Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion ... A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last ...
Bardin, C W; Robbins, A; O'Connor, B M; Spitz, I
In 1996, an application was submitted to the US Food and Drug Administration for the use of mifepristone (RU-486) plus the prostaglandin misoprostol in medical abortion. Over 100,000 women in more than 20 countries have received this regimen, which results in pregnancy termination in 92.7-99.0% of treated women. This article presents state-of-the-art information on medical abortion. Reviewed are its pharmacokinetics and metabolism, mechanism of action, and history of use. The article outlines a standard protocol that includes RU-486 administration at the first visit (day 1), misoprostol administration at the second visit (day 3), and post-treatment examination at the third visit (days 14-20) and suggests counseling guidelines. It discusses the contraindications and potential complications of abortifacient agents. Finally, the article compares the experience in the US and Europe of medical versus surgical abortion in terms of effectiveness, complications, and acceptability. PMID:9174759
Ho, Pak Chung
The reasons why women choose medical abortion vary in different countries. In most countries, the most common reasons for choosing medical abortion are as follows: (a) avoidance of surgery or general anesthesia; (b) perception that it is safer; and (c) perception that it is more natural than a surgical procedure. In most studies, over 80% of women who chose medical abortion found it acceptable and would choose the same method again if they needed another abortion in the future. They would also recommend this procedure to other women who need an abortion. In selected women, the administration of misoprostol at home was also acceptable. The acceptability of medical abortion may decrease with increasing gestational age of pregnancy, failure of medical abortion, prolonged bleeding and high levels of discomfort and anxiety during the abortion procedure. There was no significant difference in the emotional responses or incidences of psychiatric morbidity between women undergoing medical and women undergoing surgical abortion. PMID:16781253
Hodgson, J E
This article provides a brief history of women's efforts to control their reproductive lives through access to abortion in the 20th century. The first section presents a world overview that traces the development of anti-abortion laws and the subsequent liberalization of these laws. Section 2 reviews the frequency of abortions and abortion fees in the US and pays special attention to patient characteristics. The third section delineates the new type of counseling developed for abortion patients; and section 4 describes procedures for first trimester abortion (the history and advantages of vacuum aspiration, the proper setting, the format, complications, and procedural variations. Section 5 examines the practice of menstrual extraction as it occurred in the US from 1970-75 and occurs in Bangladesh. The next two sections cover abortions at 8-14 weeks and dilation and evacuation at 14-20 weeks. Section 8 looks at late mid-trimester abortion techniques and considers issues related to fetal personhood. Section 9 covers the history, current use, and multiple insertions of laminaria tents. Section 10 explains methods of postcoital contraception, and section 11 discusses currently available abortifacients. The next two sections argue that abortion is far safer than childbirth and explore the psychological impact of abortion. The article ends with three sections on recent legal changes, current problems in the delivery of abortion services in the US, and the prognosis for the future. PMID:12348331
Gendron, Nicolas; Joubrel, Caroline; Nedellec, Sophie; Campagna, Jennifer; Agostini, Aubert; Doucet-Populaire, Florence; Casetta, Anne; Raymond, Josette; Poyart, Claire; Kernéis, Solen
Medical abortion is not recognized as a high-risk factor for invasive pelvic infection. Here, we report two cases of group A Streptococcus (GAS; Streptococcus pyogenes) endometritis following medical abortions with a protocol of oral mifepristone and misoprostol. PMID:24829245
While the medical abortion (MA) drugs, mifepristone and misoprostol, have radically altered reproductive health practices around the world, there has been little field research on the sales and use of these drugs, especially in developing countries. This leaves the family planning community with many unanswered questions. While good profiles of contraceptive use are available for many countries and we have good technical data on the MA drugs' efficacy, dosages and regimens such as home dosage of misoprostol versus clinic dosage, we have very little information about the quantities of MA drugs sold, how they are used, where they are used, and, in the case of misoprostol, for what purposes. Sales data are available from one excellent commercial survey and from social marketing sales of mifepristone and misoprostol and these are presented. Acknowledging the sensitivity of the issue, especially in countries where abortion is severely restricted, the author makes a plea for careful additional research to shed light on an important and growing part of the international reproductive health picture. PMID:26106105
Dorothy Sit; Anthony J. Rothschild; Mitchell D. Creinin; Barbara H. Hanusa; Katherine L. Wisner
BACKGROUND: Hypercortisolaemia is associated with certain depressive disorders. Mifepristone has possible antidepressant properties related to its anti-glucocorticoid activity. To explore the possible mood effects of mifepristone, we examined the mood outcomes after surgical and medical (mifepristone-misoprostol) abortion. The objectives were to determine post-abortion depression risk, evaluate risk factors for post-abortion depression and to explore the relationship between cortisol and depression.
Beverly Winikoff; Charlotte Ellertson; Shelley Clark
Medical abortion opens a new choice to women wishing to terminate a pregnancy. Increasingly, providers in the developing and developed world will begin to offer this option. Yet, the nomenclature and concepts used for measuring failure of surgical abortion are not directly adaptable because of important differences inherent in the method and in the way it is offered in a
Bryant, Amy G; Regan, Elizabeth; Stuart, Gretchen
Medical abortion is a safe, convenient, and effective method for terminating an early unintended pregnancy. Medical abortion can be performed up to 63 days from the last menstrual period and may even be used up to 70 days for women who prefer medical abortion over surgical abortion. Counseling on the adverse effects and expectations for medical abortion is critical to success. Medical abortion can be performed in a clinic without special equipment, and it is perceived as more "natural" than a surgical abortion by many women. Follow-up for medical abortion can be simplified to include only serum human chorionic gonadotropin measurements when necessary, although obtaining an ultrasound remains the criterion standard. Pain associated with medical abortion is best treated with nonsteroidal anti-inflammatory medications, possibly in combination with opioid analgesics. Medical abortion can contribute to continuity of care for women who wish to remain with their primary care providers for management of their abortion. PMID:25102250
Kapoor, Garima; Salhan, Sudha; Sarda, Nivedita; Aggarwal, Deepika
The aim of this study is to compare the effectiveness of 100 mg versus 200 mg mifepristone along with misoprostol for medical abortion in gestation upto 56 days. This is a prospective controlled study. Eighty women seeking medical abortion with a gestation up to 56 days were included in the study. The women were randomly allotted into two groups. They received 100 mg/200 mg mifepristone on day 1 followed by 800 mcg misoprostol two days later. Women who had not aborted completely by day 14, received a repeat dose of 400 mcg misoprostol and were evaluated on day 21 for completeness of the procedure. Five women in both the groups had incomplete abortion by day 14 (12.5%), while one woman in the test group had to undergo dilatation and evacuation on day 3 due to excessive bleeding. By repeating a second dose of misoprostol, all of them aborted completely and the complete abortion rates were markedly improved from 85% and 87.5% in the test and the control group, respectively to 97.5% and 100%, respectively. It may be concluded that 100 mg mifepristone is as effective as 200 mg and appears to be the lowest effective dose for medical abortion. PMID:25935963
Mihciokur, Sare; Akin, Ayse; Dogan, Bahar Guciz; Ozvaris, Sevkat Bahar
Abortion has been legal and safe in Turkey since 1983, but the unmet need for safe abortion services remains high. Many medical practitioners believe that the introduction of medical abortion would address this. However, since 2012 there has been political opposition to the provision of abortion services. The government has been threatening to restrict the law, and following an administrative change in booking of appointments, some hospital clinics that provided family planning and abortion services had to stop providing abortions. Thus, the availability of safe abortion depends not only on permissive legislation but also political support and the ability of health professionals to provide it. We conducted a study among university medical school students in three provinces on their knowledge of abortion and abortion methods, to try to understand their future practice intentions. Pre-tested, structured, self-administered questionnaires were answered by 209 final-year medical students. The students' level of knowledge of abortion and abortion methods was very low. More than three-quarters had heard of surgical abortion, but only 56% mentioned medical abortion. Although nearly 90% supported making abortion services available in Turkey, their willingness to provide surgical abortion (16%) or medical abortion (15%) was low, due to lack of knowledge. Abortion care, including medical abortion, needs to be included in the medical school curriculum in order to safeguard this women's health service. PMID:25702066
An abortion is a procedure to end a pregnancy. It uses medicine or surgery to remove the embryo or ... personal. If you are thinking of having an abortion, most healthcare providers advise counseling.
This article reviews the most recent studies that compare psychological outcomes after either a medical or a surgical abortion to pre-procedure findings. Some studies demonstrated slightly higher levels of anxiety and depression following surgical versus medical methods. Studies that evaluated post-traumatic stress showed conflicting results. Overall, the majority of the studies demonstrated that psychological outcomes, specifically quality of life, anxiety and depression, are markedly improved following either method. Finally, the studies reviewed suggest that having a choice of method may improve women's psychological outcomes following abortion. PMID:22900806
Over the past three decades, medical methods of abortion have been developed throughout the world and are now a standard method of providing abortion care in the United States. Medical abortion, which involves the use of medications rather than a surgical procedure to induce an abortion, is an option for women who wish to terminate a first-trimester pregnancy. Although the method is most commonly used up to 63 days of gestation (calculated from the first day of the last menstrual period), the treatment also is effective after 63 days of gestation. The Centers for Disease Control and Prevention estimates that 64% of abortions are performed before 63 days of gestation (1). Medical abortions currently comprise 16.5% of all abortions in the United States and 25.2% of all abortions at or before 9 weeks of gestation (1). Mifepristone, combined with misoprostol, is the most commonly used medical abortion regimen in the United States and Western Europe; however, in parts of the world, mifepristone remains unavailable. This document presents evidence of the effectiveness, benefits, and risks of first-trimester medical abortion and provides a framework for counseling women who are considering medical abortion. PMID:24553166
de Costa, Caroline M; Russell, Darren B; de Costa, Naomi R; Carrette, Michael; McNamee, Heather M
Recent changes to Federal Therapeutic Goods Administration legislation have seen the limited introduction of the drug mifepristone to Australia for the purpose of early medical abortion. At the same time it has become evident that both methotrexate and misoprostol, licenced and available for other indications, are being used safely and appropriately for early abortion by Australian medical practitioners. Early medical abortion is widely practiced overseas where its safety and effectiveness are well supported by current evidence. However, abortion law in many states is still contained within the Criminal Codes and does not reflect current evidence-based abortion practice. In other states and territories restrictions on where abortions may be performed pose potential barriers to the introduction of mifepristone for medical abortion. There is an urgent need for abortion law to be clarified and made uniform across the country so that the best possible services can be provided to Australian women. PMID:18082063
Mckenas, David K.; Jennings, Richard T.
NASA and DOD studies of medical-planning and logistical problems are reviewed as applicable to providing emergency medical care at remote transoceanic abort landing (TAL) sites. Two options are analyzed including a modified surgical response team and a combination physician/medical technician team. The two concepts are examined in terms of cost-effectiveness, specific types of medical support such as blood procurement, and search-and-rescue requirements. It is found that the physician/technician team is more economically efficient, and the description of the concept permits the development of an effective TAL-site astronaut medical-support system. A balance is struck between the competing problems of cost and medical capability by planning for on-scene medical stabilization and air evacuation to DOD tertiary medical centers.
Tey, Nai-peng; Yew, Siew-yong; Low, Wah-yun; Su’ut, Lela; Renjhen, Prachi; Huang, M. S. L.; Tong, Wen-ting; Lai, Siow-li
Background Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students’ attitudes toward abortion education and presents a case for including abortion education in medical schools. Methods and Results A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students’ pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students’ attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity. Conclusions Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights. PMID:23300600
Medical abortion has the potential to expand US women's access to pregnancy termination, especially in areas that lack surgical providers. Exploratory interviews conducted in 1996 with 25 long-term providers of surgical abortion offered a "snapshot" of an early moment in the adoption of medical abortion techniques in the US. 20 of these providers already had experience with methotrexate and/or mifepristone. Overall, the interviews suggested that innovation in the area of abortifacient agents is likely to proceed slowly and cautiously, despite their high degrees of efficacy and safety. Although providers were committed to providing women a full range of abortion alternatives, they indicated that medical abortion demands substantial modifications in office routines. For example, counseling medical abortion patients requires twice the time as talking to a surgical abortion patient. The need for ultrasound to size very early pregnancies and ensure the abortion has been completed restricts provision to physicians with access to this technology. The requirement of ultrasound and multiple office visits makes medical abortion more costly than the surgical approach. Continued expansion in the ranks of medical abortion providers is dependent upon factors such as the ultimate status of mifepristone in terms of US Food and Drug Administration approval and appropriate manufacturing and distribution arrangements, clarification of whether misoprostol insertion must be performed in a physician's office, the willingness of managed care insurance plans to cover this alternative, and the response of US anti-abortion organizations. PMID:10029931
Shannon, Caitlin; Brothers, L Perry; Philip, Neena M; Winikoff, Beverly
Medical abortion regimens have become widely used, but the frequency of infection after medical abortion is not well documented. This systematic review provides data on infectious complications after medical abortion. We searched Medline for articles written before July 2003 to determine the frequency of infection after medical abortion up to 26 weeks of gestation. We reviewed all articles and extracted data on the frequency of infection from 65 studies. The frequency of diagnosed and/or treated infection after medical abortion was very low (0.92%, N = 46,421) and varied among regimens. Results of this review confirm that, with respect to infectious complications, medical abortion is a safe and effective option for first- and second-trimester pregnancy termination. After accounting for regional variations in diagnosis, there is little difference in frequency of infection among the regimens reviewed. Future studies should report clear diagnosis and treatment standards for infection so that more precise information becomes available. PMID:15325886
For another thing, the division of medical opinion about the matter at most means uncertainty, a factor that signals the presence of risk, not its absence. That division here involves highly qualified knowledgeable experts on both sides of the issue.--Stenberg v. Carhart, 2000. While we find no reliable data to measure the phenomenon, it seems unexceptionable to conclude some women come to regret their choice to abort the infant life they once created and sustained.--Gonzales v. Carhart, 2007. PMID:26237984
Moreau, Caroline; Trussell, James; Desfreres, Julie; Bajos, Nathalie
Background Using a large national sample of women undergoing an abortion in France, we explore the factors associated with medical or surgical abortion. We draw particular attention to the influence of women’s preferences in the decision making process. Study design The data are drawn from a nationally representative survey of 8,245 women undergoing an elective abortion in France in 2007. Analyses of factors associated with the type of abortion technique were performed among the 4,650 women who were identified as being eligible for the two techniques. Results Sixty-seven percent of all abortions were medical procedures among women eligible for both techniques. The type of abortion technique was not dependent on women’s age, parity, cohabitation status, socioeconomic circumstances nor on the type of facility providing the abortion (private or public). Conversely, women’s participation in the decision making process was strongly associated with the type of abortion method. Among the 50% of women who reported they had been given a choice, 84% underwent a medical procedure versus 52% of those who were not offered a choice. Among the 2,286 women who were not involved in the decision, 35% indicated they trusted their doctor to make the best choice for them, while 44% were told it was too late for a medical procedure, although they had consulted before 8 weeks of amenorrhea. Conclusion In this sample of French women who participated in a national survey on abortion, those who were involved in the decision making process as to whether to have a medical or surgical procedure showed a strong preference for the medical procedure. PMID:21843684
Powell-Jackson, Timothy; Acharya, Rajib; Filippi, Veronique; Ronsmans, Carine
Background Medical abortion (mifepristone and misoprostol) has the potential to contribute to reduced maternal mortality but little is known about the provision or quality of advice for medical abortion through the private retail sector. We examined the availability of medical abortion and the practices of pharmacists in India, where abortion has been legal since 1972. Methods We interviewed 591 pharmacists in 60 local markets in city, town and rural areas of Madhya Pradesh. One month later, we returned to 359 pharmacists with undercover patients who presented themselves unannounced as genuine customers seeking a medical abortion. Results Medical abortion was offered to undercover patients by 256 (71.3%) pharmacists and 24 different brands were identified. Two thirds (68.5%) of pharmacists stated that abortion was illegal in India. Only 106 (38.5%) pharmacists asked clients the timing of the last menstrual period and 38 (13.8%) requested to see a doctor’s prescription – a legal requirement in India. Only 59 (21.5%) pharmacists correctly advised patients on the gestational limit for medical abortion, 97 (35.3%) provided correct information on how many and when to take the tablets in a combination pack, and 78 (28.4%) gave accurate advice on where to seek care in case of complications. Advice on post-abortion family planning was almost nonexistent. Conclusions The retail market for medical abortion is extensive, but the quality of advice given to patients is poor. Although the contribution of medical abortion to women’s health in India is poorly understood, there is an urgent need to improve the practices of pharmacists selling medical abortion. PMID:25822656
Abortion is legally restricted in most of Latin America where 95% of the 4.4 million abortions performed annually are unsafe. Medical abortion (MA) refers to the use of a drug or a combination of drugs to terminate pregnancy. Mifepristone followed by misoprostol is the most effective and recommended regime. In settings where mifepristone is not available, misoprostol alone is used. Medical abortion has radically changed abortion practices worldwide, and particularly in legally restricted contexts. In Latin America women have been using misoprostol for self-induced home abortions for over two decades. This article summarizes the findings of a literature review on women’s experiences with medical abortion in Latin American countries where voluntary abortion is illegal. Women’s personal experiences with medical abortion are diverse and vary according to context, age, reproductive history, social and educational level, knowledge about medical abortion, and the physical, emotional, and social circumstances linked to the pregnancy. But most importantly, experiences are determined by whether or not women have the chance to access: 1) a medically supervised abortion in a clandestine clinic or 2) complete and accurate information on medical abortion. Other key factors are access to economic resources and emotional support. Women value the safety and effectiveness of MA as well as the privacy that it allows and the possibility of having their partner, a friend or a person of their choice nearby during the process. Women perceive MA as less painful, easier, safer, more practical, less expensive, more natural and less traumatic than other abortion methods. The fact that it is self-induced and that it avoids surgery are also pointed out as advantages. Main disadvantages identified by women are that MA is painful and takes time to complete. Other negatively evaluated aspects have to do with side effects, prolonged bleeding, the possibility that it might not be effective, and the fact that some women eventually need to seek medical care at a hospital where they might be sanctioned for having an abortion and even reported to the police. PMID:23259660
Raymond, Elin; Kaczorowski, Janusz; Smith, Pat; Sellors, John; Walsh, Allyn
OBJECTIVE: To determine the knowledge, attitudes, and interest in providing medical abortion reported by family physicians and residents in rural and urban settings. DESIGN: A self-administered mailed survey using the modified Dillman method. SETTING: Hamilton and Thunder Bay County in Ontario. PARTICIPANTS: Family medicine residents (n = 93) and physicians (n = 234) in predominantly urban (Hamilton) and rural (Thunder Bay) settings. All faculty family physicians at McMaster University practising general family medicine and all family physicians in Thunder Bay County were surveyed. MAIN OUTCOME MEASURES: Knowledge of, attitudes toward, and interest in providing medical abortion. RESULTS: Overall response rate to the survey was 62.7% (n = 327); 74.2% (69/93) of residents responded; 58.1% (136/234) of physicians responded. Physicians and residents rated their knowledge about medical abortion as poor, but most were interested in receiving more information and training in this area. Many (83.1%, 157/189) reported that medical abortion was an acceptable procedure for family physicians to perform, and 52.0% (64/123) of the physicians would consider providing medical abortions for their patients. Residents training in the more rural Thunder Bay program were less likely to support first-trimester abortions for both medical and nonmedical reasons than those training in Hamilton (P < .05). Male respondents were significantly less supportive of abortion for nonmedical reasons and were less likely to consider providing medical abortions for their patients (P < .05). CONCLUSION: Most family physicians and residents showed interest in receiving more information about and training in medical abortion. PMID:11935718
Louie, Karmen S; Chong, Erica; Tsereteli, Tamar; Avagyan, Gayane; Vardanyan, Susanna; Winikoff, Beverly
In Armenia, abortion is the main means of fertility regulation; however, before research activities were initiated only surgical methods were available and the quality of services was low in some areas. Our clinical study from 2008-2011 aimed to show that early medical abortion is an acceptable and feasible option. A total of 700 eligible women with pregnancies up to 63 days LMP presenting for abortion were recruited for the study in five locations. Participants took 200 mg mifepristone and 800 ?g buccal misoprostol 24-48 hours later. They returned for a follow-up visit two weeks after mifepristone administration. 95% of the women had successful abortions and 95% were satisfied with the method. In 2012-2013, we conducted a follow-up assessment to examine the ongoing provision and quality of medical abortion services at the former research sites. Medical record reviews, interviews and observations were carried out three times approximately six months apart. The assessment found that all five sites had continued providing medical abortion, with about half of eligible women choosing the medical method. Four of the five sites were achieving high success rates. Staff turnover and the lack of trained providers likely contributed to the higher failure rate at the fifth site. These findings provide evidence that first trimester medical abortion is an acceptable and feasible option for Armenian women and providers, and that high quality services are being delivered. PMID:25702069
Epner, J E; Jonas, H S; Seckinger, D L
Recent proposed federal legislation banning certain abortion procedures, particularly intact dilatation and extraction, would modify the US Criminal Code such that physicians performing these procedures would be liable for monetary and statutory damages. Clarification of medical procedures is important because some of the procedures used to induce abortion prior to viability are identical or similar to postviability procedures. This article reviews the scientific and medical information on late-term abortion and late-term abortion techniques and includes data on the prevalence of late-term abortion, abortion-related mortality and morbidity rates, and legal issues regarding fetal viability and the balance of maternal and fetal interests. According to enacted American Medical Association (AMA) policy, the use of appropriate medical terminology is critical in defining late-term abortion procedures, particularly intact dilatation and extraction, which is a variant of but distinct from dilatation and evacuation. The AMA recommends that the intact dilatation and extraction procedure not be used unless alternative procedures pose materially greater risk to the woman and that abortions not be performed in the third trimester except in cases of serious fetal anomalies incompatible with life. Major medical societies are urged to collaborate on clinical guidelines on late-term abortion techniques and circumstances that conform to standards of good medical practice. More research on the advantages and disadvantages of specific abortion procedures would help physicians make informed choices about specific abortion procedures. Expanded ongoing data surveillance systems estimating the prevalence of abortion are also needed. PMID:9728645
Petitet, Pascale Hancart; Ith, Leakhena; Cockroft, Melissa; Delvaux, Thérèse
In 2010, following its approval by the Ministry of Health, the medical abortion combination pack Medabon (containing mifepristone and misoprostol) was made available at pharmacies and in a restricted number of health facilities in Cambodia. The qualitative study presented in this paper was conducted in 2012 as a follow-up to longer-term ethnographical research related to reproductive health and fertility regulation between 2008 and 2012. Observations were carried out at several clinic and pharmacy sites and in-depth interviews were conducted with a purposive sample of 20 women who attended two MSI Cambodia centres and 10 women identified through social networks; six men (women's male partners); eight health care providers at the two MSI centres and four pill sellers at private or informal pharmacies (who also provided health care services in private clinics). Although the level of training among the drug sellers and providers varied, their knowledge about medical abortion regimens, correct usage and common side effects was good. Overall, women were satisfied with the services provided. Medical abortion was not always a women-only process in this study as some male partners were also involved in the care process. The study illustrates positive steps forward being taken in making abortion safe and preventing and reducing unsafe abortion practices in Cambodia. PMID:25702068
Creinin, Mitchell David
information about significant adverse events and outcomes after medical abortionabortion are reported as required. In accordance with the Mifeprex® (mifepristone) prescribing information,information) is collected through the PPFA reporting system only for those women with significant adverse events or outcomes after medical abortion.
pill, ring or patch) following medical abortion wereabortion, chose to start a combined hormonal method of contraception (pill,pill, applied their first patch or placed the ring in the clinic during their first medical abortion
Background A high percentage of abortions performed in South Africa are in the second trimester. However, little research focuses on women's experiences seeking second trimester abortion or the efficacy and safety of these services. The objectives are to document clinical and acceptability outcomes of second trimester medical and surgical abortion as performed at public hospitals in the Western Cape Province. Methods We performed a cross-sectional study of women undergoing abortion at 12.1-20.9 weeks at five hospitals in Western Cape Province, South Africa in 2008. Two hundred and twenty women underwent D&E with misoprostol cervical priming, and 84 underwent induction with misoprostol alone. Information was obtained about the procedure and immediate complications, and women were interviewed after recovery. Results Median gestational age at abortion was earlier for D&E clients compared to induction (16.0 weeks vs. 18.1 weeks, p < 0.001). D&E clients reported shorter intervals between first clinic visit and abortion (median 17 vs. 30 days, p < 0.001). D&E was more effective than induction (99.5% vs. 50.0% of cases completed on-site without unplanned surgical procedure, p < 0.001). Although immediate complications were similar (43.8% D&E vs. 52.4% induction), all three major complications occurred with induction. Early fetal expulsion occurred in 43.3% of D&E cases. While D&E clients reported higher pain levels and emotional discomfort, most women were satisfied with their experience. Conclusions As currently performed in South Africa, second trimester abortions by D&E were more effective than induction procedures, required shorter hospital stay, had fewer major immediate complications and were associated with shorter delays accessing care. Both services can be improved by implementing evidence-based protocols. PMID:21929811
Park, Min Hae; Nguyen, Thang Huu; Dang, Anh Thi Ngoc; Ngo, Thoai Dinh
Objective To describe medical abortion (MA) practices among private providers in Vietnam. Methods The study subjects were women (n = 258) undergoing early MA through 12 private providers in Hanoi during February–June 2012. The women were interviewed on the day of their procedure and were followed up by telephone 14 days after mifepristone administration. Results Of the 258 women in the study, 97% used a regimen of mifepristone plus misoprostol; 80% were instructed to administer misoprostol at home. MA resulted in a complete termination in 90.8% of cases. All women were provided with information on potential complications and were instructed to return for a follow-up visit. We successfully followed up 77.5% (n = 200) of participants by telephone, while nearly two-thirds of women returned to the clinic for a follow-up visit. At follow-up, 39.5% of women reported having used a Help line service, while 7% had sought help from a health provider. A high unmet need for postabortion family planning was identified. Conclusion Follow-up of women, postabortion care, and the provision of family planning have been identified as important areas to address for strengthening MA services in the private sector in Vietnam. PMID:24082795
P. W. Ashok; G. C. Penney; G. M. M. Flett; A. Templeton
A combination of the anti-progesterone mifepristone and gemeprost provides an effective non-surgical method for the induction of abortion at gestations up to 63 days, achieving complete abortion rates of over 95%. We report our experience with an alternate regimen, comprising a reduced dose of mifepristone in combination with vaginal misoprostol. A consecutive series of 2000 women requesting early medical abortion
SJ Etuk; FE Okonofua
This study examined the knowledge, attitude and practice of private medical practitioners in Calabar on abortion, post- abortion care and post-abortion family planning. Forty eight private practitioners who were proprietors of private clinics in the city were interviewed using a structured questionnaire. The results showed that 22.9% of the doctors routinely terminate unwanted pregnancies when requested to do so by
Fischer, Marc; Bhatnagar, Julu; Guarner, Jeannette; Reagan, Sarah; Hacker, Jill K; Van Meter, Sharon H; Poukens, Vadims; Whiteman, David B; Iton, Anthony; Cheung, Michele; Dassey, David E; Shieh, Wun-Ju; Zaki, Sherif R
Endometritis and toxic shock syndrome associated with Clostridium sordellii have previously been reported after childbirth and, in one case, after medical abortion. We describe four deaths due to endometritis and toxic shock syndrome associated with C. sordellii that occurred within one week after medically induced abortions. Clinical findings included tachycardia, hypotension, edema, hemoconcentration, profound leukocytosis, and absence of fever. These cases indicate the need for physician awareness of this syndrome and for further study of its association with medical abortion. PMID:16319384
Clark, Wesley H; Gold, Marji; Grossman, Daniel; Winikoff, Beverly
Mifepristone medical abortion has been a valuable addition to the reproductive health options of women. Aspects of its provision have however sometimes limited its accessibility and use. This article summarizes existing evidence for simplifying the provision of medical abortion and thus increasing its availability. We identify three ways through which medical abortion provision might be simplified based on existing evidence and suggest five additional simplifications that require further research to confirm their safety and efficacy. PMID:17362700
R C Henshaw; S A Naji; I T Russell; A A Templeton
OBJECTIVES--To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN--Patient centred, partially randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg vaginal pessary. Vacuum aspiration was performed under general anaesthesia. SETTING--Teaching hospital in Scotland. PATIENTS--363 women undergoing legal induced abortion at
Beverly Winikoff; Irving Sivin; Kurus J. Coyaji; Evelio Cabezas; Xiao Bilian; Gu Sujuan; Du Ming-kun; Usha R. Krishna; Andrea Eschen; Charlotte Ellertson
OBJECTIVE: We investigated safety, efficacy, and acceptability of an oral regimen of medical abortion compared with surgical abortion in three developing countries.STUDY DESIGN: Women (n = 1373) with amenorrhea ?56 days chose either surgical abortion (as provided routinely) or 600 mg of mifepristone followed after 48 hours by 400 ?g of misoprostol. This is the appropriate design for studying safety,
Puri, Mahesh; Tamang, Anand; Shrestha, Prabhakar; Joshi, Deepak
Medical abortion was introduced in Nepal in 2009, but rural women's access to medical abortion services remained limited. We conducted a district-level operations research study to assess the effectiveness of training 13 auxiliary nurse-midwives as medical abortion providers, and 120 female community health volunteers as communicators and referral agents for expanding access to medical abortion for rural women. Interviews with service providers and women who received medical abortion were undertaken and service statistics were analysed. Compared to a neighbouring district with no intervention, there was a significant increase in the intervention area in community health volunteers' knowledge of the legal conditions for abortion, the advantages and disadvantages of medical abortion, safe places for an abortion, medical abortion drugs, correct gestational age for home use of medical abortion, and carrying out a urine pregnancy test. In a one-year period in 2011-12, the community health volunteers did pregnancy tests for 584 women and referred 114 women to the auxiliary nurse-midwives for abortion; 307 women in the intervention area received medical abortion services from auxiliary nurse-midwives. There were no complications that required referral to a higher-level facility except for one incomplete abortion. Almost all women who opted for medical abortion were happy with the services provided. The study demonstrated that auxiliary nurse-midwives can independently and confidently provide medical abortion safely and effectively at the sub-health post level, and community health volunteers are effective change agents in informing women about medical abortion. PMID:25702073
Harper, Cynthia C; Henderson, Jillian T; Darney, Philip D
Abortion is an extremely safe and common medical procedure. In the United States, over one million women had an abortion in the year 2000. Advances in early abortion techniques have helped to increase the proportion of early procedures, the safest type. Abortion rates have been declining since the early nineties among adults and adolescents, but rates among poor, minority women remain high. State restrictions to abortion have a larger impact on poor women and young women. Restrictions and regulations have also resulted in the concentration of abortion services in specialized clinics. These clinics are subject to harassment. The expansion of abortion services to more types of providers could increase access, as well as integrate abortion into women's health care. PMID:15760299
Lemkau, Jeanne Parr
Summarizes literature on normative reactions to abortion and factors that increase risk of negative emotional sequelae. Discusses characteristics of woman, social support and cultural milieu around the abortion, the medical environment and abortion procedure itself, and events subsequent to abortion which may cause conflict. Discusses implications…
Pazol, Karen; Creanga, Andreea A.; Zane, Suzanne B.
Background With changing patterns and increasing use of medical abortion in the United States, it is important to have accurate statistics on the use of this method regularly available. This study assesses the accuracy of medical abortion data reported annually to the Centers for Disease Control and Prevention (CDC) and describes trends over time in the use of medical abortion relative to other methods. Study Design This analysis included data reported to CDC for 2001–2008. Year-specific analyses included all states that monitored medical abortion for a given year, while trend analyses were restricted to states that monitored medical abortion continuously from 2001 to 2008. Data quality and completeness were assessed by (a) examining abortions reported with an unspecified method type within the gestational age limit for medical abortion (med-eligible abortions) and (b) comparing the percentage of all abortions and med-eligible abortions reported to CDC as medical abortions with estimates based on published mifepristone sales data for the United States from 2001 to 2007. Results During 2001–2008, the percentage of med-eligible abortions reported to CDC with an unspecified method type remained low (1.0%–2.2%); CDC data and mifepristone sales estimates for 2001–2007 demonstrated strong agreement [all abortions: intraclass correlation coefficient (ICC)=0.983; med-eligible abortions: ICC=0.988]. During 2001–2008, the percentage of abortions reported to CDC as medical abortions increased (p<.001 for all abortions and for med-eligible abortions). Among states that reported medical abortions for 2008, 15% of all abortions and 23% of med-eligible abortions were reported as medical abortions. Conclusion CDC’s Abortion Surveillance System provides an important annual data source that accurately describes the use of medical abortion relative to other methods in the United States. PMID:22770796
Dixon, Darrin P
Many women are unprepared to make prenatal decisions about fetuses diagnosed with Down Syndrome because of societal pressures to have "normal" children, a negative view of persons with disabilities by many in society, a fear of legal liability by those in the medical community, the lack of genuine informed consent before undergoing genetic testing and abortion, and the failure of non-directive pre-abortion counseling in the medical community. Moreover, medical professionals fail to communicate correct and unbiased information before and during the genetic screening, diagnostic testing, and abortion decision-making process. This article addresses the contributing factors and causes that ultimately lead to a lack of informed consent and a very high abortion rate for fetuses diagnosed with Down Syndrome. PMID:18771038
Umaña, A O
Abortion is a social problem and criminal sanctions are very ineffective in limiting it and are seldom applied (133 legal actions vs. 65,600 cases of induced abortion in 1965). Abortion is a social disease, as are prostitution, juvenile delinquency, drug abuse, and so far has been an insoluble problem. Colombian laws should be modified to reflect reality. Sex education must be emphasized, because ignorance is one of the main causes of abortion. Leniency should be applied toward women who cooperate with the authorities in identifying the person who performed an abortion. Legalization of abortion and enforcement of strict laws against it are considered as possible solutions, but both are rejected. The former is regarded as morally unacceptable and as imposing an excessive burden on scarce health services, the latter as even worse, imposing an equivalent burden on the court system, without s olving either health or social problems. The best and probably only solution is to improve education in family planning, to promote knowledge and motivation to enable the population to make sound and responsible decisions. PMID:4804875
Hull, T H; Sarwono, S W; Widyantoro, N
Induced abortion is one of the most difficult sociomedical problems facing the Indonesian government. While well-known in traditional society, the practice was discouraged by all Indonesian religious groups, and forbidden by the Dutch colonial authorities. Although abortion was technically illegal under the criminal code, a judicial interpretation in the early 1970s permitted medical professionals to offer the procedure so long as they were discreet and careful. The numbers of medical abortions carried out in Indonesia rose dramatically, and there was evidence of matching declines in the incidence of morbidity and mortality caused by dangerous illegal procedures. Medical and community groups campaigned for a more liberal abortion law to protect legal practitioners and stamp out illegal traditional practices. Their efforts appeared to bear fruit in the draft Health Law, but when the law was passed by the legislature in late 1992, the issue was again clouded by contradictions and inconsistencies. PMID:8212094
Sneeringer, Robyn K; Billings, Deborah L; Ganatra, Bela; Baird, Traci L
Unsafe abortion continues to be a major contributor to maternal mortality and morbidity around the world. This article examines the role of pharmacists in expanding women's access to safe medical abortion in Latin America, Africa, and Asia. Available research shows that although pharmacists and pharmacy workers often sell abortion medications to women, accurate information about how to use the medications safely and effectively is rarely offered. No publication covered effective interventions by pharmacists to expand access to medical abortion, but lessons can be learned from successful interventions with other reproductive health services. To better serve women, increasing awareness and improving training for pharmacists and pharmacy workers about unsafe abortion – and medications that can safely induce abortion – are needed. PMID:22402571
The purpose of the manual is to provide the medical assisting student a text which presents the common laboratory procedures in use today in physician's offices. The procedures for performing a complete urinalysis are outlined, along with those for carrying out various hematological tests. Information is also presented to help the student learn to…
Gemzell-Danielsson, Kristina; Lalitkumar, Sujata
Second trimester abortions constitute 10-15% of all induced abortions worldwide but are responsible for two-thirds of major abortion-related complications. During the last decade, medical methods for second trimester induced abortion have been considerably improved and become safe and more accessible. Today, in most cases, safe and efficient medical abortion services can be offered or improved by minor changes in existing health care facilities. Second trimester medical abortion can be provided by a nurse-midwife with the back-up of a gynaecologist. Because of the potential for heavy vaginal bleeding and serious complications, it is advisable that second trimester terminations take place in a health care facility where blood transfusion and emergency surgery (including laparotomy) are available. This article provides basic information on regimens recommended for second trimester medical abortion. The combination of mifepristone and misoprostol is now an established and highly effective method for second trimester abortion. Where mifepristone is not available or affordable, misoprostol alone has also been shown to be effective, although a higher total dose is needed and efficacy is lower than for the combined regimen. Therefore, whenever possible, the combined regimen should be used. Efforts should be made to reduce unnecessary surgical evacuation of the uterus after expulsion of the fetus. Future studies should focus on improving pain management, the treatment of women with failed medical abortion after 24 hours, and the safety of medical abortion regimens in women with a previous caesarean section or uterine scar. PMID:18772097
Erdman, Joanna N
The Irish Protection of Life During Pregnancy Act seeks to clarify the legal ground for abortion in cases of risk to life, and to create procedures to regulate women's access to services under it. This article explores the new law as the outcome of an international human rights litigation strategy premised on state duties to implement abortion laws through clear standards and procedural safeguards. It focuses specifically on the Irish law reform and the jurisprudence of the European Court of Human Rights, including A. B. and C. v. Ireland (2010). The article examines how procedural rights at the international level can engender domestic law reform that limits or expands women's access to lawful abortion services, serving conservative or progressive ends. PMID:25555760
Dickens, B M
Alarm over the prospect that prenatal diagnostic techniques, which permit identification of fetal sex and facilitate abortion of healthy but unwanted female fetuses has led some to urge their outright prohibition. This article argues against that response. Prenatal diagnosis permits timely action to preserve and enhance the life and health of fetuses otherwise endangered, and, by offering assurance of fetal normality, may often encourage continuation of pregnancies otherwise vulnerable to termination. Further, conditions in some societies may sometimes render excusable the inclination to abort certain healthy female fetuses. In places where abortion for fetal sex alone is recognised as unethical, however, medical licensing authorities already possess the power to discipline, for professional misconduct, physicians who prescribe or perform prenatal diagnosis purely to identify fetal sex, or those who disclose fetal sex when that is unrelated to the fetus's medical condition. PMID:3761335
Abbas, Dina; Chong, Erica; Raymond, Elizabeth G
Data show that an outpatient regimen of 200-mg mifepristone followed by a single dose of misoprostol is safe and effective for medical abortion for up to 70days from last menstrual period (LMP). Yet, many clinics only provide services up to 63days LMP, and some practice guidelines do not recommend the higher gestational age limit. We review the studies published to date that include women 64 to 70days LMP and conclude that outpatient medical abortion is safe and effective in this interval and that there are no clinically meaningful differences between outcomes at 57 to 63days LMP and 64 to 70days LMP. Updating clinical protocols and revising the Food and Drug administration label for Mifeprex® to change the indication for termination of pregnancies through 70days LMP will give women more choices and expand access to safe abortion services. PMID:26118638
An engineering analysis and computer code (AERSEP) for predicting Space Shuttle Orbiter - HO Tank longitudinal aerodynamic characteristics during abort separation has been developed. Computed results are applicable at Mach numbers above 2 for angle-of-attack between plus or minus 10 degrees. No practical restrictions on orbiter-tank relative positioning are indicated for tank-under-orbiter configurations. Input data requirements and computer running times are minimal facilitating program use for parametric studies, test planning, and trajectory analysis. In a majority of cases AERSEP Orbiter-Tank interference predictions are as accurate as state-of-the-art estimates for interference-free or isolated-vehicle configurations. AERSEP isolated-orbiter predictions also show excellent correlation with data.
