Abortion

By Siramon Kanchanachittakorn, Pornpairin Tainpotong, Chalit Veerakulwatana, Pattaravit Kumplean, Thanrada Vittayapanyanon

What is Abortion?

‘Abortion’ or the ‘Termination of Pregnancy’ is when pregnancy is ceased by the removal or expulsion of the fetus, placenta (afterbirth), products of conception, or pregnancy tissue from the uterus which doesn’t give birth to a child. In general, the terms fetus and placenta are used after the 8th week of pregnancy. Pregnancy tissue and products of conception refer to tissue produced by the union of sperm and egg before the 8th week. Most importantly, the procedure should legally be done by licensed healthcare professionals.

The decision to abort is very personal. In some countries, it is considered the patients’ autonomy to choose whether to abort or not.

Types of abortion

Medical abortion

Medical abortion is functioned through taking two medicines: mifepristone (Mifeprex) and misoprostol (Cytotec). The two pills work together to end the pregnancy, but will be effective only for the first 10 weeks of pregnancy.

Methotrexate and misoprostol

Methotrexate is an alternative that can be used within the 7th week of pregnancy. It is actually a cancer drug that helps inhibit cells in the embryo from multiplying. Then, the uterus contracts due to misoprostol to release its chemicals. This option takes longer than mifepristone and misoprostol, and is infrequently used for planned abortions. Doctors tend to select this procedure for women who have gravidity outside their uteruses, or ectopic pregnancies, which can be life-threatening if continued.

Vacuum aspiration

Vacuum aspiration, also known as suction aspiration, is done during the first 12 weeks (trimester) or early the 12th to 16th week (second trimester) of pregnancy. The procedure is to utilize a vacuum source to displace an embryo or fetus through the cervix.

Dilation and evacuation

Dilation and evacuation (D&E) is an alternative abortion procedure that is used in the second trimester, usually after the 14th week of pregnancy. It is recommended for patients whose abortion decisions are delayed or the fetuses have severe anomalous or medical issues. This surgical procedure is to place a speculum in the vagina to allow visualization of the cervix. Then, the uterine contents are displaced using a cannula to apply aspiration, followed by forceps. The procedure may be operated under ultrasound guidance.

Induction abortion

Induction abortion is processed in the second trimester of pregnancy. It may be an option if the pregnancy is over 24 weeks, and D&E procedure is not applicable. This procedure is done using medicines to start the labor and the delivery of the fetus.

Late-term abortions

Late-term abortion is often done after the 20th week of pregnancy. The first process is to dilate and soften the cervix. Then, the physician will widen the vagina opening by using speculum to clean and apply a local anesthetic. The physician will then scrape the uterus with a piece of sharp-tip equipment called a curette. Lastly, the fetus and placenta will be extracted by vacuum suction and other surgical equipment.

Societal Aspect of Abortion

Abortion, specifically induced abortion, is currently a controversial issue in our society. Generally, positions on the morality of abortion can be distinctively divided into two; pro-choice and pro-life. The foundation of pro-choice involves supports for reproductive rights or supports for laws that allow people to access the full range of reproductive health care, including safe and legal abortion, especially on unwanted pregnancies. Contrarily, the foundation of pro-life involves wanting abortion to be illegal and not believing that pregnant people should be able to opt for abortion under any circumstances, even if their pregnancies are the results of rape or if carrying the pregnancy to term puts their lives in danger. To promote a better understanding of the controversy, we try to elaborate major perspectives on abortion with ethical arguments and underlying issues rather than political considerations that might also be involved.

Pro-choice aspect on abortion

Reasoning Behind the Positions.

• Fostercare

  • According to Guttmacher Institute, the estimated effect of abortion legalization on adoption rates is sizable, and may account for most of the decline in adoptions. These findings support that abortion legalization leads to a reduction in the number of "unwanted" children; such a reduction may have improved average infant health and children's living conditions.

