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RUNNING HEAD: HOW ABORTION AFFECTS WOMEN’S HEALTH

HOW ABORTION AFFECTS WOMEN’S HEALTH 11

Title of Paper: How abortion affects women’s health

Student Name: Leonel Lubin

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How abortion affects women’s health

Abstract

Abortion is the expulsion of a fetus or embryo before it is fully developed to survive outside the uterus. It can occur in two different ways, which are, loss of the fetus naturally as a spontaneous abortion (miscarriage) or deliberately as an induced abortion (therapeutic abortion). The latter is a surgical or medicinal procedure that terminated a pregnancy. Abortion as a topic is extremely diverse and mostly controversial and not everyone agrees that it is morally right. However, regardless of abortion being a touchy topic, we have to accept that its reality is not going away anytime soon and if anything, it is only going to get broad as years and age advances. Therefore, being able to recognize and not necessarily accept both sides can be highly beneficial in the education of this diverse topic ("Reproduction: Abortion," 2017).

Abortion is a practice that is carried out around the globe and statistics state that about 56 million abortions are performed each year around the world, with 45% being done unsafely. Unsafe abortions are influenced by a number of issues such as cultural and religious beliefs as well as abortion laws which differ in states around the world. Practice of unsafe abortion is performed by unskilled individuals, with hazardous equipment or even in unsanitary facilities increasing the risk of repercussions involved for women undergoing abortions. About 47,000 deaths and 5 million hospital admissions occur every year as a result of unsafe abortion. This unfortunate cases happen despite having modern methods of abortion that involve the use of medication or surgery.

The World Health Organization (WHO) recommends safe and legal abortions be made available to all women as way of reducing the dire consequences be it instant, short term or long term on women that result from most abortion procedures. Diversity in abortion is vital and beneficial to a woman who is contemplating abortion, since by recognizing all aspects of her decision, she can make a sound decision and will be less likely to regret her option in case the repercussions come in heavy.

Introduction

Abortion, whether safely or unsafely performed can endanger a woman’s physical, reproductive and even mental health. In addition, it can lead to serious life threatening complications. On the brighter side, safely done procedures reduce the risk of complicated effects on women after performance of abortion. Women are advised to have their pregnancies terminated in hospitals or licensed clinics. However, in most African countries, abortion is still unauthorized and unsafe. Women, including adolescents having unwanted pregnancies, turn to unsafe abortion when they cannot access safe abortion as most times it is illegal. Historically abortion practices mainly included unsafe means such as, attempts using herbal medicines, using sharp tools and even forceful massages. Some cultures took the procedure to extreme levels by attempting to induce abortion through physical means such as, battery, high intensity exercise as well as tightening the girdle. A few of this ancient methods of abortion and more are still used in the modern world especially in developing nations. The extremes measures taken back then and now are an obvious cause of severe risks and complications of abortion with death being the main and almost immediate consequence ("effects of abortion work," 2019).

Most abortions are done during the first 12weeks of pregnancy (first trimester). In some states where abortion is legal, abortion is allowed until the 24th week (end of second trimester), but others prohibit it after week 20. Third-trimester abortions are not encouraged unless in a necessary situation such as when the mother’s or the baby’s life is in danger. Procedures after the first trimester are referred to as late term abortion, since at this duration the fetus has the potential to survive outside the womb. There are two main types of abortion; medical abortion and surgical abortion. The almost immediate and obvious explanation that women often give for seeking induced abortion is that the pregnancy was either unplanned or unwanted. However, there have not been a full exploration on the other reasons and explanations like the myriad social, economic and health circumstances. Despite all the reasons and justification given on abortion, it goes without saying that women’s health is at stake as a result of abortions. Therefore, how does abortion affect women’s health?

Literature Review

Surgical abortion. This is one of the two main methods of abortion. In this mode there is a mode of pain management in which a woman is advised at the clinic on the types of anesthetic offered. They include, general anesthetic where one is completely unconscious. This mode comes with the danger of chocking if fasting is not properly undertaken beforehand. Nitrous oxide gas (similar gas) that puts one in a state of ‘twilight sleep’ in that you relaxed but sedated and awake. Local anesthetic in which the cervix area is injected with anesthetic to numb it so that you don’t feel anything during the procedure and local anesthetic with intravenous sedation where sedative medication is put into your vein using an intravenous line and local anesthetic injected directly into the cervix. The procedure is then done using ‘suction (vacuum) aspiration and is only done on women in their first trimester. It involves the widening of the cervix opening using rods of increasing size followed by a slim tube inserted into the uterus. The fetus and placenta is then withdrawn with gentle suction. A curette is finally used to check if the uterus is empty. The procedure can take less than 15 minutes.