Foster, Angel M.; Wynn, L. L.; Trussell, James
Introduction The worldwide expansion of the Internet offers an important modality of disseminating medically accurate information about medication abortion. We chronicle the story of www.medicationabortion.com, an English-, Spanish-, Arabic-, and French-language website dedicated to three early abortion regimens. Methods We evaluated the website use patterns from 2005 through 2009. We also conducted a content and thematic analysis of 1,910 emails submitted during this period. Results The website experienced steady growth in use. In 2009, it received 35,000 visits each month from more than 20,000 unique visitors and was accessed by users in 208 countries and territories. More than half of all users accessed the website from a country in which abortion is legally restricted. Users from more than 40 countries sent emails with individual questions. Women often wrote in extraordinary detail about the circumstances of their pregnancies and attempts to obtain an abortion. These emails also reflect considerable demand for information about the use of misoprostol for self-induction. Conclusion The use patterns of www.medicationabortion.com indicate that there is significant demand for online information about abortion, and the findings suggest future priorities for research, collaboration, and educational outreach. PMID:24360644
In October 2010 the District Court sitting in Cairns, Queensland, found Tegan Leach not guilty of attempting to procure her own abortion and Sergie Brennan not guilty of supplying Leach with the drugs Mifepristone and Misoprostol to procure an abortion. Brennan obtained the drugs from his sister in the Ukraine through the regular postal system. R v Brennan and Leach was the first case in Queensland's history where a woman was charged with procuring her own abortion. The drugs are accepted by the medical profession worldwide for medical abortions. A prosecution witness gave evidence that Mifepristone is not harmful or injurious to the health of a woman and it is listed as an essential medicine by the World Health Organisation and approved for use by the Australian Therapeutic Goods Administration. The jury found the defendants not guilty because they were not satisfied beyond reasonable doubt that the combination of the drugs Mifepristone and Misoprostol was a "noxious" substance under the Criminal Code (Old). This article concludes that there is no regulatory miracle which will stop the traffic of Mifepristone and Misoprostol into Australia and therefore an intelligent regulatory response is required which would make it unnecessary for women to seek Mifepristone and Misoprostol from overseas networks and the internet. Among other things, this would include the repeal of confusing, inappropriate and ineffective abortion laws. PMID:21528743
Klausen, Susanne M.
After its formation in 1910 as a self-governing dominion within the British empire, the Union of South Africa followed a combination of English and Roman-Dutch common laws on abortion that decreed the procedure permissible only when necessary to save a woman’s life. The government continued doing so after South Africa withdrew from the Commonwealth and became a republic in 1961. In 1972 a sensational trial took place in the South African Supreme Court that for weeks placed clandestine abortion on the front pages of the country’s newspapers. Two men, one an eminent doctor and the other a self-taught abortionist, were charged with conspiring to perform illegal abortions on twenty-six white teenagers and young unmarried women. The prosecution of Dr Derk Crichton and James Watts occurred while the National Party government was in the process of drafting abortion legislation and was perceived by legal experts as another test of the judiciary’s stance on the common law on abortion. The trial was mainly intended to regulate the medical profession and ensure doctors ceased helping young white women evade their ‘duty’ to procreate within marriage. Ultimately, the event encapsulated a great deal about elites’ attempt to buttress apartheid culture and is significant for, among other reasons, contributing to the production of South Africa’s extremely restrictive Abortion and Sterilisation Act (1975). PMID:24775430
Klausen, Susanne M
After its formation in 1910 as a self-governing dominion within the British empire, the Union of South Africa followed a combination of English and Roman-Dutch common laws on abortion that decreed the procedure permissible only when necessary to save a woman's life. The government continued doing so after South Africa withdrew from the Commonwealth and became a republic in 1961. In 1972 a sensational trial took place in the South African Supreme Court that for weeks placed clandestine abortion on the front pages of the country's newspapers. Two men, one an eminent doctor and the other a self-taught abortionist, were charged with conspiring to perform illegal abortions on twenty-six white teenagers and young unmarried women. The prosecution of Dr Derk Crichton and James Watts occurred while the National Party government was in the process of drafting abortion legislation and was perceived by legal experts as another test of the judiciary's stance on the common law on abortion. The trial was mainly intended to regulate the medical profession and ensure doctors ceased helping young white women evade their 'duty' to procreate within marriage. Ultimately, the event encapsulated a great deal about elites' attempt to buttress apartheid culture and is significant for, among other reasons, contributing to the production of South Africa's extremely restrictive Abortion and Sterilisation Act (1975). PMID:24775430
Abortion figures for 1978 in West Germany reflect underregistration of unknown magnitude. A total of 73,548 abortions were registered in 1978, 35.4% more than the preceding year. 5.6 abortions were reported per 1000 women aged 15-45, compared to 4.1 in 1977. There were 127.0 abortions per 1000 live and still births, compared to 92.6 in 1977. The number of reported abortions increased in every region of the Federal Republic. "Social indications" accounted for 67% of the abortions in 1978, compared to 57.7% in 1977 and 44.9% in 1976. A breakdown of reasons for abortion by woman's age is provided. 55% of abortions were performed in women under 30 years. 42,620 abortions in 1978 were obtained by married women and 24,490 by single women. Over 90% of abortions were performed between 6 and 12 weeks of gestation, with 41.8% between 8 and 9 weeks and 29.6% between 10 and 12 weeks. Vacuum aspiration was employed in 57.1% of the procedures, while curettage was used in 35.4%. Vacuum aspiration is becoming increasingly important while curettage is declining in use. Complications were reported in 2,566 of the 73,548 abortions reported in 1978, with vacuum aspiration having the lowest complication rates. Despite the deficiencies the available abortion statistics do indicate the structure and development of abortion in Germany. PMID:12178650
Rautanen, E; Kantero, R L; Widholm, O
Socio-medical aspects concerning 193 pregnant patients under the age of 18 were analysed. Of these patients 131 had an interruption of the pregnancy and 62 gave birth to a baby. All the abortion patients were unmarried. The mean age in the abortion group was 16.8 years and in the delivery group 17.2 years. The girls of this study had their first experience of sexual intercourse very early, 32% under the age of 15. The frequency of complications after abortion was 18.5%. In the delivery group the prematurity and prenatal mortality were at least twice as great as in the general population. The girls who gave birth to their babies often came from lower social strata and the relationships in their families were more harmonious than in those who had had abortions. The birth of the baby or the decision to have an abortion is not accidental. The different behaviour patterns have a different background regarding both the personal and the environmental characteristics. The decision of the patient whether to abort or not was influenced by the attitude of the immediate family. The relations between family members were better in the homes of the girls who had a baby than in the homes of those who belonged to the abortion group. In both groups more than 40% of the subjects had suffered the risk of being emotionally deprived because of environmental conditions, including crowded housing and limited economic means. Almost all the subjects knew about the means of prevention, although they may not have had proper instruction and sufficient knowledge of their use. The services given by the goverment to adolescent pregnant patients are insufficient and require immediate attention by society. PMID:560171
Clinical language applied to early pregnancy loss changed in late twentieth century Britain when doctors consciously began using the term ‘miscarriage’ instead of ‘abortion’ to refer to this subject. Medical professionals at the time and since have claimed this change as an intuitive empathic response to women's experiences. However, a reading of medical journals and textbooks from the era reveals how the change in clinical language reflected legal, technological, professional and social developments. The shift in language is better understood in the context of these historical developments, rather than as the consequence of more empathic medical care for women who experience miscarriage. PMID:23429567
Sri, Subha B; Ravindran, T K Sundari
Women's control over their own bodies and reproduction is a fundamental prerequisite to the achievement of sexual and reproductive health and rights. A woman's ability to terminate an unwanted pregnancy has been seen as the exercise of her reproductive rights. This study reports on interviews with 15 women in rural South India who had a medical abortion. It examines the circumstances under which they chose to have an abortion and their perspectives on medical abortion. Women in this study decided to have an abortion when multiple factors like lack of spousal support for child care or contraception, hostile in-laws, economic hardship, poor health of the woman herself, spousal violence, lack of access to suitable contraceptive methods, and societal norms regarding reproduction and sexuality converged to oppress them. The availability of an easy and affordable method like medical abortion pills helped the women get out of a difficult situation, albeit temporarily. Medical abortion also fulfilled their special needs by ensuring confidentiality, causing least disruption of their domestic schedule, and dispensing with the need for rest or a caregiver. The study concludes that medical abortion can help women in oppressive situations. However, this will not deliver gender equality or women's empowerment; social conditions need to change for that. PMID:25702077
Kottow Lang, Miguel Hugo
Voluntarily induced abortion has been under permanent dispute and legal regulations, because societies invariably condemn extramarital pregnancies. In recent decades, a measure of societal tolerance has led to decriminalize and legalize abortion in accordance with one of two models: a more restricted and conservative model known as therapeutic abortion, and the model that accepts voluntary abortion within the first trimester of pregnancy. Liberalization of abortion aims at ending clandestine abortions and decriminalizes the practice in order to increase reproductive education and accessibility of contraceptive methods, dissuade women from interrupting their pregnancy and, ultimately, make abortion a medically safe procedure within the boundaries of the law, inspired by efforts to reduce the incidence of this practice. The current legal initiative to decriminalize abortion in Chile proposes a notably rigid set of indications which would not resolve the three main objectives that need to be considered: 1) Establish the legal framework of abortion; 2) Contribute to reduce social unrest; 3) Solve the public health issue of clandestine, illegal abortions. Debate must urgently be opened to include alternatives in line with the general tendency to respect women's decision within the first trimester of pregnancy. PMID:26057783
Raymond, Elizabeth G; Grossman, Daniel; Wiebe, Ellen; Winikoff, Beverly
The requirement that every woman desiring medical abortion must come in person to a clinical facility to obtain the drugs is a substantial barrier for many women. To eliminate this requirement in the United States, two key components of the standard initial visit would need to be restructured. First, alternatives to ultrasound and pelvic exam would need to be identified for ensuring that gestational age is within the limit for safe and effective treatment. This is probably feasible: for example, data from a large study suggest that in selected patients menstrual history is highly sensitive for this purpose. Second, the Food and Drug Administration would need to remove the medically unwarranted restriction on distribution of mifepristone. These two changes could allow provision of the service by a broader range of providers in nontraditional venues or even by telemedicine. Such options could have profound benefits in reducing cost and expanding access to abortion. PMID:26134280
Grimes, David A; Creinin, Mitchell D
Internists care for many women who have had abortions and many who will seek abortions in the future. Each year, about 2% of all women of reproductive age have an abortion. Women having abortions tend to be young, white, unmarried, and early in pregnancy. Most abortions are done by suction curettage under local anesthesia in a freestanding clinic. However, medical abortion is growing in popularity as a nonsurgical alternative. The regimen approved by the U.S. Food and Drug Administration specifies mifepristone, 600 mg orally, followed 2 days later by misoprostol, 400 microg orally (within 49 days from last menses). Recent studies have recommended alternative approaches, such as mifepristone, 200 mg orally, followed in 1 to 3 days by misoprostol, 800 microg vaginally (up to 63 days). Medical abortion can be provided by a broader variety of physicians than can surgical abortion. The overall case-fatality rate for abortion is less than 1 death per 100,000 procedures. Infection, hemorrhage, acute hematometra, and retained tissue are among the more common complications. Referral back to the original abortion provider for management is advisable. Overall, induced abortion does not lead to late sequelae, either medical or psychiatric. Of importance, no link exists between induced abortion and later breast cancer. For physicians who are asked to help with a referral, the National Abortion Federation and Planned Parenthood Federation of America have helpful Web sites and networks of high-quality clinics. The cost of abortion (currently about 372 dollars at 10 weeks) has decreased in recent decades. Provision of ongoing contraception and encouragement of emergency contraception can reduce unintended pregnancies and the need for abortion. PMID:15096333
Paul, Mandira; Iyengar, Kirti; Essén, Birgitta; Gemzell-Danielsson, Kristina; Iyengar, Sharad D.; Bring, Johan; Soni, Sunita; Klingberg-Allvin, Marie
Background Studies evaluating acceptability of simplified follow-up after medical abortion have focused on high-resource or urban settings where telephones, road connections, and modes of transport are available and where women have formal education. Objective To investigate women’s acceptability of home-assessment of abortion and whether acceptability of medical abortion differs by in-clinic or home-assessment of abortion outcome in a low-resource setting in India. Design Secondary outcome of a randomised, controlled, non-inferiority trial. Setting Outpatient primary health care clinics in rural and urban Rajasthan, India. Population Women were eligible if they sought abortion with a gestation up to 9 weeks, lived within defined study area and agreed to follow-up. Women were ineligible if they had known contraindications to medical abortion, haemoglobin < 85mg/l and were below 18 years. Methods Abortion outcome assessment through routine clinic follow-up by a doctor was compared with home-assessment using a low-sensitivity pregnancy test and a pictorial instruction sheet. A computerized random number generator generated the randomisation sequence (1:1) in blocks of six. Research assistants randomly allocated eligible women who opted for medical abortion (mifepristone and misoprostol), using opaque sealed envelopes. Blinding during outcome assessment was not possible. Main Outcome Measures Women’s acceptability of home-assessment was measured as future preference of follow-up. Overall satisfaction, expectations, and comparison with previous abortion experiences were compared between study groups. Results 731 women were randomized to the clinic follow-up group (n = 353) or home-assessment group (n = 378). 623 (85%) women were successfully followed up, of those 597 (96%) were satisfied and 592 (95%) found the abortion better or as expected, with no difference between study groups. The majority, 355 (57%) women, preferred home-assessment in the event of a future abortion. Significantly more women, 284 (82%), in the home-assessment group preferred home-assessment in the future, as compared with 188 (70%) of women in the clinic follow-up group, who preferred clinic follow-up in the future (p < 0.001). Conclusion Home-assessment is highly acceptable among women in low-resource, and rural, settings. The choice to follow-up an early medical abortion according to women’s preference should be offered to foster women’s reproductive autonomy. Trial Registration ClinicalTrials.gov NCT01827995 PMID:26327217
Ganatra, Bela; Sorhaindo, Annik; Karver, Tahilin S; Seuc, Armando; Villalobos, Aremis; García, Sandra G; Pérez, Martha; Bousieguez, Manuel; Sanhueza, Patricio
Abstract Objective To examine the effectiveness, safety, and acceptability of nurse provision of early medical abortion compared to physicians at three facilities in Mexico City. Methods We conducted a randomized non-inferiority trial on the provision of medical abortion and contraceptive counselling by physicians or nurses. The participants were pregnant women seeking abortion at a gestational duration of 70 days or less. The medical abortion regimen was 200 mg of oral mifepristone taken on-site followed by 800 ?g of misoprostol self–administered buccally at home 24 hours later. Women were instructed to return to the clinic for follow-up 7–15 days later. We did an intention-to-treat analysis for risk differences between physicians’ and nurses’ provision for completion and the need for surgical intervention. Findings Of 1017 eligible women, 884 women were included in the intention-to-treat analysis, 450 in the physician-provision arm and 434 in the nurse-provision arm. Women who completed medical abortion, without the need for surgical intervention, were 98.4% (443/450) for physicians’ provision and 97.9% (425/434) for nurses’ provision. The risk difference between the group was 0.5% (95% confidence interval, CI: ?1.2% to 2.3%). There were no differences between providers for examined gestational duration or women’s contraceptive method uptake. Both types of providers were rated by the women as highly acceptable. Conclusion Nurses’ provision of medical abortion is as safe, acceptable and effective as provision by physicians in this setting. Authorizing nurses to provide medical abortion can help to meet the demand for safe abortion services. PMID:26229189
Larsen, J V
The morbidity and mortality of illegal abortion are briefly discussed with reference to South Africa, where it seems that 1 in every 8-10 pregnant women deals with an unwanted pregnancy in this way. A review of the literature regarding legal abortion has been undertaken, detailing mortality and morbidity with various methods in many countries. The medical problems resulting from a permissive abortion policy have been highlighted, and an attempt has been made to define the place of medically induced abortion in health services, as it is understood by countries with extensive experience in this field. It is hoped that this contribution will help to define the real issues in the current abortion debate in South Africa. PMID:99825
Thein Thein Htay; Josephine Sauvarin; Saba Khan
Complications of unsafe abortion are a significant cause of maternal morbidity and mortality in Myanmar, and are recognised by the Ministry of Health as a priority. The Department of Health developed a strategy to address the problem of abortion complications by integrating post-abortion care and contraceptive services into the existing township health system. The quality of post-abortion care was assessed
Ramos, Silvina; Romero, Mariana; Aizenberg, Lila
This article presents the findings of a qualitative study exploring the experiences of women living in Buenos Aires Metropolitan Area, Argentina, with the use of misoprostol for inducing an abortion. We asked women about the range of decisions they had to make, their emotions, the physical experience, strategies they needed to use, including seeking health care advice and in dealing with a clandestine medical abortion, and their overall evaluation of the experience. An in-depth interview schedule was used. The women had either used misoprostol and sought counselling or care at a public hospital (n=24) or had used misoprostol based on the advice of a local hotline, information from the internet or from other women (n=21). Four stages in the women's experiences were identified: how the decision to terminate the pregnancy was taken, how the medication was obtained, how the tablets were used, and reflections on the outcome whether or not they sought medical advice. Safety and privacy were key in deciding to use medical abortion. Access to the medication was the main obstacle, requiring a prescription or a friendly drugstore. Correct information about the number of pills to use and dosage intervals was the least easy to obtain and caused concerns. The possibility of choosing a time of privacy and having the company of a close one was highlighted as a unique advantage of medical abortion. Efforts to improve abortion law, policy and service provision in Argentina in order to ensure the best possible conditions for use of medical abortion by women should be redoubled. PMID:25702064
The topic of this article is the use of unsafe abortion for unwanted pregnancies among adolescents. The significance of unsafe abortion is identified as a high risk of serious health problems, such as infection, hemorrhage, infertility, and mortality, and as a strain on emergency room services. The World Health Organization estimates that at least 33% of all women seeking hospital care for abortion complications are aged under 20 years. 50 million abortions are estimated to be induced annually, of which 33% are illegal and almost 50% are performed outside the health care system. Complications are identified as occurring due to the procedure itself (perforation of the uterus, cervical lacerations, or hemorrhage) and due to incomplete abortion or introduction of bacteria into the uterus. Long-term complications include an increased risk of ectopic pregnancy, chronic pelvic infection, and infertility. Mortality from unsafe abortion is estimated at 1000/100,000 procedures. Safe abortion mortality is estimated at 0.6/100,000. When infertility results, some cultures ascribe an outcast status or marriages are prevented or prostitution is assured. The risk of complications is considered higher for adolescents. Adolescents tend to delay seeking an abortion, lack knowledge on where to go for a safe procedure, and delay seeking help for complications. Peer advice may be limited or inadequate knowledge. Five studies are cited that illustrate the impact of unsafe abortion on individuals and health care systems. Abortions may be desired due to fear of parental disapproval of the pregnancy, abandonment by the father, financial and emotional responsibilities of child rearing, expulsion from school, or inability to marry if the child is out of wedlock. Medical, legal, and social barriers may prevent women and girls from obtaining safe abortion. Parental permission is sometimes a requirement for safe abortion. Fears of judgmental or callous health personnel may be barriers to seeking safe abortion. Some countries lack adequately trained medical personnel and supplies. Mortality and morbidity declines are considered possible with legalization, more trained health personnel, and family planning programs for youth and education for parents. PMID:12287144
Smargisso, Dana M; Lester, David
The decline in mortality from abortions after Roe vs Wade was probably a result of the introduction of safer procedures for abortions, but the decline in mortality was greater for induced abortions than for other types of abortions. PMID:12530723
Bela Ganatra; Vinoj Manning; Suranjeen Prasad Pallipamulla
The clinical safety, efficacy and acceptability of mifepristone and misoprostol in the Indian context have been well studied, but little is known about how they are being used, who is using them, how women access them or how providers, chemists, women and their partners perceive medical abortion. This paper reports on part of a study on these issues, a survey
Xu, M F; Jin, Y C; Cen, H X
Four hundred and fifty pregnant women were recruited for termination of early gestation by mifepristone combined with dl-15-methyl PGF2 alpha or misoprostol. Eight-four out of 450 subjects received curettage because of heavy or prolonged vaginal bleeding and slow decline of urinary hCG levels. Histopathology examinations of specimens obtained during curettage revealed denatured, necrotic and obscure villi and trophoblasts in 77 specimens, which accounted for 91.7%. Among them, 68 samples were mingled with inflammatory cell infiltration, and 15 with decidual cells, only 3 were villi and trophoblasts alone. The remaining 7 specimens were decidua in 6 and inflammatory infiltration in 1, which accounted for 7.1% and 1.2% respectively. This study suggested that the major cause resulting in heavy or prolonged vaginal bleeding after medical abortion by mifepristone and prostaglandin analogue was residual villi and trophoblasts with inflammatory cell infiltration. PMID:7712904
A post-independence (1992-93) decree issued by the Estonian Ministry of Social Affairs permits abortion on request up to 12 weeks of gestation and, on medical grounds, up to 20 weeks. According to reports received by the Estonian Medical Statistical Bureau, the 1994 abortion rate was 53.8/1000 women of reproductive age. Among women under 20 years of age, the abortion rate declined from 55.5/1000 in 1992 to 41.5/1000 in 1994. Only mini-abortions and abortions performed for medical reasons are free of charge; women with health insurance pay 50% of the cost of most procedures. Funds from abortion fees are used to subsidize contraception for full-time students, women in the first postpartum year, and women who had an induced abortion in the past three months. All other women must pay the full price of contraception. In 1994, only 234 out of every 1000 fertile women were using effective forms of contraception (IUDs and hormonal methods). However, the birth rate has been declining rapidly since 1990 and the rate of natural increase became negative in 1993 (-4.0). The fact that abortion but not contraception is subsidized has facilitated reliance on abortion as a family planning method. Recommended, to reduce the abortion rate and improve the family planning situation in Estonia, are improved contraceptive counseling, including pre- and post-abortion services, and school-based sex education. PMID:9225637
Background Identifying unsafe abortion among the major causes of maternal deaths and respecting the rights to health of women, in 2002, the Nepali parliament liberalized abortion up to 12 weeks of pregnancy on request. However, enhancing women’s awareness on and access to safe and legal abortion services, particularly in rural areas, remains a challenge in Nepal despite a decade of the initiation of safe abortion services. Methods Between January 2011 and December 2012, an operations research study was carried out using quasi-experimental design to determine the effectiveness of engaging female community health volunteers, auxiliary nurse midwives, and nurses to provide medical abortion services from outreach health facilities to increase the accessibility and acceptability of women to medical abortion. This paper describes key components of the operations research study, key research findings, and follow-up actions that contributed to create a conducive environment and evidence in scaling up medical abortion services in rural areas of Nepal. Results It was found that careful planning and implementation, continuous advocacy, and engagement of key stakeholders, including key government officials, from the planning stage of study is not only crucial for successful completion of the project but also instrumental for translating research results into action and policy change. While challenges remained at different levels, medical abortion services delivered by nurses and auxiliary nurse midwives working at rural outreach health facilities without oversight of physicians was perceived to be accessible, effective, and of good quality by the service providers and the women who received medical abortion services from these rural health facilities. Conclusions This research provided further evidence and a road-map for expanding medical abortion services to rural areas by mid-level service providers in minimum clinical settings without the oversight of physicians, thus reducing complications and deaths due to unsafe abortion. PMID:24886393
Assessment of completion of early medical abortion using a text questionnaire on mobile phones compared to a self-administered paper questionnaire among women attending four clinics, Cape Town, South Africa.
Constant, Deborah; de Tolly, Katherine; Harries, Jane; Myer, Landon
In-clinic follow-up to assess completion of medical abortion is no longer a requirement according to World Health Organization guidance, provided adequate counselling is given. However, timely recognition of ongoing pregnancy, complications or incomplete abortion, which require treatment, is important. As part of a larger trial, this study aimed to establish whether women having a medical abortion could self-assess whether their abortion was complete using an automated, interactive questionnaire on their mobile phones. All 469 participants received standard abortion care and all returnees filled in a self-assessment on paper at clinic follow-up 2-3 weeks later. The 234 women allocated to receive the phone messages were also asked to do a mobile phone assessment at home ten days post-misoprostol. Completion of the mobile assessment was tracked by computer and all completed assessments, paper and mobile, were compared to providers' assessments at clinic follow-up. Of the 226 women able to access the mobile phone assessment, 176 (78%) completed it; 161 of them (93%) reported it was easy to do so. Neither mobile nor paper self-assessments predicted all cases needing additional treatment at follow-up. Prediction of complete procedures was good; 71% of mobile assessments and 91% of paper assessments were accurate. We conclude that an interactive questionnaire assessing completion of medical abortion on mobile phones is feasible in the South African setting; however, it should be done later than day 10 and combined with an appropriate pregnancy test to accurately detect incomplete procedures. PMID:25702072
Fetters, Tamara; Raisanen, Keris; Mupeta, Stephen; Malisikwanda, Isikanda; Vwalika, Bellington; Osur, Joachim; Dijkerman, Sally
Despite broad grounds for legal abortion in Zambia, access to abortion services remains limited. Pharmacy workers, a primary source of health care for communities, present an opportunity to bridge the gap between policy and practice. As part of a larger operations study, 80 pharmacy workers, both registered pharmacists and their assistants, participated in a training on medical abortion in 2009 and 2010. Fifty-five of the 80 pharmacy workers completed an anonymous, structured training pre-test, treated as a baseline questionnaire; 53 of the 80 trainees were interviewed 12-24 months post-training in face-to-face interviews to measure the retention of information and training effectiveness. Survey questions were selected to illustrate the principles of a harm reduction approach to unsafe abortion. Bivariate analysis was used to examine pharmacy worker knowledge, attitudes and dispensing behaviours pre-training and at follow-up. A higher percentage of pharmacy workers reported referring women to a health care facility between surveys (47% to 68%, p = 0.03). The number of pharmacy workers who reported dispensing ineffective abortifacients decreased from baseline to end-line (30% to 25%) but the difference was non-significant. However, study results demonstrate that Zambian pharmacy workers have a role to play in safe abortion services and some are willing to play that role. PMID:25702075
Stotland, Nada L
The subject of abortion is fraught with politics, emotions, and misinformation. A widespread practice reaching far back in history, abortion is again in the news. Psychiatry sits at the intersection of the religious, ethical, psychological, sociological, medical, and legal facets of the abortion issue. Although the religions that forbid abortion are more prominent in the media, many religions have more liberal approaches. While the basic right to abortion has been upheld by the U.S. Supreme Court, several limitations have been permitted, including parental notification or consent (with the possibility of judicial bypass) for minors, waiting periods, and mandatory provision of certain, sometimes biased, information. Before the Roe v. Wade decision legalizing abortion in 1973, many women were maimed or killed by illegal abortions, and psychiatrists were sometimes asked to certify that abortions were justified on psychiatric grounds. Currently, there are active attempts to convince the public and women considering abortion that abortion frequently has negative psychiatric consequences. This assertion is not borne out by the literature: the vast majority of women tolerate abortion without psychiatric sequelae. The psychiatric outcome of abortion is best when patients are able to make autonomous, supported decisions. Psychiatrists need to know the medical and psychiatric facts about abortion. Psychiatrists can then help patients prevent unwanted pregnancies, make informed decisions consonant with their own values and circumstances when they become pregnant, and find appropriate social and medical resources whatever their decisions may be. PMID:15985924
For many years, illegal abortion has been denounced in Spain. The estimate of 300,000 abortions annually is widely quoted but poorly founded in fact. Weekend "charters" to London and Amsterdam for women seeking abortions have been commented upon, denounced, and caricatured. The evidence indicates that abortions occur in Spain despite their illegality, just as they occur in every other country and have always occurred. Poor women abort in a poor way, with traditional healers, while rich women abort in a rich way, with physicians. "Charters" are the solution of the middle class. Proposed legislation in Spain would permit abortion on 3 grounds: rape, fetal malformation, and risk to the woman's life if the pregnancy continued. Excesses have been committed both by those opposing abortion and by those struggling for liberalization of laws. Defenders of abortion, such as radical feminists, appear to forget that abortion is a medical procedure with possible dangerous psychophysical consequences, and that preventive measures such as sex education and diffusion of contraception or social measures such as assistance for unwed mothers and their children would be preferrable to abortion. There is the question of whether medical personnel should be excused from assisting in abortions on grounds of conscience and whether those who do assist in abortions automatically become "progressive" by doing so. The staunchest defenders of fetal life are not moved to contribute anything beyond words to improvement of the plight of the many millions of already born who live in miserable conditions of hunger and want. Abortion is a violent act against the fetus and the pregnant woman. Its criminalization is a violent act against the woman and a social intrusion into matters better left to personal ethics. The government which proposes abortion on a few grounds fails to initiate a program to promote life through social protection of single mothers and their children or of families in general and fails to specify remedies for conditions leading to abortion. Enemies of abortion, so motivated by the death of a fetus, are silent in the face of deaths that have become common in developed countries--youths shot by police, victims of traffic and labor accidents, victims of deficiency diseases--or that are institutionalized in Third World countries. PMID:6554009
Background Medical abortion is legal in South Africa but access and acceptability are hampered by the current protocol requiring a follow-up visit to assess abortion completion. Objective To assess the feasibility and efficacy of information and follow-up provided via mobile phone after medical abortion in a randomized controlled trial (RCT). Methods Mobile phones were used in three ways in the study: (1) coaching women through medical abortion using short message service (SMS; text messages); (2) a questionnaire to assess abortion completion via unstructured supplementary service data (USSD, a protocol used by GSM mobile telephones that allows the user to interact with a server via text-based menus) and the South African mobile instant message and social networking application Mxit; and (3) family planning information via SMS, mobisite and Mxit. A needs and context assessment was done to learn about women’s experiences undergoing medical abortion and their use of mobile phones. After development, the mobile interventions were piloted. Recruitment was done by field workers at the clinics. In the RCT, women were interviewed at baseline and exit. Computer logs were also analyzed. All study participants received standard of care at the clinics. Results In the RCT, 234 women were randomized to the intervention group. Eight did not receive the intervention due to invalid numbers, mis-registration, system failure, or opt-out, leaving 226 participants receiving the full intervention. Of the 226, 190 returned and were interviewed at their clinic follow-up visit. The SMSs were highly acceptable, with 97.9% (186/190) saying that the SMSs helped them through the medical abortion. In terms of mobile phone privacy, 86.3% (202/234) said that it was not likely or possible that someone would see SMSs on their phone, although at exit, 20% (38/190) indicated that they had worried about phone privacy. Having been given training at baseline and subsequently asked via SMS to complete the self-assessment questionnaire, 90.3% (204/226) attempted it, and of those, 86.3% (176/204) reached an endpoint of the questionnaire. For the family planning information, a preference for SMS was indicated by study clients, although the publicly available Mxit/mobisite was heavily used (813,375 pages were viewed) over the study duration. Conclusions SMS provided a good medium for timed, "push" information that guided and supported women through medical abortion. Women were able to perform a self-assessment questionnaire via mobile phones if provided training and prompted by SMS. Phone privacy needs to be protected in similar settings. This study may contribute to the successful expansion of medical abortion provision aided by mobile phones. Trial Registration Pan African Clinical Trials Registry (PACTR): PACTR201302000427144; http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?dar=true&tNo=PACTR201302000427144 (Archived by WebCite at http://www.webcitation.org/6N0fnZfzm). PMID:25098569
Cook, R J; Erdman, J N; Dickens, B M
National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny. PMID:17889879
...2009-07-01 true Procedures for obtaining medical care. 564.40 Section 564.40...RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining medical care. (a) When a...