• Pregnant Person’s and Child’s Physical and Mental Status

  • According to American Psychology Association, women who deny abortions are more likely to initially experience higher levels of anxiety, lower life satisfaction, and lower self-esteem compared to women who abort. Experiencing unwanted pregnancies appears to be strongly associated with poor mental health for women later in life. Moreover, unwanted pregnancy has been associated with deficits in the subsequent child's cognitive, emotional, and social processes. These children are more likely to experience negative long-term outcomes in adulthood, such as an increased likelihood of engaging in criminal behavior, dependency on public assistance, and having an unstable marriage.

  • To a considerable degree, antiabortion activists have charged that abortion causes mental instability and may even lead to suicide. For example, patients may develop "post-abortion traumatic stress syndrome". However, in reality, it is not recognized by either the American Psychological Association (APA) or the American Psychiatric Association. In addition, Nancy Adler, professor of psychology at the University of California, San Francisco, testified that the severe negative impacts of abortion reactions are rare and are in line with those following other normal life stresses. She also stated that if severe reactions were common, there would be an epidemic of women seeking treatment which there is no evidence of such an epidemic.

• Financial Situation of Pregnant Person

  • According to American Psychology Association, access to safe and legal abortion is central to attain social equality for women. Laws restricting access to safe and legal abortion will be particularly harmful to low-income women, women of color, and sexual and gender minorities, as well as those who live in rural or medically underserved areas. Research indicates that women living in poverty, low-income women, and women of color are more likely than others to experience cumulative adversity and are at increased risk for unintended pregnancy. As noted by the Black Women's Health Imperative, “Black women continue to struggle to afford birth control that best meets their needs, the lack of which leads to higher rates of unintended pregnancies. As a result, Black women have significantly higher abortion rates than whites and Hispanics. Moreover, those who are unable to access abortion care are more likely to be thrown into persistent poverty." These bills will further reduce Black women's access to contextually appropriate and effective sexual health information.

• Sexual Assault

  • There are various types of sexual assault. The following is a list of the diverse acts that are considered sexual assault and abuse, as well as a short description of some of the most well-known sorts of attacks.

  • Sexual assault includes:

    • Assault—sex against an individual's will

    • Forcible sodomy—anal or oral sex against a person’s will

    • Forcible object penetration—penetrating someone’s vagina or anus, or causing that person to penetrate her or himself, against that person’s will

    • Marital rape

    • Unwanted sexual touching

    • Sexual contact with minors, whether consensual or not

    • Incest -- sexual intercourse or sexual intrusion between family members

    • Any unwanted or coerced sexual contact

• Reduce risk from unsafe abortions

  • Unsafe abortion can be prevented through:

    • comprehensive sex education

    • prevention of unintended pregnancy through the use of practical contraception, including crisis contraception

    • provision of safe and legal abortion

  • In addition, deaths and disabilities from unsafe abortion can be reduced through the timely provision of emergency treatment of complications

Pro-life Aspects on Abortion

Religions and Abortion

Buddhism

Buddhist’s perspectives

In the past, Buddhists believed that life should not be destroyed, causing the rejection of abortion since they saw life as the concept of the new beginning. Moreover, destroying someone’s life meant it was morally wrong. However, though murder is still unacceptable, modern Buddhists have different notions about life, because they are more informed about the differences between morality and abortion.

Abortion for the sake of mother and baby

Buddhists undergo difficult decision-making when abortion is necessary to save the mother’s life. In such cases, abortion is related to intentions. If they, the parents, consider carefully and decide to abort because of the mother's health, the karma will be reduced due to good intentions. Furthermore, if the baby does not have to suffer adverse medical conditions such as genetic diseases and disabilities, abortion is permissible.

Roman Catholic

Abortion is morally wrong as it bases on natural law and the written word of God. The Church says that human life begins at the moment when an egg and a sperm are fertilized, giving the new life. A document titled Didache stated “You shall not kill the embryo by abortion and shall not cause the newborn to perish,” which shows that The Church has been opposing abortion since the 2nd century when the document was written.

• Pro-life groups

Pro-life groups have been formed against the legalization of abortion which are underpinned by The Roman Catholic Church. Moreover, the church is a major part of the politics of the abortion debate.

• Pro-choice groups

A few Catholics disagree with the Vatican line on abortion. They put forward arguments against enforcing a total abortion ban.