Dilation and Evacuation (D&E) is the surgical procedure done for pregnancies after week 12. Forceps In this case a pair of forceps is used. The cervix is dilated for several hours or up to a day then conscious sedation or general anesthetic is introduced before the procedure. In both cases there are immediate side effects which include stomach cramps and vaginal bleeding of about 1 to 2 weeks. However, light bleeding can be experienced up to a month after the procedure.

It is correct to say that in most occasions the effects of abortion on the health of a woman are dire. Infection in the womb is one of the major health complications that may occur 24hours after an abortion procedure. In the case that the infection isn’t treated promptly, it could spread to the fallopian tubes and ovaries a condition known as pelvic inflammatory disease (PID), which can increase the risk of infertility or ectopic pregnancy (the egg implants itself outside the womb).Several abortions done on a woman has an increased risk of giving birth prematurely, especially in future pregnancies ("Reproduction: Abortion," 2017).

Asherman’s syndrome is a condition in which a scar tissue grows in the uterus as a result of a surgical abortion. This condition can lead to abnormal, absent or painful menstrual cycles, future miscarriages and also infertility. Cases of puncture of the wall of the uterus have been reported. This happens when a medical instrument cuts through the walls of the uterus during suction abortion procedures and in the worst case scenario, surgical removal of the uterus (hysterectomy) has to be done as repair. Severe hemorrhaging that is unlike some bleeding which is typical after an abortion and can lead to quick death. Other possible side effects on a woman after abortion include, cervical laceration (cut or torn cervix) which leads to incompetent cervix in a subsequent pregnancy, placenta problems like retained placenta, low birth weight in future pregnancies and even injury to the bowel or the bladder. Complications from anesthesia like nausea, vomiting, headaches and respiratory problems may occur. Studies also confirm that breast cancer is a possible effect in the future after an abortion.

Pro-choice researches came to the conclusion that a lot of women have difficulty in coping in life after abortion. This is mainly as a result of the effects that abortion is said to have on a woman’s mental/psychological health. For instance, severe psychological trauma can and does happen. Feelings of guilt may lead to uncertainty on their initial decision to terminate the pregnancy may lead to depression or more serious grief responses. In some cases post-traumatic stress disorder (PTSD) and researchers have previously confirmed that post-abortion syndrome results in PTSD. Symptoms in a victim may include depression, guilt, anger, social and sexual dysfunction and even shame.

Method

The method used in this review is the careful examination of literature reviews on abortion and health effects from published articles from the early 90’s to date. The intention of this review is to be more than an academic discussion, such that a better understanding of the underlying issue in abortion and the health effects associated with it are brought to light. Conclusions in this review are drawn from an extensive study from the references cited so as to further the comprehension of health effects that result from abortion procedures. A study in the article named Abortion Worldwide brings out a comprehensive examination of laws that regulate abortion, how they have evolved over the years, the barriers women face to secure abortions as well as the impacts of unsafe abortion on women’s health. The World Health Organization having played a major role in health matters especially abortion in this case turned out to be a great study that provides detailed and compressive information including estimates from research done in figures ("Abortion," 2017).

Results

Worldwide, 25million unsafe abortions which is 45% of all abortions occur every year. This is according to a study WHO for the period 2010 to 2014, with 97% occurring in developing countries in Asia, Africa and Latin America. In 2008, a report by American Psychological Association (APA) came to the conclusion that, some women experience clinically significant disorders, including depression, anxiety, sadness and grief following the termination of a pregnancy. Medical abortions are the most common followed by surgical abortions. The complications are registered of all abortions were mostly for registered patients past week 12 of pregnancy, with incomplete abortion being the leading complication related to medical abortions. In Sweden, induced abortion is the most common gynecological procedure. In Finland, the rate of complications related to medical abortions were investigated, and of the 24,006 adult participants who underwent medical abortion,, 15.4% were later diagnosed with bleeding, 2% experienced infection, 10.2% experienced an incomplete abortion, and 13% had to proceed with a vacuum curettage (Tietze, 2017).

Abortion related infections are often caused by ascending bacterial infection like chlamydia that moves from the lower genitals and proceeds to the uterus via the cervix and can spread to the fallopian tube causing infertility. WHO recommend the use of an antibiotic called prophylaxis to treat infectious complications resulting from abortions. Antibiotic treatment should be administered in the case that an infection is traced which could be before, during or after an abortion. Bleeding is part of the normal process of abortion. However, heavy bleeding lasting longer than 12 hours is a bleeding complication and medical advice should be sought. Different women have different reasons for contemplating abortion with the main reason being the pregnancy being unplanned for.