...2014-07-01 false Procedures for obtaining medical care. 564.40 Section 564.40...RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining medical care. (a) When a...
...2009-07-01 true Procedures for obtaining medical care. 564.40 Section 564.40...RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining medical care. (a) When a...
...2013-07-01 false Procedures for obtaining medical care. 564.40 Section 564.40...RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining medical care. (a) When a...
...2010-07-01 true Procedures for obtaining medical care. 564.40 Section 564.40...RESERVES NATIONAL GUARD REGULATIONS Medical Attendance and Burial § 564.40 Procedures for obtaining medical care. (a) When a...
Sally B. Rose; Zhang Wei; Annette J. Cooper; Beverley A. Lawton
BackgroundMigrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether
A proposal is presented for a Community College of Philadelphia course, entitled "Medical Office Laboratory Procedures," which provides a laboratory introduction to microscopic and chemical analysis of blood and urine as performed in the physician's office. Following a standard cover form, a statement of the purpose of the course discusses course…
Marshburn, Tom; Goode, Julie
The Health Maintenance System (HMS) hardware will be used to support a medical contingency for the International Space Station (ISS). During two test flights, the procedures for performing Advanced Cardiac Life Support (ACLS) were evaluated to determine the required level of detail, assess the logic of the steps and division of tasks among crew members.
Polish laws specify the parties responsible for lawful medical care in the availability of abortion differently than the Resolution of the Council of Europe. According to Polish regulations they include all Polish doctors while according to the Resolution, the state. Polish rules should not discriminate against anyone in connection with his religion or belief, even more so because the issue of abortion is an example of an unresolved ethical dispute. The number of lawful abortion in Poland does not exceed 1000 per year and can be carried out by only a few specialists contracted by the National Health Fund. Sufficient information and assistance should be provided to all pregnant women by the National Health Fund. The participation of all physicians in the informing process is not necessary, as evidenced by the lack of complaints to provide information on where in vitro fertilization treatment can be found - until recently only available when paid for by the individual and performed in much larger numbers than abortion. Entities performing this paid procedure made sure to provide information on their own. The rejection of the right to the conscientious objection clause by negating the right to refuse information may lead some to give up the profession or cause the termination of certain professionals on the basis of the professed worldview. Meanwhile, doctors are not allowed to be discriminated against on the basis of their conscience or religion. PMID:25815623
Leistikow, Bruce N.
POLICIES AND PROCEDURES University of California, Davis Medical Center Medical Staff Administration Administration Policy: 128 Approved: 12/14/09 IMPAIRED MEDICAL STAFF MEMBERS Page: 2 of 5 Medical Officer Medical Center Medical Staff Administration Policy: 128 Approved: 12/14/09 IMPAIRED MEDICAL STAFF MEMBERS
Donnelly, Kyla Z; Thompson, Rachel
Introduction Currently, we lack understanding of the content, quality and impact of patient decision aids to support decision-making between medical and surgical methods of early abortion. We plan to undertake a systematic review of peer-reviewed literature to identify, appraise and describe the impact of early abortion method decision aids evaluated quantitatively (Part I), and an environmental scan to identify and appraise other early abortion method decision aids developed in the US (Part II). Methods and analysis For the systematic review, we will search PubMed, Cochrane Library, CINAHL, EMBASE and PsycINFO databases for articles describing experimental and observational studies evaluating the impact of an early abortion method decision aid on women's decision-making processes and outcomes. For the environmental scan, we will identify decision aids by supplementing the systematic review search with Internet-based searches and key informant consultation. The primary reviewer will assess all studies and decision aids for eligibility, and a second reviewer will also assess a subset of these. Both reviewers will independently assess risk of bias in the studies and abstract data using a piloted form. Finally, both reviewers will assess decision aid quality using the International Patient Decision Aid Standards criteria, ease of readability using Flesch/Flesch-Kincaid tests, and informational content using directed content analysis. Ethics and dissemination As this study does not involve human subjects, ethical approval will not be sought. We aim to disseminate the findings in a scientific journal, via academic and/or professional conferences and among the broader community to contribute knowledge about current early abortion method decision-making support. Trial registration number This protocol is registered in the International Prospective Register of Systematic Reviews (CRD42015016717). PMID:26173718
Rehan, N; Inayatullah, A; Chaudhary, I
A study of the characteristics of Pakistani women seeking abortion and a profile of abortion clinics was conducted in 32 abortion clinics in three provincial capitals of the country. All 452 women who had their pregnancies terminated between October and December 1997 were interviewed. Except for 39 women (8.6%), all study subjects were married. A majority of the women (36.6%) were aged >35 years, 61.0% had given birth to > or =5 children, and 40.2% were illiterate. The predominant reasons for abortion were "too many children" (64.4%), contraceptive failure (20.3%), premarital affairs (8.6%), medical reasons (5.4%), and extramarital affairs (1.3%). Nearly two thirds of the abortions were induced by inadequately trained persons. Only 22% of the abortion clinics met the World Health Organization (WHO) standards required for safe termination of pregnancy. At all these clinics, the procedure used to terminate the pregnancy was dilatation and curettage (D&C). Only one clinic was using manual vacuum aspiration (MVA). Induced abortion seems to be fairly common among married women of high parity, advanced age, and low educational status. Keeping in view the large number of terminations, new medical and surgical techniques of pregnancy termination should be introduced to those already providing abortion services. PMID:11703893
Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...
Duprez, D; Fortuna, P
All physicians should be aware of the possible complications of induced abortions if only because the procedure is so commonplace. Some 250,000 induced abortions occur annually in France, amounting to 24.4 abortions per 100 live births. The rates of different complications of induced abortions before 12 weeks are .5-5/1000 for uterine perforation, .5-3.4% for hemorrhage with or without placental retention, 1% for endometritis, .3% for salpingitis .5% for continuing pregnancy, and .006 to .3/10,000 for death. A well done curettage is preferable to a poorly performed aspiration procedure. If an aspiration is done, the practitioner should bear in mind that retention of 50-200 cc of blood clots may occur if dilatation is insufficient. Symptoms appear 1-5 days after the abortion and end with expulsion of the clots or aspiration. Curettage is useless, as the clots do not represent a true retention. Uterine contractions during the aspiration can occasionally prompt a premature decision that evacuation is complete. Retention is difficult to diagnose immediately after aspiration but can be sonographically confirmed after the 8th day. Aspiration should be done after the 6th week and before the 12th week. Aspiration before the 6th week is often painful and is associated with higher rates of partial retention and of complete failure. Endouterine aspiration, regardless of technical proficiency, establishes a pathway between the vagina and the uterine cavity, which exposes the latter to the risk of trauma, endometrial lesions, and perforation. Induced abortion promotes infection by 2 mechanisms. Latent infections that were not detected in the medical history or physical examination can emerge and cause endometritis, which should be treated by ice, rest, and antibiotics. Or contamination of the passage by an infected cervical mucus can lead to salpingitis, abscess, and pelviperitonitis, or even general peritonitis. More often, these conditions develop from inadequately treated nonretentional endometritis. The condition should be treated with antibiotics and ice. Postoperative hemorrhage is unusual and is most frequently caused by retention. Psychological complications of abortion can be minimized by effective counseling. The counselor should seek to identify any history of psychological pathology or particularly stressful current situation. A certain amount of regret is a normal psychic response to abortion, but more serious symptoms such as suicidal thoughts or obvious depression may indicate the need for specialized care. Experience demonstrates that serious psychic reactions are rare and that a population at high risk can be defined. It includes very ambivalent women, those coerced into abortion, and those at the legal time limit. Women with a recent history of death or illness of a child, intrauterine death in the preceding pregnancy, or spontaneous abortions are also at risk. PMID:2705090
Replies to the request by the Journal of Nursing on readers' positions against induced abortion indicate there is a definite personal position against induced abortion and the assistance in this procedure. Some writers expressed an emotional "no" against induced abortion. Many quoted arguments from the literature, such as a medical dictionary definition as "a premeditated criminally induced abortion." The largest group of writers quoted from the Bible, the tenor always being: "God made man, he made us with his hands; we have no right to make the decision." People with other philosophies also objected. Theosophical viewpoint considers reincarnation and the law of cause and effect (karma). This philosophy holds that induced abortion impedes the appearance of a reincarnated being. The fundamental question in the abortion problem is, "can the fetus be considered a human life?" The German anatomist Professor E. Bleckschmidt points out that from conception there is human life, hence the fertilized cell can only develop into a human being and is not merely a piece of tissue. Professional nursing interpretation is that nursing action directed towards killing of a human being (unborn child) is against the nature and the essence of the nursing profession. A different opinion states that a nurse cares for patients who have decided for the operation. The nurse doesn't judge but respects the individual's decision. Some proabortion viewpoints considered the endangering of the mother's life by the unborn child, and the case of rape. With the arguments against abortion the question arises how to help the woman with unwanted pregnancy. Psychological counseling is emphasized as well as responsible and careful assistance. Referral to the Society for Protection of the Unborn Child (VBOK) is considered as well as other agencies. Further reader comments on this subject are solicited. PMID:6913282
Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. This article examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally. PMID:10859852
Sanhueza Smith, Patricio; Peña, Melanie; Dzuba, Ilana G; García Martinez, María Laura; Aranguré Peraza, Ana Gabriela; Bousiéguez, Manuel; Shochet, Tara; Winikoff, Beverly
Extensive evidence exists regarding the efficacy and acceptability of medical abortion through 63 days since last menstrual period (LMP). In Mexico City's Secretariat of Health (SSDF) outpatient facilities, mifepristone-misoprostol medical abortion is the first-line approach for abortion care in this pregnancy range. Recent research demonstrates continued high rates of complete abortion through 70 days LMP. To expand access to legal abortion services in Mexico City (where abortion is legal through 12 weeks LMP), this study sought to assess the efficacy and acceptability of the standard outpatient approach through 70 days in two SSDF points of service. One thousand and one women seeking pregnancy termination were enrolled and given 200 mg mifepristone followed by 800 ?g misoprostol 24-48 hours later. Women were asked to return to the clinic one week later for evaluation. The great majority of women (93.3%; 95% CI: 91.6-94.8) had complete abortions. Women with pregnancies ? 8 weeks LMP had significantly higher success rates than women in the 9th or 10th weeks (94.9% vs. 90.5%; p = 0.01). The difference in success rates between the 9th and 10th weeks was not significant (90.0% vs. 91.2%; p = 0.71). The majority of women found the side effects (82.9%) and the use of misoprostol (84.4%) to be very acceptable or acceptable. This study provides additional evidence supporting an extended outpatient medical abortion regimen through 10 weeks LMP. PMID:25702071
Informed consent mandates for abortion providers may infringe the First Amendment's freedom of speech. On the other hand, they may reinforce the physician's duty to obtain informed consent. Courts can promote both doctrines by ensuring that compelled physician speech pertains to medical facts about abortion rather than abortion ideology and that compelled speech is truthful and not misleading. PMID:25846035
Tamang, Anand; Puri, Mahesh; Lama, Kalyan; Shrestha, Prabhakar
In Nepal, despite policy restrictions, both registered and unregistered brands of mifepristone and misoprostol can easily be obtained at pharmacies. Since many women visit pharmacies for abortion information, ensuring that they receive effective care from pharmacy workers remains an important challenge. We conducted an operations research study to examine whether trained pharmacy workers can correctly provide information on safe use of mifepristone and misoprostol for early first trimester medical abortion. Pharmacy workers in one district were given orientation and training using a harm-reduction approach, and compared with a non-equivalent comparison group in the second district. Overall, trained pharmacy workers' knowledge increased substantially, but no increase was found in the comparison group. Compared to the baseline (65%), 97% of trained pharmacy workers knew up to what stage of pregnancy and how women should use mifepristone and misoprostol. A higher percentage of pharmacy workers in the intervention group (77%) compared to the comparison group (49%) were knowledgeable at follow-up about determining whether an abortion was successful, implying a need for improving this aspect of training. As many mid-level health providers run their own pharmacies and offer medical abortion pills, it is important for the government to consider training these providers and registering their pharmacies as safe medical abortion service outlets. PMID:25702074
Aksel, Sarp; Fein, Lydia; Ketterer, Em; Young, Emily; Backus, Lois
The US Supreme Court's 1973 Roe v Wade decision had clear implications for American women's reproductive rights and physician ability to carry out patient choices. Its effect on physician abortion training was less apparent. In an effort to increase patient access to abortions after Roe, provision shifted from hospitals to nonhospital clinics. However, these procedures and patients were taken out of the medical education realm, and physicians became vulnerable to intimidation. The consequent provider shortage created an unexpected barrier to abortion access. Medical Students for Choice was founded in 1993 to increase abortion-training opportunities for medical students and residents. Its mission ensures that motivated medical students will learn and a growing number of physicians will commit to comprehensive abortion provision. PMID:23327239
Enactment of mandated pre-procedure disclosures in abortion and assisted reproductive technology (ART) services has swelled in recent years. Calls to equally regard these mandates as neutral tools in furtherance of patient protection fail to acknowledge key substantive and structural differences in these reproduction-affecting mandates. While ART mandates permit physicians to use their medical judgment to protect presumptively vulnerable egg donors and gestational carriers, abortion disclosures impart scientifically suspect messaging aimed at dissuading women from pursuing pregnancy termination. These and other distinctions counsel in favor of regarding and analyzing abortion and ART mandated disclosures as separate and distinguishable informed consent tools. PMID:26242946
Frit Jofsson, A F
Abortion statistics for Sweden in 1976 are presented. The liberalized abortion law passed in 1975 caused an increase in the number of abortions performed, but an increase in the incidence of abortion is apparent as early as 1974. This would indicate that a more liberal attitude toward abortion coincided with the 1974 proposal to liberalize the abortion law. 32,351 abortions were performed in 1976, compared to 32,526; this may indicate that a peak has been reached in the demand for abortion. Between 1971 and 1976, the percentage of abortions performed up to the 12th week of pregnancy and the percentage of abortions performed in open wards increased. PMID:651447
Department of the Army, Washington, DC.
This manual presents laboratory procedures for the differentiation and identification of disease agents from clinical materials. Included are procedures for the collection of specimens, preparation of culture media, pure culture methods, cultivation of the microorganisms in natural and simulated natural environments, and procedures in…
The House of Representatives passed a bill, by a two-thirds majority (288-139), prohibiting late (at 19-20 weeks gestation) abortion using intrauterine cranial decompression. The bill now awaits judgment from the Senate Judiciary Committee for hearings. If the bill becomes law, physicians performing the procedure could face up to two years in prison. Chris Smith, Republican cochairman of the House Pro-Life Caucus, who introduced the bill in the House, described the vote as historic. During his emotional speech, the procedure was described in order to desanitize a form of abortion that he called barbaric torture. Patricia Schroeder, Colorado House Representative, argued that the wording of the bill allowed the procedure only when it was the only possible way of saving the mother's life; the woman's health and future fertility were, in effect, set aside. There is no exception clause for when the woman's life or health is endangered. Schroeder fears women will be forced to choose more dangerous methods of abortion and believes more discussion is required regarding health risks and a more precise definition of when the procedure may be used. She is joined by the California Medical Association, the American Medical Women's Association, the American College of Obstetricians and Gynaecologists, and the American Medical Association. PMID:7496271
Yamamoto, K; Yamamoto, Y; Hayase, T
In Japan, the artificial abortion is a penal offence; only in the presence of certain conditions it is authorized under the provision of the Eugenic Protection Law which was promulgated in 1948. According to the law, the artificial abortion is restricted to the period, in which the fetus is not viable outside of the uterus. This period is prescribed by notification from the Ministry of Public Welfare; up to now it has been shortened twice (1976, 1991). Due to the introduction of economic reasons in the list of conditions and the simplification of the procedure the artificial abortion in Japan was virtually liberalized. Prosecution for illegal abortion is very rare in recent years. The number of reported artificial abortions decreases; in the about last 30 years it reduced by half. However, the increase in the number of abortions in women younger than 20 years of age is a problem. The abortion in teenagers is late compared with that in other age groups. Although the number of neonaticides does not seem to increase, the increase in the number of abortions in teenagers remains a serious problem in Japan. PMID:8352642
Spitz, A M; Oberle, M; Zaro, S M
According to data reported to the Georgia Department of Human Resources (DHR), the number of induced abortions performedin Georgia in 1980 decreased for the 1st time since 1968 when the state legalized abortion. To verify this reported decrease, the DHR data were compared with statistics obtained by the Alan Guttmacher Institute in a 1980 survey of abortion providers in Georgia. Since the AGI contacts providers directly, its statistics are considered a more accurate reflection of abortions performed. According to the DHR, the number of abortions dropped from 36,579 in 1979 to 33,288 in 1980, a 9% decrease, and the abortion rate fell from 26.6/1000 women ages 15-44 years to 23.9/1000. AGI data indicated a drop from 38,760 abortions in 1979 to 37,890 in 1980, a 2% decrease. Since both sources noted a similar trend despite differences in data collection methods, the 1980 decline in abortion procedures in Georgia is considered to represent a true decline rather than s statistical artifact. The sociodemographic characteristics of women obtaining abortions in Georgia in 1980 were also analyzed on the basis of DHR data. Although the number of abortions in Georgia performed on Georgia residents increased 2.5% from 1979-80 to 90.7%, the abortion ratio for residents decreased from 367.7 to 327.4 abortions/1000 live births. There was little change in the age, race, or marital status distribution of women receiving abortions. The ratio for white women was 317 abortions/1000 live births and that for blacks was 342/1000. The abortion ratio for unmarried women (1166/1000) was 13 times that for married women (88/1000). The number of repeat abortions decreased form 34% in 1979 to 29% in 1980. Moreover, 93% of women obtaining abortions did so in the 1st 12 weeks of gestation compared with 89% in 1979. The percentage of abortions performed in clinics increased from 66.5% in 1979 to 75.3% in 1980, with suction curettage accounting for 85% of all abortions in the 1st 12 weeks of gestation. Further analysis ruled out the possibility that the decreased abortion rate was caused by an increase in the number of births, declining numbers of abortion providers, changes in public funding for abortion, or an increase in the number of Georgia residents obtaining out of stat abortions. PMID:6707546
Fawcus, Susan R
Unsafe abortions refer to terminations of unintended pregnancies by persons lacking the necessary skills, or in an environment lacking the minimum medical standards, or both. Globally, unsafe abortions account for 67,900 maternal deaths annually (13% of total maternal mortality) and contribute to significant morbidity among women, especially in under-resourced settings. The determinants of unsafe abortion include restrictive abortion legislation, lack of female empowerment, poor social support, inadequate contraceptive services and poor health-service infrastructure. Deaths from unsafe abortion are preventable by addressing the above determinants and by the provision of safe, accessible abortion care. This includes safe medical or surgical methods for termination of pregnancy and management of incomplete abortion by skilled personnel. The service must also include provision of emergency medical or surgical care in women with severe abortion complications. Developing appropriate services at the primary level of care with a functioning referral system and the inclusion of post abortion contraceptive care with counseling are essential facets of abortion care. PMID:18249585
Maternal mortality is the second most common cause of death among women in Ghana, and more than one in 10 maternal deaths (11%) are the result of unsafe induced abortions.1 In addition, a substantial proportion of women who survive an unsafe abortion experience complications from the procedure. This suffering is all the more tragic because it is unnecessary: Many women likely turn to unsafe providers or do not obtain adequate postabortion care when it is needed because they are unaware that abortion is legal on fairly broad grounds in Ghana. PMID:20653094
Benson, J; Nicholson, L A; Gaffikin, L; Kinoti, S N
The Commonwealth Regional Health Community Secretariat undertook a study in 1994 to document the magnitude of abortion complications in Commonwealth member countries. The results of the literature review component of that study, and research gaps identified as a result of the review, are presented in this article. The literature review findings indicate a significant public health problem in the region, as measured by a high proportion of incomplete abortion patients among all hospital gynaecology admissions. The most common complications of unsafe abortion seen at health facilities were haemorrhage and sepsis. Studies on the use of manual vacuum aspiration for treating abortion complications found shorter lengths of hospital stay (and thus, lower resource costs) and a reduced need for a repeat evacuation. Very few articles focused exclusively on the cost of treating abortion complications, but authors agreed that it consumes a disproportionate amount of hospital resources. Studies on the role of men in supporting a woman's decision to abort or use contraception were similarly lacking. Articles on contraceptive behaviour and abortion reported that almost all patients suffering from abortion complications had not used an effective, or any, method of contraception prior to becoming pregnant, especially among the adolescent population; studies on post-abortion contraception are virtually nonexistent. Almost all articles on the legal aspect of abortion recommended law reform to reflect a public health, rather than a criminal, orientation. Research needs that were identified include: community-based epidemiological studies; operations research on decentralization of post-abortion care and integration of treatment with post-abortion family planning services; studies on system-wide resource use for treatment of incomplete abortion; qualitative research on the role of males in the decision to terminate pregnancy and use contraception; clinical studies on pain control medications and procedures; and case studies on the provision of safe abortion services where legally allowed. PMID:10158454
On July 19, 2005, the Food and Drug Administration (FDA) issued a public health advisory regarding the deaths of four women in the United States after medical abortions with Mifeprex (mifepristone, formerly RU-486; Danco Laboratories, New York, New York) and intravaginal misoprostol. Two of these deaths occurred in 2003, one in 2004, and one in 2005. Two of these U.S. cases had clinical illness consistent with toxic shock and had evidence of endometrial infection with Clostridium sordellii, a gram-positive, toxin-forming anaerobic bacteria. In addition, a fatal case of C. sordellii toxic shock syndrome after medical abortion with mifepristone and misoprostol was reported in 2001, in Canada. All three cases of C. sordellii infection were notable for lack of fever, and all had refractory hypotension, multiple effusions, hemoconcentration, and a profound leukocytosis. C. sordellii previously has been described as a cause of pregnancy-associated toxic shock syndrome. PMID:16049422
Chenier, Tracey S.; Whitehead, Ashley E.
The purpose of this study was to determine foaling rates in mares presented for medical or surgical treatment of colic, and to examine risk factors associated with abortion following colic. A retrospective analysis of 153 medical records found that mares treated surgically for colic (P = 0.0007) were 3.5 times more likely to have a negative pregnancy outcome than were mares treated medically for colic. Anesthetic time (P = 0.01) and intra-operative hypotension (P = 0.03) were significantly associated with negative pregnancy outcome. Mares with an anesthetic time ? 3 h were 6 times more likely to abort. Signs of endotoxemia (P = 0.30), hypoxia (P = 0.89), flunixin meglumine administration (P = 0.13), mucous membrane color at the time of presentation (P = 0.82) and capillary refill time (P = 0.76) were not associated with pregnancy outcome. There was no difference in the foaling rate for mares that had received progestin supplementation versus those that had not (P = 0.42). In this study, the significant risk factors for abortion were surgically treated colic, long anesthetic time, and intraoperative hypotension. PMID:19436632
There is an increasing demand for anesthesiologists to work outside the operating room in order to provide general anesthesia or monitored sedation for a variety of medical investigations or procedures in infants and children. The concept that treatment should be a pain- and stress-free experience is now well accepted, and this has placed additional responsibilities on anesthesiologists. We describe pediatric anesthesia and monitored sedation for diagnostic medical procedures. Children requiring a painful procedure and prolonged examination should be provided with optimal sedation and analgesia. The child should be monitored with standard ASA monitors. In the case of medical procedures such as gastrointestinal endoscopy, transesophageal echocardiography, and cardiac catheterization, general endotracheal anesthesia with neuromuscular block is recommended. Several short-acting anesthetic drugs, including sevoflurane, propofol, remifentanil, and rocuronium, have become available in Japan, and the safety and efficacy of pediatric general anesthesia for diagnostic medical procedures have improved. Infants who require a noninvasive and short examination may not be provided with anesthetics. The feed and wrap method is recommended. Satisfactory immobilization of the child during noninvasive medical procedures, including magnetic resonance imaging, may be achieved by intravenous sedation or general anesthesia. Monitored intravenous sedation using propofol is the most widely used for healthy children; general anesthesia with a laryngeal mask airway or endotracheal intubation and controlled ventilation is required for a critically ill child. PMID:25669029
Gold, Marji; Chong, Erica
Given the highly political nature of abortion in the United States, the provision of medical abortion with mifepristone (Mifeprex®) and misoprostol has always occurred under a unique set of circumstances. The Food and Drug Administration-approved regimen requires clinicians to administer the mifepristone in the office and also requires women to return to the office for the misoprostol. In the US, where off-label drug use is an accepted practice when supportive evidence exists, most clinicians give women the misoprostol at the initial visit for her to take at home, eliminating an unnecessary visit to the office. This commentary suggests that, based on current studies, there is also enough evidence to offer women the option to self-administer mifepristone out of the office and that this is just another feature of off-label use. Six studies, enrolling over 1800 women, found that the option of taking mifepristone out of the office was popular and acceptable among women and providers. Given that it is safe, highly acceptable and not burdensome on providers, outside-office-use of mifepristone should be offered to all women as part of routine medical abortion services. PMID:26093187
Winkler, H. E. (inventor)
A bio-medical flow sensor including a packageable unit of a bottle, tubing and hypodermic needle which can be pre-sterilized and is disposable. The tubing has spaced apart tubular metal segments. The temperature of the metal segments and fluid flow therein is sensed by thermistors and at a downstream location heat is input by a resistor to the metal segment by a control electronics. The fluids flow and the electrical power required for the resisto to maintain a constant temperature differential between the tubular metal segments is a measurable function of fluid flow through the tubing. The differential temperature measurement is made in a control electronics and also can be used to control a flow control valve or pump on the tubing to maintain a constant flow in the tubing and to shut off the tubing when air is present in the tubing.
Randall, Amy E
This article examines Soviet reproductive politics after the Communist regime legalized abortion in 1955. The regime's new abortion policy did not result in an end to the condemnation of abortion in official discourse. The government instead launched an extensive campaign against abortion. Why did authorities bother legalizing the procedure if they still disapproved of it so strongly? Using archival sources, public health materials, and medical as well as popular journals to investigate the antiabortion campaign, this article argues that the Soviet government sought to regulate gender and sexuality through medical intervention and health "education" rather than prohibition and force in the post-Stalin era. It also explores how the antiabortion public health campaign produced "knowledge" not only about the procedure and its effects, but also about gender and sexuality, subjecting both women and men to new pressures and regulatory norms. PMID:22145180
Across four decades of political and social action, Nepal changed from a country strongly enforcing oppressive abortion restrictions, causing many poor women's long imprisonment and high rates of abortion-related maternal mortality, into a modern democracy with a liberal abortion law. The medical and public health communities supported women's rights activists in invoking legal principles of equality and non-discrimination as a basis for change. Legislative reform of the criminal ban in 2002 and the adoption of an Interim Constitution recognizing women's reproductive rights as fundamental rights in 2007 inspired the Supreme Court in 2009 to rule that denial of women's access to abortion services because of poverty violated their constitutional rights. The government must now provide services under criteria for access without charge, and services must be decentralized to promote equitable access. A strong legal foundation now exists for progress in social justice to broaden abortion access and reduce abortion stigma. PMID:24890742
Young, Alma T.; And Others
When New York State's abortion laws were liberalized in 1970, there was a sharp rise in the number of clinic patients who requested abortions. Because social workers at Mount Sinai Medical Center believed that abortion still is an emotional risk for many women, a study was conducted to determine which patients needed intensive counseling. (Author)
Smith, J C; Cates, W
As with the delivery of any medical service, abortion has definite public health effects that should be evaluated. The Center for Disease Control (CDC) has monitored the impact of abortion in three ways: (a) conducting epidemiologic surveillance of legally induced abortion beginning in 1969. (b) funding a multicenter study of abortion morbidity beginning in 1971, and (c) undertaking surveillance of abortion-related mortality beginning in 1972. These activities are intended to identify health problems related to abortion, to assess the magnitude of these problems, and to make recommendations directed at eliminating the problems. In addition to the Programmatic uses of abortion data, the CDC statistics have also provided a basis for both legislative and judicial decisions that have had national and local impact. The CDC and the National Center for Health Statistics are currently working collectively to strengthen the reporting of national abortion statistics so that the public health need for abortion statistics can be met. PMID:635096
Physically-based Simulation of Medical Procedures for Training and Planning The Challenge Computer simulations of medical procedures enable physicians and other clinicians to train in a controlled environment on simulating and planning medical procedures involving needles. Numerous medical procedures, including
Brashear, Diane B.
