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May 16, 2011
Nursing 330
Human Reproductive Health
IMPORTANT DATES

Mon, May 23, 2011



Guest Speaker, American Cancer Society
Mon, May 30, 2011 – Holiday
Mon, June 6, 2011 – Final Exam




7:00pm – 10pm
Cumulative
100 questions, 2 points each
Study Guide will be posted by Fri, May 27, 2011
Abortion
Abortion

Spontaneous abortion



aka miscarriage
Loss of baby before 20 weeks of pregnancy
Induced abortion


Surgical
Drug-based
Surgical Method

Vacuum Aspiration


First trimester method
Dilation and Extraction (D & X)

Late surgical method
Drug-Based Methods

Mifepristone (RU 486) –Injection, 0rally

An anti-progesterone
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
Approved by FDA in September 2000 for abortion



prevents progesterone from making uterine lining hospitable for
implantation
If fetus is already implanted, causes the uterus to shed its lining
and, along with it, the fertilized fetus
As an alternative to surgical procedure
Effectiveness is increased if used with another drug,
Misoprostol (95-98%)
Most effective within 7 weeks of fertilization
Drug-Based Methods (cont)

Methotrexate –Injection; orally (rarely)

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Prevents cell division and multiplication
Can be used to induce an abortion



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Effectiveness is increased if used with another drug, Misoprostol (95%)
Approved by FDA for treatment of cancer, arthritis and psoriasis
Most effective within 7 weeks of fertilization
Misoprostol – orally or vaginally


Legal Drug used in conjunction with above drugs
The second drug used to complete the abortion procedure



Taken a day or two after administration of the first drug
Causes the uterus to contract and expel its contents
Approved in the US for coating the stomach of people who take
stomach-irritating anti-inflammatory drugs.
Abortifacient


A method or substance that causes a
fertilized egg that has implanted in the
uterine wall or fetus to be expelled.
Which of the drug-based methods is an
abortifacient?
Incidence of Abortions




Nearly half of pregnancies among American women are
unintended, and four in 10 of these are terminated by
abortion.
Twenty-two percent of all pregnancies (excluding
miscarriages) end in abortion.
In 2005, 1.21 million abortions were performed, down from
1.31 million in 2000. From 1973 through 2005, more than
45 million legal abortions occurred.
Each year, about two percent of women aged 15-44 have
an abortion; 47% of them have had at least one previous
abortion.
Source: Perspectives on Sexual
and Reproductive Health
When women have abortions
Source: Guttmacher Institute
Cost

Surgical

In 2005, the cost of a non-hospital abortion
with local anesthesia at 10 weeks’ gestation
ranged from $90 to $1,800; the average
amount paid was $413
(Source: Perspectives on Sexual and Reproductive Health)

Drug-based

most providers do charge more for this method
Abortion and the Law

Roe v. Wade

1973 Supreme Court decision stating



1st trimester abortions cannot be regulated by
states and the decision to abort is between woman
and physician
2nd trimester abortions permitted when mental or
physical health of mother at risk
3rd trimester abortions allowed when life of mother
at risk
California Law

California does not have any of the major
types of abortion restrictions – such as
waiting period, mandated parental
involvement or limitations on publicly funded
abortions – often found in other states.
Source: Alan Guttmacher Institute
The Pro-Life and Pro-Choice
Controversy


Anti-abortion (Pro-life) position
Pro-choice position