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Introduction to Issues in Abortion Rels 300 / Nurs 330 January 2016 Stages of Fetal Development Some pictures taken from this website: http://www.w-cpc.org/index.htm They used pictures from these sources: Nine Month Miracle CD ROM, by A.D.A.M. Software, Inc. the book A Child Is Born by the famous Swedish photographer Lennart Nilsson the handbook When You were Formed in Secret, by Gary Bergel Additional pictures are from this website: http://visembryo.com/ appleby 300/330 2 Human Pregnancy 9 months: 3 trimesters • 1st trimester: • • varies from week 20 to week 26 • earlier than 24 weeks, fetuses have a much smaller chance of healthy survival; • survival rate at 24 weeks is approximately 50% 2nd trimester: • • fertilization to week 13 Fetal viability: weeks 13 to 26 3rd trimester: • weeks 26 to 40 appleby 300/330 3 Fetal Development Make your own record on paper of fetal development Draw a graph, or a time-line, or any other method of keeping track of stages of fetal development How long does a process take? When does it occur? What is the natural % of loss? appleby 300/330 4 Fertilization sperm moves up the vaginal canal, through cervix, and into the fallopian tube; 1% make it this far 1 sperm penetrates zona pellucida; this takes 20 minutes fusion of nuclei of egg & sperm takes another 24 hours appleby 300/330 5 Single-cell zygote begins cell division: 2, 4, 8, etc.; every 20 hours • At 16 cells: zygote becomes a morula Morula leaves fallopian tube, enters uterus Process takes 3-4 days 5 days after intercourse conception is now complete Rate of success = 25% appleby 300/330 6 Implantation process continues: Blastocele cavity forms in centre of morula Traphoblast cells develop an implantation site for the blastocyst Implantation site becomes swollen with new capillaries This process takes place from day 7 to day 12 appleby 300/330 Yellow = the blastocele cavity Blue ring = the traphoblast cells Purple ring = the placenta The small black cluster at 10:00 on the circle is the developing embryo 7 Day 14: implantation is complete Primitive streak appears on the surface of the embryonic disc appleby 300/330 This is the future axis of the embryo By day 15 or 16, viable embryo will continue to develop Now possible to determine if there are multiple embryos 42% of zygotes fail to achieve implantation Of these, 8% spontaneously miscarry or result 8in a stillbirth 4 week embryo appleby 300/330 Embryo produces hormones These function to prevent the woman’s menstrual cycle from shedding the uterine lining and embryo Embryo is the size of a poppy seed 9 5 weeks Embryo is the size of a small peanut appleby 300/330 Internal organs are forming Heart has begun to beat Neural tube splits into 3 sections as brain develops Placenta is functioning Spine and spinal cord are growing Umbilical cord is clear 10 8 weeks Fetal brain waves can be measured • Facial features developing • Eyes have both retina and lens • Major muscles are sufficiently developed to allow movement • Fingers have begun to develop • Fetus has own blood type, with blood cells being produced by its own liver appleby 300/330 11 12 weeks end of 1st trimester All essential external and internal structures are present in early stages appleby 300/330 Head: external ear, retina, eyelids, palate, tongue, teeth buds Abdomen: intestines beginning to move from umbilical cord to body cavity Pelvis: external genitalia not yet present Limbs: arms, legs, fingers & toes all developing 12 20 weeks: genitalia now present + fetus can hear mother’s voice + nearing viability weight = 10 – 11 ounces appleby 300/330 13 24 weeks [viability = 20 to 26 weeks] • Fetus is thin • Little fat development • Auditory and visual systems continue to develop • Reflex movements improving appleby 300/330 Blood vessels forming in lungs Lung surfactants begin production Fingernails & toenails developing Spine is strengthening All internal organs are formed 50% of 24-week fetuses survive outside womb Of these, many have life-long disabilities 14 Full-term fetus: 40 weeks Fetus has continued to grow Fatty tissue has formed under the skin All body parts and organs are more developed and stronger Lungs are not yet fully developed Lungs complete development only after breathing begins appleby 300/330 15 On your timeline of fetal development, place each of these methods of CONTRACEPTION METHOD STAGE OF DEVELOPMENT rhythm method condoms pill depo-provera norplant IUD morning-after pill appleby 300/330 16 http://www.womenshealthmatters.ca/health-resources/sexual-health/birth-control/ On your timeline of fetal development, place each of these methods of Abortion Medical Abortion 7 weeks Manual Vacuum Aspiration 8 weeks Suction Curettage 6 - 14 weeks Dilation and Evacuation 14 - 23 weeks (see http://www.womenshealthmatters.ca/healthcentres/sexual-health/abortion/what-to-expect/) appleby 300/330 17 What does it mean to be a person? When does a fetus become a person? Is a fertilized ovum a person? a zygote prior to implantation? an implanted embryo? Is a fetus which has attained some certain