Overall, although the pro-choice group doesn’t think abortion is morally right, they perceive abortion as the least morally wrong choice available.

Islam

Muslims regard abortion as wrong and haram (forbidden), but many accept that it may be permitted in certain cases. For example, it is allowed when pregnancy puts a mother’s life in danger under the condition that the pregnancy has be to be within the first 120 days However, even scholars who permit early abortion still do not regard abortion as entirely acceptable, and, they believe, the more advanced the pregnancy, the greater the sin.

Normal Side Effects

Risks and side effects vary by the type of procedure and how far along patients are.

• Dying – normal draining lasts 14 days, but it can be stretched to 21 days

• Squeezing

• Dazedness

• Sleepiness

• Sickness/Vomiting

These side effects are regularly alleviated within seven days.

Immediate Complications

• Harm to the belly or cervix

• Inordinate dying

• Deficient early termination, requiring an (extra) careful fetus removal technique

• Contamination of the uterus or fallopian tubes

• Scarring within the uterus

• Sepsis or Septic shock

• Uterine hole

• Demise

Possible Future Health Risks

• Future Preterm Deliveries Breast Cancer

• STDs & girdle disease

• Psychological state

- Regret

- PTSD

- Grief

- Sadness/Depression

- Anxiety

- Guilt/Shame

- unsafe thoughts

• Abortion and Sexual dysfunction

• Increased channel xerotes

• small desire

• Loss of sexual climax ability

• Dyspareunia (painful intercourse)

References

“Abortion and Mental Health.” American Psychological Association, American Psychological Association, Jan. 2008, www.apa.org/pi/women/programs/abortion.

Bitler, Marianne, and Madeline Zavodny. “Did Abortion Legalization Reduce the Number of Unwanted Children? Evidence from Adoptions.” Perspectives on Sexual and Reproductive Health, vol. 34, no. 1, 2002, pp. 25–33. JSTOR, www.jstor.org/stable/3030229. Accessed 3 Sept. 2021.

British Pregnancy Advisory Service. “What is abortion?”. BPAS. https://www.bpas.org/abortion-care/considering-abortion/what-is-abortion/. Accessed 2 Sept. 2021.

Cohen, Susan A. “Abortion and Mental Health: Myths and Realities.” Guttmacher Institute, 6 Dec. 2016, www.guttmacher.org/gpr/2006/08/abortion-and-mental-health-myths-and-realities#.

Ernst, H., and Watson, S., ( 2018, December 6 ). “What Are the Different Types of Abortion?”. Healthline. https://www.healthline.com/health/types-of-abortion. Accessed 2 Sept. 2021.

“Ethics - Abortion: Religion and Abortion.” BBC, BBC, www.bbc.co.uk/ethics/abortion/religion/religion.shtml.

Grimaudo, Johanna. “Abortion Risks and Side Effects.” CompassCare, 22 Apr. 2020, www.compasscare.info/health-information/abortion/abortion-risks-and-side-effects/.

Harvard Medical School. ( 2019, January 9 ). “Abortion (Termination Of Pregnancy)”. Harvard Health Publishing. https://www.health.harvard.edu/medical-tests-and-procedures/abortion-termination-of-pregnancy-a-to-z Accessed 2 Sept. 2021.

Miriam. “Can You Explain What pro-Choice Means and pro-Life Means?” Planned Parenthood, 16 Oct. 2019, www.plannedparenthood.org/learn/teens/ask-experts/can-you-explain-what-pro-choice-means-and-pro-life-means-im-supposed-to-do-it-for-a-class-thanks.

Salvador, Z., ( 2017, November 30 ). “Vacuum or aspiration abortion procedure”. inviTRA. https://www.invitra.com/en/fertility-after-pregnancy-loss/vacuum-or-aspiration-abortion-procedure/. Accessed 2 Sept. 2021.

“Types of Sexual Assault.” Women Gender Center, Marshall University, www.marshall.edu/wcenter/sexual-assault/types-of-sexual-assault/.

U.S. National Library of Medicine. ( 2021, April 22 ). “Abortion”. MedlinePlus. https://medlineplus.gov/abortion.html. Accessed 2 Sept. 2021.