The author discusses the characteristics and feelings of women undergoing abortion. She mentions the decisions which counselors must help such women face, the information they must be given, and the types of support they need. Increased counseling services are needed, she feels, for the markedly increased number of women seeking abortions. (EK)
The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee…
According to international press reports, a law that would have allowed Portuguese women abortions through the 10th week of pregnancy and into the 16th week if their physical or mental health was at risk has been rescinded after a referendum to determine the statute's future was voided because of low voter turnout. Passed in February, the law was a liberalization of Portugal's strict anti-abortion laws, which ban all abortions except for narrowly defined medical reasons or in the case of rape (and those are permitted only until the 12th week of pregnancy). Because the issue is such a controversial one, politicians had turned to a national referendum asking Portuguese voters to overturn or ratify the new law. The referendum was the first in the country since the end of its right-wing dictatorship in 1974, and 50% participation was required. Only 31.5% of the country's 8.5 million eligible voters went to the polls on June 28. Of those voting, 50.9% voted against the liberalized new legislation. Sunny weather and World Cup soccer matches were both pointed to as reasons for the low turnout. Officials estimate there are some 20,000 illegal abortions annually in Portugal. Abortion-rights activists in the mostly Roman-Catholic country say hospitals see roughly 10,000 women a year suffering from complications from illegal abortions, and that at least 800 women die each year from the procedure. In the next day's Diario de Noticias, a daily paper in Portugal, the entire front page was filled with a giant question mark. "What now, lawmakers?" the headline read. PMID:12293809
Cook, R J; Dickens, B M; Horga, M
In 2003, the World Health Organization published its well referenced handbook Safe Abortion: Technical and Policy Guidance for Health Systems to address the estimated almost 20 million induced abortions each year that are unsafe, imposing a burden of approximately 67 thousand deaths annually. It is a global injustice that 95% of unsafe abortions occur in developing countries. The focus of guidance is on abortion procedures that are lawful within the countries in which they occur, noting that in almost all countries, the law permits abortion to save a woman's life. The guidance treats unsafe abortion as a public health challenge, and responds to the problem through strategies concerning improved clinical care for women undergoing procedures, and the appropriate placement of necessary services. Legal and policy considerations are explored, and annexes present guidance to further reading, international consensus documents on safe abortion, and on manual vacuum aspiration and post-abortion contraception. PMID:15207687
Karen O. Anderson; Frank T. Masur
Psychological preparation for invasive medical and dental procedures has been based on the rationale that high levels of preprocedural fear are detrimental to patients' subsequent adaptation. After a brief survey of the theoretical and empirical evidence pertaining to this rationale, the major psychological approaches designed to alleviate preprocedural concern and enhance recovery are discussed. Outcome studies that have employed informative,
Annas, G J
In the US, a new antiabortion strategy of using legislative and judicial forums to change the rhetoric of abortion rather than using abortion rhetoric to change the law arose out of disappointment when the 1992 Casey decision failed to overturn Roe. This new approach is crystallized by the 1995 introduction of federal legislation (vetoed by the President) to ban so-called "partial-birth" abortions. Opponents to this late-term procedure undertaken to preserve a women's life or health distinguish intact dilatation and extraction from induced labor to terminate a nonviable pregnancy (failing to recognize the lack of ethical difference) and make inaccurate political statements linking the abortion procedure to infanticide. When the ban was reintroduced to Congress in 1997, the previously silent American Medical Association agreed to support the bill if two "physician-friendly" amendments were added, but the American College of Obstetricians and Gynecologists made it clear that it is "inappropriate, ill advised, and dangerous" for legislative bodies to intervene into medical decision-making. The new version of the bill shifted the focus to all abortions after viability unless they are necessary to protect the mother from grievous harm to her physical (not mental) health, thus limiting the reach of the Roe decision. Clinton vetoed this bill also. Such legislation would be unlikely to prevent even one abortion, and its importance rests in its view of the proper role of government in regulating health care. This follows previous efforts to reframe the abortion debate by creating a dichotomy that marginalizes either women or fetuses and shifts the focus to another issue. PMID:9673308
Lithur, Nana Oye
Traditional and cultural values, social perceptions, religious teachings and criminalisation have facilitated stigmatisation of abortion in Ghana. Abortion is illegal in Ghana except in three instances. Though the law allows for performance of abortion in three circumstances, the Ghana reproductive health service policy did not have any induced legal abortion services component to cover the three exceptions until it was revised in 2003. The policy only had 'unsafe and post-abortion' care components, and abortions performed in health facilities operated by the Ghana Health Service were performed under this component. Though the policy has been revised, women and girls who need abortion services in Ghana more often resort to the backstreet dangerous methods and procedures. Criminalisation of abortion and those who perform abortions has contributed to unsafe abortion, the second leading cause of maternal deaths in Ghana. Most of these are performed outside the formal health service structures. Traditionally, abortion is perceived as a shameful act and the community may shun and give a woman who has caused anabortion derogatory names. Would provision of legal abortion services be culturally acceptable within a Ghanaian community? Yes, if they are made aware of the reproductive health benefits of providing safe abortion services. Three major strategies that would help to destigmatise abortion in the community are (1) the liberal interpretation of the three exceptions to the law on abortion; (2) expanding community awareness of its reproductive health benefits; and (3) improving and increasing access to legal abortion services within the formal health facilities. PMID:15487616
Wallin Lundell, Inger; Öhman, Susanne Georgsson; Sundström Poromaa, Inger; Högberg, Ulf; Sydsjö, Gunilla; Skoog Svanberg, Agneta
Objectives To identify perceived deficiencies in the quality of abortion care among healthy women and those with mental stress. Methods This multi-centre cohort study included six obstetrics and gynaecology departments in Sweden. Posttraumatic stress (PTSD/PTSS) was assessed using the Screen Questionnaire-Posttraumatic Stress Disorder; anxiety and depressive symptoms, using the Hospital Anxiety Depression Scale; and abortion quality perceptions, using a modified version of the Quality from the Patient's Perspective questionnaire. Pain during medical abortion was assessed in a subsample using a visual analogue scale. Results Overall, 16% of the participants assessed the abortion care as being deficient, and 22% experienced intense pain during medical abortion. Women with PTSD/PTSS more often perceived the abortion care as deficient overall and differed from healthy women in reports of deficiencies in support, respectful treatment, opportunities for privacy and rest, and availability of support from a significant person during the procedure. There was a marginally significant difference between PTSD/PTSS and the comparison group for insufficient pain alleviation. Conclusions Women with PTSD/PTSS perceived abortion care to be deficient more often than did healthy women. These women do require extra support, relatively simple efforts to provide adequate pain alleviation, support and privacy during abortion may improve abortion care. PMID:25666812
Curtin, L L
Management of abortion personnel within a hospital setting involves a number of rights: the patient's rights to privacy and to the provision of competent, compassionate, and understanding nursing care; the right of nurses to refrain from abortion procedures due to conscience; and the right of hospitals to hire employees who will fulfill their contractual obligations. The US Supreme Court has held that the decision to abort is protected under the right to privacy; no one may interfere with a woman's decision. Public institutions do not have an obligation to fund abortion. If the Court had made abortion a right, then society would be obliged to provide abortion. The discussion of abortion rights focuses on the following topics: the legal duties of health professionals, the legal and moral rights and obligations of nurses, the legal rights and obligations of hospitals, and the rights of abortion patients. A case study is provided of a head nurse and staff in the gynecology ward of a large metropolitan hospital in 1974 who objected to the performance of saline abortion on the ward, to disposing of the fetuses, and to the validity of patients' consent. Their concern was for the health and safety of patients and the rights of patients to informed consent. The hospital did not have a right to force the nurses to comply with the directive on saline abortion procedures, because the hospital did not have the right to violate the conscience of an individual citizen. In another example of a transfer of a nurse to another area of the hospital, the hospital was exercising its prerogative to expect fulfillment of contractual obligations in a way that did not interfere with health care workers' objections to abortion. Roe v. Wade and Doe v. Bolton were the 2 cases that established the existence of institutional conscience. Health care workers have an obligation to inform hospitals in writing if they have objections to participation in abortion procedures. Nurses have an obligation to respect the legal right to privacy in making or carrying out an abortion decision, and to provide competent nursing care to all who receive their services. Nurses should not make judgments about their approval or disapproval of abortion or the patient's reasons for abortion. Patients have a right to be protected from emotional and physical harm from objecting nurses; nurses may withdraw their services only if there are other qualified professionals available to provide care. PMID:8429970
A table showing the current status of abortion in the world based on two recent and detailed studies is presented. Countries are categorized according to whether they totally prohibit abortion, permit it to save the mother's life, permit it to preserve her physical health or mental health, permit it for maternal socioeconomic reasons, or provide it at the mother's request. The countries are grouped into 5 geographic areas: America and the Caribbean; Central Asia, Middle East, and North Africa; East and South Asia and the Pacific; Europe; sub-Saharan Africa. The trend toward liberalization of laws is clear. The development of abortion laws is moving in the direction of complete legalization, that is, the creation of health norms that facilitate abortion for all women, with guarantees of medical safety. There are still countries that move to restrict access to abortion, and in a few cases, such as Colombia and Poland, legalization and prohibition have alternated depending on the social and political circumstances of the moment. In the past 12 years, 28 countries liberalized their laws in some way, while 4 countries with close ties to the Vatican restricted or prohibited access. PMID:12348900
The aim of this paper is to present current controversies concerning the safety of medical devices and procedures under pressure in a hyperbaric chamber including: defibrillation in a multiplace chamber; implantable devices during hyperbaric oxygen treatment (HBOT) and the results of a recent European questionnaire on medical devices used inside hyperbaric chambers. Early electrical defibrillation is the only effective therapy for cardiac arrest caused by ventricular fibrillation or pulseless ventricular tachycardia. The procedure of defibrillation under hyperbaric conditions is inherently dangerous owing to the risk of fire, but it can be conducted safely if certain precautions are taken. Recently, new defibrillators have been introduced for hyperbaric medicine, which makes the procedure easier technically, but it must be noted that sparks and fire have been observed during defibrillation, even under normobaric conditions. Therefore, delivery of defibrillation shock in a hyperbaric environment must still be perceived as a hazardous procedure. Implantable devices are being seen with increasing frequency in patients referred for HBOT. These devices create a risk of malfunction when exposed to hyperbaric conditions. Some manufacturers support patients and medical practitioners with information on how their devices behave under increased pressure, but in some cases an individual risk-benefit analysis should be conducted on the patient and the specific implanted device, taking into consideration the patient's clinical condition, the indication for HBOT and the capability of the HBOT facility for monitoring and intervention in the chamber. The results of the recent survey on use of medical devices inside European hyperbaric chambers are also presented. A wide range of non-CE-certified equipment is used in European chambers. PMID:25596835
Background Complications of clandestine abortions increase with gestational age. The aim of this study was to identify complications of second trimester clandestine abortions (STA) and those of first trimester clandestine abortions (FTA). Methods This retrospective descriptive study was conducted between March 1st and August 31st, 2012 in the University Teaching Hospital and the Central Hospital, Yaoundé (Cameroon). The files of women with clandestine abortions carried out outside our units, but received in our settings for some complications were reviewed. Variables studied were maternal age, parity, marital status, gestational age at the time of abortion, the abortion provider and the method used, the duration of antibiotic coverage, the time interval between abortion and consultation, the complications presented and the duration of hospital stay. Data of 20 women with STA (?13 weeks 1 day) and those of 74 women with FTA (?13 complete weeks) were analyzed and compared. The t-test was used to compare continuous variables. P value <0.05 was considered statistically significant. Results Women with STA had high parities (P?=?0.0011). STAs were mostly performed by nurses and were usually done by dilatation and curettage or dilatation and evacuation, manual vacuum aspiration, intramuscular injection of an unspecified medication, transcervical foreign body insertion, amniotomy and misoprostol. STA complications were severe anemia, hypovolemic shock, uterine perforation and maternal death. Conclusions Clandestine abortions, especially second trimester abortions, are associated with risks of maternal morbidity and mortality especially when done by nurses. Therefore, women should seek for help directly from trained health personnel (Gynecologists & Obstetricians). Moreover, nurses should be trained in uterine evacuation procedures. They should also refer women who want to carry out STA to Gynecologists and Obstetricians. Finally, to reduce the prevalence of abortion in general, the government should make contraception available to all women, as well as use public media to sensitize women on the dangers of abortion and on the need to use family planning services. PMID:25199407
Background Internet surveys that draw from traditionally generated samples provide the unique conditions to engage adolescents in exploration of sensitive health topics. Methods We examined awareness of unwanted pregnancy, abortion behaviour, methods, and attitudes toward specific legal indications for abortion via a school-based internet survey among 378 adolescents aged 12–21 years in three Rio de Janeiro public schools. Results Forty-five percent knew peers who had undergone an abortion. Most students (66.0%) did not disclose abortion method knowledge. However, girls (aOR 4.2, 95% CI 2.4-7.2), those who had experienced their sexual debut (aOR1.76, 95% CI 1.1-3.0), and those attending a prestigious magnet school (aOR 2.7 95% CI 1.4-6.3) were more likely to report methods. Most abortion methods (79.3%) reported were ineffective, obsolete, and/or unsafe. Herbs (e.g. marijuana tea), over-the-counter medications, surgical procedures, foreign objects and blunt trauma were reported. Most techniques (85.2%) were perceived to be dangerous, including methods recommended by the World Health Organization. A majority (61.4%) supported Brazil’s existing law permitting abortion in the case of rape. There was no association between gender, age, sexual debut, parental education or socioeconomic status and attitudes toward legal abortion. However, students at the magnet school supported twice as many legal indications (2.7, SE.27) suggesting a likely role of peers and/or educators in shaping abortion views. Conclusions Abortion knowledge and attitudes are not driven simply by age, religion or class, but rather a complex interplay that includes both social spaces and gender. Prevention of abortion morbidity and mortality among adolescents requires comprehensive sexuality and reproductive health education that includes factual distinctions between safe and unsafe abortion methods. PMID:24521075
Background The study aimed to describe the overall and age-specific trends of induced abortions from 1996 to 2011 with an emphasis on socio-demographic characteristics and contraceptive use of women having had repeat abortions in Estonia. Methods Data were retrieved from the Estonian Medical Birth and Abortion Registry and Statistics Estonia. Total induced abortion numbers, rates, ratios and age-specific rates are presented for 1996–2011. The percentage change in the number of repeat abortions within selected socio-demographic subgroups, contraception use and distribution of induced abortions among Estonians and non-Estonians for the first, second, third, fourth and subsequent abortions were calculated for the periods 1996–2003 and 2004–2011. Results Observed trends over the 16-year study period indicated a considerable decline in induced abortions with a reduction in abortion rate of 57.1%, which was mainly attributed to younger cohorts. The percentage of women undergoing repeat abortions fell steadily from 63.8% during 1996–2003 to 58.0% during 2004–2011. The percentage of women undergoing repeat abortions significantly decreased over the 16 years within all selected socio-demographic subgroups except among women with low educational attainment and students. Within each time period, a greater percentage of non-Estonians than Estonians underwent repeat abortions and obtained third and subsequent abortions. Most women did not use any contraceptive method prior to their first or subsequent abortion. Conclusion A high percentage of women obtaining repeat abortions reflects a high historical abortion rate. If current trends continue, a rapid decline in repeat abortions may be predicted. To decrease the burden of sexual ill health, routine contraceptive counselling, as standard care in the abortion process, should be seriously addressed with an emphasis on those groups - non-Estonians, women with lower educational attainment, students and women with children - vulnerable with respect to repeat abortion. PMID:25005363
The purpose of this article is to show that the current level of scientific evidence linking induced abortion with increased breast cancer risk is sufficient to support an ethical and legal duty to disclose fully the risk to women who are considering induced abortion. The article examines the relationship between this evidence and the elements of a medical malpractice claim alleging failure to obtain informed consent. The first part focuses on the elements of informed consent, which require the plaintiff to establish that the physician had a duty to disclose information, which he failed to disclose, that this failure to disclose was a legal cause of the plaintiff's decision to undergo the procedure, and the procedure was a legal cause of the plaintiff's injury. The second part compares two prevalent standards for determining which risks a physician has a duty to disclose. Part three reviews the scientific evidence of the abortion/breast cancer (ABC) link and explains why it survives both the Frye and the Daubert tests for admissibility of expert testimony. The fourth part assesses the materiality of the risk posed by the ABC link. Parts five and six discuss evidentiary issues and the possibility of punitive damage awards. PMID:10758700
general on information regarding abortions. 13 Zancarini-?asking for information on where to get an abortion, theninformation they needed to prevent unwanted pregnancies and by performing safe, medical abortions
The rising costs of medical treatment in the United States are fueling a movement to outsource medical treatment. Estimates of the number of Americans traveling overseas for treatment range from 50,000 to 500,000. Charges for common procedures such as heart bypass can be $11,000 in Thailand compared to $130,000 in the United States. Knee replacement in the United States can cost $40,000 compared to $13,000 in Singapore.A new industry, medical tourism, has been created to advise patients on the appropriate facility in the right country for their condition, handle all travel arrangements, teleconference with physicians, and send medical records. To respond to the growth in medical travel, the Joint Commission (formerly the Joint Commission on Accreditation of Health Care Organizations) initiated the Joint Commission International (JCI) to accredit hospitals worldwide. Although outcome statistics from hospitals outside the United States are rare, first-person reports on quality are numerous. Making surgery possible for uninsured and underinsured individuals or self-insured state, municipal, and private entities is a major benefit of medical tourism. Mitigating against medical travel are the lack of legal remedies in place for malpractice and the possibility that travel itself can impose risk to patients. For example, lengthy air flights where the patient is in a fixed position for hours at a time can cause embolisms. If the trend toward medical tourism continues, continuing education, credentialing, and certification services may be required to help assure patient safety. PMID:18521877
Mouniq, C; Moron, P
Results are presented of a literature review to identify social and psychological aspects of abortion. The literature does not provide a true profile of women requesting abortions, but some characteristics emerge. Reasons for requesting abortion include economic problems, difficult previous pregnancies, general medical contraindications to pregnancy, marital conflicts, feelings of loneliness, professional aspirations, problems with existing children, and feelings of insecurity about the future. However, the same feelings are found among women carrying their pregnancies to term. Unplanned pregnancies are more common during periods of depression. Most authors have found about 1/2 of women seeking abortions to be single and about 1/2 to be under 25 years old. Religion does not appear to be a determining factor. 1 study of psychological factors in abortion seekers found that a large number of single women seeking abortion had suffered traumatic experiences in childhood and were seeking security in inappropriate amorous relationships. Helene Deutsch stressed the destructive impulses latent in all pregnancies. Others have cited the ambivalence of the desire for pregnancy and feelings of loss after abortion. Studies published after legalization of abortion in the US and France however have stressed the nearly total absence of moderate or severe psychiatric symptoms after abortion. Responses immediately after the abortion may include feelings of relief, guilt, indifference, or ambivalence. Secondary affects appear minor to most authors. Psychological effects do not appear to be influenced by age, marital status, parity, intelligence, occupation, existence of a later pregnancy, or concommitant sterilization. "Premorbidity" and coercion by spouse or family were most closely associated with psychological symptoms. Numerous authors have found about twice as many negative reactions among women undergoing abortion for medical reasons. Most patients undergoing abortions for genetic reasons have been found to experience shame and guilt. Repeat abortion constitutes about 10-15% of all abortions, and reflects resistence to contraception. 1 study found repeat abortion seekers to have a low educational level, lack of knowledge of sex, image of sexuality as degrading, self-punishing masochistic tendencies, passivity, and other pathology. Routine psychiatric consultations for abortion should be avoided, and primary responsibility should be assumed by the physician for identifying patients at risk of psychological sequelae. Factors placing women at high psychological risk after abortion can be identified in the American literature: severe psychiatric ailment, lack of familial support, abortion for medical reasons, severe ambivalence, and familial or medical pressure. A consultation or brief treatment permitting the woman to elaborate her decision can help prevent postabortal difficulties. The interviewer should help the woman to understand whether her unexpected pregnancy was in reality an accident or the expression of an intense but unconscious desire for pregnancy, and thus to understand the reasons for her indecision. Various patterns of disturbance may be uncovered during treatment. PMID:12268236
...from the National Registry of Certified Medical Examiners. 390.115 Section 390...GENERAL National Registry of Certified Medical Examiners § 390.115 Procedure for...from the National Registry of Certified Medical Examiners. (a) Voluntary...
...from the National Registry of Certified Medical Examiners. 390.115 Section 390...GENERAL National Registry of Certified Medical Examiners § 390.115 Procedure for...from the National Registry of Certified Medical Examiners. (a) Voluntary...
...from the National Registry of Certified Medical Examiners. 390.115 Section 390...GENERAL National Registry of Certified Medical Examiners § 390.115 Procedure for...from the National Registry of Certified Medical Examiners. (a) Voluntary...
Lewis, Robert Michael
Medical & Emotional Emergency Policy The College has a medical/emotional emergency procedure to maintain the safety of individual students, as well as the community. The medical/emotional emergency-4314; or Campus Police, 221-4596 to alert the On-Call Clinician. When the College medical/emotional emergency
McAvoy, P A; McCrorie, P; Jolly, B; Ayers, A B; Cox, J; Howes, A D; Macdonald, E B; Slimmon, D J; Southgate, L
From July 1997, the General Medical Council (GMC) has had the power to investigate doctors whose performance is considered to be seriously deficient. Assessment procedures have been developed for all medical specialties to include peer review of performance in practice and tests of competence. Peer review is conducted by teams of at least two medical assessors and one lay assessor. A comprehensive training programme for assessors has been developed that simulates the context of a typical practice-based assessment and has been tailored for 12 medical specialties. The training includes the principles of assessment, familiarization with the assessment instruments and supervised practice in assessment methods used during the peer review visit. High fidelity is achieved through the use of actors who simulate third party interviewees and trained doctors who role play the assessee. A subgroup of assessors, selected to lead the assessment teams, undergo training in handling group dynamics, report writing and in defending the assessment report against legal challenge. Debriefing of assessors following real assessments has been strongly positive with regard to their preparedness and confidence in undertaking the assessment. PMID:11895252
...procedure concerning OSHA access to employee medical records. 1913.10 Section 1913...PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS § 1913.10 Rules of agency...procedure concerning OSHA access to employee medical records. (a) General policy....
...procedure concerning OSHA access to employee medical records. 1913.10 Section 1913...PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS § 1913.10 Rules of agency...procedure concerning OSHA access to employee medical records. (a) General policy....
...procedure concerning OSHA access to employee medical records. 1913.10 Section 1913...PROCEDURE CONCERNING OSHA ACCESS TO EMPLOYEE MEDICAL RECORDS § 1913.10 Rules of agency...procedure concerning OSHA access to employee medical records. (a) General policy....
Selective reduction and abortion both involve the termination of fetal life, but they are classified by different designations to underscore the notion that they are regarded as fundamentally different medical procedures: the two are performed using distinct techniques by different types of physicians, upon women under very different circumstances, in order to further dramatically different objectives. Hence, the two procedures appear to call for a distinct moral calculus, and they have traditionally evoked contradictory reactions from society. This essay posits that despite their different appellations, selective reduction and abortion are essentially equivalent. PMID:26242939
This paper examines how death is managed in a larger regional hospital within the Norwegian health-care. The central focus of my paper concerns variations in how healthcare personnel enact death and handle the dead patient. Over several decades, modern standardised hospital death has come under critique in the western world. Such critique has resulted in changes in the standardisation of hospital deaths within Norwegian health-care. In the wake of the hospice movement and with greater focus on palliative care, doors have gradually been opened and relatives of the deceased are now more often invited to participate. I explore how the medical practice around death along with the procedure manual of post-mortem care at Trondheim University Hospital has changed. I argue that in the late-modern context, standardisation of hospital death is a multidimensional affair, embedded in a far more comprehensive framework than the depersonalized medico-legal. In the late-modern Norwegian hospital, interdisciplinary negotiation and co-operation has allowed a number of different agendas to co-exist, without any ensuing loss of the medical power holder's authority to broker death. I follow Mol's notion of praxiographic orientation of the actor-network approach while exploring this medical practice. PMID:19228301
Westley, S B
In Korea, China, and Taiwan--countries where son preference persists--the availability of prenatal screening techniques and induced abortion has produced an imbalance in the naturally occurring sex ratios of 104-107 male births for every 100 female births. Policy responses to sex-selective abortion were the focus of a 1994 International Symposium on Sex Preference for Children in the Rapidly Changing Demographic Dynamics in Asia sponsored by the United Nations Population Fund and the Government of the Republic of Korea. Modern technology (i.e., amniocentesis, ultrasound, and chorionic villi sampling) enables couples to control both family size and sex selection. According to data from the 1990 Korean Census, 80,000 female fetuses were aborted from 1986-90 as a result of son preference. In the late 1980s, the Governments of Korea, China, and India imposed bans on the use of medical technology for prenatal sex determination, but many observers maintain that regulations have served only to make the procedures clandestine and more expensive. To remedy the problems underlying sex-selective abortion, the Symposium recommended the following government actions: 1) implement policies and programs to diminish gender discrimination; 2) establish guidelines for the monitoring and regulation of prenatal testing; 3) utilize mass and folk media, interpersonal channels, and school curricula to promote gender equality; 4) strengthen the ethics curriculum of medical schools to address son preference; and 5) increase the capability of statistical and research organizations to collect gender-disaggregated data. PMID:12319402
David Shanks; Roger Y Wong; James M Roberts; Parvathy Nair; Irene WY Ma
BACKGROUND: Simulation is increasingly used for teaching medical procedures. The goal of this study was to assess learner preferences for how simulators should be used in a procedural curriculum. METHODS: A 26-item survey was constructed to assess the optimal use of simulators for the teaching of medical procedures in an internal medicine residency curriculum. Survey domains were generated independently by
Abbasi, Mahmoud; Shamsi Gooshki, Ehsan; Allahbedashti, Neda
Abortion traditionally means, "to miscarry" and is still known as a problem which societies has been trying to reduce its rate by using legal means. Despite the pregnant women and fetuses have being historically supported; abortion was firstly criminalized in 1926 in Iran, 20 years after establishment of modern legal system. During next 53 years this situation changed dramatically, so in 1979, the time of Islamic Revolution, aborting fetuses before 12 weeks and therapeutic abortion (TA) during all the pregnancy length was legitimate, based on regulations that used medical justification. After 1979 the situation changed into a totally conservative and restrictive approach and new Islamic concepts as "Blood Money" and "Ensoulment" entered the legal debates around abortion. During the next 33 years, again a trend of decriminalization for the act of abortion has been continuing. Reduction of punishments and omitting retaliation for criminal abortions, recognizing fetal and maternal medical indications including some immunologic problems as legitimate reasons for aborting fetuses before 4 months and omitting the fathers' consent as a necessary condition for TA are among these changes. The start point for this decriminalization process was public and professional need, which was responded by religious government, firstly by issuing juristic rulings (Fatwas) as a non-official way, followed by ratification of "Therapeutic Abortion Act" (TAA) and other regulations as an official pathway. Here, we have reviewed this trend of decriminalization, the role of public and professional request in initiating such process and the rule-based language of TAA. PMID:24338232
Sushanta K. Banerjee; Kathryn Andersen
Nearly 40 years after enactment of the Medical Termination of Pregnancy Act of 1971, unsafe abortion continues to be a neglected women's health issue in India. This prospective study of women presenting for post-abortion care in 10 selected hospitals in Madhya Pradesh, India, aimed to understand the incidence, types and severity of post-abortion complications, probable causes of complications and consequences
A. L Hattel; M. D Castro; J. D Gummo; D Weinstock; J. A Reed; J. P Dubey
Neospora caninum was found in fetal tissues of 34 of 688 cases of bovine abortion submitted to the Pennsylvania Animal Diagnostic Laboratory System during the period from May 1994 to November 1996. The aborted fetuses ranged in gestational age from 3 to 8 months. Microscopic lesions consisted primarily of encephalitis and myocarditis. A labeled (strept) avidin–biotin staining procedure using anti-N.
...psychological information may name a medical doctor or other person to act as his agent...individual has not named a medical doctor as agent, the Council may determine, after consultation with a medical doctor, that disclosure of the...
...psychological information may name a medical doctor or other person to act as his agent...individual has not named a medical doctor as agent, the Council may determine, after consultation with a medical doctor, that disclosure of the...
...psychological information may name a medical doctor or other person to act as his agent...individual has not named a medical doctor as agent, the Council may determine, after consultation with a medical doctor, that disclosure of the...
Unsafe abortion is a significant cause of death and ill health in women in the developing world. A substantial body of research on these consequences exists, although studies are of variable quality. However, unsafe abortion has a number of other significant consequences that are much less widely recognized. These include the economic consequences, the immediate costs of providing medical care for abortion-related complications, the costs of medical care for longer-term health consequences, lost productivity to the country, the impact on families and the community, and the social consequences that affect women and families. This article will review the scientific evidence on the consequences of unsafe abortion, highlight gaps in the evidence base, suggest areas where future research efforts are needed, and speculate on the future situation regarding consequences and evidence over the next 5-10 years. The information provided is useful and timely given the current heightened interest in the issue of unsafe abortion, growing from the recent focus of national and international agencies on reducing maternal mortality by 75% by 2015 (as one of the Millennium Development Goals established in 2000). PMID:21118043
Kay, B J; Whitted, N A; Hardin, S S
Compared with other medical services, elective abortion is a special case where economic factors affecting delivery remain essentially constant. The consumer purchases it infrequently and the provider provides relatively frequently; the patient is not seeking information or interpretation of symptoms, only therapeutic service for which the technique is almost universal. In this area of medicine the consumer assesses the symptoms and decides on treatment before selecting a provider. U.S. women are not using abortion as a means of contraception in general and if they do, it is only once or twice. Prices charged for 1st trimester abortions are relatively stable ($171 in 1978, $174 in 1980). Since the liberalization of abortion legislation in 1973 there has been a yearly increase in elective 1st trimester abortions (85%), but a decreasing rate for each subsequent year (21% for 1973-74, 4% for 1977-78). Unmet need decreased from 58% in 1973 to 26% in 1978, concentrated in rural areas. The supply of abortions is subjected to constraints such as the aura of illegality, negative professional peer pressure, and distribution of providers. In 1977 13% of all providers performed 71% of all abortions, freestanding clinics had an average case load of more than 1600 year, hospitals provided 3% of abortions and office-based physicians performed 4%. In contrast to other medical services, abortion is a cash-on-delivery transaction with only 10% of patients submitting insurance forms. Information is provided to consumers regarding cost and quality of services through advertising and professional referral and is relatively widely available due to efforts of women's organizations, evaluative information is also disseminated. In Atlanta, 7 clinics performed 20,337 procedures in 1977, an increase of 1859 from 1976, prices ranging from $125-$165 in 1978 with a coefficient of variation of 0.09, the same since 1972-73. In a survey of 75 university students who had had abortions (16.8% of those who returned a questionnaire distributed at the university), it was found that newspaper and word of mouth are initial information sources about providers. Most important factors in choosing a provider were medical reputation, time required, absence of need for parental consent, and staff attitude. If present trends in delivery of services continue as demand levels off, large freestanding clinics will grow and choices will decrease. Statewide dissemination of information about facilities, particularly to people with access problems, would assist the consumer to increase competition between large and small clinics. 1 option for further research is the comparison of abortion services in different locations with varying market structure and degree of unmet need. PMID:6460698
Bélanger, Danièle; Flynn, Andrea
Cuba's annual induced abortion rate persistently ranks among the highest in the world, and abortion plays a prominent role in Cuban fertility regulation despite widespread contraceptive prevalence and state promotion of modern contraceptives. We explore this phenomenon using the concept of an "abortion culture," typically used in reference to Soviet and post-Soviet countries. We synthesize existing literature to provide a historical account of abortion and contraception in Cuba. We also provide a qualitative analysis of abortion and contraceptive use based on in-depth interviews conducted in 2005 in Havana with 24 women who have had an abortion and 10 men whose partners have had an abortion. Information gained from a focus-group discussion with medical professionals also informed the study. Our four principal findings are: (a) longstanding awareness of abortion, (b) the view of abortion as a personal decision, (c) the influence of economic constraints on the decision to induce an abortion, and (d) general skepticism toward contraceptives. We discuss our results on abortion in Cuba in relation to the notion of social diffusion, an approach commonly used to explain the spread of fertility control throughout a population. PMID:19397182
Andrew L. Schlafly
Dozens of studies have shown that the greater the number of abortions, the higher the incidence of breast cancer. Three states expressly require physicians to disclose to patients seeking abortion that the procedure may increase the risk of breast cancer. Three other states have more general disclosure requirements about abortion. There is a legal obligation of informed consent for any
Jovic, Olga S
The content of this work is conceived on the research of the consequences of surrogate motherhood as a process of assisted procreation, which represent a way of parenthood in cases when it is not possible to realize parenthood through a natural way. Surrogate motherhood is a process in which a woman (surrogate mother) agrees to carry a pregnancy with the intent to give the child to the couple with whom she has made a contract on surrogate maternity after the birth. This process of conception and birth makes the determination of the child's origin on its mother's side hard to determine, because of the distinction of the genetic and gestation phases of the two women. The concept of surrogate motherhood is to appear in two forms, depending on the existence or the non-existence of the genetic link between the surrogate mother and the child she gives birth to. There are gestation (full) and genetic (partial) surrogates each with different modalities and legal and ethical implications. In Serbia, Infertility Treatment and the Bio-medically Assisted Procreation Act from 2009 explicitly forbids surrogate motherhood, despite the fact that an infertile couple decides to use it, as a rule, after having tried all other treatment procedures, in cases when there is a diagnosis but the conventional treatment applied has not produced the desired results. Given the fact that no one has the right to ignore the sufferings of people who cannot procreate naturally, the medical practice and legal science in our country plead for a formulation of a legal framework in which to apply surrogate motherhood as an infertility treatment, under particular conditions. PMID:21528795
Before 1975 abortion was illegal in South Africa unless the life of the mother was at risk. The Abortion and Sterilization Act (ASA) of 1975 broadened the scope of legal abortion. The act allows abortion to save the life of the mother, in cases of severe fetal deformity, in cases or rape or incest, or if the woman is mentally incompetent. The procedure to get the abortion includes finding a doctor to recommend the procedure, then finding 2 other doctors to claim, in good faith, that abortion is indicated. At least 1 of these doctors must have been practicing for 4 years and neither can participate in the procedure. The operation must take place in a state controlled institution or an institution specifically designed for abortion. This law is currently not serving the needs of the women of South Africa, even among the women who are legally entitled to have an abortion. Annually only 40% of those that apply for abortion are approved and over 70% of the approved procedures are performed on psychological grounds. It is estimated that there are 200,000-300,000 illegal abortions every year. At Baragwanath there are 15,000 patients admitted for infection related to abortion every year. The ASA has failed to stop illegal abortion and failed to meet the needs of society. The abortion law should be liberalized for a variety of reasons. Women do not have adequate access to contraceptives in South Africa. This results in the birth of many unwanted children which are more likely to be abused and abandoned. Even if contraceptives were universally available, they all have associated failure rates. Since it is assumed that a women using contraceptives does not want to become pregnant, abortion needs to be available as a backup to contraceptives. Since South Africa is a patriarchal society, women must be given control over their reproduction if they are to achieve equal status. Thus for the reasons of preventing unwanted and unwanted and abused children, backing up contraceptives, and helping emancipate women, the abortion law needs to be liberalized. PMID:12284532
Lodl, K M; Mcgettigan, A; Bucy, J
Family planning and abortion clinics are starting to recognize the importance of providing postabortion counseling as part of the overall follow-up procedure. The literature on the psychosocial consequences of abortion reveals that abortion is a positive, growth-producing experience for the majority of women. However, abortion can be a stressful and emotionally difficult experience for other women as a result of ambivalence over the pregnancy or abortion, lack of positive support from significant others, feelings of guilt and loss, and inadequate coping skills. This paper reports a model for postabortion support groups aimed at clarifying feelings, reducing alienation and isolation, facilitating appropriate mourning, increasing self-esteem, and bringing appropriate closure to the abortion experience. Since 1984, such groups have been offered by the University of Washington Young Women's Christian Association (YWCA) Abortion Birth Control Referral Service in Seattle, Washington. The groups, which meet weekly for 6 sessions and include 2-8 women, use discussions, role play, art therapy techniques, and psychodrama to alleviate abortion-related stress and effect changes in problematic ideas and feelings. Plans for the group developed out of the leaders' observation that women who returned to the Service for a second abortion often had not dealt with feelings or issues from the first procedure. Nonjudgmental acceptance of abortion as an individual choice has empowered many group participants to raise their consciousness about women's social status and take a more active role in decision making about their reproductive life. PMID:12179640
An epidemiological study was undertaken using data from a series of 1217 consecutive cases of abortion collected at Eden Hospital, Calcutta, India, during the 1956-57 period. Since the obstetric admission total during the same period was 30,362, the abortion rate at this hospital was approximately 4%. Analysis of personal characteristics of the patients shows that more than 1/2 were in the 20-29 age group with the extremes of age ranging from 14 to 47. The lower age incidence when compared to Western abortion statistics is attributed to early marriages and poor socioeconomic conditions in the area. Since the incidence of abortions peaked at the 8th, 12th, 16th, and 20th weeks of pregnancy, it is suggested that naturally-occurring abortions occur near the expected dates of normal menstruations. Almost 1/4 of the patients had a history of at least 1 previous abortion, indicating a gynecologic problem. Mortality for the series was approximately .5%, attributable to gas-gangrene infection, peritonitis, septicemia, and anuria. The incidence of spontaneously-occurring abortion cannot be lessened until the etiology of the occurrence has been determined. Maternal morbidity and mortality connected with abortion can be reduced by public education regarding the need for early hospitalization, blood loss replacement, reduction of criminal abortion induction procedures, and use of prophylactic antibiotics. PMID:12336440
A statistical analysis of 13,044 abortions performed in West Germany between 22 June 1976 and 31 December 1976 is presented; this represented 4 abortions for every 100 living and stillborn births. Women 25-40 years of age most often underwent abortion. Two thirds of the women were married. 49% of the abortions were performed under the medical indication, 45% under the emergency indication, 5% under the eugenic indication, and .2% under the ethical indication. 90% of the abortions were performed before the 12th week of pregnancy; 58% were performed by curettage, 33% by vacuum aspiration. The complication rate was 6%. 8% of the operations were performed on an outpatient basis. PMID:12336456
Joyce, Ted; Tan, Ruoding; Zhang, Yuxiu
We use unique data on abortions performed in New York State from 1971 to 1975 to demonstrate that women traveled hundreds of miles for a legal abortion before Roe. A 100-mile increase in distance for women who live approximately 183 miles from New York was associated with a decline in abortion rates of 12.2 percent whereas the same change for women who lived 830 miles from New York lowered abortion rates by 3.3 percent. The abortion rates of nonwhites were more sensitive to distance than those of whites. We found a positive and robust association between distance to the nearest abortion provider and teen birth rates but less consistent estimates for other ages. Our results suggest that even if some states lost all abortion providers due to legislative policies, the impact on population measures of birth and abortion rates would be small as most women would travel to states with abortion services. PMID:23811233
Joyce, Ted; Tan, Ruoding; Zhang, Yuxiu
We use unique data on abortions performed in New York State from 1971–1975 to demonstrate that women travelled hundreds of miles for a legal abortion before Roe. A100- mile increase in distance for women who live approximately 183 miles from New York was associated with a decline in abortion rates of 12.2 percent whereas the same change for women who lived 830 miles from New York lowered abortion rates by 3.3 percent. The abortion rates of nonwhites were more sensitive to distance than those of whites. We found a positive and robust association between distance to the nearest abortion provider and teen birth rates but less consistent estimates for other ages. Our results suggest that even if some states lost all abortion providers due to legislative policies, the impact on population measures of birth and abortion rates would be small as most women would travel to states with abortion services. PMID:23811233
Hu, Howard; Straube, Tim; Madsen, Jennifer; Ricard, Mike
One of the most demanding tasks that must be performed by the Space Shuttle flight crew is the process of determining whether, when and where to abort the vehicle should engine or system failures occur during ascent or entry. Current Shuttle abort procedures involve paging through complicated paper checklists to decide on the type of abort and where to abort. Additional checklists then lead the crew through a series of actions to execute the desired abort. This process is even more difficult and time consuming in the absence of ground communications since the ground flight controllers have the analysis tools and information that is currently not available in the Shuttle cockpit. Crew workload specifically abort procedures will be greatly simplified with the implementation of the Space Shuttle Cockpit Avionics Upgrade (CAU) project. The intent of CAU is to maximize crew situational awareness and reduce flight workload thru enhanced controls and displays, and onboard abort assessment and determination capability. SAFM was developed to help satisfy the CAU objectives by providing the crew with dynamic information about the capability of the vehicle to perform a variety of abort options during ascent and entry. This paper- presents an overview of the SAFM application. As shown in Figure 1, SAFM processes the vehicle navigation state and other guidance information to provide the CAU displays with evaluations of abort options, as well as landing site recommendations. This is accomplished by three main SAFM components: the Sequencer Executive, the Powered Flight Function, and the Glided Flight Function, The Sequencer Executive dispatches the Powered and Glided Flight Functions to evaluate the vehicle's capability to execute the current mission (or current abort), as well as more than IS hypothetical abort options or scenarios. Scenarios are sequenced and evaluated throughout powered and glided flight. Abort scenarios evaluated include Abort to Orbit (ATO), Transatlantic Abort Landing (TAL), East Coast Abort Landing (ECAL) and Return to Launch Site (RTLS). Sequential and simultaneous engine failures are assessed and landing footprint information is provided during actual entry scenarios as well as hypothetical "loss of thrust now" scenarios during ascent.
Cook, R J; Dickens, B M
During the period between 1977 and the first quarter of 1988, 35 countries liberalized their abortion laws and four countries limited grounds for the procedure. Most legislation has extended abortion eligibility through traditional indications such as danger to maternal health or fetal handicap, but a number of other indications have been created such as adolescence, advanced maternal age, family circumstances, and AIDS or HIV infection. A number of countries have redesigned their abortion laws as part of a comprehensive package to facilitate access to and delivery of contraception, voluntary sterilization, and abortion services. Abortion litigation has increased and stimulated the liberalization of abortion provisions and the support of women's autonomous choice within the law. In Canada, the entire criminal prohibition of abortion was held unconstitutional for violating women's integrity and security. In contrast, Latin American and other constitutional developments may limit legal abortion to instances of danger to women's lives. PMID:3048126
Gugerty, Leo; Halgren, Shannon; Gosbee, John; Rudisill, Marianne
This study investigated two methods to improve organization and presentation of computer-based medical procedures. A literature review suggested that the GOMS (goals, operators, methods, and selecton rules) model can assist in rigorous task analysis, which can then help generate initial design ideas for the human-computer interface. GOMS model are hierarchical in nature, so this study also investigated the effect of hierarchical, hypertext interfaces. We used a 2 x 2 between subjects design, including the following independent variables: procedure organization - GOMS model based vs. medical-textbook based; navigation type - hierarchical vs. linear (booklike). After naive subjects studies the online procedures, measures were taken of their memory for the content and the organization of the procedures. This design was repeated for two medical procedures. For one procedure, subjects who studied GOMS-based and hierarchical procedures remembered more about the procedures than other subjects. The results for the other procedure were less clear. However, data for both procedures showed a 'GOMSification effect'. That is, when asked to do a free recall of a procedure, subjects who had studies a textbook procedure often recalled key information in a location inconsistent with the procedure they actually studied, but consistent with the GOMS-based procedure.