level of development a person? development of nervous system (20 wks)? ability to feel pain? fetal viability (20, 24, 28 ? wks)? at live birth? at some point after birth? Is a stillborn child a person? appleby 300/330 Choose 2 points of fetal development where a person could argue that a fetus becomes a person give reasons to support 2 different points 18 A Third Way by L. Wayne Sumner LIBERAL VIEW CONSERVATIVE VIEW “The liberal view” “The conservative view” of abortion: of abortion: (voluntary) abortion is always morally innocuous the only acceptable abortion policy is one which treats it as minor elective surgery appleby 300/330 (text p.275-6) abortion is always morally serious the only acceptable abortion policy is one which treats abortion as a form of homicide. 19 Sumner proposes a 3rd view: Moral status of the fetus: conservative view = full moral standing from point of conception liberal view = full moral standing from live birth Sumner’s view = a gradual, differential, and developmental view of increasing moral status throughout gestation appleby 300/330 20 What does this mean? early abortion is more like contraception late abortion is more like infanticide permissive abortion policy in early stages of pregnancy/gestation more restrictive abortion policy in later stages of pregnancy/gestation seek agreement on “threshold stage” which divides the 2 appleby 300/330 21 Possible criteria of moral standing criterion of life = too weak (not all living things have moral standing as persons) criterion of rationality = too strong (some beings who are not rational still have moral standing as persons) criterion of sentience (or consciousness) = promising middle path appleby 300/330 22 What is sentience? ability to experience sensations ability to feel pleasure and pain ability to enjoy and suffer capacity for feeling affect (emotional states) sentience = consciousness and rationality “A fetus is…probably sentient by the conventional stage of viability (around the end of the second trimester). (Sumner, p.198) appleby 300/330 23 Sentience as a threshold point Capacity for sentience depends on the required physiological structures for sensing Cerebral cortex – thought, voluntary movement, language, perception, reasoning Cerebellum – movement, balance, posture Brain stem – respiration, circulation, blood pressure Hypothalamus – body temperature, emotions, hunger, thirst, sleep/wake cycles Thalamus – sensory processing, movement Limbic system – emotions, memory Midbrain – vision, eye movement, hearing, movement What is the timeframe for neural development? appleby 300/330 24 When does sentience begin? 1st trimester fetuses do not have the physiological capacity for sentience 3rd trimester fetuses do have the physiological capacity for sentience Physiological capacity for sentience develops during the 2nd trimester of fetal development Full sentience, including consciousness and rationality, does not develop until some time after birth appleby 300/330 25 2nd trimester abortions According to Sumner, 2nd trimester abortions will need to be justified by a competing moral consideration: serious threat to the woman’s life serious threat to the woman’s physical or mental health serious fetal deformity What would you regard as justifiable reasons for a 2nd trimester abortion? In your opinion, should personal inconvenience and choice count as sufficient reasons for abortion appleby 300/330 in the 1st trimester in the 2nd trimester? 26 B.C. woman, Robyn Benson, 22 weeks pregnant, declared brain-dead http://www.cbc.ca/news/canada/british-columbia/robyn-benson-on-life-support-ashusband-awaits-her-c-section-1.2520768 Dylan Benson says his unborn son was just over five months along and growing normally when Robyn complained of a headache and collapsed on Dec. 28. "She was non-responsive. I tried to call her name and stuff but nothing would happen," he said. Rushed to hospital, staff determined that she had suffered a cerebral hemorrhage, and that damage was irreparable. She was declared brain-dead the next day. "On one hand, I can’t wait to meet my son and try, and give him the best life possible and try my hardest to be a great dad for him. On the other hand, I know that the day or the day after he is born will be the day that I have to say goodbye to Robyn." appleby 300/330 27 If you were in this situation, 22 weeks into a pregnancy, and suffered a brain hemorrhage, what would your wishes be? Would you wish to have your life artificially maintained for 12 more weeks to increase the likelihood of a healthy C-section birth? Would you wish to have life-sustaining interventions removed to allow for your own natural death? WHY? appleby 300/330 28 Feb. 8, 2014: 'Baby Iver' born healthy B.C. woman declared brain-dead on Dec. 28 underwent surgery to deliver 'Baby Iver' on Saturday Robyn Benson, the Victoria woman who was declared brain-dead in December, underwent surgery on Saturday to deliver a healthy baby boy before she died the next day. appleby 300/330 http://www.cbc.ca/news/canada/british-columbia/baby-iverborn-healthy-body-of-mother-robyn-benson-dies-1.2531549 29