WHAT IS ABORTION?

Abortion is a medical procedure that aims to end a pregnancy with either medicine or surgery. This is done in order to remove the products of conception from the uterus. Products of conception may be tissue that results from the union of sperm and egg. It may either be an embryo (within 8 weeks) or fetus and placenta (after 8 weeks).

Safe abortions are carried out by professionals who have been trained with the necessary skills in accordance with guidelines and methods that have been set in place by the World health organization. Safe abortions are usually carried out in the first trimester or the early second trimester (The first trimester of pregnancy lasts from 0 to week 12 of pregnancy, while the second trimester is from week 13 to week 28). These pregnancy durations have been considered to be the appropriate time for abortion and such abortions can be performed using tablets or a simple outpatient surgical procedure.

Abortion is considered to be unsafe when it is performed by an untrained professional, or in an environment that does not meet up with the standards of medical safety precautions, or both. The people, skills, and medical standards considered safe in the provision of induced abortions are different for medical abortion (which is performed with drugs alone). And also, surgical abortion (which is performed with a manual or electric aspirator). People, skills, and medical standards are all pre-requisites for safe abortion. Expertise may however differ based on the duration of the pregnancy that is to be aborted and the method that is to be used. The percentage of unsafe abortions is higher in places where effective contraception and safe abortion are not readily available.

BARRIERS TO SAFE ABORTION

Women of all ages often resort to unsafe abortion when safe abortion becomes inaccessible. Other barriers include:

  • Poverty and high cost of safe abortion
  • Stigmatization of women who do abortion
  • Non-availability of abortion services or centres and delayed rendering of services
  • Laws restricting medical professionals from carrying out abortion in some countries
  • Religious and conscientious objection of some medical professionals in carrying out abortion

TYPES

In terms of procedure or method, there are basically two types of safe abortion. These are medical and surgical abortion. One other type which is rare, is labor induction.

Medical abortion

This type of abortion involves taking abortion pills. A certified medical professional provides instruction about the dosage and timing of the drug(s). After taking the abortion pills, the woman may feel some cramping and bleeding as the uterus empties itself. Severity of the cramping may differ from woman to woman. Medical abortion can be done in first trimester and does not involve any form of surgery. However, it is not recommended in second trimester pregnancy and it may come with bleeding or spotting that lasts several weeks.

Common side effects of abortion pills include nausea, fatigue, diarrhea, dizziness, fever, vaginal bleeding

Surgical Abortion

This type of abortion can either be in form of vacuum aspiration or dilation and evacuation.

Vacuum aspiration

is a type of surgical abortion where a doctor inserts a speculum into a woman’s vagina and then numbs the entire area. Afterwards, s/he opens the cervix with the aid of thin rods called dilators and inserts a tube into the uterus to suction it. The suctioning device can either be manually or mechanically operated. This method of abortion can only be used within the first 12 weeks of pregnancy and it takes less than 15 minutes. It does not require general anesthesia but antibiotics are usually prescribed to prevent infection, although the risk for infection is low if done under strict sterile conditions.

Also, some women experience cramping for a few days following the procedure, and irregular bleeding or spotting can occur for several weeks.

Dilation and evacuation

This type of surgical abortion is commonly used by doctors during the second trimester of pregnancy. The doctor gives a general anesthetic before performing the procedure to ensure that the woman doesn’t feel any pain throughout the procedure. A speculum is inserted into the woman’s vagina and the cervix is dilated with the use of dilators. Then, pregnancy tissues are removed with forceps and any remaining tissue is suctioned out. With this method of abortion, there is an increased risk of infection, heavy bleeding, and injury to the uterus.

Labor Induction Abortion

Labor induction abortion is a rare method of abortion and is used to terminate pregnancies in late second or third trimester. It is usually recommended when a woman’s life is in danger. It involves using medications to initiate labor. The medications can either be taken by mouth or be placed into the vagina or injected into the uterus. Common side-effects of these drugs include diarrhea, fever, nausea and so on.

These drugs cause the uterus to empty its contents over a period of 12–24 hours. After the procedure is complete, a woman typically remains in the hospital for 1–2 days. The length of hospitalization is determined by the doctor.

Labor induction is rarely complicated but complications may include infection, uterine rupture, injury to the cervical, hemorrhage and incomplete removal of pregnancy tissues.

DANGERS OF UNSAFE ABORTION

Following unsafe abortion which has been defined above, complications of unsafe abortion may affect the quality of life and well-being of women. As such, there may be need for emergency medical care.

Complications may include one or more of the followings:

  • Incomplete abortion: a situation where not all the pregnancy tissues were removed.
  • Heavy bleeding, also known as hemorrhage
  • Severe infection
  • Perforation of the uterus
  • Damage to the genito-urinary organs

PREVENTION AND CONTROL

Unsafe abortion can be prevented by one or many of the following means:

  1. Assessment and provision of comprehensive sexuality education
  2. Health education on the use of effective contraception for the prevention of unintended pregnancy
  3. Introduction of legal abortion
  4. Provision of emergency management of complications

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