Ngene, Nnabuike Chibuoke; Moodley, Jagidesa
The most appropriate primary cause of death in a patient who had multiple medical conditions is that medical condition which initiated the chain of events that led to the other medical conditions that resulted in death. In clinical practice, there are deceased patients who had several medical conditions that could lead to death (primary causes of death) without biological plausibility that any of the medical conditions initiated the chain of events that resulted in the other medical conditions. To assign the single most appropriate primary cause of death to such a deceased patient is challenging. Under such circumstances, the International classification of diseases and related health problems, tenth revision (ICD-10) guidelines recommend that the medical practitioner certifying the death should decide on the primary cause to be assigned. The ICD-10 also acknowledges that the recommendation is arbitrary. Similar difficulty is also encountered when a single indication is being assigned to a patient for a medical procedure when there are multiple indications for such a procedure. The ICD-10 and its clinical modification (ICD-10-CM) which provides the guidelines for assigning indication for a medical procedure use criteria that are insufficient. In the present article, comprehensive, easy and objective clinicopathological criteria on how to assign the single most appropriate primary cause of death or indication for a medical procedure are recommended. The new criteria (referred to NJ model II) may be used to improve the ICD-10. PMID:25892489
Kleinschmidt, Karen A
The disposal of controlled medication left in the school nurse office is problematic for school nurses. Medications are left for a variety of reasons: students transfer out of the district, state, or country; parents and guardians lack transportation to pick up their child's medication; and some families simply forget. The medications of concern are controlled substances, primarily Schedule II medications including Adderall, Concerta, and methylphenidate. Over time, these medications begin to accumulate in a school nurse's office. Schools should establish procedures that address safe disposal of controlled medications as well as liability protection for the school nursing staff. This article will discuss a procedure created for the Christina School District in conjunction with a state board of pharmacy and subsequently shared with other school nurses in the State of Delaware. PMID:25816421
Recent Congressional hearings have identified over 2000 pro-life counseling centers that deceptively portray themselves as abortion clinics. The issue has now become regulating these facilities referred to as bogus clinics. The bogus clinics enjoy a good deal of protection from the Federal Trade Commission because they are all registered as non-profit organizations. Many people investigating the situation feel that the issues of pro-life and pro-choice are not central. What is most important is the fact that these bogus clinics are able to attract people who think they can obtain abortions when in fact these facilities do not offer such services. The staff at the bogus clinics have been reported to detain, harass, and coerce women who want to have abortions. They often show graphic films and employ psychological pressure in an attempt to convince the woman not to have an abortion. The Pearson Foundation published a 93 page manual titled, "How to Start and Operate Your Own Pro-Life Crisis Pregnancy Center". The manual outlines all the steps and procedures necessary to run an operation committed into deceiving women into thinking they offer abortion services. So far, proposed legislation would either require Yellow Pages publishers to list abortion alternatives and abortion services separately, or make facilities that do not provide abortions declare it in a disclaimer. However, federal authority in this situation is unclear. other proposals would give the FTC control of non-profits, or only deceptive non-profits. PMID:12284514
Paulsen, James A.
Discusses general attitudes towards unwanted pregnancies and abortions, the methods that students have resorted to in order to abort themselves, and the mental state of college women, who become pregnant with children they don't want. (RK)
Ng, Jia Hui; Yeak, Seth; Phoon, Natalie; Lo, Stephen
INTRODUCTION Although cosmetic procedures have become increasingly popular among the younger population in recent years, limited research on this subject has been done in the Asian context. We aimed to explore the views and knowledge regarding cosmetic procedures among junior college (JC) and medical students in Singapore. METHODS In the first phase of the study, a cross-sectional, self-administered survey of 1,500 JC students aged 16–21 years from six JCs was conducted in 2010. The same survey was then conducted on a random sample of Year 2–5 medical students from an undergraduate medical school in 2011. RESULTS In total, 1,164 JC and 241 medical students responded to the surveys. There was an overall female to male ratio of 1.3:1. Of all the respondents, 2.5% of the JC students and 3.0% of the medical students admitted to having undergone cosmetic procedures. Among those who claimed to have never had cosmetic procedures done, 9.0% and 44.0% of the JC and medical students, respectively, responded that they would consider such procedures in the future. Those who disapproved of their peers undergoing cosmetic surgery comprised 35.0% of JC students and 56.8% of medical students. Among the JC and medical students, 52.0% and 36.1%, respectively, were unaware of any risks associated with cosmetic procedures. CONCLUSION The younger population is increasingly accepting of cosmetic procedures. However, there is a general lack of understanding of the risks associated with such procedures. Education of both the general public and medical students may help prevent potential medicolegal issues. PMID:25189303
Adler, Nancy E.; Ozer, Emily J.; Tschann, Jeanne
Reviews the current status of abortion laws pertaining to adolescents worldwide, examining questions raised by parental consent laws in the United States and by the relevant psychological research (risk of harm from abortion, informed consent, consequences of parental involvement in the abortion decision, and current debate). Discusses issues…
Clinton, H R
This news brief presents the US President's wife's statement on the association between use of family planning and a decline in abortions worldwide. Hillary Rodham Clinton attended the Sixth Conference of Wives of Heads of State and Government of the Americas held in La Paz, Bolivia. The conference was suitably located in Bolivia, a country with the highest rates of maternal mortality in South America. Bolivia has responded by launching a national family planning campaign coordinated between government, nongovernmental, and medical organizations. Half of Bolivian women experience pregnancy and childbirth without the support of trained medical staff. Mortality from abortion complications account for about half of all maternal deaths in Bolivia. Voluntary family planning workers teach women about the benefits of child spacing, breast feeding, nutrition, prenatal and postpartum care, and safe deliveries. Bolivia has succeeded in increasing its contraceptive use rates and decreasing the number of safe and unsafe abortions. Bolivia's program effort was supported by USAID. USAID provided technical assistance and funds for the establishment of a network of primary health care clinics. Mrs. Clinton visited one such clinic in a poor neighborhood in La Paz, which in its first six months of operation provided 2200 consultations, delivered 200 babies, registered 700 new family planning users, and immunized 2500 children. Clinics such as this one will be affected by the US Congress's harsh cuts in aid, which reduce funding by 35% and delay program funding by 9 months. These US government cuts in foreign aid are expected to result in an additional 1.6 million abortions, over 8000 maternal deaths, and 134,000 infant deaths in developing countries. An investment in population assistance represents a sensible, cost-effective, and long-term strategy for improving women's health, strengthening families, and reducing abortion. PMID:12293000
Hess, Rosanna F
The purpose of this study was to explore the reasons women in rural, southern Gabon, Africa, chose to terminate their pregnancies, the methods used to induce abortions, and postabortion effects experienced by these women. Abortion is illegal in this country. A descriptive qualitative design guided the methodology for this study. Five women with a history of induced abortion were interviewed in-depth for their abortion story. Reasons cited for an abortion included lack of financial and partner support. Abortion methods included oral, rectal, and vaginal concoctions of leaves, bark, and water and over-the-counter medications, including misoprostol. Affects were physical, spiritual, and relational. Health care professionals need to provide women with guidance for appropriate contraceptive usage. Abortion after-care of women with physical and spiritual needs is important. Future research is suggested on the use of misoprostol in Gabon to understand its affects on women's reproductive health. PMID:17202528
DREES,A.; AHRENS,L.; III FLILLER,R.; GASSNER,D.; MCINTYRE,G.T.; MICHNOFF,R.; TRBOJEVIC,D.
During the RHIC Au-run in 2001 the 200 MHz storage cavity system was used for the first time. The rebucketing procedure caused significant beam debunching in addition to amplifying debunching due to other mechanisms. At the end of a four hour store, debunched beam could account for approximately 30%-40% of the total beam intensity. Some of it will be in the abort gap. In order to minimize the risk of magnet quenching due to uncontrolled beam losses at the time of a beam dump, a combination of a fast transverse kicker and copper collimators were used to clean the abort gap. This report gives an overview of the gap cleaning procedure and the achieved performance.
Ilkka Helenius; Ilkka Sinisaari; Eero Hirvensalo; Ville Remes
Background. Surgical procedures constitute an important part of every physician's daily practice. However, few studies have investigated the surgical skills of graduating medical students and, especially, factors that might be related to their degree of surgical competence. The present study sought to gather information on the basic surgical skills of graduating medical students and to establish whether factors influencing the
Anupama Rao; DMD Tate; Howard L. Needleman
Purpose: This study evaluated the association between patient medical history and the outcomes of restorative procedures per- formed under general anesthesia. Methods: The dental records of patients who had dental reha- bilitation under general anesthesia at Children's Hospital in Boston (1990-1992) and Children's National Medical Center in Wash- ington, DC (1994-1998) were examined. Data regarding restorative outcomes and the association
In 1998, the US House of Representatives amended an appropriations bill to prohibit the US Food and Drug Administration (FDA) from approving abortifacients. While it would have had broader implications, this amendment targeted mifepristone, which has been used since 1988 in France to cause early medical abortions. The measure failed to gain the support of the Senate after opponents argued that it would represent an inappropriate interference of the Congress into scientific processes and pointed out that mifepristone is a promising treatment for other conditions, such as Cushing's syndrome and endometriosis. Mifepristone is just one of a number of emerging technologies that allow women to obtain abortions at very early stages of pregnancy. Most public support for abortion is directed to early abortion, and most US women have early abortions (50% in the first eight weeks, and 90% in the first trimester). A 1997 poll revealed that the US public is largely uninformed about drugs used for early abortion, such as mifepristone or the cancer-fighting drug methotrexate, which is being used off-label as an abortifacient. However, 4200 medical abortions were performed in the US in 1996, and this figure increased to 4300 in the first half of 1997. The public must be informed that the process of medical abortion is not as simple as "popping a pill" but requires several days of medical supervision. In France, the abortion rate has declined since mifepristone was introduced. PMID:12321968
Margolick, Joseph; Kanters, David; Cameron, Brian H
Background International medical electives (IMEs) are unique learning opportunities; however, trainees can risk patient safety. Returning medical students often express concern about doing procedures beyond their level of training. The Canadian Federation of Medical Students has developed guidelines for pre-departure training (PDT), which do not address procedural skills. The purpose of this research is to determine which procedural skills to include in future PDT. Methods Twenty-six medical students who returned from IMEs completed surveys to assess PDT. Using a Likert scale, we compared procedures performed by students before departing on IME to those performed while abroad. We used a similar scale to assess which procedures students feel ought to be included in future PDT. Results There was no significant increase in number of procedures performed while on IME. Skills deemed most important to include in future PDT were intravenous line insertion, suturing of lacerations, surgical assisting and post-operative wound care. Conclusions Pre-departure training is new and lacks instruction in procedural skills. Over half the students rated several procedural skills such as IV line insertion, suturing, assisting in surgery, post operative wound management and foley catheterization as important assets for future PDT.
... of pregnancy, the abortion procedure is called a dilation and evacuation (D&E) . A D&E takes ... control method to prevent pregnancy right away. Glossary Dilation and Evacuation (D&E): A procedure in which ...
Katz, Ernest R.
Improving prognosis for many forms of childhood cancer has resulted in increased attention on the quality-of-life experience. Conditioned anxiety and pain associated with recurrent diagnostic and treatment procedures have been identified as major sources of distress in children with malignant disease. To evaluate the efficacy of various…
Globally, abortion mortality accounts for approximately 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high maternal mortality and morbidity from abortion tend to occur together. Unplanned and unwanted pregnancies constitute a serious public health responsibility. While fertility has declined by half in developing countries, the motivation to control and space births has risen faster than the rate of contraceptive use. Preventing maternal mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. A range of positive steps has been taken to reduce deaths and morbidity from abortion in a growing number of countries over the past 15 years. Making abortion legal is an essential prerequisite in making it safe. In this respect, changing the law does matter and assertions to the contrary are ill conceived and unsupported in practice. Although, in many countries, trends towards safer abortion have often occurred prior to or in the absence of changes in the law, legal changes need to take place if safety is to be sustained for all women. Religious laws may also require attention when legal change is being contemplated. There are three main ways of approaching this problem: liberalizing the existing law within the penal or criminal code; partially or fully legalizing abortion through a positive law or a court ruling; and decriminalising abortion by taking it out of the law. Women's health groups and other advocates, parliamentarians and health professionals, can work together to support the right of women not to die from unsafe abortions and to ensure they receive treatment for complications. Committed doctors can make a difference by providing treatment for abortion complications, interpreting the law in a liberal way and providing safe services where these are legal as well as training providers in the safest techniques to reduce mortality and morbidity. Although law, policy and women's rights are central to this issue, making abortions safe is above all a public health responsibility of governments. Moreover, reducing maternal mortality by making abortions safe is also an important part of the international commitment made in Cairo in 1994 at the ICPD and reaffirmed at the Cairo meeting in 1999. PMID:14556348
David, H P
This article grew out of a keynote address prepared for the conference, "From Abortion to Contraception: Public Health Approaches to Reducing Unwanted Pregnancy and Abortion Through Improved Family Planning Services," held in Tbilisi, Georgia, USSR in October 1990. The article reviews the legal, religious, and medical situation of induced abortion in Europe in historical perspective, and considers access to abortion services, attitudes of health professionals, abortion incidence, morbidity and mortality, the new antiprogestins, the characteristics of abortion seekers, late abortions, postabortion psychological reactions, effects of denied abortion, and repeat abortion. Special attention is focused on the changes occurring in Romania, Albania, and the former Soviet Union, plus the effects of the new conservatism elsewhere in the formerly socialist countries of central and eastern Europe, particularly Poland. Abortion is a social reality that can no more be legislated out of existence than the controversy surrounding it can be stilled. No matter how effective family planning services and practices become, there will always be a need for access to safe abortion services. PMID:1557791
Cousins, C; Sharp, C
Over the last 40 years, the number of percutaneous interventional procedures using radiation has increased significantly, with many secondary care clinicians using fluoroscopically guided techniques. Many procedures can deliver high radiation doses to patients and staff, with the potential to cause immediate and delayed radiation effects. The challenge for interventionists is to maximize benefit, whilst minimizing radiation risk to patients and staff. Non-radiologist clinicians are often inadequately trained in radiation safety and radiobiology. However, clinical governance and legislation now requires a more rigorous approach to protecting patients and staff. Protection can be ensured, and risks can be controlled, by appropriate design, procurement and commissioning of equipment; quality assurance; and optimal operational technique, backed by audit. Interventionists need knowledge and skills to reduce the risks. Appropriate training should include awareness of the potential for radiation injury, equipment operational parameters, doses measurement and recording methods and dose reduction techniques. Clinical governance requires informed consent, appropriate patient counselling and follow-up. PMID:15145716
Csapo, A I; Peskin, E G; Sauvage, J P; Pulkkinen, M O; Lampe, L; Godeny, S; Laajoki, V; Kivikoski, A
In the early 1970s the effort was begun to examine the clinical benefits of "menstrual induction" (MI) at 6 weeks pregnancy (last menstrual period), in the belief that if pregnancy is to be terminated there was no sound medical nor psychological reason to delay the procedure. It was found that the transcervical, intrauterine delivery of a "PG-impact" compromised the conceptus and terminated pregnancy in 95% of the cases, with clinical symptoms of menstruation rather than abortion. The side-effects were acceptable; the prematurity rate did not increase in subsequent pregnancies. Yet, the need for strict asepsis limited the use of this otherwise simple and effective procedure. Recently, this limitation has been overcome by the development of the PGE2 analogue 16-phenoxy-w17,18,19,20 tetranor-PGE2-methyl sulfanylamide ('Sulproston'). Clinical trials have been done in terms of dealing with the questions of efficacy, acceptability, and preference. 90 volunteers have been studied. At 14 days follow-up the success rate (negative pregnancy test) was 96%. The side effects were acceptable -- vomiting 26%, diarrhea 10%, and endometritis 2%. Of the 42 patients interviewed, 90% were satisfied with the procedure. Of those who had previously experienced surgical interruption, 89% preferred this pharmacological method. PMID:6101432
Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis
International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task completion and/or navigation, in particular the execution of the Surgeon call sequence. Debrief comments were used to analyze unclear procedural steps and to discern any discrepancies between the procedure and generally accepted BME actions. The sequence followed by BME participants differed considerably from the sequence intended by the procedure. Common deviations included the call sequence used to contact Surgeon, the content of BME and crew interaction and the gathering of pertinent console resources. Differing perceptions of task priority and imprecise language seem to have caused multiple deviations from the procedure s intended sequence. The study generated 40 recommendations for the procedure, of which 34 are being implemented. These recommendations address improving the clarity of the instructions, identifying training considerations, expediting Surgeon contact, improving cues for anticipated flight control team communication and identifying missing console tools.
Schaff, E A; Eisinger, S H; Stadalius, L S; Franks, P; Gore, B Z; Poppema, S
The objectives of this study were to determine the effectiveness, side effects, and acceptability of one-third the standard 600 mg dose of mifepristone (200 mg) to induce abortion. A prospective trial at seven sites enrolled women > or = 18 years, up to 8 weeks pregnant, and wanting an abortion. The women received 200 mg mifepristone orally, self-administered 800 micrograms misoprostol vaginally at home 48 h later, and returned 1-4 days later for ultrasound evaluation. Surgical intervention was indicated for continuing pregnancy, excessive bleeding, persistent products of conception 5 weeks later, or other serious medical conditions. Of the 933 subjects, 906 (97%) had complete medical abortions, 22 had surgical intervention, two were protocol failures, and three were lost to follow up. Of the 746 subjects who had no or minimal bleeding before misoprostol, 80% bled within 4 h and 98% within 24 h of using misoprostol. By day 7, 95% of women had a complete abortion. Side effects were aceptable in 85% of subjects, and 94% found the procedure acceptable. Low-dose mifepristone followed by vaginal misoprostol was highly effective as an abortifacient. PMID:10342079
Legislators or regulators in Mississippi, South Carolina, and Missouri have imposed burdensome and unnecessary clinic requirements on abortion providers. In each case, the legislators or regulators designed the requirements to make abortions more difficult to obtain. Mississippi, a state with only two licensed abortion clinics, already had restrictive abortion laws. In August 1996, it implemented stringent regulations on private physicians who provide abortion services in their offices. Some requirements include purchasing specific equipment, widening hallways, and hiring more staff. Several physicians have filed a lawsuit to stop enforcement of the regulations because they make the provision of abortion services so cumbersome and expensive as to discourage physicians from offering abortions. Antiabortion groups testified before the legislature that the Department of Health had been negligent in monitoring private practices for compliance with Mississippi's many abortion laws, particularly counseling requirements. The Republican governor signed the legislation in March 1996. In July 1996, a federal judge prohibited the South Carolina Department of Health from enforcing a new regulation making physicians who perform as few as five abortions a month to meet strict specifications for their office (e.g., disclosure of patient records and medical agreements). The regulation was a response to a 1995 law targeting private physicians who perform abortions in their offices. The judge held that the substantial changes in terms of privacy and expense could bring an undue burden on women seeking abortions. The state denied that the regulation would close clinics or would increase costs so much as to make abortions inaccessible. In September 1996, the House did not override the Democratic governor's veto of a bill that would have required all facilities where abortions are done to be licensed and undergo annual inspections and that would have required all physicians to have $500,000 in medical malpractice insurance and to have ob/gyn privileges at a Missouri hospital. PMID:12347483
Iyengar, M S; Carruth, T N; Florez-Arango, J; Dunn, K
Currently, paper-based and/or electronic together with telecommunications links to Earth-based physicians are used to assist astronaut crews perform diagnosis and treatment of medical conditions during space travel. However, these have limitations, especially during long duration missions in which telecommunications to earth-based physicians can be delayed. We describe an experimental technology called GuideView in which clinical guidelines are presented in a structured, interactive, multi-modal format and, in each step, clinical instructions are provided simultaneously in voice, text, pictures video or animations. An example application of the system to diagnosis and treatment of space Decompression Sickness is presented. Astronauts performing space walks from the International Space Station are at risk for decompression sickness because the atmospheric pressure of the Extra-vehicular Activity space- suit is significantly less that that of the interior of the Station. PMID:19048089
This piece describes abortion practices in use from the 1600s to the 19th century among the inhabitants of North America. The abortive techniques of women from different ethnic and racial groups as found in historical literature are revealed. Thus, the point is made that abortion is not simply a "now issue" that effects select women. Instead, it is demonstrated that it is a widespread practice as solidly rooted in our past as it is in the present. PMID:10297561
Rovie, Eric M.
benevolent, warm-agent based way, in having the abortion. If her motives are truly about both her current children and the potential negative effects of her advanced age on her potential child, her painful decision may be in accordance with virtue. Slote... Abortion: Approaches from Virtue Eric M. Rovie Washington University in St. Louis It is a platitude that the issue of abortion polarizes people into extreme positions. In this paper, I explore the oft-neglected gray area between the pro...
Tavakoli, Nahid; Saghaiannejad, Sakineh; Reza Habibi, Mohammad
Introduction: The health record serves several purposes and must be retained to meet those purposes. These varied purposes influence how long health records must be kept, or their retention period. Aim: Present study aimed to recognize laws and procedures pertaining to retention of health records in selected countries and provide a proposed guideline for Iran. Methods: This was an applied and descriptive-comparative research on laws and procedures pertaining to retention of medical records in USA, United Kingdom, Australia and Iran that performed in 2011. The data were collected via library sources, websites, and consultation with specialists in and out of the country. The validity of the data was confirmed by experts. Finally, the recommendations were provided for medical record retention in Iran. Results: The study revealed that, there are complete and transparent record retention schedules in selected counties so that retention situation for adults, minors, emergency, outpatients and deaths records is clearly recommended. But in Iran, either there aren’t specific laws and procedures for medical record or they are unspecified. Conclusion: The lack of a complete, transparent and update medical record retention schedule in Iran, lead to confusion for hospitals. Some of hospitals maintain medical records more than of determined retention period and some of them destruct them before expiring of essential retention period. In order to optimize the situation of health records retention in Iran, it is necessary to review, correction and correction and completion of medical records retention schedule on the provided recommendations for kinds of medical record. PMID:23322974
Pulgini, Linda M
Abortion as an issue is tried in a courtroom situation. The followi ng questions are dealt with: 1) At what point in the gestation process is the fetus recognized to be a human being and accorded the protection of a human being? and 2) Does a woman have a right to abort her pregnancy? Witnesses present evidence and viewpoints from the following disciplines: law, religion, biology, history, legal history, and medicine. The advocate for abortion focuses on a woman's right to privacy and to control over her own body. The opponent of abortion emph asizes the sacredness of life. PMID:11664382
Parker, Nigel; O'Quinn, Veronica
Several technological enhancements have been made to METI's commercial Emergency Care Simulator (ECS) with regard to how microgravity affects human physiology. The ECS uses both a software-only lung simulation, and an integrated mannequin lung that uses a physical lung bag for creating chest excursions, and a digital simulation of lung mechanics and gas exchange. METI s patient simulators incorporate models of human physiology that simulate lung and chest wall mechanics, as well as pulmonary gas exchange. Microgravity affects how O2 and CO2 are exchanged in the lungs. Procedures were also developed to take into affect the Glasgow Coma Scale for determining levels of consciousness by varying the ECS eye-blinking function to partially indicate the level of consciousness of the patient. In addition, the ECS was modified to provide various levels of pulses from weak and thready to hyper-dynamic to assist in assessing patient conditions from the femoral, carotid, brachial, and pedal pulse locations.
Mckay, H; Hartley, B
Outlined are 7 strategies for combatting unsafe abortion, even in countries with limited resources and serious legal obstacles. One of the most basic tasks is to educate the public, political leaders, and health authorities about the harm and costs associated with unsafe abortion. To cultivate strong leadership for the campaign to improve access to safe abortion, coalitions of community and religious leaders and representatives from legal, medical, media, and social welfare sectors should be formed. Also important is the dissemination of research findings to government decision makers and donor agencies. Topics for study include: societal costs of unsafe abortion, measurement of abortion morbidity, contraceptive use following abortion, subpopulations of women (e.g., adolescents), and resource needs for improved services. The provision of vacuum aspiration instruments, infection prevention equipment, contraceptives, and printed technical materials can be important in countries with limited technology. Training programs for abortion care providers--midwives, private sector physicians, public sector hospital staff, and post-abortion family planning personnel-can be used to introduce improved technology. Where possible, high quality, comprehensive abortion services can be provided directly to women. Finally, international collaboration and experience sharing among those working to combat unsafe abortion is urged. PMID:12345330
Medical abortion using methotrexate and misoprostol and manual vacuum aspiration are two new methods for pregnancy termination during the first 8 weeks of gestation. Compared to the regimen of mifepristone (RU 486) and misoprostol, both methods offer high rates of complete abortion and acceptability to users. Limitations of the new two-drug regimen compared with mifepristone include a longer time to effect abortion, transient gastrointestinal side effects, and risk of potential teratogenicity from methotrexate's cytotoxicity. Compared to standard surgical abortion, both methods allow women to avoid surgery, are more privately performed, and may be more easily accessible. The safety of first-trimester abortion provided by nurse practitioners and physician assistants has been established. Whether midwives and either new method to their practices depends on several factors. These include obtaining appropriate training, overcoming legal restrictions, and meeting professional and personal challenges inherent in providing early abortion care. PMID:9871382
Reiter, R C; Johnson, S R; Beller, F K
Recent Supreme Court rulings have augmented the potential role of the individual states in abortion regulation. As a result, largely political influences have escalated the abortion debate to the point that there is currently no identifiable center, and consensus seems impossible. The traditional concept of viability has proven an inadequate basis for extension of personal rights and protections to the fetus. Conservative interpretation of a proposed neurologic definition of human life would suggest that human life does not start until approximately 70 days post-conception. Standardization and widespread acceptance of a definition of "brain life" would potentially clarify many medical and legal questions regarding elective abortion and would parallel currently accepted medical and legal definitions of death. PMID:1876385
Fallah, Razieh; Ferdosian, Farzad; Shajari, Ahmad
Procedural sedation may be needed in many diagnostic and therapeutic procedures in children. To make pediatric procedural sedation as safe as possible, protocols should be developed by institutions. Response to sedation in children is highly variable, while some become deeply sedated after minimal doses, others may need much higher doses. Child developmental status, clinical circumstances and condition of patient should be considered and then pharmacologic and non-pharmacologic interventions for sedation be selected. Drug of choice and administration route depend on the condition of the child, type of procedure, and predicted pain degree. The drugs might be administered parenteral (intravenous or intramuscular) or non parenteral including oral, rectal, sublingual, aerosolized buccal and intranasal. The use of intravenous medication such propofol, ketamine, dexmedetomidine, or etomidate may be restricted in use by pediatric anesthesiologist or pediatric critical care specialists or pediatric emergency medicine specialists. In this review article we discuss on non-parenteral medications that can be used by non- anesthesiologist. PMID:26401146
Faced with a situation in which an estimated 60,000 illegal abortions (a major cause of maternal mortality) were performed annually, the Dominican Republic has adopted a new Health Code which contains a chapter dedicated to maternal health. Included in the new code are cases in which abortion is allowed: 1) when 2 specialists affirm that the pregnancy or childbirth constitutes a risk to the mother's health or life; 2) if the medical history of the parents and 2 doctors confirm the likelihood of the baby being born seriously disabled or deformed; or 3) if the mother's mental health is put in jeopardy by continuing the pregnancy. Despite the disapproval of church representatives, the legalization of abortion was unanimously approved by the Congress. The debate which surrounded the process was increased by a petition signed by more than 260 women decrying the lack of input that women had in the decision-making process. Women's action groups have been trying to widen the context in which the political discussion is taking place to stress the importance of viewing abortion from a reproductive rights perspective. The women's groups wish to prevent a situation in which the discussion surrounding the issue will be limited to legislators and church leaders. The women have pointed out that women should make the decisions about their lives and their bodies. In the meantime, the president of the Congress predicts that illegal abortion will continue in the Dominican Republic regardless of the current provisions for legal abortion. PMID:12286344
Campbell, Nancy B.; And Others
Explored differences between 35 women who had abortions as teenagers and 36 women who had abortions as adults. Respondents reported on their premorbid psychiatric histories, the decision-making process itself, and postabortion distress symptoms. Antisocial and paranoid personality disorders, drug abuse, and psychotic delusions were significantly…
Carpenter, P J
Children's anticipatory attributional assessment of the source(s) of perceived control is hypothesized to play an important role in the etiology of distress in children undergoing invasive medical procedures. Four perceived control types, based on learned helplessness theory, are specified by a conceptual model that guides this research: Mutual, Powerful Other, Personal, and Unknown. Among 73 children between the ages of 4 and 18 having their blood drawn, it was predicted that children with an attributional analysis of unknown perceived source of control prior to the impending medical procedures would experience a heightened level of anxiety (procedure-related distress). As predicted, children with an anticipatory attributional assessment of unknown perceived control interfered with or extended the medical procedure significantly more (41%) than children who could attribute some perceived source of control (13%). They were also rated by themselves, the parents, and a trained clinical observer as manifesting significantly greater (p < .05) anticipatory procedural distress using both cognitive (subjective) and behavioral (objective) assessment perspectives. These findings were independent of children's age. This paper supports the need for additional theory-driven research and the importance of investigating the role of attributional variables in the etiology of procedure-related distress in children. PMID:1484337
Byrne, V. E.; Hudy, C.; Smith, D.; Whitmore, M.
As part of the Space Human Factors Engineering Critical Questions Roadmap, a three year Technology Development Project (TDP) was funded by NASA Headquarters to examine emergency medical procedures on ISS. The overall aim of the emergency medical procedures project was to determine the human factors issues in the procedures, training, communications and equipment, and to recommend solutions that will improve the survival rate of crewmembers in the event of a medical emergency. Currently, each ISS crew remains on orbit for six month intervals. As there is not standing requirement for a physician crewmember, during such time, the maintenance of crew health is dependant on individual crewmembers. Further, in the event of an emergency, crew will need to provide prolonged maintenance care, as well as emergency treatment, to an injured crewmember while awaiting transport to Earth. In addition to the isolation of the crew, medical procedures must be carried out within the further limitations imposed by the physical environment of the space station. For example, in order to administer care on ISS without the benefit of gravity, the Crew Medical Officers (CMOs) must restrain the equipment required to perform the task, restrain the injured crewmember, and finally, restrain themselves. Both the physical environment and the physical space available further limit the technology that can be used onboard. Equipment must be compact, yet able to withstand high levels of radiation and function without gravity. The focus here is to highlight the human factors impacts from our three year project involving the procedures and equipment areas that have been investigated and provided valuable to ISS and provide groundwork for human factors requirements for medical applications for exploration missions.
The Roe v Wade decision made safe abortion available but did not change the reality that more than 1 million women face an unwanted pregnancy every year. Forty years after Roe v Wade, the procedure is not accessible to many US women. The politics of abortion have led to a plethora of laws that create enormous barriers to abortion access, particularly for young, rural, and low-income women. Family medicine physicians and advanced practice clinicians are qualified to provide abortion care. To realize the promise of Roe v Wade, first-trimester abortion must be integrated into primary care and public health professionals and advocates must work to remove barriers to the provision of abortion within primary care settings. PMID:23153160
The Roe v Wade decision made safe abortion available but did not change the reality that more than 1 million women face an unwanted pregnancy every year. Forty years after Roe v Wade, the procedure is not accessible to many US women. The politics of abortion have led to a plethora of laws that create enormous barriers to abortion access, particularly for young, rural, and low-income women. Family medicine physicians and advanced practice clinicians are qualified to provide abortion care. To realize the promise of Roe v Wade, first-trimester abortion must be integrated into primary care and public health professionals and advocates must work to remove barriers to the provision of abortion within primary care settings. PMID:23153160
Colorado State Board of Nursing, Denver.
Increasing numbers of students must be given medications at school, with a variety of staff assisting these children. In order to standardized the format for instructing personnel in medication administration procedures, an instructional program was developed for those in schools and out-of-home child care settings who are giving medications that…
Nathanson, Bernard; Lawrence, George
Two physicians debate whether abortions should be available on request regardless of medical indications. The crux of the issue is whether the fetus should be considered body tissue over which the woman has complete control or whether society has an interest in the embryo and should protect it. (Author/BY)
Turell, S C; Armsworth, M W; Gaa, J P
Anti-abortion groups in the US cite the existence of a post-abortion syndrome--a sense of loss, emptiness, and grief similar to that reported by trauma survivors. Although research on the longterm effects of induced abortion is marred by methodological errors, most studies have found no adverse psychological sequelae; rather, there appears to be a sense of relief and opportunity for personal growth. Nevertheless, there is a small group of women who do experience emotional distress after abortion and it is important to identify the demographic, social, and psychological factors that place women at risk of such a reaction. In terms of demographic factors, young age (adolescence), low or nulliparity, 2nd-trimester procedures, and Catholicism have been characteristics of women who suffered post-abortion depression. Of the social variables that have been examined, a lack of support from significant others (parents or partner) has been linked in some studies to emotional distress after abortion. A relatively consistent finding is that women who feel coerced to abort or are ambivalent about their decision at the time of the procedure are most likely to experience regret, depression, and anger. Women whose coping style involves avoiding responsibility are also prone to post-abortion distress. As noted, the literature does not support the contention that abortion causes longterm trauma. On the other hand, given the fact that 1.5 million abortions take place each year in the US, the existence of some post-abortion distress in even as small percentage of acceptors is enough to indicate a need for pre- and post-abortion counseling to help women determine the meaning of the experience and own their decisions. PMID:12316615
H. Trent MacKay; Andrea Phillips MacKay
112 programs to formally train residents in abortion procedures and in the manage- ment of complications from spontaneous and elective abortions. Nevertheless, shortly after the 1973 Supreme Court decision in Roe v. Wade, a survey of residency programs found that most university departments of obstetrics and gynecology were not providing rou- tine abortion training in their programs. 3 A subsequent
Jay, Susan M.; Elliott, Charles H.
