Why Abortion?

Women have abortions for many reasons. Every woman that is seen has her own unique combination of reasons for having an abortion. There are over 200 million abortions that take place in the world today. It is estimated that over 70,000 women die of an unsafe abortion each year. This means that 1 woman a minute dies of an abortion which represents approximately 13% of maternal deaths. The crux of the problem is the number of unintended or unwanted pregnancies that occur because of lack of access to family planning facilities and education about birth control and prevention of sexually transmitted diseases. Over 50% of pregnancies that occur in the world today are unintended or unwanted. The majority of women believe that they are not able to get pregnant the first time that they have sex or if they are age 40 or greater, they are too old to get pregnant. There are many women who fear using any form of birth control because of the side effects. This leaves only the use of natural planning methods or no method of birth control used for many women. Most women have only heard of Emergency Contraception (morning after pill, day after pill, post coital contraception, day after contraception, plan b) which can reduce the incidence of pregnancy by 89% if used within 72 hours of unprotected intercourse. Until women gain the education and knowledge, and have access to family planning facilities to be on long term contraceptive methods and birth control, and learn to prevent themselves from being exposed to unprotected sex which increases the incidence of pregnancy (unwanted) and Sexually Transmitted Diseases, there will be a high rate of abortions that occur.
The most common reasons women seek abortions are the fact that 1) they are not financially able to afford a child at the moment, 2) they wish not to have any more children, 3) they are trying to advance their career and a child would interfere with doing so, 4) they were using birth control and it failed, 5) they were out of their birth control, 6) they were forced to have intercourse, 7) the partner died or left the mother, 8) maternal illness threatened the mother’s health or life if she continued the pregnancy, 9) severe fetal abnormalities that are not compatible with it living, etc.
No woman wants to have an abortion. The decision to have one includes moral, ethical, religious, family, age, and financial considerations. Women must have access to having a legal abortion performed as this is the only way to assure women equality and the opportunity to maintain their independence and control over their bodies.

What is the safest method of abortion for first trimester of pregnancy?

Patients in the first trimester (3 to 9 weeks) have a choice of having the abortion procedure safely performed with either the surgical or abortion pill method. Both are very safe procedures with advantages and disadvantages.

Is having early abortion safe?

An early abortion is performed between 3 and 6 weeks pregnant. There was a time when abortions were not performed before 7 weeks due to lack of sonograms and the fear that there was the possibility of an ectopic pregnancy, or the higher complication rates of uterine perforation, incomplete abortion and cervical tears. With advancements in medical equipment, surgical techniques and new medications, early abortions can be safely performed surgical abortion methods or abortion pill procedure. As long as the pregnancy can be visualized in the uterus by sonogram (ultrasound) it is safe to perform a suction aspiration surgical procedure or non-surgical abortion with minimal complications or side effects.

Are there any complications in pregnancy after abortion?

Patients who become pregnant after having an abortion procedure using cervical ripening agents, advanced new medications and surgical techniques have no problems becoming pregnant, or maintaining their pregnancy. There is no increase in the incidence of infertility, preterm labor, preterm births, ectopic pregnancies, fetal death in utero, or increased incidence of C-section as long as the abortion procedure occurred without complications.

What are the early abortion options to terminate the pregnancy of less than 6 weeks?

Early abortion options available to terminate pregnancies 7 weeks or less are the Abortion Pill which is a prostaglandin that causes uterine contractions 34 to 96 hours after taking the pill and results into bleeding. A sonogram is done 7 to 14 days after the first visit to make sure that the pregnancy tissue has passed. There is a 95 to 99% of success. Bleeding can last from two days to as many as 69 days. It usually only lasts 10 to 14 days. The early surgical procedure can be done under local anesthesia or with IV sedation. The bleeding usually only lasts for 1 or 2 days. There is minimal cramping associated with the procedure which normally lasts only 5 to 10 minutes. Patients are normally able to return to their normal activities the same day and have sex and insert tampons 24 hours after having the surgical procedure.

Is there a lot of bleeding post abortion?

The amount of bleeding that occurs during and after an abortion is always a potential concern as sepsis and hemorrhage are common reasons for maternal morbidity and mortality around the world. The number one reason for maternal death is anesthesia complications.
For patients who are undergoing the medical abortion (abortion pill) procedure, there is less than a .3% chance of requiring a blood transfusion. Heavy bleeding defined as bleeding greater than 2 pads an hour for two hours in a row is rare with medical abortion procedures (less than 1%).

What is a PAP Smear?

It is a simple test to detect the precancerous changes of the cervix before they can turn cancerous. Cervix is the entry or the neck of the uterus and cervical cancer is the commonest cancer affecting Indian women. Unfortunately this cancer is showing a rising trend in our country unlike most of the western countries where they have been able to control the cervical cancer because of effective screening though Pap smears.

Who should get it done?

Every married or sexually active woman should get a Pap smear test done at least once in three years till the age of 65 years to detect the changes in cervical cells which might later on turn cancerous. The test can first be started 2-3 years after marriage or sexual initiation irrespective of the childbirth and pregnancy.