Abortion: a journey always difficult
Abortion: What do we talk about?
Although the best way to avoid having to request voluntary termination of pregnancy (abortion) is to have a contraceptive (long-term or emergency) effective, an accident can still happen. Thus, about 210,000 abortions are performed each year. Fundamental right of women, abortion is no longer considered a crime, but it is a difficult journey, both physiologically and psychologically.
Conditions for practicing abortion
Since the Act of 4 July 2001, an abortion can be performed legally at the request of the woman up to 12 weeks of pregnancy (not amenorrhea, that is to say there are no rules). In case of uncertainty about the age of pregnancy (irregular cycles or menstrual dates unknown), an ultrasound may be performed.
Two consultations with the doctor are necessary before any abortion, with a reflection period of one week between the two.
The first consultation should take place as soon as possible, it can not only determine the technique used, but also to detect potential health problems (sexually transmitted diseases, including the AIDS virus or hepatitis B). A smear of the cervix can also be done.
For minors, the law of 4 July 2001 relaxed the requirement of parental consent. Even if the consent of a representative of parental authority is desirable, an underage girl can keep a secret and be accompanied by an adult of their choice at its request an abortion.
Between the two consultations with a physician, psychosocial counseling is always offered, but it is no longer required for the major.
At the end of the two medical consultations, a certificate of consultation is established if the center who practiced abortion differs from the place of consultations. If the choice of the method involves the aspiration of the embryo, a pre-anesthetic consultation is necessary before any intervention.
In cases of rape?
The steps to take to perform an abortion are the same. However, if the 12 weeks of pregnancy is over and that the survey shows that this is indeed a rape, we can perform an abortion: we then speak of therapeutic abortion. This implies that the woman makes a complaint. It is in his immediate interest and later.
Two methods for abortion
Abortion can be done in two ways depending on the age of the pregnancy health and personal preferences: the instrumental method (aspiration of uterine contents) method or the drug (which empties the uterus).
In the first case, the aspiration of the uterus is done under local or general anesthesia. This method is applicable regardless of the gestational age (and within legal deadlines), takes place in hospital (public or private authorized) in the day. It requires a preliminary dilatation of the cervix for introducing a suction tube of a diameter adapted to the stage of pregnancy. A drug taken the same day, a few hours or days before surgery, facilitates the opening of the cervix.
The second method can be done in a medical office as City, it requires the administration of two drugs at 2-day intervals. This method can be up to 7 weeks of pregnancy. The first drug, mifepristone (RU-486) is a antihormone of pregnancy opposes embryo implantation and promotes the opening of the cervix. Bleeding can occur after taking this drug first, but that does not mean that the pregnancy is terminated.
Two days later, another drug in the class of prostaglandins (misoprostol more often), taken orally or vaginally, causes uterine contractions and expulsion of its contents, which is manifested by increased bleeding that the normal rules.
Taking the second drug is usually done during a short hospital stay for a few hours, but some centers deliver prostaglandins to take them home, so without hospitalization. Treatment against pain caused by contractions is often suggested that because abortion is evil, we must think about the claim.
Verification of abortion
To ensure the interruption has occurred and that it is complete, an inspection is indispensable in the month following abortion in cases of aspiration, and within 12 days in case of interruption drug.
In all cases, a blood test to check if the blood group is Rhesus negative. In this case, the woman should receive an injection of anti-D to prevent complications in a subsequent pregnancy: immunization against subsequent Rh-positive fetus.
The risks and disadvantages of abortion method chosen
Like any intervention, abortion has drawbacks and some exceptional risks. These vary according to the condition, history, current treatments before surgery.
The main complications are aspiration method uterine perforation during dilatation of the cervix or during aspiration, the tearing of the cervix and bleeding during aspiration. These complications represent less than 1% of cases in specialized medical service. However, clandestine abortions are always conducive to such dangers. Very exceptionally, serious wounds of the internal organs of the abdomen may occur and require the achieving at the same time operating a laparoscopic or an opening in the abdomen.
The aspiration is not perfect, a uterine infection is possible as well as a "missed" incomplete abortion, that is to say that the pregnancy continues.
The main drawbacks of the prior drug are too abundant bleeding that may require aspiration or curettage of the uterus in an emergency, where the importance of vigilant monitoring of his condition by the woman herself. Retention of a portion of the egg or the persistence of pregnancy is seen in less than 5% of cases. In case of total or partial retention of the egg-embryo aspiration may be necessary to evacuate the uterus remaining fragments.
Abortion is not a trivial
In the context of a proper medical management, the risks are very low compared to the tragedies recurring abortions. But whatever the technical maneuvers abortion carries a risk of infertility by more or less pronounced imperfect healing of the uterus, in addition to the risk of serious bleeding, sepsis and even death.
The Board primordial
After an abortion, an emergency consultation is required in case of severe abdominal pain, fever equal to or greater than 38 ° C, increased bleeding as rules, smelly vaginal discharge or discomfort.
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