Compared program efficacy in helping parents cope with children's painful medical procedures. Parents (n=72) of pediatric leukemia patients participated in either stress inoculation program or observed child participating in cognitive behavior therapy. Found parents in stress inoculation program reported lower anxiety scores and higher positive…
used for treating prostate cancer due to the excellent long-term outcomes. Before the implant procedure of the prostate and medical considerations to provide a high radioactive dose to cancerous cells and a low do. This is difficult because (1) needle insertion causes soft tissues to displace and deform, and (2) it is often
Maternowska, M Catherine; Mashu, Alexio; Moyo, Precious; Withers, Mellissa; Chipato, Tsungai
In Zimbabwe, abortions are legally restricted and complications from unsafe abortions are a major public health concern. This study in 2012 explored women's and providers' perspectives in Zimbabwe on the acceptability of the use of misoprostol as a form of treatment for complications of abortion in post-abortion care. In-depth interviews were conducted with 115 participants at seven post-abortion care facilities. Participants included 73 women of reproductive age who received services for incomplete abortion and 42 providers, including physicians, nurses, midwives, general practitioners and casualty staff. Only 29 providers had previously used misoprostol with their own patients, and only 21 had received any formal training in its use. Nearly all women and providers preferred misoprostol to surgical abortion methods because it was perceived as less invasive, safer and more affordable. Women also generally preferred the non-surgical method, when given the option, as fears around surgery and risk were high. Most providers favoured removing legal restrictions on abortion, particularly medical abortion. Approving use of misoprostol for post-abortion care in Zimbabwe is important in order to reduce unsafe abortion and its related sequelae. Legal, policy and practice reforms must be accompanied by effective reproductive health curricula updates in medical, nursing and midwifery schools, as well as through updated training for current and potential providers of post-abortion care services nationwide. Our findings support the use of misoprostol in national post-abortion care programmes, as it is an acceptable and potentially life-saving treatment option. PMID:25702065
Joyce Kinaro; Tag Elsir Mohamed Ali; Rhonda Schlangen; Jessica Mack
Unsafe abortion in Sudan results in significant morbidity and mortality. This study of treatment for complications of unsafe abortion in five hospitals in Khartoum, Sudan, included a review of hospital records and a survey of 726 patients seeking abortion-related care from 27 October 2007 to 31 January 2008, an interview of a provider of post-abortion care and focus group discussions
vide information and medication for women seeking abortion,information for the planning and improvement of abortioninformation to pharmacists is needed, including encouraging women to seek trained and safe abortion
Cook, R J; Dickens, B M
Modern thinking on abortion, reflected in recent legal developments around the world, has turned from concentration upon criminality in favor of female and family well-being. New laws enacted during the last decade are coming to focus upon conditions of health and social welfare of women and their existing families as indications for lawful termination of pregnancy. Regulations governing the delivery of services may be restrictive, however, so as to limit in practice access to means of safe, legal abortion made available in theory. Requirements may be imposed that only medical personnel with unduly high qualifications perform procedures, or that they be undertaken only in institutions meeting standards higher than similar health care requires. Approval procedures may be established involving second medical opinions or committees to monitor observance of the law, which may delay abortions and therefore increase their hazards. Parental and spousal consent requirements may exist in addition with the same effects, or to veto a pregnant female's request. Regulations may be employed more positively, however, to encourage contraceptive practice. A disappointment with legislative reform is that it may fail to improve circumstances if public resources are not applied to achieve the supply of services newly rendered legitimate, and illegal practice may persist. PMID:665881
Treatment guidelines are a crucial part of every medical aesthetic practice and must be in place before utilizing aesthetic medical injectables. An "Aesthetic Policy and Procedure Manual" features specific details (e.g., patient assessment, indication, contraindications, warnings and precautions, injection techniques, documentation, etc.) around dermal fillers (e.g., Restylane, Juvéderm, Voluma), hyaluronidase, neurotoxins (e.g., Botox Cosmetic, Dysport, and Xeomin) and Sculptra. This article describes why an "Aesthetic Policy and Procedure" manual is a necessary tool in every aesthetic provider's armamentarium, what it is composed of, as well as how these guidelines serve as a protective mechanism for the aesthetic provider's clinic if legal action is brought against their staff, their medical director, and/or their clinic. PMID:26313675
Perkins, Kenneth A.; Lerman, Caryn
Rationale Initial screening of new medications for potential efficacy (i.e. FDA early Phase 2), such as in aiding smoking cessation, should be efficient in identifying which drugs do, or do not, warrant more extensive (and expensive) clinical testing. Objectives This focused review outlines our research on development, evaluation, and validation of an efficient crossover procedure for sensitivity in detecting medication efficacy for smoking cessation. First-line FDA-approved medications of nicotine patch, varenicline, and bupropion were tested, as model drugs, in 3 separate placebo-controlled studies. We also tested specificity of our procedure in identifying a drug that lacks efficacy, using modafinil. Results This crossover procedure showed sensitivity (increased days of abstinence) during week-long “practice” quit attempts with each of the active cessation medications (positive controls) vs. placebo, but not with modafinil (negative control) vs. placebo, as hypothesized. Sensitivity to medication efficacy signal was observed only in smokers high in intrinsic quit motivation (i.e. already preparing to quit soon) and not smokers low in intrinsic quit motivation, even if monetarily reinforced for abstinence (i.e., given extrinsic motivation). Conclusions A crossover procedure requiring less time and fewer subjects than formal trials may provide an efficient strategy for a go/no-go decision whether to advance to subsequent Phase 2 randomized clinical trials with a novel drug. Future research is needed to replicate our results and evaluate this procedure with novel compounds, identify factors that may limit its utility, and evaluate its applicability to testing efficacy of compounds for treating other forms of addiction. PMID:24297304
Thomas J Kane; Douglas Staiger
The authors investigate the effect of abortion access on teen birthrates using county-level panel data. Past research suggested that prohibiting abortion led to higher teen birthrates. Perhaps surprisingly, the authors find that more recent restrictions in abortion access, including the closing of abortion clinics and restrictions on Medicaid funding, had the opposite effect. Small declines in access were related to
Background While induced abortion is considered to be illegal and socially unacceptable in Nigeria, it is still practiced by many women in the country. Poor family planning and unsafe abortion practices have daunting effects on maternal health. For instance, Nigeria is on the verge of not meeting the Millennium development goals on maternal health due to high maternal mortality ratio, estimated to be about 630 maternal deaths per 100,000 live births. Recent evidences have shown that a major factor in this trend is the high incidence of abortion in the country. The objective of this paper is, therefore, to investigate the factors determining the demand for abortion and post-abortion care in Ibadan city of Nigeria. Methods The study employed data from a hospital-based/exploratory survey carried out between March to September 2010. Closed ended questionnaires were administered to a sample of 384 women of reproductive age from three hospitals within the Ibadan metropolis in South West Nigeria. However, only 308 valid responses were received and analysed. A probit model was fitted to determine the socioeconomic factors that influence demand for abortion and post-abortion care. Results The results showed that 62% of respondents demanded for abortion while 52.3% of those that demanded for abortion received post-abortion care. The findings again showed that income was a significant determinant of abortion and post-abortion care demand. Women with higher income were more likely to demand abortion and post-abortion care. Married women were found to be less likely to demand for abortion and post-abortion care. Older women were significantly less likely to demand for abortion and post-abortion care. Mothers’ education was only statistically significant in determining abortion demand but not post-abortion care demand. Conclusion The findings suggest that while abortion is illegal in Nigeria, some women in the Ibadan city do abort unwanted pregnancies. The consequence of this in the absence of proper post-abortion care is daunting. There is the need for policymakers to intensify public education against indiscriminate abortion and to reduce unwanted pregnancies. In effect, there is need for effective alternative family planning methods. This is likely to reduce the demand for abortion. Further, with income found as a major constraint, post abortion services should be made accessible to both the rich and poor alike so as to prevent unnecessary maternal deaths as a result of abortion related complications. PMID:25024929
A discussion of the role to be played by the medical profession in more effective contraceptive services for the purpose of reducing the widespread practice of abortion took place in Budapest in September 1969 when doctors and demographers from 35 countries met for a three-day conference of the IPPF Europe and Near East Region. Among the specific topics discussed were the shocking abortion statistics from Greece, Hungary, and Rumania; the importance of collaboration between doctors and scientists; and reports by Swedish, British, Rumanian, Yugoslavian, Swiss and Dutch doctors on the hazards of oral contraceptives, survey of present experiences with the IUD, barrier methods, infertility, etc. PMID:12275735
Kitamura, T; Toda, M A; Shima, S; Sugawara, M
Despite its social, legal and medical importance, termination of pregnancy (TOP) (induced abortion) has rarely been the focus of psychosocial research. Of a total of 1329 women who consecutively attended the antenatal clinic of a general hospital in Japan, 635 were expecting their first baby. Of these 635 women, 103 (16.2%) had experienced TOP once previously (first aborters), while 47 (7.4%) had experienced TOP two or more times (repeated aborters). Discriminant function analysis was performed using psychosocial variables found to be significantly associated with either first abortion or repeated abortion in bivariate analyses. This revealed that both first and repeated aborters could be predicted by smoking habits and an unwanted current pregnancy while the repeated aborters appear to differ from first aborters in having a longer pre-marital dating period, non-arranged marriages, smoking habits, early maternal loss experience or a low level of maternal care during childhood. These findings suggest that both the frequency of abortion and its repetition have psychosocial origins. PMID:9844843
Faúndes, Aníbal; Duarte, Graciana Alves; de Sousa, Maria Helena; Soares Camargo, Rodrigo Paupério; Pacagnella, Rodolfo Carvalho
Unsafe abortions remain a major public health problem in countries with very restrictive abortion laws. In Brazil, parliamentarians - who have the power to change the law - are influenced by "public opinion", often obtained through surveys and opinion polls. This paper presents the findings from two studies. One was carried out in February-December 2010 among 1,660 public servants and the other in February-July 2011 with 874 medical students from three medical schools, both in São Paulo State, Brazil. Both groups of respondents were asked two sets of questions to obtain their opinion about abortion: 1) under which circumstances abortion should be permitted by law, and 2) whether or not women in general and women they knew who had had an abortion should be punished with prison, as Brazilian law mandates. The differences in their answers were enormous: the majority of respondents were against putting women who have had abortions in prison. Almost 60% of civil servants and 25% of medical students knew at least one woman who had had an illegal abortion; 85% of medical students and 83% of civil servants thought this person(s) should not be jailed. Brazilian parliamentarians who are currently reviewing a reform in the Penal Code need to have this information urgently. PMID:24315072
Lalos, A; Frankman, O; Jacobsson, L; von Schoultz, B
459 women seeking abortion answered a questionnaire about their motives, contraceptive methods and use, and their reasons for failing to use them. An additional 50 in-depth interviews were conducted to obtain a more detailed view of their relationship to partners, decision to seek abortion, and experience with contraceptives. Results indicated that 254 women (56%) admitted to not having used any contraception before getting pregnant, and 44% had used condoms. Socioeconomic factors were less important than geographical location for those seeking abortion. Those under 20 were most likely not to use contraceptives (67%), while only the 30-34 age group's usage pattern exceeded 50%. 174 women (38%) had had 1 or more previous abortions, while 11% had 3 or more. The rate of contraceptive use increased from 40% to 45% after abortion. Repeat abortions were typical for very fertile, sexually active women. Women who had harmonious relationships with their partners used contraceptives more extensively. 11 of 14 women who had problematic relationships had not used any contraception at the time the unwanted pregnancy occurred. Women with several partners tended to use contraceptives less -- a paradoxical finding. Women who made the decision about abortion alone were less likely to use contraception than those whose partners were also involved in the decision making. Only 37% of the women who were ambivalent about having a child in the future used contraception, evincing an unconscious desire to have children. Counseling after the abortion procedure combined with advice about contraception may help prevent repeat abortions. PMID:6621194
In 1975, a new Abortion Act which allowed abortion on request went into effect in Sweden. From the mid-1960s until then, the number of induced abortions increased from 6000 (4/1000 women ages 15-44 years) to 30,500 (or 19/1000) in 1974. In 1975 and 1976, 20 abortions/1000 women of fertile age were performed while the corresponding figures in 1977 and 1978 were 19/1000 both years. During the last few years, women under age 30 have undergone abortions to a lesser extent, both absolutely and relatively, and there has been an increase in the number of abortions for women above this age. In 1971, less than 2% of the abortions were performed before the end of the 8th week of pregnancy and 6% after the 12th week. In 1978, the corresponding figures were 15% and 1% respectively. Between 1971 and 1978, the rate of the 2-step abortion fell from 28% to 4%. An increasing number of abortions are now performed as outpatient procedures. In 1971, the figure was 16% while in 1978 it has risen to 74%. (Authors modified) PMID:7374283
Abortion legalization in the early 1970s led to dramatic changes in fertility. Some research has suggested that it altered cohort outcomes, but this literature has been limited and controversial. In this paper, we provide ...
This privately posted page offers extensive and highly credible information on legislation and jurisprudence relating to abortion in the US. The site offers thoroughly linked discussions of constitutional law, Roe v. Wade, Planned Parenthood v. Casey, state and federal abortion laws, including partial-birth abortion laws, and much more. The hypertext links are to primary documents including court decisions, texts of legislation, court briefs, and oral argument transcripts. There is also an index to primary documents for ease of access. We found the page to have no political agenda. As the author states, "this page is being constructed to help people, regardless of their political bent, understand the background and state of abortion law in America, and access related legal material--especially that which is less available and less well known."
This table presents abortion statistics in Scotland for the years 1972-80 and includes the number and rates/1000 women ages 15-44 by age as well as marital status. Sites for the abortion were either an NHS hospital or another approved place as defined by the Abortion Act of 1967. The women were either married, single, widowed, separated/divorced, or their status was unknown. Grounds for termination of pregnancy included risk to life of the woman, risk to her physical or mental health, risk to the physical or mental well-being of living children, or risk of fetal abnormality. Across the entire 8 year span, risk to physical or mental health of the woman was clearly the reason most often cited as grounds for termination. In 1980, it was responsible for 95.9% or 7470 abortions. PMID:7327939
Hattel, A L; Castro, M D; Gummo, J D; Weinstock, D; Reed, J A; Dubey, J P
Neospora caninum was found in fetal tissues of 34 of 688 cases of bovine abortion submitted to the Pennsylvania Animal Diagnostic Laboratory System during the period from May 1994 to November 1996. The aborted fetuses ranged in gestational age from 3 to 8 months. Microscopic lesions consisted primarily of encephalitis and myocarditis. A labeled (strept) avidin-biotin staining procedure using anti-N. caninum polyclonal rabbit serum revealed N. caninum organisms within the fetal brain (27 of 27), heart (10 of 13), placenta (5 of 6), kidney (2 of 2), liver (1 of 4) and skeletal muscle (1 of 1). PMID:9561715
Statistics on legal abortion in Britain between 1968-1974 are presented. There was a mortality rate of 10+ or -2 per 100,000 abortions: 27+ or -11 in 1968-1969, 12+ or -4 in 1970-1972, and 6+ or -3 in 1973-1974. Legal abortion mortality increased from 4+ or -3 when performed at gestation under 9 weeks to 5+ or -2 at 9-12 weeks, 13+ or -7 at 13-16 weeks, and 62+ or -33 at 17 weeks and over. The ratio was 11+ or -6 for women under 20 years of age, increasing to 5+ or -3 at age 20-29, 10+ or -6 at age 30-39, and 23+ or -19 at age 40 and over. The parity had little influence on abortion mortality, but the technique used had a great influence. Hysterotomy, hypertonic saline, and abortifacient paste were the most dangerous, in increasing order, with mortality rates of 39+ or -30, 106+ or -75, and 152+ or -89, respectively. The rates for aspiration and curretage were 4+ or -2 and 4+ or -3, respectively. There was a higher mortality risk with abortion with sterilization. The main causes of legal abortion mortality were infection, pulmonary embolism, and complications of general anesthesia. The high incidence of mortality associated with legal abortion in Britain is partially caused by: 1) high incidence of concurrent sterilization, 2) former use of dangerous techniques, 3) significant incidence of second trimester abortion, 4) routine use of general anesthesia, and 5) previous ill health of some of the women. PMID:12178337
Statistics compiled from notifications of abortions performed in Sco tland during the calender year 1970 are presented in 17 tables. Subject breakdowns include: 1) regional, 2) marital status, 3) percentage by month, 4) age, 5) associated sterilizations, 6) social class, 7) ground for termination, 8) period of gestation at termination, 9) method of termination, 10) reported complications, and 11) numbers according to parity. A table giving the number of abortions performed during the quarter ending September 1971 is appended. PMID:5063622
Recent efforts to change the law regulating abortion in Japan are being met with resistence. Proponents of the revisions claim that the current law does not respect the life of the fetus and is also outdated. The clause in question permits abortions to be performed if the mother's health would be compromised from an economic viewpoint. Given Japan's high economic level, the revisionists do not feel the clause is relevant. A 1981 random survey of 3750 married Japanese women less than 50 years old revealed that 82.6% approve of abortion under certain circumstances and 65% approve of abortion from an economic viewpoint. Several organizations are concerned about the impact of restricting abortions especially with the limited availability of contraceptives (oral contraceptives are illegal and only 5 types of IUDs have been approved for use) and the lack of sex and contraceptive education. Family Planning Federation of Japan (FPFJ) issued resolutions in defense of the current law stating that the state should not interfere with the choice to bear a child, national economic prosperity does not necessarily reflect the individual woman's situation, and that changing the current law may increase the number of illegal abortions, increase the incidence of unmarried young mothers and the incidence of maternal death and child abandonment. FPFJ proposed that the restrictions on the use of contraceptives be relaxed, sex and contraceptive education be improved, and counseling services in family planning be consolidated. PMID:12338648
Henker, F O
The article reports upon the characteristics of 300 abortion applicants in Arkansas manifesting significant stress from unwanted pregnancy between May 1, 1970 and June 30, 1971. The sample is limited by the fact that all of these women had been willing to seek medical aid. Patients ranged from ages 13-47, 131 of them ages 17-21. 35% had had some college education; another 29% were high school graduates. 50.6%, 20.6%, and 27.3% were single, divorced, and married, respectively. 59.6% of the patients were primiparas. 18.3%, 9.6%, and 12.3% were classified as being neurotic, having psychophysiologic tendencies (gastrointestinal problems, obesity, chronic headaches), and having sociopathic features (passive-aggressive, frankly rebellious, delinquent, antisocial, alcoholic), respectively. 12 women had noticeable schizoid features; 4 women had mildly active schizophrenia. Fathers of the women were usually blue-collar workers (55.3%) or white-collar workers (24.6%). The most frequent ordinal sibling position among the women was oldest child (38%). Parental instability (1 or both parents lost through death, divorce, father usually away working, chronic alcoholism, etc.) was reported by 39.6% of the patients. Patients' attitudes toward the unwanted pregnancy included dislike of inexpediency of the situation (82.6%), self-depreciation (55.6%), and aversion (28.6%). Precipitated psychiatric disorders were for the greatest part mild. Manifesting symptoms included depression (66.7%), anxiety (21%), and mixed anxiety and depression (12.2%). Suicidal threats and gestures were made by 22 and 8 patients, respectively. In summary, the study reveals a group of predominantly Caucasian women from unstable, middle-class urban families who were going through an adjustment reaction to adolescence or adult life. PMID:4265812
Paterson, L.E.; Nachtwey, D.S.
Radiation protection standards for space activities differ substantially from those applied to terrestrial working situations. The levels of radiation and subsequent hazards to which space workers are exposed are quite unlike anything found on Earth. The new more highly refined system of risk management involves assessing the risk to each space worker from all sources of radiation (occupational and non-occupational) at the organ level. The risk coefficients were applied to previous space and medical exposures (diagnostic x ray and nuclear medicine procedures) in order to estimate the radiation-induced lifetime cancer incidence and mortality risk. At present, the risk from medical procedures when compared to space activities is 14 times higher for cancer incidence and 13 times higher for cancer mortality; however, this will change as the per capita dose during Space Station Freedom and interplanetary missions increases and more is known about the risks from exposure to high-LET radiation.
Based on articles found on the PubMed and Popline databases on the provision of first-trimester abortion by mid-level providers, this article describes policies on type of abortion provider, comparative studies of different types of abortion provider, provider perspectives, and programmatic experience in Bangladesh, Cambodia, France, Mozambique, South Africa, Sweden, the United States of America and Viet Nam. It shows that it is safe and beneficial for suitably trained mid-level health-care providers, including nurses, midwives and other non-physician clinicians, to provide first-trimester vacuum aspiration and medical abortions. Moreover, it finds that projects in Kenya, Myanmar and Uganda have successfully trained nurse-midwives to provide post-abortion care for incomplete abortion with manual vacuum aspiration, and that studies in Ethiopia and India have recommended that providers such as auxiliary nurse-midwives should be trained in abortion service delivery to ensure that they provide safe abortions for low-income women. The paper recommends the authorization of all qualified mid-level health-care providers to carry out first-trimester abortions, and it also recommends the integration of training in providing first-trimester abortion care into basic education and clinical training for all mid-level providers and medical students interested in obstetrics and gynaecology. Finally, it calls for documentation of the role of mid-level providers in managing second-trimester medical abortions to further inform policy and practice. PMID:19197405
Moreau, Caroline; Trussell, James; Bajos, Nathalie
Purpose Although more than 30,000 teenagers had an induced abortion in France in 2007 (14.3% of all abortions), little is known about their abortion experience. We explore young women’s decisions related to their abortion and the patterns of abortion care among teenagers in France, and draw particular attention to the contraceptive circumstances surrounding the abortion. Methods The data are drawn from the French National Survey of Abortion Patients conducted in 2007, comprising 1,525 women aged 13–19 years. Results A majority of French teens (82%) reported their pregnancy was unplanned and took on the responsibility of having an abortion: 45% made the decision alone, 46% shared the decision with their family or partner, and 9% reported the decision was made on their family’s or partner’s request alone. Sixty-nine percent of teenagers were eligible for both medical and surgical abortions, but only 43% thought they were given a choice of methods. Two-thirds of pregnancies were caused by contraceptive misuse or failure, mostly due to condom slippage or breakage (26%) or inconsistent pill use (20%). In 68% of cases, teenagers were prescribed a more effective method than the one they were using before, although only 11% received a prescription for a long-acting method. One in five teenagers reported not receiving a prescription for contraception. Conclusions Our results reveal varying degrees of young women’s autonomy in the decisions regarding their abortion. Although most teens switch to more effective methods of contraception after an abortion, only a minority receives a prescription for a long-acting method. PMID:22443844
Othman, Mohamad Sabri; Merican, Hassan; Lee, Yew Fong; Ch'ng, Kean Siang; Thurairatnam, Dharminy
A prospective cross-sectional study was conducted at 3 government hospitals over 6 months to evaluate the confidence level of medical officers (MOs) to perform clinical procedure in nonspecialist government hospitals in Penang. An anonymous self-administered questionnaire in English was designed based on the elective and emergency procedures stated in the houseman training logbook. The questionnaire was distributed to the MOs from Penang State Health Department through the respective hospital directors and returned to Penang State Health Department on completion. The results showed that there was statistically significant difference between those who had undergone 12 months and 24 months as houseman in performing both elective and emergency procedures. MOs who had spent 24 months as housemen expressed higher confidence level than those who had only 12 months of experience. We also found that the confidence level was statistically and significantly influenced by visiting specialist and working together with cooperative experienced paramedics. PMID:23695541
Initiatives to mandate parental involvement for minors seeking abortion have been presented in 11 US states to date during the 1997 legislative session. In four of these states (Virginia, South Dakota, Montana, and Massachusetts) final legislative or judicial actions have taken place. For example, effective July 1, 1997, a new Virginia law will require parental notice in person or by telephone at least 24 hours prior to the time an unemancipated minor is scheduled for induced abortion. The law provides an exception in cases of medical emergency and a judicial bypass procedure. To date, 38 states have some form of mandatory parental involvement law, of which 28 are enforceable. Four states (Alabama, Alaska, New Mexico, and Iowa) are seeking amendments to existing laws this legislative session and three states with no parental involvement laws on the books (Oklahoma, Texas, and Washington) seek to implement such legislation. Most stringent is a bill already passed by the Texas Senate stipulating that any court costs associated with use of the judicial bypass provision be deducted from the state's family planning funds. PMID:12347837
Campbell, N B; Franco, K; Jurs, S
Sexual attitudes and behavior of adolescent females have been the topic of much interest over the past decade. Feelings about contraception, conception, and abortion have been described in relation to the adolescents' beliefs about the possibility of becoming pregnant, who will or will not "protect" them, and the influence of significant others on their decision making. This study explores differences in 35 women who had abortions during their teenage years with 36 women whose abortions occurred after the age of twenty. A demographic questionnaire, the Millon Clinical Multiaxial Inventory, and the Beck Depression Inventory were completed by women who were members of a patient-led support group. Premorbid psychiatric histories, the decision-making process itself, and distressing symptoms postabortion are reported. Specific differences in perceptions of coercion, preabortion suicidal ideation, and nightmares post-abortion were found in the adolescent group. Antisocial and paranoid personality disorders as well as drug abuse and psychotic delusions were found to be significantly higher in the group who aborted as teenagers. Hypotheses regarding the influences of adolescent development on mother/child relationships, power struggles, and the use of fantasy as a coping device are explored. PMID:3232570
In Jewish law right and wrong, good and evil, are absolute values which transcend time, place, and environment. They defy definition by human intuition or expediency. Jewish law derives from the Divine revelation at Mount Sinai as expounded by sages faithful to, and authorized by, its writ. The Talmud rules that if a woman is in hard travail, and her life must be saved, the child must be aborted and extracted. The mother's life comes first. The fetus is not a human life until it is born. But 19th century Rabbinical works state that it is immoral to destroy a monster child. Modern rabbis are unanimous in condemning abortion, feticide, or infanticide as an unconscionable attack on human life. However, Jewish law allows abortion if the pregnancy will cause severe psychological damage to the mother. No civilized society could survive without laws which occasionally cause some suffering or personal anguish. One human life is worth a million lives, because each life is infinite in value. In cases of rape or incest Jewish law still does not sanction abortion. Man's procreative responsibilities are serious and carry rights and obligations which would be upset by liberalized abortion laws. If a person kills a person who is mortally wounded, the killer is guilty of a moral offense. PMID:12309928
Wyatt, L; Wyatt, G E; Morgan, J; Riederle, M; Tucker, M B; Guthrie, D; James, A; Brook, D
Research suggests that private physician providers of office abortions and the women who seek their services are not included in nationwide surveys of abortion statistics. This study describes the demographic characteristics of private physicians and the prevalence of abortions performed in their offices in Los Angeles County, California, a state in which office abortions are prohibited by law. Factors that influence physicians' decisions to provide the service, as well as the age and ethnicity of the office abortion recipients, are examined. Of 1,004 California Medical Association members who practiced obstetrics and gynecology in Los Angeles County during 1990, 49% returned anonymous, confidential surveys. Seventy percent of physicians had performed at least one abortion in California, and 29% were currently providing this service in their offices. Physician gender, age, ethnicity, and religion were associated with performing abortions. The average abortion patient was not young and ethnic, but White, middle-class, and in her mid- to late twenties. The implications of these findings are discussed. PMID:8585225
Moreau, Caroline; Trussell, James; Desfreres, Julie; Bajos, Nathalie
Background Using a large national survey of women undergoing an abortion in France, we explore their contraceptive use surrounding an abortion. Study design The study comprised a representative sample of 7,541 women undergoing an abortion in 2007. We compared their use of contraception before and after the abortion and examined the factors associated with the prescription of a very effective method (IUD, hormonal methods) after the procedure. Results Sixty-six percent of women were using contraception in the month they conceived. A third of women reported the same use of contraception before and after the abortion, 54% were prescribed a more effective method while 14% changed to less effective or no method at all. After the abortion, 77% of women were prescribed a very effective contraceptive. Conclusions Abortion offers an opportunity to improve contraceptive uptake and a chance for providers to adjust their prescriptions according to the difficulties women experience in their use of contraceptives. PMID:20851227
In India, the 1971 Medical Termination of Pregnancy Act, while allowing abortions under a broad range of circumstances, can be considered a conservative law from a feminist perspective. The Act allows healthcare providers rather than women seeking abortion to have the final say on abortion, and creates an environment within which women are made dependent on their healthcare providers. On October 29, 2014, the Ministry of Health and Family Welfare released a draft of the MTP (Amendment) Bill 2014, which proposes changes that could initiate a shift in the focus of the Indian abortion discourse from healthcare providers to women. Such a shift would decrease the vulnerability of women within the clinical setting and free them from subjective interpretations of the law. The Bill also expands the base of healthcare providers by including mid-level and non-allopathic healthcare providers. While the medical community has resisted this inclusion, the author is in favour of it, arguing that in the face of the high rates of unsafe abortion, such a step is both ethical and necessary. Additionally, the clause extending the gestational limit could trigger ethical debates on eugenic abortions and sex-selective abortions. This paper argues that neither of these should be used to limit access to late-trimester termination, and should, instead, be dealt with separately and in a way that enquires into why such pregnancies are considered unwanted. PMID:25716439
Medoff, Marshall H.
This study uses pooled cross-section time-series data, over the years 1982, 1992 and 2000, to estimate the impact of various restrictive abortion laws on the demand for abortion. This study complements and extends prior research by explicitly including the price of obtaining an abortion in the estimation. The empirical results show that the real…
Abortion has been a reality in women's lives since the beginning of recorded history, typically with a high risk of fatal consequences, until the last century when evolutions in the field of medicine, including techniques of safe abortion and effective methods of family planning, could have ended the need to seek unsafe abortion. The context of women's lives globally is an important but often ignored variable, increasingly recognised in evolving human rights especially related to gender and reproduction. International and regional human rights instruments are being invoked where national laws result in violations of human rights such as health and life. The individual right to conscientious objection must be respected and better understood, and is not absolute. Health professional organisations have a role to play in clarifying responsibilities consistent with national laws and respecting reproductive rights. Seeking common ground using evidence rather than polarised opinion can assist the future focus. PMID:20303830
Michael, M; Buckle, S
This paper examines a proposal to make use of IVF techniques to provide an alternative to therapeutic abortion of fetuses with genetic abnormalities. We begin by describing the proposed procedure, and then show that, considered in itself, it is morally on a par with therapeutic abortion. However, once the wider practical implications are brought into view, the proposed new procedure loses its initial appeal. The pros and cons are not sufficiently clear-cut entirely to rule out the IVF procedure, so the paper concludes by indicating some further complications which may follow, should the procedure come to be adopted. PMID:2319572
Henderson, Edward M.; Nguyen, Tri X.
This paper documents some of the evolutionary steps in developing a rigorous Space Shuttle launch abort capability. The paper addresses the abort strategy during the design and development and how it evolved during Shuttle flight operations. The Space Shuttle Program made numerous adjustments in both the flight hardware and software as the knowledge of the actual flight environment grew. When failures occurred, corrections and improvements were made to avoid a reoccurrence and to provide added capability for crew survival. Finally some lessons learned are summarized for future human launch vehicle designers to consider.
A table presents the number of abortions and rates/1000 women aged 15-44 by age and marital status of women and grounds for abortion for the years 1976-83. The total number of abortions performed was 7219 in 1976, 7334 in 1977, 7453 in 1978, 7754 in 1979, 7905 in 1980, 9007 in 1981, 8425 in 1982, and 8419 in 1983. The abortion rate was 6.9 in 1976, 7.0 in 1976, 7.0 in 1978. 7.3 in 1979, 7.3 in 1980, 8.3 in 1981, 7.6 in 1982, and 7.6 in 1983. In 1976, 43 abortions were performed on the grounds of risk to life of woman, 6866 on the grounds of risk to physical or mental health of woman, 1184 on grounds of risk to physical or mental health of existing children, and 176 on grounds of risk of abnormality to fetus. In 1977, 33 abortions were performed on the grounds of risk to life of woman, 7054 on the grounds of risk to physical or mental health of woman, 999 on grounds of risk to physical or mental health of existing children, and 161 on grounds of risk of abnormality to fetus. In 1978, 27 abortions were performed on the grounds of risk to life of woman, 7089 on grounds or risk to physical or mental health of woman, 973 on grounds of risk to physical or mental health of existing children, and 224 on grounds of risk of abnormality to fetus. In 1979, 28 abortions were performed on grounds of risk to life of woman, 7362 on grounds of risk to physical or mental health of women, 948 on grounds of risk to physical or mental health of existing children, and 329 on grounds of risk of abnormality to fetus. These figures were, respectively, 28, 7593, 826, and 241 for 1980; 23, 8683, 780, and 232 for 1981; 27, 8141, 607, and 210 for 1982; and 16, 8140, 608, and 209 for 1983. PMID:6490372
Tuyet, Hoang T D; Thuy, Phan; Trang, Huynh N K
In Viet Nam, abortion has been legal up to 22 weeks of pregnancy since the 1960s. There are about one million induced abortions every year. First trimester abortion is provided at central, provincial, district and commune level, while second trimester abortion is provided only at central and provincial level. For second trimester abortion, dilatation and evacuation (D&E) has been introduced at some central and provincial hospitals, and medical abortion protocols have been included in the draft National Standards and Guidelines currently being updated. However, Kovac's, an unsafe method, is still often used at many provincial hospitals. While access to first trimester abortion services is not difficult, there are still many barriers to second trimester abortion, especially for young, unmarried women. In order to prevent unwanted pregnancies, increase access to safe abortion and improve quality of care, the Vietnamese Ministry of Health is working with others to establish national policies and developing effective models for women-friendly comprehensive abortion care, including post-abortion family planning. This paper, based on published information, interviews and observations by the second author of service delivery in 2006-2008, provides an overview of second trimester abortion services in Viet Nam and ongoing plans for improving them. PMID:18772095
Díaz Treviño, Rafael
Medicare coverage policies of medical procedures can be promulgated at a national level by the Centers of Medicare and Medicaid Services (CMS) as National Coverage Determinations (NCDs) or at a local level by Medicare ...
Maxwell, Joseph W.
Attitudes toward the desirability of abortion were significaantly related to sex, college, classification, level of church activity, residence background, family size, exposure to abortion, and attitude toward premarital sex. The data suggest an increasing acceptance of abortion in the future. (Author)
Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.
Osler, Mogens; David, Henry P.; Morgall, Janine M.
Women having an induced abortion in an urban clinic were studied. First, second, and third time aborters (N=150) were interviewed. Variables including reasons for choosing abortion, life situations, contraceptive risk-taking, and ease of becoming pregnant were examined. Related studies and suggestions for postabortion counseling are discussed.…
Lycett, J E; Dunbar, R I
Parental investment decisions in human beings, including infanticide, have usually been considered in relation to the postnatal survival probabilities of their children. A number of factors which influence parental ability and willingness to invest in offspring have been identified from these studies. Here we argue that at least some of the same factors which influence investment decisions postpartum also affect the decision to terminate a current pregnancy through voluntary abortion. We show that both female age and marital status influence the probability of abortion, with the key variable being the likelihood of future marriage. Thus, abortion procedures extend a woman's ability to manage her reproduction into the prenatal period. PMID:10643080
Japanese attitude toward induced abortion with its historical background is examined. There is a record of induced abortion as early as the beginning of the 12th century. Abortion was practiced frequently as a means of family planning during Edo Period (1603-1867), especially among the poor. Shogunate and feudal lords were aware of the problem but generally acquiesced. Some Buddhist priest preached on the vice of abortion from a humanitarian point of view and suggested that each community should cooperate and regulate the practice. In 1842 Shogunate at last banned induced abortion in the capital, Edo, but left the rest of the country alone. Ironically this practice of voluntary abortion among the poor and the killing of newborns among peasants controlled the size of population of the nation throughout Edo Period, which saw 35 famines and undue taxation on peasants. In 1868 the new government of Meiji announced to have a tight control over midwives who performed abortion in most cases. In modernizing the nation the government advocated enlarged population under the slogan: rich nation with strong soldiers. This trend persisted till the end of World War II. Overpopulation and shortage of food after World War II with soldiers and people from lost colonies returning home prompted Japan to control her population and adopt a eugenic law. It was not until 1970's in the midst of women's liberation movement that Japanese women became aware of their own right to the reproductive aspect of their life. In comparison, in the United States Supreme Court decision in 1973 virtually legalized abortion and each state has responded to it differently. Prior to 1900 induced abortion was accepted as a means of birth control in the United States, and midwives had monopolized that area of medicine. Crusaders of anti-abortion from the turn of the century were not necessarily well publicized Catholics but "licensed" doctors who joined forces in their attempt to shut out midwives from medical practice. PMID:6759734
Guttmacher, Alan F.; And Others
A roundtable discussion on legal abortion includes Dr. Alan F. Guttmacher, President of The Planned Parenthood Federation of America, Robert Hall, Associate Professor of Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons, Christopher Tietze, a diretor of The Population Council, and Harriet Pilpel, a lawyer.…
Evensen, A R
In an editorial comment on an article entitled Induced Abortions in Teenagers, it is pointed out that Norway has the highest abortion rate in Scandinavia for women between 15-19 and that the rate has been rising in Norway while decreasing in Denmark, Finland, and Sweden. Abortion is a preventable threat to health. Teenagers should be encouraged to postpone intercourse and the use of oral contraceptives, and this advice should be coupled with discussions on sexuality in general. Pregnancy among teenagers is often the result of a transitory relationship, and teenagers should be encouraged to learn the techniques of self control to gain enough confidence to say no to sex they do not desire. 1 study showed that 61% of women seeking abortion had not used any contraceptive at the time of conception. A marketing approach is needed to make use of condoms obligatory in sexual relationships among teenagers. Although condoms are an imperfect contraceptive, improper use is possible the most important cause of failure both for pregnancies and HIV infection. Condoms should be made easily available from machines installed in suitable places and instruction in proper use of condoms should be made a part of normal sex education. School authorities in cooperation with teachers and parents have clear responsibility to improve guidance and instruction in contraception. PMID:3206428
Start, R D; Cross, S S
The pathological investigation of deaths following surgery, anaesthesia, and medical procedures is discussed. The definition of "postoperative death" is examined and the classification of deaths following procedures detailed. The review of individual cases is described and the overall approach to necropsy and interpretation considered. There are specific sections dealing with the cardiovascular system (including air embolism, perioperative myocardial infarction, cardiac pacemakers, central venous catheters, cardiac surgery, heart valve replacement, angioplasty, and vascular surgery); respiratory system (postoperative pneumonia, pulmonary embolism, pneumothorax); central nervous system (dissection of cervical spinal cord), hepatobiliary and gastrointestinal system; musculoskeletal system; and head and neck region. Deaths associated with anaesthesia are classified and the specific problems of epidural anaesthesia and malignant hyperthermia discussed. The article concludes with a section on the recording of necropsy findings and their communication to clinicians and medicolegal authorities. PMID:10655984
Mabel LS Lie; Stephen C Robson; Carl R May
BACKGROUND: Although abortion or termination of pregnancy (TOP) has become an increasingly normalized component of women's health care over the past forty years, insufficient attention has been paid to women's experiences of surgical or medical methods of TOP. OBJECTIVE: To undertake a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods.
