Abortion

The uterus can be massaged after the placenta has delivered in order to promote contractions, which will slow the bleeding. The biggest risk of this stage is a retained placenta; this can lead to hemorrhaging or infection if part of the placenta does not leave the uterus. The umbilical cord can be clamped after it stops pulsating, which can take several minutes.

The fourth stage of labor is the beginning of the postpartum period. The uterus contracts and the bleeding slows. The episiotomy is repaired to restore the perineal structure. The woman may have chills or shivering during this stage and there is a risk of postpartum hemorrhaging. Skin-to-skin contact with the infant is recommended at this stage as long as mother and baby are stable.

Sometimes, labor needs to be induced for medical or practical purposes. It involves giving intravenous oxytocin, although other medications are sometimes given to ripen the cervix beforehand. Those who require an emergency delivery or who do not progress in labor will often require a cesarean section. The majority of these surgeries are done with an incision across the lower uterine segment, which allows for later being able to have a vaginal birth after cesarean or what’s called a VBAC.

ABORTION

An abortion is the termination of a pregnancy by removing or allowing for the expulsion of the embryo or fetus before it can survive. A spontaneous abortion is called a miscarriage, while a deliberate abortion is called an induced abortion. When used by itself, the term abortion usually means an induced abortion. A late-term abortion is one in which the pregnancy is terminated after the fetus is technically viable.

Induced abortions can be therapeutic for the health of the fetus or mother, or elective, which is an abortion done for other reasons. Most abortions are done because of an unintended pregnancy. Those abortions on an intended pregnancy are done because of genetic issues in the fetus. The manner by which the abortion is performed depends on the gestational age. Selective reduction involves terminating one or more fetuses in a multiple gestation in order to reduce the total number.

A spontaneous abortion or miscarriage is the expulsion of the fetus before 20 weeks’ gestation. If the fetus dies after that, it is referred to as a stillbirth or intrauterine fetal demise. Less than half of all pregnancies make it past 12 weeks’ gestation. Most that fail will fail before a woman knows she’s pregnant. About 15 to 30 percent of known pregnancies will end in miscarriage, usually before the twelfth week of gestation. Chromosomal abnormalities account for the majority of these terminations.

An induced abortion can happen with the use of drugs, called a medical abortion. Methotrexate and misoprostol, which induces abortions, will both kill and expel the fetus. It can only be done up to 10 weeks’ gestational age. A combination of mifepristone and methotrexate can be used later in the second trimester. Medical abortions are the most effective measure before 7 weeks’ gestation.

A surgical abortion is done after a medical abortion fails or in the second and third trimesters. Up to 15 weeks’ gestation, vacuum aspiration or suction is used to dilate the cervix and suck out the products of conception. This can be done manually or with an electric pump. Curettage can be done in order to scrape out the interior of the uterus. Dilation and evacuation use suction to remove the fetus after 12 to 16 weeks.

An abortion an also be done by inducing labor and then by causing fetal demise if necessary. It can be done in the second or third trimester to expel the fetus naturally. This is rarely done in the US but is done more often in Europe. Rarely, herbal treatments have been used, but this is dangerous. Also dangerous is causing trauma to the uterus in order to kill the fetus.

Abortions can be very safe, except when it is done by unskilled people in situations that are unsanitary. Abortions are about fourteen times safer than childbirth in developed countries. Vacuum aspiration is the safest technique in the first trimester; it can be done as an outpatient. Infections are the greatest cause of death in abortions so antibiotics are often given before an abortion procedure. Research has shown that even illegal abortions can be safe if done by skilled practitioners, which isn’t necessarily guaranteed.

There are no correlations between having an abortion and later having mental health problems, especially when compared to the mental health issues of an unwanted

pregnancy. Some women will regret their abortion in what’s called “post-abortion syndrome”, which is not recognized as being a true psychological disorder by health professionals.

The abortion rate is the number of abortions per 1000 women of childbearing age. This is about 28 out of 1000 worldwide. The abortion percent includes the number of abortions out of 100 known pregnancies, including pregnancies that end in live births or miscarriages. This rate is about 21 percent worldwide. In those countries that restrict abortions, there is an increased risk of unsafe abortions. Access to contraceptives reduces the chances of abortions and abortion complications.

There is a wide variety of reasons why a woman would want an abortion. Some cite domestic violence, finances, the desire to finish education, feeling too young to have a baby, rape, and lack of social support as personal reasons to have an abortion. There might be pressure to have a child of a certain race or gender, population control in society, lack of access to contraceptives, and the stigma of having a child with a disability that play into wanting to have an abortion. Maternal or fetal health can play a role. Exposure to a teratogenic infection or chemical might lead to the decision to have an abortion.