Aspects of Abortion


I have decided to place this post up, as yet unfinished, because so many people are finding my blog with regards to searching for abortion. I will keep updating it  – so please come back to see the rest!!

I am not promising to keep this blog free of emotional experiences, and limit it to the facts, I am also not suggesting that you be swayed by what I say but to make your own decisions regarding this highly broad topic. There are no right or wrong answers, just what really happens. Do not be childish and remark on how “wrong” I am.

This is probably going to be a rather long post…

History:
The debate over abortion laws stretches back to 1973, when it was the Supremem Court’s ruling in Roe vs. Wade that changed state  laws against abortion. The court decided it was illegal to put regulations on a first trimester abortion, allowed only regulations relating to a mother’s health in the second, and authorized any control in the third.

Two sides of the debate are: pro-life and pro-choice.

Pro-lifers believe that abortions should only be legal in situations where the mother’s life is in danger, and in cases of rape or incest. Their strongest argument is that by aborting a foetus you’re destroying a sentient human being. Notice, I use the word sentient and not live. Humans have this special quality that separates us from other animals, however all plants and animals are alive. Pro-lifer’s religious beliefs, and their belief that no doctor, congressman or mother have a right to kill an unborn baby. They wonder if they do not fight for the unborn baby’s rights, then who will help the unborn babies?

A poem written by an anonymous pro-lifer goes thus:

Six weeks old today mummy, a birthday gift for me
A pair of big blue eyes through one day I will see
Where are we going mummy, the rain splashing down
Why is it that you frown?
Bang through the doors mummy, people dressed in green
If they hurt you mummy, just run away and scream.
Please help me mummy, they’re tearing me apart
There go my big blue eyes, there goes my little heart.
I love you mummy, believe me I do
But the worst part about this is…
I thought you loved me too.

Pro-choice on the other hand, believe that a woman may make all decisions concerning her body. Yet where is the defining line between her body and a potential child? They argue that if a government cannot trust them with a choice, then how can they trust them with a child? They also believe that if a woman is forced to keep this child, then the child may be beaten, starved, locked away, molested or even raped, borne out of resentment for the unwanted child. They believe that the government should not be charged with making decisions on personal matters and that an individual is the best judge of their situation. People may not always make the best choices, but that is the responsibility placed upon them by a free society.

To me, the choice vs life argument could be easily resolved if one could identify exactly when a human being becomes sentient. What characteristic in the unborn is the dividing line between a symbiote and baby? The answer is autonomy, that is, self-sufficiency – when provided with the requirements that exist in nature, it should be able to survive. Before that it is a symbiote – something that requires  another life to sustain it – a parasite if you will.  Given current medical knowledge, it is generally considered that a foetus less than 20 weeks is unable to exist on its own. An existing life should trump a potential life.

However, if abortion is wrong, then abortion after rape or incest is wrong. Thus there are huge flaws in the pro-lifer’s argument.

The Decision

When we converse with women about their decision to terminate a pregnancy it is like entering a secret world where we start to speak about the unspoken. Their is almost a societal audience (even if it is an imagined one) that places judgement on a woman’s unique story. This audience judges whether the story is sad, traumatic or desperate enough to make an abortion “morally justifiable”. The same audience compels individuals to feel shame about their decision, to avoid openly telling their stories, and therefore, undermining any attempts to actively deal with the events of their life surrounding the decision to terminate. – Elna McIntosh

The decision to abort is not an easy one. Most women that I have seen, abort because of economic difficulties. They are not only teens. They are simply unable to afford a child, and were the child to be given up for adoption who knows what s/he may encounter – including the emotions of complete and utter neglect. These people, who perhaps practiced unsafe sex and were thus completely irresponsible, have taken responsibility now over the life of a potential child. They know what this world is like, and for their various reasons they choose to terminate. Sometimes this decision is done wholly on your own, otherwise with a partner or even the whole family. But, the decision remains YOURS. I hate it when the woman wants to abort and the man (who may perhaps already be in another relationship after this failed one, or perhaps not) goes and says: Please don’t kill our baby. How dare you for making a lady feel even guiltier? When you know you cannot support the child, when you know you are not going to leave the other relationship to return to her, and when you know that she will most probably be raising this child as a single mother anyway. It really grills me. If however, the events are not such, and he still asks, then DISCUSS it again – but know in your mind that ultimately it is her decision. I am so proud of women who go through with such a decision – you think its easy?! Have you been in a situation? Although I have not had an abortion – I can understand to greater lengths about their decisions. I can sympathise and empathise more than anything, understand a little.

Women: You have a decision to make. You have three options: abortion, placing for adoption, and keeping it. Be realistic. Can you afford to keep it? Can you imagine for the rest of your life where “your” child is and if s/he is safe with others? Would you prefer not to bring this child into situations where s/he will know hardship and suffering?