Törnbom, M; Ingelhammar, E; Lilja, H; Möller, A; Svanberg, B
In a study of 404 women (simple random sample), 20-29 years of age, 201 (group A) applying for abortion and 203 (group B) continuing their pregnancies, the women were given a questionnaire and in addition were interviewed. The aim of the study was to evaluate the spontaneous personal motives of women for abortion at a time when age is not supposed to be a common reason. The results showed that more than half of the women expressed that a bad relationship with the partner in one way or another was a motive for the abortion. Other important motives included characteristics of the women and their partners, mainly immaturity, work/studies and unsuitable life situation for having a child. Less common motives seemed to be economy, dwelling and medical and health factors. It is obvious that women in this study wanted to have a stable relationship to the child's father before they dared or wanted to have a child. Social networks in modern society seem to be too weak. The women do not want to face social and emotional problems as lonely mothers. Political decisions in the society, for example with parental benefit according to your income discourage women from continuing their pregnancies during their studies. It also seems important for the woman to feel mature enough to have a child. The provision and encouragement of methods for safer sex may be a possible way by which to reduce the number of abortions. PMID:8038886
Notably absent from the public debate on abortion in Ireland have been the voices of women who have experienced induced abortion. Interviews with six acquaintances of the author who underwent abortion identified four themes underlying women's post-abortion silence. First, women fear public condemnation and personal rejection. Second, women are concerned that any emotional ambivalence they express about the abortion experience will be misconstrued as anti-abortion sentiment. Third, women worry that speaking out about their experience would be upsetting to friends and family. Fourth, women report frustration about the lack of a suitable public forum for voicing the complexities inherent in the abortion issue. The women's perception that their experience did not fit neatly with the rhetoric of either pro- or anti-abortion groups caused them to feel alienated from a political discourse that tends to depersonalize abortion. Although none of the women regretted the abortion decision, they continued to struggle with unresolved conflicts over taking responsibility for ending some form of life. A cycle has been created in which women do not feel safe to discuss their personal experiences until a more favorable political climate exists, yet the public perception of abortion is unlikely to change until more women's voices are heard. Feminist leaders are urged to address this dilemma. PMID:12290498
Anti-abortion organizations have extended their protest activities from free-standing abortion clinics to hospitals. In 1988-89, a number of US hospitals faced not only peaceful picketing, but also bomb treats, entrance blocking, and forced entry. This report describes strategies developed by security directors at North Shore Hospital (Manhasset, NY), Highland Hospital (Rochester, NY), Franklin General Hospital (Franklin Square, NY), Sutter Davis Hospital (Davis, CA), and Deaconess Medical Center (Spokane, WA) to contain the treat posed to hospital operations by these protesters. Among the measures recommended are: seriously assess each threat; maintain continuous contact with the local police and their intelligence personnel; obtain as much information as possible on the anti-abortion organizations and their future plans; give a show of strong security presence before any trouble begins; set up barriers to prevent demonstrators from entering the hospital grounds; maintain a neutral stance on the abortion issue; try to keep the mass media away from the protests, and appoint a designated spokesperson to speak to the press when it becomes necessary; and communicate frequently with the hospital's legal counsel. In the period ahead, as each state works to define its own abortion legislation, hospitals that perform abortions should anticipate accelerated protest demonstrations from both pro-and anti-abortion forces. PMID:10292794
Escarce, J J; Epstein, K R; Colby, D C; Schwartz, J S
OBJECTIVES. This study sought to examine racial differences in the use of medical procedures and diagnostic tests by elderly Americans. METHODS. We used 1986 physician claims data for a 5% national sample of Medicare enrollees aged 65 years and older to study 32 procedures and tests. For each service, we calculated the age- and sex-adjusted rate of use by race and the corresponding White-Black relative risk. RESULTS. Whites were more likely than Blacks to receive 23 services, and for many of these services, the differences in use were substantial. In contrast, Blacks were more likely than Whites to receive seven services. Whites had a particular advantage in access to higher-technology or newer services. Racial differences in use persisted among elders who had Medicaid in addition to Medicare coverage and increased among rural elders. CONCLUSIONS. There are pervasive racial differences in the use of medical services by elderly Americans that cannot be explained by differences in the prevalence of specific clinical conditions. Financial barriers to care do not fully account for these findings. Race may exacerbate the impact of other barriers to access. PMID:8328615
Vu?emilo, Luka; Borove?ki, Ana
Background High quality of informed consent form is essential for adequate information transfer between physicians and patients. Current status of medical procedure consent forms in clinical practice in Croatia specifically in terms of the readability and the content is unknown. The aim of this study was to assess the readability and the content of informed consent forms for diagnostic and therapeutic procedures used with patients in Croatia. Methods 52 informed consent forms from six Croatian hospitals on the secondary and tertiary health-care level were tested for reading difficulty using Simple Measure of Gobbledygook (SMOG) formula adjusted for Croatian language and for qualitative analysis of the content. Results The averaged SMOG grade of analyzed informed consent forms was 13.25 (SD 1.59, range 10–19). Content analysis revealed that informed consent forms included description of risks in 96% of the cases, benefits in 81%, description of procedures in 78%, alternatives in 52%, risks and benefits of alternatives in 17% and risks and benefits of not receiving treatment or undergoing procedures in 13%. Conclusions Readability of evaluated informed consent forms is not appropriate for the general population in Croatia. The content of the forms failed to include in high proportion of the cases description of alternatives, risks and benefits of alternatives, as well as risks and benefits of not receiving treatments or undergoing procedures. Data obtained from this research could help in development and improvement of informed consent forms in Croatia especially now when Croatian hospitals are undergoing the process of accreditation. PMID:26376183
Hanada, Eisuke; Takano, Kyoko; Antoku, Yasuaki; Matsumura, Kouji; Watanabe, Yoshiaki; Nose, Yoshiaki
Problems involving electromagnetic interference (EMI) with electronic medical equipment are well-documented. However, no systematic investigation of EMI has been done. We have systematically investigated the causes of EMI. The factors involved in EMI were determined as follows: 1) Electric-field intensity induced by invasive radio waves from outside a hospital. 2) Residual magnetic-flux density at welding points in a building. 3) Electric-field intensity induced by conveyance systems with a linear motor. 4) The shielding capacity of hospital walls. 5) The shielding capacity of commercial shields against a wide range frequency radio waves. 6) The immunity of electronic medical equipment. 7) EMI by cellular telephone and personal handy-phone system handsets. From the results of our investigation, we developed a following practical procedure to prevent EMI. 1) Measurement of electric-field intensity induced by invasive radio waves from outside the hospital and industrial systems in the hospital. 2) Measurement of residual magnetic-flux density at electric welding points of hospital buildings with steel frame structures. 3) Control of the electromagnetic environment by utilizing the shielding capacity of walls. 4) Measurement of the immunity of electronic medical equipment. And 5) Installation of electronic gate equipment at the building entrance to screen for handsets. PMID:11777312
This paper provides an overview of legal, religious, medical and social factors that serve to support or hinder women's access to safe abortion services in the 21 predominantly Muslim countries of the Middle East and North Africa (MENA) region, where one in ten pregnancies ends in abortion. Reform efforts, including progressive interpretations of Islam, have resulted in laws allowing for early abortion on request in two countries; six others permit abortion on health grounds and three more also allow abortion in cases of rape or fetal impairment. However, medical and social factors limit access to safe abortion services in all but Turkey and Tunisia. To address this situation, efforts are increasing in a few countries to introduce post-abortion care, document the magnitude of unsafe abortion and understand women's experience of unplanned pregnancy. Religious fat?wa have been issued allowing abortions in certain circumstances. An understanding of variations in Muslim beliefs and practices, and the interplay between politics, religion, history and reproductive rights is key to understanding abortion in different Muslim societies. More needs to be done to build on efforts to increase women's rights, engage community leaders, support progressive religious leaders and government officials and promote advocacy among health professionals. PMID:17512379
Prata, Ndola; Holston, Martine; Fraser, Ashley; Melkamu, Yilma
Limited access to modern contraceptives in populations that desire smaller families can lead to repeat unintended pregnancy and repeat abortions. We conducted an analysis of the medical records of 1,200 women seeking abortion-related services in public and private facilities in Addis Ababa, Ethiopia from October 2008 to February 2009. We examined the characteristics of initial and repeat abortion clients including prior contraceptive use and subsequent method selection. The incidence of repeat abortion was 30%. Compared with women seeking their first abortion, significantly more repeat abortion clients had ever used contraceptives and they were nearly twice as likely to leave the facility with a method. However, repeat abortion clients were significantly more likely to have ever used short-term reversible methods and to choose short-term methods post-abortion. Contraceptive counseling services for repeat abortion clients' should address reasons for previous contraceptive failure, discontinuation, or non-use. Post-abortion family planning services should be strengthened to help decrease repeat abortion. PMID:24558782
Twenty-eight years after the United State Supreme Court issued its landmark Roe v. Wade, the struggle continues to ensure that all women have the full range of reproductive choices, including abortion. While the struggle can be addressed through its political, religious, and medical dimensions, it also can be examined through the perspectives of those who actually provide abortions. This paper examines the perspectives of physician abortion providers to understand more fully their motivations, the quality of their personal and professional lives, their views on the future of abortion services, and their recommendations for undergraduate and residency medical education. Such questions are often best answered through qualitative inquiry, particularly when the subject at hand has had little interpretive scrutiny, lacks theoretical understandings, and remains in general an under-investigated phenomenon. Because abortion providers and the work they do fit those criteria, a qualitative study of physician providers in Ohio was undertaken. This paper is divided into the following sections: a literature review of abortion services in the United States, methods, interview data and discussion, and last, recommendations and conclusions. PMID:12555805
Reagan, L J
During 1890-1920, physicians, public health workers, and reformers across the US debated the practice of abortion by midwives. The author traces the nature of the development of the intertwined campaigns against midwives and abortion in Chicago. In Chicago, nearly all midwives were foreign-born and practiced in immigrant neighborhoods. A debate which began in the medical profession became part of popular discourse and political action. As the medical story of midwives and abortion caught the attention of different groups, each gave the story its own emphasis. Nonetheless, all advanced the obstetricians' program to restrict midwives' practices. The combined campaign to control abortion and midwifery took the form of a classic Progressive Era reform movement: a coalition of private interest groups of the native-born, white middle class identified a problem, investigated and documented its extent, and mobilized to promote a state-sponsored solution. The problem of midwives and abortion tended to be located among the city's immigrant population. The author stresses that neither the perception that immigrant midwives posed a problem nor the tendency to link midwives with abortion was unique to Chicago physicians and reformers. The leaders of medicine and reform in Chicago not only advocated midwife regulations in their own city, but also held considerable influence in the shaping of national health policy. PMID:8563453
Moore, G P
The use of the newly dead to teach procedures is widely practiced in training institutions. This model allows a realistic opportunity both to become more familiar with lifesaving maneuvers before they are actually necessary and to maintain proficiency. Whether to notify the next of kin first has been an issue of ethical debate. Some argue a "don't ask, don't tell" policy is justified, while others mandate open consent by family members prior to the practice. Several medical studies have found that patients and families are likely to consent to the procedures but prefer to be asked permission first. Multiple legal cases have addressed the issue of usage of cadavers postmortem without expressed permission. Earlier cases emphasized the concept of "pseudo-property" rights and declared that the next of kin do not have constitutional ownership of the deceased person's body. More recent legal cases are declaring that families do, in fact, possess these rights. In this day and age of increasing recognition of personal autonomy, it is probably prudent to approach the next of kin for permission before performing procedures on the newly deceased. PMID:11282676
Christian, W; Grillmaier, G
The study is an attempt to elucidate the official number of abortions on German women from the Federal Bureau of Statistics (FBS) in the Federal Republic of Germany (BRD). These numbers are derived from the General Medical Council up to mid-1976; after this date, from the FBS; also from registered and nonregistered cases in neighboring countries. There are "hidden numbers" in these data. Fetal deaths are reliably included in the abortion statistics. Abortions performed in Holland and Great Britain are fairly reliably registered. Abortions performed elsewhere (e.g. Austria) are not reliably registered but probably not quantitatively important. Miscarriages, a non-notifiable occurrence, are included insofar as numbers were ascertainable from hospital statistics. Data from the General Medical Council show an increase of 300% in 5 years--from 1970 to 1975. The first year of liberalized legislation, 1977, 54,309 abortions are registered, increasing to 82,788 in 1979 (50%). During those latter years there is a diminishing abortion rate on German women done abroad. Hard-to-estimate figures stem from: 1) legal, but not reported abortions, 2) nonsubstantiated abortions abroad, and 3) illegal abortions. Total number of abortions in 1979 is set at 135,600 which gives the BRD the lowest abortion rate of the European countries. However, the number of illegal abortions is set by independent experts at 75,000-300,000/year. With such divergent numbers it is difficult to accurately quantify the abortion rate. It can only be measured against the number of abortions no longer performed by quacks. The abortion rate (number of abortions/1000 women of childbearing age) and abortion ratio (number of abortions/1000 live births) are compared between various European countries for the year 1977. It shows the BDR with the 2nd lowest rate after the Netherlands and 3rd lowest rate after the Netherlands and Scotland. Hungary has both the highest rate (39.2/1000) and ratio (502/1000) in this table. Time will tell if the number of abortions continues to increase within the BRD and decrease in the neighboring countries. Statistics seem to indicate this trend. PMID:7450646
The field of abortion counseling originated in the abortion rights movement of the 1970s. During its evolution to the present day, it has faced significant challenges, primarily arising from the increasing politicization and stigmatization of abortion since legalization. Abortion counseling has been affected not only by the imposition of antiabortion statutes, but also by the changing needs of patients who have come of age in a very different era than when this occupation was first developed. One major innovation--head and heart counseling--departs in significant ways from previous conventions of the field and illustrates the complex and changing political meanings of abortion and therefore the challenges to abortion providers in the years following Roe v Wade. PMID:23153144
Klausen, Susanne M
This article examines the struggle over abortion law reform that preceded the enactment in 1975 of the first statutory law on abortion in South Africa. The ruling National Party government produced legislation intended to eliminate access to doctors willing to procure abortions in an attempt to prevent young, unmarried white women from engaging in premarital (hetero) sexual activity. It was also aimed at strictly regulating the medical profession’s actions with regards to abortion. The production of the abortion legislation was directly influenced by international struggles for accessible abortion and, more broadly, sexual liberation. The regime believed South Africa was being infiltrated by Western "immorality" and the abortion law was an attempt to buttress racist heteropatriarchal apartheid culture. Examining the abortion controversy highlights the global circulation of ideas about reproduction in the twentieth century and foregrounds a neglected dimension of the history of sexual regulation in apartheid South Africa: the disciplining and regulation of white female reproductive sexuality. PMID:20857591
Henshaw, S K
In 1982 and 1983, as in previous years, the majority of abortions in the United States were obtained by young women (62 percent), white women (70 percent) and unmarried women (81 percent). Half of all abortions were performed eight or fewer weeks after the last menstrual period, and 91 percent, at 12 weeks or earlier. The proportion of abortions that were repeat procedures continued to rise, to 37 percent in 1982 and 39 percent in 1983. The rate of abortion, 29 per 1,000, has remained essentially the same since 1981. Women aged 18-19 continue to have the highest abortion rate of any age-group (60 per 1,000). While most abortions are obtained by white women, the nonwhite abortion rate is more than twice that of whites. Thirty percent of all pregnancies were terminated by abortion in 1983, the same proportion as in 1982 and 1981. The highest abortion ratios are found among unmarried women (63 percent), women 40 and older (51 percent), teenagers (42 percent) and nonwhites (40 percent). Teenage nonwhites and whites have about the same abortion ratios. After rising during the 1970s, the adolescent pregnancy rate peaked around 1980-1981 and fell slightly in 1982-1983. The relative differentials between the pregnancy, birth and abortion rates of nonwhite and white teenagers narrowed somewhat between 1978 and 1981, but then widened slightly between 1981 and 1983. PMID:3556538
Weitz, Tracy A.; Jones, Rachel K.; Barar, Rana E.; Foster, Diana Greene
Objectives. We examined the factors influencing delay in seeking abortion and the outcomes for women denied abortion care because of gestational age limits at abortion facilities. Methods. We compared women who presented for abortion care who were under the facilities’ gestational age limits and received an abortion (n?=?452) with those who were just over the gestational age limits and were denied an abortion (n?=?231) at 30 US facilities. We described reasons for delay in seeking services. We examined the determinants of obtaining an abortion elsewhere after being denied one because of facility gestational age limits. We then estimated the national incidence of being denied an abortion because of facility gestational age limits. Results. Adolescents and women who did not recognize their pregnancies early were most likely to delay seeking care. The most common reason for delay was having to raise money for travel and procedure costs. We estimated that each year more than 4000 US women are denied an abortion because of facility gestational limits and must carry unwanted pregnancies to term. Conclusions. Many state laws restrict abortions based on gestational age, and new laws are lowering limits further. The incidence of being denied abortion will likely increase, disproportionately affecting young and poor women. PMID:23948000
Read, Christine Margaret
I recently watched a fascinating documentary about the crusade of Dr Bertram Wainer in the 1960s to bring the practice of illegal abortion in Victoria to an end. It documented the profound horror of the backyard abortion that so often ended in infection, sterility or death, and served as a potent reminder of a practice to which we must never return. Of course that cant happen again, abortion is legal now, isnt it? In Victoria in 1969 a Supreme Court judge ruled that an abortion is not unlawful if a doctor believed that: the abortion is necessary to preserve the woman from serious danger to her life or physical or mental health (Menhennit ruling). In Australia today however, abortion law remains conditional, unclear and inconsistent and, except in the ACT, is still part of criminal statutes. PMID:16969440
Since the RHIC Au-Au run in the year 2001 the 200 MHz cavity system was used at storage and a 28 MHz system during injection and acceleration. The rebucketing procedure potentially causes a higher debunching rate of heavy ion beams in addition to amplifying debunching due to other mechanisms. At the end of a four hour store, debunched beam can easily account for more than 50% of the total beam intensity. This effect is even stronger with the achieved high intensities of the RHIC Au-Au run in 2004. A beam abort at the presence of a lot of debunched beam bears the risk of magnet quenching and experimental detector damage due to uncontrolled beam losses. Thus it is desirable to avoid any accumulation of debunched beam from the beginning of each store, in particular to anticipate cases of unscheduled beam aborts due to a system failure. A combination of a fast transverse kickers and the new 2-stage copper collimator system are used to clean the abort gap continuously throughout the store with a repetition rate of 1 Hz. This report gives. an overview of the new gap cleaning procedure and the achieved performance.
This article responds to two important recent treatments of abortion rights. I will mainly discuss Ronald Dworkin's recent writings concerning abortion: his article "Unenumerated rights: whether and how Roe should be overruled," and his book Life's Dominion. In these writings Dworkin presents a novel view of what the constitutional and moral argument surronding abortion is really about. Both debates actually turn, he argues, on the question of how to interpret the widely shared idea that human life is sacred. At the heart of the abortion debate is the essentially religious notion that human life has value which transcends its value to any particular person; abortion is therefore at bottom a religious issue. Dworkin hopes to use this analysis to show that the religion clauses of the First Amendment provide a "textual home" for a woman's right to choose abortion. I wish to scrutinize this suggestion here; I want to probe the precise consequences for abortion rights of such an understanding of their basis. I will argue that the consequences are more radical than Dworkin seems to realize. The other work I will examine here is the important 1992 Supreme Court decision on abortion, Planned Parenthood v. Casey. The controlling opinion in that case, written jointly by Justices Kennedy, O'Connor, and Souter, strongly reaffirmed Roe v. Wade, but also upheld most of the provisions of a Pennsylvania statute that had mandated various restrictions on abortion. The justices' basis for upholding these restictions was their introduction of a new constitutional standard for abortion regulations, an apparently weaker standard than those that had governed previous Supreme Court abortion decisions. I think there is a flaw in Casey's new constitutional test for abortion regulations, and I will explain, when we turn to Casey, what it is and why it bears a close relation to Dworkin's reluctance to carry his argument as far as it seems to go. PMID:11660187
Hässig, M; Waldvogel, A; Corboz, L; Strickler, L; Zanoni, R; Weiss, M; Regi, G; Peterhans, E; Zerobin, K; Rüsch, P
Cases of abortions in cattle were investigated using several different laboratory procedures. The purpose was to collect information on an individual animal and on a herd basis that would allow a correct etiological diagnosis and also the institution of prophylactic measures. The cause of the abortion was diagnosed in 30% of the cases and in 16.3% of the herds. Due to the complexity of the problem, there is no routine diagnostic procedure that can universally be recommended and applied. There was no association between the number of tests performed or the number of herd mates included in the diagnostic work-up and the diagnostic success rate. In order to make a more efficient use of the diagnostic procedures, a better understanding of the mechanisms leading to abortion, on an individual animal basis and on a herd basis, is required. PMID:7494998
Khoury, H J; Garzon, W J; Andrade, G; Lunelli, N; Kramer, R; de Barros, V S M; Huda, A
The purpose of this study was to evaluate patient and medical staff absorbed doses received from transarterial chemoembolisation of hepatocellular carcinoma, which is the most common primary liver tumour worldwide. The study was performed in three hospitals in Recife, capital of the state of Pernambuco, located in the Brazilian Northeastern region. Two are public hospitals (A and B), and one is private (C). For each procedure, the number of images, irradiation parameters (kV, mA and fluoroscopy time), the air kerma-area product (PKA) and the cumulative air kerma (Ka,r) at the reference point were registered. The maximum skin dose (MSD) of the patient was estimated using radiochromic film. For the medical staff dosimetry, thermoluminescence dosemeters (TLD-100) were attached next to the eyes, close to the thyroid (above the shielding), on the thorax under the apron, on the wrist and on the feet. The effective dose to the staff was estimated using the algorithm of von Boetticher. The results showed that the mean value of the total PKA was 267.49, 403.83 and 479.74 Gy cm(2) for Hospitals A, B and C, respectively. With regard to the physicians, the average effective dose per procedure was 17 µSv, and the minimum and maximum values recorded were 1 and 41 µSy, respectively. The results showed that the feet received the highest doses followed by the hands and lens of the eye, since the physicians did not use leaded glasses and the equipment had no lead curtain. PMID:25870436
Parker, Samantha E; Gissler, Mika; Ananth, Cande V; Werler, Martha M
Induced abortion (IA) has been associated with a lower risk of preeclampsia among nulliparous women, but it remains unclear whether this association differs by method (either surgical or medical) or timing of IA. We performed a nested case-control study of 12,650 preeclampsia cases and 50,600 matched control deliveries identified in the Medical Birth Register of Finland from 1996 to 2010. Data on number, method, and timing of IAs were obtained through a linkage with the Registry of Induced Abortions. Odds ratios and 95% confidence intervals were calculated. Overall, prior IA was associated with a lower risk of preeclampsia, with odds ratios of 0.9 (95% confidence interval (CI): 0.9, 1.0) for 1 prior IA and 0.7 (95% CI: 0.5, 1.0) for 3 or more IAs. Differences in the associations between IA and preeclampsia by timing and method of IA were small, with odds ratios of 0.8 (95% CI: 0.6, 1.1) for late (?12 gestation weeks) surgical abortion and 0.9 (95% CI: 0.7, 1.2) for late medical abortion. There was no association between IA in combination with a history of spontaneous abortion and risk of preeclampsia. In conclusion, prior IA only was associated with a slight reduction in the risk of preeclampsia. PMID:26377957
This article traces the establishment of abortion clinics following Roe v Wade. Abortion clinics followed one of two models: (1) a medical model in which physicians emphasized the delivery of high quality medical services, contrasting their clinics with the back-alley abortion services that had sent many women to hospital emergency rooms prior to legalization, or (2) a feminist model in which clinics emphasized education and the dissemination of information to empower women patients and change the structure of women's health care. Male physicians and feminists came together in the newly established abortion services and argued over the priorities and characteristics of health care delivery. A broad range of clinics emerged, from feminist clinics to medical offices run by traditional male physicians to for-profit clinics. The establishment of the National Abortion Federation in the mid-1970s created a national forum of health professionals and contributed to the broadening of the discussion and the adoption of compromises as both feminists and physicians influenced each other's practices. PMID:23327251
This article traces the establishment of abortion clinics following Roe v Wade. Abortion clinics followed one of two models: (1) a medical model in which physicians emphasized the delivery of high quality medical services, contrasting their clinics with the back-alley abortion services that had sent many women to hospital emergency rooms prior to legalization, or (2) a feminist model in which clinics emphasized education and the dissemination of information to empower women patients and change the structure of women’s health care. Male physicians and feminists came together in the newly established abortion services and argued over the priorities and characteristics of health care delivery. A broad range of clinics emerged, from feminist clinics to medical offices run by traditional male physicians to for-profit clinics. The establishment of the National Abortion Federation in the mid-1970s created a national forum of health professionals and contributed to the broadening of the discussion and the adoption of compromises as both feminists and physicians influenced each other's practices. PMID:23327251
Schleiss, L; Mygind, K A; Borre, R V; Petersson, B H
One hundred and thirty consecutive women were interviewed about the development of psychological symptoms related to induced abortion two days before and four months after the abortion. Sixty-one (47%) participated in the second interview. Of the 61 women, 52% were psychologically influenced before the abortion to an extent which indicated severe crisis or actual psychiatric illness. Four months after the abortion 13 of these women were still psychologically affected. Furthermore, five women who were not affected before the abortion had developed psychological problems. Among ten of these women (16%) the physiological problems could only be related to the circumstance in connection with the abortion. For a number of women (30%) the abortion had a negative influence on their relationships and their sex lives, whereas other claimed that their relationship had become closer because of their reactions towards the abortions. In spite of these conditions all women indicated that their decision about the abortion had been the correct one under the given circumstances. PMID:9206861
Izugbara, Chimaraoke O; Egesa, Carolyne; Okelo, Rispah
Public health discourses on safe abortion assume the term to be unambiguous. However, qualitative evidence elicited from Kenyan women treated for complications of unsafe abortion contrasted sharply with public health views of abortion safety. For these women, safe abortion implied pregnancy termination procedures and services that concealed their abortions, shielded them from the law, were cheap and identified through dependable social networks. Participants contested the notion that poor quality abortion procedures and providers are inherently dangerous, asserting them as key to women's preservation of a good self, management of stigma, and protection of their reputation, respect, social relationships, and livelihoods. Greater public health attention to the social dimensions of abortion safety is urgent. PMID:26233296
Chambers, Gloria T.; Meyer, Walter J.; Arceneaux, Lisa L.; Russell, William J.; Seibel, Eric J.; Richards, Todd L.; Sharar, Sam R.; Patterson, David R.
Introduction Excessive pain during medical procedures is a widespread problem but is especially problematic during daily wound care of patients with severe burn injuries. Methods Burn patients report 35–50% reductions in procedural pain while in a distracting immersive virtual reality, and fMRI brain scans show associated reductions in pain-related brain activity during VR. VR distraction appears to be most effective for patients with the highest pain intensity levels. VR is thought to reduce pain by directing patients’ attention into the virtual world, leaving less attention available to process incoming neural signals from pain receptors. Conclusions We review evidence from clinical and laboratory research studies exploring Virtual Reality analgesia, concentrating primarily on the work ongoing within our group. We briefly describe how VR pain distraction systems have been tailored to the unique needs of burn patients to date, and speculate about how VR systems could be tailored to the needs of other patient populations in the future. PMID:21264690
Karlsson, Katarina; Englund, Ann-Charlotte Dalheim; Enskär, Karin; Rydström, Ingela
When children endure needle-related medical procedures (NRMPs), different emotions arise for the child and his/her parents. Despite the parents’ own feelings, they have a key role in supporting their child through these procedures. The aim of this study is to describe the meanings of supporting children during NRMPs from the perspective of the parents. Twenty-one parents participated in this study. A reflective lifeworld research (RLR) approach was used and phenomenological analysis was applied. The essential meaning of the phenomenon—supporting children during an NRMP—is characterized as “keeping the child under the protection of one’s wings,” sometimes very close and sometimes a little further out under the wingtips. The essential meaning is additionally described through its constituents: paying attention to the child’s way of expressing itself, striving to maintain control, facilitating the child’s understanding, focusing the child’s attention, seeking additional support, and rewarding the child. The conclusion is that parents’ ability to be supportive can be affected when seeing their child undergo an NRMP. To regain the role as the child’s protector and to be able to keep the child “under the protection of one’s wings,” parents need support from the staff. PMID:25008196
Consedine, Nathan S; Windsor, John A
Mismatches between the needs of public health systems and student interests have led to renewed study on the factors predicting career specializations among medical students. While most work examines career and lifestyle values, emotional proclivities may be important; disgust sensitivity may help explain preferences for careers with greater and lesser degrees of procedural content. In the study, 294 students completed measures assessing: (1) demographics, (2) career interest or intention regarding emergency medicine, internal medicine, obstetrics/gynecology, and pediatric medicine, (3) traditional determinants of career intention/interest, and (4) core/bodily product, animal reminder, contamination, and sexual/moral disgust sensitivity. As predicted, logistic regressions controlling for demographics and traditional career predictors, showed that greater animal reminder disgust predicted reduced interest in emergency medicine but greater interest in pediatric medicine. Conversely, greater core/bodily product disgust predicted lower interest in obstetrics/gynecology and pediatric medicine; greater contamination and sexual/moral disgust both predicted increased odds of interest in internal medicine. Overall, specific disgust sensitivities were the best predictors of specialization intention in multivariate models. Specific disgust sensitivities appear to differentially deter and/or predispose self-selection into specific trajectories varying in procedural content. Such findings may permit the early identification of specialty fit and provide guidance in career counseling. PMID:23797803
...INSTITUTIONAL MANAGEMENT MISCELLANEOUS Birth Control, Pregnancy, Child Placement, and Abortion § 551.23 Abortion...counseling to aid her in making the decision whether to carry the pregnancy to full term or to have an elective abortion. If an...
The main purpose of this study was to reach a deeper understanding of factors influencing the attitudes toward organ donation and other procedures with the dead body. From a survey of 400 inhabitants of Uppsala, a city in the middle of Sweden, concerning attitudes toward transplantation issues, 38 individuals with different attitudes toward donation of their own organs were selected for follow-up interviews. From the interviews, more than 600 statements concerning motives and reactions to medical procedures with the dead body were listed. These statements were summarized in 20 motive categories, in which 17 the nature of the motives were negative to organ donation and three promoting such a procedure. The categories were then analyzed and interpreted within a frame of reference of psychodynamic defense theory. In several cases it was possible to relate them to common death anxiety defenses. Six different motive complexes were extracted. These are called (1) illusion of lingering life; (2) protection of the value of the individual; (3) distrust, anxiety and alienation; (4) respecting the limits set by Nature or God; (5) altruism; and (6) rationality. Individuals not willing to donate their own organs were judged as either (a) reacting out of strenthened death anxiety defenses, or (b) as having a special outlook on life, where the idea of what is 'natural' was emphasized. The adverse reactions of the positive attitude group were seen as initial reactions perceived as derivations of common death anxiety defenses and weakened when confronted with altruistic and fact-stressing arguments. In the 'undecided group' of 14 persons, 11 arrived at a definite opinion. Seven decided for organ donation when their mistaken beliefs were corrected or when they took time to work through their initial uneasiness, while 4 persons actually were clearly negative. Three still remained uncertain. The stability of these attitudes seems to be high, often being experienced as a part of one's philosophy of life. PMID:8042059
Nesheim, B I
A Norwegian investigation from 1987-88 indicated that 25% of the women who were interviewed at a maternity ward stated that their pregnancy had not been planned. That means that 15,000 of the annual total of 60,000 births in Norway are not planned. This is roughly the same figure as the number of abortions (14,000 per year). 93% of women who carry out an unplanned pregnancy have not used contraception according to a 1991 study, but even a 1999 study showed that half of women seeking abortion had not used contraception. A 1994 investigation revealed that only 8% of women in the 20-24 age group did not use contraception and 5% used unsafe methods (coitus interruptus, safe periods, spermicides), while the rest used effective contraceptives (60% used OCs). There are 144,000 women in this age group in Norway, of which 12,000 give birth within a year. In theory the remaining 132,000 would have 2600 pregnancies. In 1996 there were 3883 abortions in this same age group; half of them would originate from that 8% of women who did not use contraception and the other half owing to contraceptive failure. Two studies among students in Oslo in 1997 demonstrated that even if a young woman started using OCs it did not mean that she would continue using them. A number of them discontinued because their relationship with their partner ended, they neglected to visit their doctor, forgot to take their pills, or thought that they could not get pregnant right after stopping OC use. PMID:10081344
Hedayat, K M; Shooshtarizadeh, P; Raza, M
Abortion is forbidden under normal circumstances by nearly all the major world religions. Traditionally, abortion was not deemed permissible by Muslim scholars. Shiite scholars considered it forbidden after implantation of the fertilised ovum. However, Sunni scholars have held various opinions on the matter, but all agreed that after 4 months gestation abortion was not permitted. In addition, classical Islamic scholarship had only considered threats to maternal health as a reason for therapeutic abortion. Recently, scholars have begun to consider the effect of severe fetal deformities on the mother, the families and society. This has led some scholars to reconsider the prohibition on abortion in limited circumstances. This article reviews the Islamic basis for the prohibition of abortion and the reasons for its justification. Contemporary rulings from leading Shiite scholars and from the Sunni school of thought are presented and reviewed. The status of abortion in Muslim countries is reviewed, with special emphasis on the therapeutic abortion law passed by the Iranian Parliament in 2003. This law approved therapeutic abortion before 16 weeks of gestation under limited circumstances, including medical conditions related to fetal and maternal health. Recent measures in Iran provide an opportunity for the Muslim scholars in other countries to review their traditional stance on abortion. PMID:17074823
Gemzell-Danielsson, Kristina; Kopp Kallner, Helena; Faúndes, Anibal
Family planning counseling and the provision of postabortion contraception should be an integrated part of abortion and postabortion care to help women avoid another unplanned pregnancy and a repeat abortion. Postabortion contraception is significantly more effective in preventing repeat unintended pregnancy and abortion when it is provided before women leave the healthcare facility where they received abortion care, and when the chosen method is a long-acting reversible contraceptive (LARC) method. This article provides evidence supporting these two critical aspects of postabortion contraception. It suggests that gynecologists and obstetricians have an ethical obligation to do everything necessary to ensure that postabortion contraception, with a focus on LARC methods, becomes an integral part of abortion and postabortion care, in line with the recommendations of the International Federation of Gynecology and Obstetrics and of several other organizations. PMID:24739476
Khitamy, Badawy A. B.