Discussion

The aim of this study was to investigate ways in which abortion complicates women’s health around the globe. The main finding that was statistically significant was that most complications result from complications after unsafe as well as medical abortions after the first trimester. Despite the complications associated with abortion decreasing over the years, the battle is far from over especially in developing countries, most of which have not legalized abortion. It is safe to say that, legalizing abortion is a step in the right direction for reduced number of complications related to abortions in the future.

Women interested in procuring an abortion should visit hospitals or licensed clinics and have appointments made for several days before the procedure is done. The necessity of having appointments is so as to discuss the reasons for considering abortion as the way out. One needs to be sure so as to make a sound decision and a counsellor may come in handy. It is also important so as to review the medical options available, their associated risks and complications. An ultrasound during this time is needed so as to know how many weeks pregnant a woman is so as to make the opted method identifiable. The clinical appointments prior to the abortion procedure are also necessary so as to test for possible STIs, blood type and low iron levels (anemia) and finally sign a consent form then have a date set for the procedure (Awoyemi & Novignon, 2018).

The reasons that women give for contemplating abortions are broad and diverse. Pregnancies being unwanted or unplanned for is one of the main reasons. It is not always that family planning methods work and in the case that they do not and one ends up pregnant, it is possible to consider terminating that ‘unwanted pregnancy’. Pregnancy as a result of crime such as rape, incest and even child abuse is a commonly noted reason for the need to terminate a pregnancy. In addition, other causes of abortion are social for instance, poverty. An expectant woman may argue that she does not have the ability to raise the expected child because of financial incapability bearing in mind that raising a child is a great and at times costly responsibility thus the need for an abortion. The inability to cope with a child or another child as well as the argument that one is too young to cope with parenting are more social reasons given for abortion. In some serious cases, some nations have a strict government policy about regulation of population in terms of size as well as given groups within a population and also improving the population status leading to abortions so as to fit by the law requirements.

In the case of unacceptable quality of life like serious handicaps, serious genetic problems and serious mental defects abortion may also be considered.

Limitations

In developing countries, inadequacy of funds to support the health sectors is one of the main issues. In this case especially, tackling abortion complications is an issue as most times there is not only the lack of funds in general, but also inadequacy of proper technology to carry out abortion related procedures. Governments all over the world have played a huge role in the deaths and casualties resulting from abortion. This is because, in the states where the procedure is legalized, the laws that govern it are not strictly followed. In addition, in the states where abortion is not legal, there are no strict polies for those unlicensed practitioners that carry out abortions and this increases the risk of complications that result from abortion ("effects of abortion work," 2019).

Religion has played a huge role in abortion majorly condemning and excommunicating those who go about the practice as well as those who get pregnant at the ‘wrong time’.

Conclusion

It is correct to conclude that women have difficulty coping in life after an abortion. It is normal for a woman to feel a range of emotions after an abortion but according to study of women who’ve had an abortion, the vast majority did not make the right decision. The risk of mental health problems in those who’ve had an abortion is no greater than those who attempted to obtain an abortion but gave birth.

Psychological and physical effects of abortion should be taken into consideration and discussed more openly within educational institutions as well as through the media. This will w=enable women to be more aware of the potential risks they are taking. Overall effects brought about by increase in knowledge for women might decrease the number of abortions as it will lead to informed decision making (Tietze & Lincoln, 2016).

Abortion should be legalized and the laws governing it be strictly looked into such that in the necessary case of an abortion, women can get proper medical attention reducing the risk of complications that result from abortions. Moreover, in the states where abortion is already legal, it is important that the governments in those states provide affordable medical services so that botched procedures cannot be sought with the excuse that they cannot be afforded.

Education on the use of family planning methods is vital and should be made affordable and accessible all over the world as a way to curb unwanted pregnancies that result in abortion. Medication such as antibiotics should come in handy so as to curd deaths or infection related complications.

References

Abortion. (2017). Women Studies Abstracts, 34(4), 56-56. doi:10.1007/s12118-005-1099-9

Awoyemi, B. O., & Novignon, J. (2018). Demand for abortion and post abortion care in Ibadan, Nigeria. Health Economics Review, 4(1). doi:10.1186/s13561-014-0003-9

The effects of abortion work. (2019). Pregnancy and abortion counselling, 165-186. doi:10.4324/9780203360125_chapter_9

Reproduction: Abortion. (2017). Encyclopedia of Women & Islamic Cultures. doi:10.1163/1872-5309_ewic_ewiccom_0187

Tietze, C. (2017). The Public Health Effects of Legal Abortion in the United States. Family Planning Perspectives, 16(1), 26. doi:10.2307/2135120

Tietze, S. L., & Lincoln, R. (2016). The Public Health Effects of Legal Abortion in the United States. Fertility Regulation and the Public Health, 142-145. doi:10.1007/978-1-4612-4702-9_15