2 Types of Abortions

Once the decision to terminate has been concluded, another decision is to be made.

There are 2 types of abortion procedures, and I will explain both, ending off with a comparison of the two.

Medical Abortion

You are a candidate for a medical abortion if:
– you have a confirmed pregnancy
– the first day of your period was up to 56 days ago
– you are willing to have a surgical (aspiration/vacuum) abortion if teh medical abortion is unsuccessful
– you are willing to return to the clinic for a follow-up in about 2 weeks.

Contra-indications:
– ectopic pregnancy
– adrenal insufficiency
– if you are taking long-term corticosteroids eg for asthma, or blood-thinners, or with a history of a blood disorder (eg porphyria)
– you are allergic to mifepristone or misoprostol
– you have sever uncontrolled asthma
–  you have an IUD
– you have a serious heart problem or high blood pressure
– you cannot return for a follow-up
– you cannot get to an emergency hospital during the procedure, in case of an emergency

A medical abortion is a termination that you can do at the comfort of your own home, in an environment where you feel safe. However should complications arise, it can be more time-wasting to still get to a hospital to be treated, than to simply be at the clinic where you can be treated right away. That is problem 1.
Problem 2: The length of time for the termination to be complete may take to within a few hours to a few days. One woman miscarried after a few hours, another after 4 days. It depends.
Problem 3: An incomplete abortion (Risk 1) may occur. I had a woman who had an incomplete abortion whereby some of the foetus terminated, yet the rest dropped onto her shower floor 2 weeks later. Again,  this may or may not occur. This abortion method, however, is successful 98 – 99% of the time. If it fails, an aspiration (vacuum) abortion may be necessary.
Problem 4: It cannot end an ectopic pregnancy (when the fetus attached to the fallopian tube that leads to the uterus, and not in the uterus) .

The procedure


In the office – you will swallow the abortion pill (Mifeprisone). You will probably not have any effects yet.
At home 48 hours later – you will take the misoprostol pills which will be accompanied by heavy bleeding and cramping for a couple of hours.
Back to the office – in about 2 weeks for a follow-up to ensure that everything is returning to normal.

Painwise: mild-severe cramps (like a period). You will be given medication for pain management.

Bleeding-wise: Usually starts off with heavy bleeding with some clots which may then become lighter bleeding.

Usually you will have a need to go to the bathroom. Then, witting on the toilet, you may feel a whoosh whereby it will all drop into the toilet.

Problem 5: Depending on how far along you are (and you can only take it up to 8 weeks) you may see the fetus – which can be traumatic. You need to know if you are ready for that.

Future children: This type of abortion does not change your chance of falling pregnant or staying pregnant in the future.

Advantages:
– highly successful and predictable
–  seems more natural; like a miscarriage
– you have more control over the process
– it is done at the comfort of your home
– you can choose to be alone or with someone
– No injections, anaesthesia or instruments inserted into your body.

Disadvantages:
– cannot end an ectopic pregnancy
– whole process is longer than with an aspiration abortion
– bleeding can be heavy and longer than with an aspiration abortion
– cramping can be severe and lasts longer than with an aspiration abortion
– 2 visits to the provider are necessary
– the chances of infection and death are higher than with an aspiration abortion.

Bleeding: Usually heavy bleeding especially on day 1 – 3 after taking the SECOND tablets. Then until around day 14 you may have breakthrough bleeding/spotting – normal. You might think you have stopped bleeding where you may suddenly have this whoosh of heavy bleeding which may be accompanied with some clots. This is normal as well and should last for about 1 day.

Note: For 2 weeks afterwards you MUST follow this rule: no toys, no boys and no tampons!!! ONLY use pads. Nothing is to go into your cookie! For the chance of infection (Risk 2) you will be given antibiotics of which you MUST finish the course, and are usually to be taken after meals. Follow these instructions carefully. After around 2 weeks you MUST come for a follow-up. This is NB NB NB! You need to make sure that your body is returning to normal again.

Warning signs of a potential problem: bleeding enough to soak through 2 thick full-size sanitary pads per hour for 2 hours in a row (4 thick pads over 2 hours), fever (that does not go away for several hours), no bleeding within 24 hours after using the second medication at home.

The Medication:

How does it work: The first medicine (mifepristone) weakens the attachment of the pregnancy to the womb whereby it separates from the womb. The second medication 2 days later (2x misoprostol) causes the contraction of the womb and bleeding, thus expelling the pregnancy.

Side effects: bleeding and cramping (shows that the medicines are working), nausea, vomiting, diarrhoea, headache, dizziness, chills, fever.

If you vomit the tablets, you will have to take them again.

Note: You can return back to normal activities (eg work) the day after the abortion.

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One response to this post.

  1. Well done for tackling a very tricky topic.
    I think you are a very compassionate and loving person and that your insights as a nurse will help you to help others to make a choice that is right for them.
    Keep it up!

    Reply

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