. This comes in especially if alcohol was involved, being under the influence will

make you do things you wouldn’t normally do sober, but just because of this does not mean the

situation can consider an abortion. Unless this situation is in fact considered rape but obviously

this would go more into legal issues and into a more complicated situation. An induced abortion

should be a last resort to anything. If you know you aren’t ready, and/or having a child would

interfere with your life goals then simply make smart decisions about having intercourse. If no

contraceptive is available then don’t risk yourself. Having an abortion isn’t anything you can just

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do and tomorrow be fine, it carries a risk of several side effects: abdominal pain and cramping,

nausea, vomiting, and diarrhea. In most professional done abortions, no serious complications

will occur. However, the risk of these complications is about one out of every hundred early

abortions and in about one out of every fifty later abortions (this does not include the abortions

being performed unsafe by a random person). These complications may include: heavy abnormal

bleeding (risking hemorrhage occurring), infection, incomplete abortion (bleeding and serious

infection may occur, RU486 may fail in up to 1 out of every 20 cases), allergic reaction to drugs

(risking convulsions, heart attack, and in extreme cases, death), tearing of the cervix, scarring of

the uterine lining, perforation of the uterus, damage to internal organs, and in some cases death.

These complications may prevent or place at high risk future wanted pregnancies and the risk of

future miscarriage is greater for women who abort their first pregnancy. You see, and with this

said, not many women sit down and actually think about later consequences about actually

having the abortion done, their only worry is that they’re pregnant and aren’t ready. What about

if no form of abortions were available, or furthermore existed? These women would use

preventative methods to their want and need at no matter what cost. For women who demand

that they have complete control of their body, well this control should include preventing

unwanted pregnancy through the responsible use of contraception or through simply abstinence.

Adoption is not an alternative to terminating their pregnancy, because it in fact remains the

womans’ decision to give or not to give their child up for adoption. I think women who are

thinking about terminating an unwanted pregnancy should really think about the obvious fact

that they are very lucky that they can actually fertilize, and the woman herself and her spouse

(homosexual) do not have vaginismus7, or dyspeneunia8 (heterosexual). People who are

7 an involuntary spasm of the muscles of the vaginal wall that interferes with intercourse

8 painful intercourse in a male

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homosexual or who do in fact have these sexual dysfunctions (and other sexual dysfunctions not

mentioned), try really hard to be in your spot of being able to conceive, give birth to, and love a

child with all they have… In which is why I think adoption should always be way before

abortion. Abortion in my opinion should ONLY be available if the womans’ health is at a serious

risk, if pregnancy was a result of a crime, such as rape, incest, or child abuse, and/or also when it

is known and diagnosed that the child has a serious terminal illness, such as Hydranencephaly9.

So yes, I would honestly classify myself as pro-life, but abortion staying legal, BUT with only

the exceptions to the reasons I mentioned above.

9 a condition where the brain cerebral hemispheres are absent and replaced by sacs filled with cerebrospinal fluid, in which the fetus will not

survive.

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References

Head, Tom. (n.d.). What is Abortion? Retrieved from

http://civilliberty.about.com/od/abortion/f/what_abortion.htm

Abortion Procedures, (11/2011). Retrieved from

http://americanpregnancy.org/unplannedpregnancy/abortionprocedures.html

Should Abortion Be Legal?, (05/08/2013). Retrieved from

http://abortion.procon.org/

Abortion and Infertility, (n.d.). Retrieved from

http://www.life.org.nz/abortion/abortionkeyissues/futurefertility/

Any information you might want about how effective contraceptives are and which are available,

visit http://www.nhs.uk/Conditions/contraception-guide/Pages/how-effective-contraception.aspx