A Muslim woman in her sixteenth week of pregnancy was informed that her ultrasound scan showed spina bifida, and laboratory results confirmed the diagnosis. The child would have various complications and, most probably, would need medical care for life. With the consent of her husband she decided to terminate the pregnancy. Her decision sparked controversy among Muslim clerics in her community, sparking debate between those who would allow abortion for medical reasons and those who oppose abortion for any reason. This paper will review the philosophical and theological arguments of the pro-life and pro-choice groups as well as the Islamic perspective concerning a woman’s autonomy over her reproductive system, the sanctity of the fetus and the embryo, therapeutic abortion, and ensoulment. PMID:23573379
In Thailand abortion is against the law except in cases of risk to a woman's health or if the pregnancy is the result of rape or other sexual crimes. This paper presents an overview of the history of the abortion debate in Thailand based upon research conducted from 1997-2001 for an ethnographic and historical study. Information was taken from media reports from 1950 in the Thai and English language press, a review of parliamentary records and interviews with 10 key informants. The debate over legal reform started in 1973. A reform bill was passed in 1981 in the House of Representatives but defeated in the Senate, primarily due to the lobbying efforts of Chamlong Srimuang, the leader of a broad-based religious coalition, who has been central in the anti-reform movement since then. The current democratically elected government in Thailand offers the best hope yet for reform, though abortion remains a politically sensitive issue, sensationalized in the press to counter reform efforts. A new advocacy network has recently been formed, including a range of women's organisations, public health advocates, academics and journalists. Current proposals from governmental and medical profession bodies may make abortions available to some women, but most, who seek abortions due to socio-economic and family planning reasons, will continue to have to find abortions by whatever means they can. PMID:12369331
Aguirre Zozaya, F; Iglesias, M; Reyes, R M; Iturralde, G; Martínez, M; Pineda Hernández, C
The history of abortion is a very long one. Every people and nation used different and widely varied methods during the centuries to get rid of unwanted pregnancies. Unfortunately, in most instances, the great majority of these methods was equivalent to zero effectiveness, or, too often, to suicide. Legal aspects of induced abortion have changed considerably with the passing of time and according to countries; these days 36% of the world countries admit abortion on request, 24% for specific reasons only, 16% for medical reasons only, and 8% still consider it an illegal practice. In Mexico abortion is legal only when pregnancy would imply death of the mother, when it is the result of rape of minors, or when it is done on women with very serious mental pathology. Obviously abortion is not the solution to unwanted pregnancies; an improvement in the socioeconomic condition and in the quality of life of many people would be a much better, and more difficult, approach to the solution. Psychosocial factors of abortion involve concepts which are difficult to define, such as those of the wanted or of the unwanted child, and can cause problems which are very difficult to handle. Health education, and sex education in particular, should not only teach the fundamentals of reproduction, but respect and consideration for the phenomenon of procreation, and a strong sense of personal and social responsibility toward family planning. PMID:7005031
Gerdts, Caitlin; DePiñeres, Teresa; Hajri, Selma; Harries, Jane; Hossain, Altaf; Puri, Mahesh; Vohra, Divya; Foster, Diana Greene
Background Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. Methods In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. Results The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. Conclusions The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services. PMID:25511805
Knutsen, M; Furnes, K; Moen, M H
The aim of this survey was to examine the number of abortion applicants not using contraception at the time of conception, to shed light on the reasons for this, and to acquire information about the knowledge of postcoital anticonception in this patient group. The registered data is collected from precoded medical records at the University Hospital of Trondheim comprising 2,074 women applying for abortion in the period 1.1. 1995-15.7. 1997. The 291 applying for abortion 15.1-15.7. 1997, and who had not used contraception were given a questionnaire. 160 (55%) answered the questionnaire. During the period of 2.5 years 57.4% had not used contraception at the time of conception. The tendency of non-use has increased significantly during the last 2.5 years. Concern about sideeffects was the most common reason for not using contraceptives (36%). One third trusted the rhythm method and coitus interruptus. The postcoital pill was known by 93%; of the 61 women who had considered using it, 67% thought of it too late. To prevent unwanted pregnancies, it is important to focus on the positive health effects of oral contraception. Information efforts should especially be aimed at young and single women, who represent the majority of the non-users. The cost is no great impediment to the use of contraception. Availability of emergency contraception should be improved. PMID:10081350
Wolleat, Patricia L.
A number of questions relating to providing abortion information to teenagers can be raised from legal, ethical and philosophical standpoints. The purpose of this article is to examine abortion information-giving from the perspective of counseling and guidance theory and practice. (Author)
Luscutoff, Sidney A.; Elms, Alan C.
Subjects in this study were asked to report the number of contacts-for-advice they had made when forming decisions to have a therapeutic abortion, or to carry a pregnancy to term. As predicted, the abortion group differed strongly from both other groups on most questions. (Author)
Christians have so far failed to show why abortion is an affront to Christian convictions. Rather than arguing when life begins, Christians must show that Christianity as a way of life which recognizes God as Lord of life makes abortion unthinkable. PMID:7350102
Ubido, J; Ashton, J
Small area analysis has developed over the last two or three decades as a useful tool in health services research, as it allows the identification of areas within health or local authority districts with high rates of morbidity and mortality, and thus provides a useful base for planning the delivery of health services. A profile was compiled for Liverpool Family Health Services Authority on planned parenthood in the Liverpool District, with the aim of identifying where resources are needed most - which parts of the City, and which groups of women, are most in need. The profile included an analysis of various outcome measures, including abortion statistics, which can be used as a guide to the apparent effectiveness of services. Using a combination of statistics on NHS abortions for electoral wards, and private abortions by postal district, it became apparent that, on the whole, areas of high NHS induced abortion rates also have high private (British Pregnancy Advisory Service; BPAS) induced abortion rates, and vice versa. The maps for NHS and BPAS abortion rates suggest that total abortion rates are high in City centre wards, and low in areas south of the City. This would suggest that there are differences in social factors, family planning provision, and other factors which are influencing abortion rates. Although available indicators would suggest that City centre wards are in greatest need of improved family planning provision, these are the wards which are relatively well provided with health authority family planning clinics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8353002
Fadale, Vincent E.; And Others
This transcript is the result of panel presentation given on the implications of liberalized abortion laws for counselors. A new law which went into effect in July, 1970, in New York State presented women with the option of obtaining a legal abortion up to the 24th week of pregnancy. Counselors in New York State were, therefore, presented with new…
Only 13% of couples in Ghana practiced contraception in 1988. During the period of nursing following childbirth, it is traditional for the new mother to abstain from sexual intercourse. She is subject to considerable social scorn should she conceive too soon after a previous delivery. Conceiving in short order, nonetheless, women long resorted to clandestine, unsafe abortions during the postpartum interval. The government of Ghana legalized the practice of induced abortion in 1985 so that women could limit their fertility in safety with registered and certified medical practitioners. The author studied 900 women seeking an induced abortion or reporting complications resulting from induced abortion performed outside a hospital setting to see why, in spite of high knowledge of contraception, Ghanaian women resort to abortion instead of using contraception. Subjects were recruited from the KorleBu Teaching Hospital in Accra, the Tema General Hospital of Tema, the Nsawam Hospital of Nsawam, and two abortion clinics in Accra. 55% were married, 25% were teenagers, and 56% were residents of Accra, while the rest were from rural areas. Among those who were married, 45% were the third wives. Most of the women had some formal education and some degree of economic independence. 99% knew of at least one method of contraception, only 21% had ever used a modern method, 6% had used a condom, 4% had used withdrawal sometimes, and 3% had used the rhythm method. The women reported not using modern contraceptives mainly because of the belief that they cause harmful side-effects. For example, it was commonly thought that the oral contraceptive pill causes infertility and withdrawal causes stroke in men. Women also viewed contraceptives as messy, complicated, and/or difficult to use. 54% said they decided to abort their fetus because the pregnancy was out of wedlock; single parenthood is stigmatized in Ghana. 25% decided to abort to better space their children. PMID:12287987
Velazco, A; Varela, L; Tanda, R; Sánchez, C; Barambio, S; Chami, S; Valero, F; Aragón, S; Marí, J; Carbonell, J L
The objectives of the present clinical study were to evaluate the safety and efficacy of misoprostol (Cytotec) self-administered into the vagina for medical abortion in adolescents under the age of 18 years. After obtaining written consent from the patients and parents or guardians, a group of 150 adolescents with gestations between 35 and 63 days received 800 microg of vaginal misoprostol every 24 h, up to a maximum of three main doses, for abortion. Outcomes assessed included successful abortion (complete abortion without surgery), side-effects, decrease in hemoglobin, mean time of vaginal bleeding, mean expulsion time and mean time for the return of menses. Complete abortion occurred in 133/150 (88.7%, 95% confidence interval 82-93) patients. The frequencies of nausea, vomiting and diarrhea were statistically significantly higher when compared to those obtained for adult females. Vaginal bleeding lasted for 12.7 +/- 5.7 days (median 12 days, range 1-23 days). The mean expulsion time was 6.8 +/- 2.4 h (median 6 h, range 3-14 h) for those who aborted after the first misoprostol dose. The mean time for the return of menses, for those who aborted with misoprostol, was 34.7 +/- 3.4 days. The mean decrease in hemoglobin was statistically significant (p = 0.001), but had no clinical relevance. Taking into account the high abortion rate obtained, we could conclude that misoprostol alone is a valid method for terminating unwanted pregnancies in adolescents under the age of 18 years. PMID:11245549
Purcell, Carrie; Hilton, Shona; McDaid, Lisa
The media play a significant part in shaping public perceptions of health issues, and abortion attracts continued media interest. Detailed examination of media constructions of abortion may help to identify emerging public discourse. Qualitative content analysis was used to examine if and how the print media in contributes to the stigmatisation of abortion. Articles from seven British and five Scottish national newspapers from 2010 were analysed for overall framings of abortion and emergent themes, including potentially stigmatising discursive constructs and language. Abortion was found to be presented using predominantly negative language and discursive associations as ‘risky’, and in association with other ‘discredited’ social practices. Key perspectives were found to be absent or marginalised, including those of women who have sought abortion. Few articles framed abortion as a positive and legitimate choice. Negative media representations of abortion contribute to the stigmatisation of the procedure and of women who have it, and reflect a discrediting of women's reproductive decision-making. There is a need to challenge the notion that abortion stigma is inevitable, and to encourage positive framings of abortion in the media and other public discourse. PMID:25115952
Purcell, Carrie; Hilton, Shona; McDaid, Lisa
The media play a significant part in shaping public perceptions of health issues, and abortion attracts continued media interest. Detailed examination of media constructions of abortion may help to identify emerging public discourse. Qualitative content analysis was used to examine if and how the print media in contributes to the stigmatisation of abortion. Articles from seven British and five Scottish national newspapers from 2010 were analysed for overall framings of abortion and emergent themes, including potentially stigmatising discursive constructs and language. Abortion was found to be presented using predominantly negative language and discursive associations as 'risky', and in association with other 'discredited' social practices. Key perspectives were found to be absent or marginalised, including those of women who have sought abortion. Few articles framed abortion as a positive and legitimate choice. Negative media representations of abortion contribute to the stigmatisation of the procedure and of women who have it, and reflect a discrediting of women's reproductive decision-making. There is a need to challenge the notion that abortion stigma is inevitable, and to encourage positive framings of abortion in the media and other public discourse. PMID:25115952
Paxman, J M; Rizo, A; Brown, L; Benson, J
In Latin America, induced abortion is the fourth most commonly used method of fertility regulation. Estimates of the number of induced abortions performed each year in Latin America range from 2.7 to 7.4 million, or from 10 to 27 percent of all abortions performed in the developing world. Because of restrictive laws, nearly all of these abortions, except for those performed in Barbados, Belize, and Cuba, are clandestine and unsafe, and their sequelae are the principal cause of death among women of reproductive age. One of every three to five unsafe abortions leads to hospitalization, resulting in inordinate consumption of scarce and costly health-system resources. Increased contraceptive prevalence and restrictive abortion laws have not decreased clandestine practices. This article addresses how the epidemic of unsafe abortion might be challenged. Recommendations include providing safer outpatient treatment and strengthening family planning programs to improve women's contraceptive use and their access to information and to safe pregnancy termination procedures. In addition, existing laws and policies governing legal abortion can be applied to their fullest extent, indications for legal abortion can be more broadly interpreted, and legal constraints on abortion practices can be officially relaxed. PMID:8212091
The US Supreme Court's unanimous decision that a section of the 1970 anti-organized crime law--racketeer influenced corrupt organizations (RICO)--may be applied to anti-abortion groups that direct violence toward abortion clinics, staff, and patients is considered a victory for the pro-choice movement. There is concern, however, that the constitutional right of anti-abortionists to protest peacefully may be undermined at the same time trial judges endeavor to protect the right of women to access to abortion. Justices Souter and Kennedy noted in their concurring opinion that it is "prudent to notice that RICO actions could deter protected advocacy." More appropriate, in the editors' opinion, would be a federal law aimed specifically at abortion protesters who use force or the threat of force to halt abortion. PMID:12287354
In Slovenia abortion will continue to be available during the first 10 weeks of pregnancy as it has been since 1978. The Slovenian Constitutional Court passed this decision in December, 1991 calling the right to abortion a basic human right. T he ruling was a setback both for the government's conservative parties and the Catholic church. In Croatia, where the Catholic church is campaigning against abortion, the situation is quite different. Zagreb is full of stickers and posters with anti-abortion messages branding abortion murder and spreading inaccurate information in announcements. In 1990, there were 56,000 abortions. For every child that was born, one was aborted. The largest Croatian newspaper publicizes the Catholic view. They want pro-choice women of the volunteer group Tresnjevka to stop their struggle. The church and conservative women's groups press for inclusion of abortion in the Constitution. They are very powerful, and the fear is that might soon succeed in restricting or outlawing abortion. Tresnjevka is making efforts to organize a coordination and information center for women in Zagreb where there are 350,000 women and children refugees. Informative brochures are printed on natural healing methods in gynecology, as drugs are very scarce, and addresses for gynecological emergency care are also provided. Abortion has been legally available on demand during the 1st 10 weeks of pregnancy since 1978. Fore year Tresnjevka has worked for women, trying to raise funds from personal donations and from the government for their activities. Funds from foreign countries have never been received. At present many of the group's activities are on hold because of lack of funds, nevertheless the determination to continue fighting is alive. PMID:12285925
Finken, L L; Jacobs, J E
A survey conducted among college students in the midwestern US indicated that abortion decision-making consultation patterns differ substantially from those associated with other types of decisions. Surveyed were 169 predominantly White, middle-income students (68 males and 101 females) 18-20 years of age recruited from an introductory psychology class. Participants were presented with vignettes that pertained to four types of decisions: abortion (unplanned pregnancy), medical (cancer treatment type), future (career move), and interpersonal (crisis with a friend). For each decision, students were asked who they would consult (specific family members, significant others, friends, various professionals) and the order in which they would consult them. The mean number of consultants selected was 3.72 for abortion, 5.54 for medical, 4.90 for future-oriented, and 2.41 for interpersonal decisions. Significant others were selected most often for all decision scenarios; however, the highest frequency of consultation and lowest mean rank order for the significant other was on the abortion decision. The next most important consultant for abortion decisions was friends, then family members, and, finally, professionals. The only gender difference was a greater tendency for females to consult their mothers. For every category of consultant (except best friend), the pattern differed depending on the type of decision. These findings underscore the importance of considering context and multifaceted approaches in the design of programs aimed at enhancing adolescents' decision-making skills. PMID:12347375
Potdar, Pritam; Barua, Alka; Dalvie, Suchitra; Pawar, Anand
In India, safe abortion services are sought mainly in the private sector for reasons of privacy, confidentiality, and the absence of delays and coercion to use contraception. In recent years, the declining sex ratio has received much attention, and implementation of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act (2003) has become stringent. However, rather than targeting sex determination, many inspection visits target abortion services. This has led to many private medical practitioners facing negative media publicity, defamation and criminal charges. As a result, they have started turning women away not only in the second trimester but also in the first. Samyak, a Pune-based, non-governmental organization, came across a number of cases of refusal of abortion services during its work and decided to explore the experiences of private medical practitioners with the regulatory mechanisms and what happened to the women. The study showed that as a fallout from the manner of implementation of the PCPNDT Act, safe abortion services were either difficult for women to access or outright denied to them. There is an urgent need to recognize this impact of the current regulatory environment, which is forcing women towards illegal and unsafe abortions. PMID:26278839
King, C R
During the 1800s, male physicians took over women's established sources of medical care and knowledge causing friction between women and their health matters and the rising medical profession. This conflict still exists today. Physicians provided little information on how to prevent pregnancy since to do so would interfere with their natural biologic function of motherhood. Reproduction no longer controlled women who used contraceptives, had an abortion, and those who supported such decisions. Since women had to actively terminate a pregnancy themselves or seek an abortionist, abortion posed a threat to the traditional male dominance of reproductive decisions. Even though no accurate data on the frequently of abortion existed, women often practice abortion in the absence of other means of fertility control. They even helped their fellow sisters by telling them what they can use to induce abortion. These women were often church-going women and well respected in their communities. During most of the century, the clergy did not condemn abortion. There were plenty of agents and materials available to induce abortion which were sometimes publicized as methods to regulate menstruation. Abortifacients included emmenagogues, purgatives, oxytocics, and herbal or botanical products. Yet many proprietary potions did not actually terminate pregnancies. Women often resorted to using sharp instruments, wax candles, penholders with attached wires, glass rods, hair curling tongues, sticks, spoons, knives, and catheters. Physicians during the 19th century did not have the diagnostics means to determine pregnancy so often women misled them so the physicians would perform medical interventions. In the mid-1800s, allopathic physicians strengthened their professional position by regulating physicians and forming the American Medical Association. This resulted in condemnation of abortionists and abortions. They blamed complications of abortion on women's reproductive decisions. The new political climate concerning abortion resulted in regulation of women and their sexuality. PMID:1628000
This paper reviews pertinent literature and identifies research needs relating to unsafe abortion in Nigeria. The paper is organised into three sections. In the first part of the article, a conceptual framework for developing a research agenda to prevent unsafe abortion among Nigerian women is articulated. This section argues for a systematic research agenda that would allow a fuller understanding of the determinants of all segments of the induced abortion cycle. In the second section of the article, we offer a detailed description of the available research data as well as gaps in knowledge on unsafe abortion in Nigeria. In the final part of the paper, recommendations are made on priority areas of research that are capable of stemming the high rate of morbidity and mortality from unsafe abortion among Nigerian women. In particular, the paper recommends high quality, multidisciplinary formative and intervention research to foster an understanding of the determinants of abortion among Nigerian women. Such research should be geared toward providing accurate information to policy makers in a logical manner so as to enable them to generate appropriate policies for preventing unsafe abortion. PMID:10214400
Joffe, C E; Weitz, T A; Stacey, C L
Abortion represents a particularly interesting subject for a social movements analysis of healthcare issues because of the involvement of both feminist pro-choice activists and a segment of the medical profession. Although both groups have long shared the same general goal of legal abortion, the alliance has over time been an uneasy one, and in many ways a contradictory one. This paper traces points of convergence as well as points of contention between the two groups, specifically: highlighting the tensions between the feminist view of abortion as a women-centred service, with a limited, 'technical' role for the physicians, and the abortion-providing physicians' logic of further medicalization/professional upgrading of abortion services as a response to the longstanding marginality and stigmatisation of abortion providers. Only by noting the evolving relationships between these two crucial sets of actors can one fully understand the contemporary abortion rights movement. We conclude by speculating about similar patterns in medical/lay relationships in other health social movements where 'dissident doctors' and lay activists are similarly seeking recognition for medical services that are controversial. PMID:15383041
du Prey, Beatrice; Talavlikar, Rachel; Mangat, Rupinder; Freiheit, Elizabeth A.; Drummond, Neil
Abstract Objective To determine what proportion of women seeking induced abortion in the Calgary census metropolitan area were immigrants. Design For 2 months, eligible women were asked to complete a questionnaire. Women who refused were asked to provide their country of birth (COB) to assess for selection bias. Setting Two abortion clinics in Calgary, Alta. Participants Women presenting at or less than 15 weeks’ gestational age for induced abortion for maternal indications. Main outcome measures The primary outcome was the proportion of women seeking induced abortion services who were immigrants. Secondary outcomes compared socioeconomic characteristics and contraception use between immigrant and Canadian-born women. Results A total of 752 women either completed a questionnaire (78.6%) or provided their COB (21.4%). Overall, 28.9% of women living in the Calgary census metropolitan area who completed the questionnaire were immigrants, less than the 31.2% background proportion of immigrant women of childbearing age. However, 46.0% of women who provided only COB were immigrants. When these data were combined, 34.2% of women presenting for induced abortion identified as immigrant, a proportion not significantly different from the background proportion (P = .127). Immigrant women presenting for induced abortion tended to be older, more educated, married with children, and have increased parity. They were similar to Canadian-born women in number of previous abortions, income status, and employment status. Conclusion This study suggests that immigrant women in Calgary are not presenting for induced abortion in disproportionately higher numbers, which differs from existing European literature. This is likely owing to differing socioeconomic characteristics among the immigrant women in our study from what have been previously described in the literature (typically lower socioeconomic status). Much still needs to be explored with regard to factors influencing the use of abortion services by immigrant women. PMID:25217694
John J. Donohue; Steven D. Levitt
We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly eighteen years after abortion legalization. The five states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater
John J. Donohue; Steven D. Levitt
We offer evidence that legalized abortion has contributed significantly to recent crime reductions. Crime began to fall roughly 18 years after abortion legalization. The 5 states that allowed abortion in 1970 experienced declines earlier than the rest of the nation, which legalized in 1973 with Roe v. Wade. States with high abortion rates in the 1970s and 1980s experienced greater
Objective—To determine if the bark from western juniper (Juniperus occidentalis) will induce late term abortions in cattle. Animals—6 two-year-old Angus heifers. Procedures—Bark from western juniper trees was collected, dried, and finely ground. Pregnant cows were dosed starting on day 250 of gesta...
...procedures, checklists, emergency plans, and contingency abort plans, if any, that ensure safe...nominal and non-nominal vehicle flight. (b) Mission rules, procedures, checklists, emergency plans, and contingency abort...
...procedures, checklists, emergency plans, and contingency abort plans, if any, that ensure safe...nominal and non-nominal vehicle flight. (b) Mission rules, procedures, checklists, emergency plans, and contingency abort...
Rovinsky, J J
3542 first-trimester and 876 second-trimester abortions were performed at City Hospital Center, Elmhurst, New York, from July 1,1970 to June 30, 1972. The relatively stable, semi-closed population of women involved permitted an analysis of the effect of a permissive abortion law and practice on general health care. Tables of patient characteristics and abortion statistics over the period indicated the following: a present rate of abortion of 1009 per 1000 births; no maternal mortality; a reduction in maternal morbidity as experience with abortion techniques increased; a reduction by 44.4% of the number of deliveries without prenatal care, by 16.5% of premature deliveries, by 23.1% of immature deliveries; and a 29.2% reduction of the perinatal mortality rate. Also shown was a marked change in age distribution from the beginning of the period to the end: the incidence of abortions decreased among patients less than 20 years old by 47.1%, and among those over 35 by 46.7%. Additionally, the number of abortions among "never-married" women was reduced by 59.5%. There was a threefold increase in utilization of the antepartum clinic during the first trimester and an increase in prenatal visits. Incidence of spontaneous early abortion was reduced 52.2% and septic abortions were almost entirely eliminated. Postpartum psychosis decreased by half, the rate of voluntary sterilization doubled, and registration of new patients for family planning increased by 116%. Improvements were also seen in pregnancy testing and counseling, in cancer detection through an increase in the number of papanicolaou smears, screening for venereal disease and sickle cell trait/disease, and in the detection of medical, surgical and psychosocial diseases. Pregnancies were largely eliminated in "high-risk" obstetric patients from the childbearing population such as the very young or old, the unmarried, or the emotionally disturbed. The influence of liberalized abortion statutes was shown to have served the community not only by solving immediate health crises but also by contributing to the development of a total health care program. PMID:4696993
Freeman, Ellen W.
Legalized abortions are not equally available to all women in the United States. The author documents the discrimination in this area that exists against the poor and urges the social work profession to extend itself to remedy this inequality. (Author)
Pshenichnaya, Natalia Yurievna; Nenadskaya, Svetlana Alexeevna
We report here a fatal case of laboratory confirmed Crimean-Congo hemorrhagic fever (CCHF), which caused nosocomial infection in eight health care workers (HCWs), who had provided medical care for the patient. All the HCWs survived. The report demonstrates that airborne transmission of CCHF is a real risk, at least when the CCHF patient is in a ventilator. During performance of any aerosol-generating medical procedures for any CCHF patient airborne precautions should always be added to standard precautions, in particular, airway protective N95 mask or equivalent standard, eye protection, single airborne precaution room, or a well-ventilated setting. PMID:25576827
Koch, D D; Oryall, J J; Quam, E F; Feldbruegge, D H; Dowd, D E; Barry, P L; Westgard, J O
Quality-control (QC) procedures (i.e., decision rules used, numbers of control measurements collected per run) have been selected for individual tests of a multitest analyzer, to see that clinical or "medical usefulness" requirements for quality are met. The approach for designing appropriate QC procedures includes the following steps: (a) defining requirements for quality in the form of the "total allowable analytical error" for each test, (b) determining the imprecision of each measurement procedure, (c) calculating the medically important systematic and random errors for each test, and (d) assessing the probabilities for error detection and false rejection for candidate control procedures. In applying this approach to the Hitachi 737 analyzer, a design objective of 90% (or greater) detection of systematic errors was met for most tests (sodium, potassium, glucose, urea nitrogen, creatinine, phosphorus, uric acid, cholesterol, total protein, total bilirubin, gamma-glutamyltransferase, alkaline phosphatase, aspartate aminotransferase, lactate dehydrogenase) by use of 3.5s control limits with two control measurements per run (N). For the remaining tests (albumin, chloride, total CO2, calcium), requirements for QC procedures were more stringent, and 2.5s limits (with N = 2) were selected. PMID:2302766
Complications of induced abortion sadly remain significant causes of maternal mortality and morbidity around the world, but only in countries that do not provide access to safe abortion services. This article presents a brief account of how high maternal mortality from induced abortion became history in the UK and the dire consequences to women's health that unsafe abortion still has in many countries of the world. It gives a brief overview of the methods available to evacuate the uterus, with particular reference to manual vacuum aspiration. The status of the law in different countries is discussed, together with the need for health professionals to interpret repressive laws in ways that enables them to care for women who seek their help. Safe abortion services are cost effective, essential services for women. Men are part and parcel of the reason women resort to terminating a pregnancy, and, together with the countless children whose lives are dependent on a healthy caring mother, are also beneficiaries of safe abortion services. There can be no excuse for continuing to deny these services to so many women around the world. PMID:16105331
Johnson, B R; Horga, M; Andronache, L
After the downfall of the Ceausescu regime in December, 1989, the new Government of Romania abolished the law that prohibited abortions on request. Subsequently, the rate of legally induced abortions increased significantly while the rate of maternal mortality declined dramatically. Despite the large number of women who request induced abortions, most women and gynaecologists say that they would prefer to prevent unwanted pregnancies through the use of modern contraception. In this paper we examine factors that contribute to the disparity between women's desire to use modern contraception to prevent unwanted pregnancies and their practice of having induced abortions to prevent unwanted births. The results show that women (and suggest that men) need a wide choice of dependably available high-quality contraceptives; they need to be able to obtain information, counselling, and methods from a wide range of sources/health-care providers; both women's and men's perceptions about, and use of, modern contraception could be positively affected through sexual education started in secondary school; and, to reduce repeat abortions, women's post-abortion family-planning needs must not be neglected. PMID:8096575
This paper does not attempt to deal with the legitimate ethical or moral debate on abortion. Utilizing abortion as a subject I will show how science and medicine in general, and abortion in particular, were used as weapons of mass destruction by Nazi physicians in their zeal to comply with the political climate of the time. Nazi policy on abortion and childbirth was just one of the methods devised and designed to ensure the extermination of those whom the Nazis deemed had "lives not worth living." Physicians implemented these policies, not with the fate of their patients in mind, but rather in the name of the "state." When discussing pregnancy, abortion and childbirth during the Holocaust it is imperative to include an essay of how these issues affected the Jewish prisoner doctors in the ghettos and camps. Nazi policy dictated their actions too. From an extensive search of their testimonies, I conclude that for these doctors ethical discourse comprised a fundamental component of their functioning. I do not propose to judge them in any way and one should not, in my opinion, argue whether their behavior was or was not morally acceptable under such duress; nevertheless, unlike their Nazi counterparts, a key theme in their testimonies was to "keep their medical values." PMID:17402341
Al-Alaiyan, Saleh; AlFaleh, Khalid M.
Congenital anomalies contribute a significant proportion of infant morbidity and mortality, as well as fetal mortality. They are generally grouped into three major categories: structural/metabolic, congenital infections, and other conditions. The most prevalent conditions include congenital heart defects, orofacial clefts, Down syndrome, and neural tube defects. Several prenatal diagnostic procedures have been introduced, both cytogenetic (such as chorion biopsy, amniocentesis and funiculocentesis) and biophysical (ultrasound 2-D, 3-D and 4-D, ultrasonography with Doppler, etc.). Insufficient data are currently available from Saudi Arabia on the epidemiology of the lethal congenital abnormalities which should be a priority due to high rate of consanguineous marriages among first cousins and their association with congenital anomalies. In terms of consanguinity and birth defects, a significant positive association has been consistently demonstrated between consanguinity and morbidity, and congenital defects with a complex etiology appear to be both more prevalent in consanguineous families and have a greater likelihood of recurrence. A debate regarding aborting a malformed fetus still exists among the senior Islamic scholars in many of the Islamic countries. The progressive interpretations of Islam have resulted in laws allowing for early abortion on request in two countries; six others permit abortion on health grounds and three more also allow abortion in cases of rape or fetal impairment. In Saudi Arabia, efforts to legalize abortion in certain circumstances have been recently discussed among Senior Religious Scholars and specialized physicians to permit abortions in certain circumstances. In this mini-review we discuss the current debate regarding aborting a malformed fetus in Saudi Arabia with a focus on the Islamic perspective. PMID:24027674
Young people, as they grow older, gain increasing competency to make their own decisions--this is reflected in many areas of their lives. Yet, in relation to medical procedures, the case law both in Australia and in England suggests that the area remains uncertain, with courts often resorting to tests of best interests in lieu of personal autonomy particularly where the medical procedure increases in complexity and/or urgency. In fact, at common law, young people must prove themselves to be more competent than adults in order to have their ethical autonomy respected. Legislation in two States in Australia has addressed the issue. However, reform is needed to prescribe an age at which competency of a young person may be presumed for both consent and refusal of medical treatment. Further, the adoption into legislation of the test of Gillick competency would provide for determinations below the age of presumption, and restrict the practice of courts imposing best interests over a young person's own interests. PMID:25715543
Stillwater, Ryan Allanque
The National Aeronautics and Space Administration created the Constellation program to develop the next generation of manned space vehicles and launch vehicles. The Orion abort system is initiated in the event of an unsafe condition during launch. The system has a controller gains schedule that can be tuned to reduce the attitude errors between the simulated Orion abort trajectories and the guidance trajectory. A program was created that uses the method of steepest descent to tune the pitch gains schedule by an automated procedure. The gains schedule optimization was applied to three potential abort scenarios; each scenario tested using the optimized gains schedule resulted in reduced attitude errors when compared to the Orion production gains schedule.
Davidson, John B., Jr.; Madsen, Jennifer M.; Proud, Ryan W.; Merritt, Deborah S.; Sparks, Dean W., Jr.; Kenyon, Paul R.; Burt, Richard; McFarland, Mike
One of the primary design drivers for NASA's Crew Exploration Vehicle (CEV) is to ensure crew safety. Aborts during the critical ascent flight phase require the design and operation of CEV systems to escape from the Crew Launch Vehicle and return the crew safely to the Earth. To accomplish this requirement of continuous abort coverage, CEV ascent abort modes are being designed and analyzed to accommodate the velocity, altitude, atmospheric, and vehicle configuration changes that occur during ascent. The analysis involves an evaluation of the feasibility and survivability of each abort mode and an assessment of the abort mode coverage. These studies and design trades are being conducted so that more informed decisions can be made regarding the vehicle abort requirements, design, and operation. This paper presents an overview of the CEV, driving requirements for abort scenarios, and an overview of current ascent abort modes. Example analysis results are then discussed. Finally, future areas for abort analysis are addressed.
Toprani, Amita; Cadwell, Betsy L; Li, Wenhui; Sackoff, Judith; Greene, Carolyn; Begier, Elizabeth
This study aims to describe factors associated with the number of past abortions obtained by New York City (NYC) abortion patients in 2010. We calculated rates of first and repeat abortion by age, race/ethnicity, and neighborhood-level poverty and the mean number of self-reported past abortions by age, race/ethnicity, neighborhood-level poverty, number of living children, education, payment method, marital status, and nativity. We used negative binomial regression to predict number of past abortions by patient characteristics. Of the 76,614 abortions reported for NYC residents in 2010, 57% were repeat abortions. Repeat abortions comprised >50% of total abortions among the majority of sociodemographic groups we examined. Overall, mean number of past abortions was 1.3. Mean number of past abortions was higher for women aged 30-34 years (1.77), women with ?5 children (2.50), and black non-Hispanic women (1.52). After multivariable regression, age, race/ethnicity, and number of children were the strongest predictors of number of past abortions. This analysis demonstrates that, although socioeconomic disparities exist, all abortion patients are at high risk for repeat unintended pregnancy and abortion. PMID:25779755
Fink, Arlene; Brook, Robert H.; Kosecoff, Jacqueline; Chassin, Mark R.; Solomon, David H.
We reviewed the English-language clinical literature on carotid endarterectomy, cholecystectomy, upper gastrointestinal endoscopy, colonoscopy, coronary angiography and coronary artery bypass graft procedure to identify the appropriateness of using these procedures in 1981. Most of the 803 relevant articles and textbooks were published after 1975; about 10% of the 571 research studies were randomized, controlled trials, while two thirds were retrospective studies. Incomplete or contradictory information was available on the indications for and efficacy of using the procedures; almost no data were available on costs and use; data on complications failed to specify patients' symptoms or the relationship between complications and reasons for doing the procedure. PMID:3501201
Although it is well established that a having a pregnancy that ends in a birth protects against subsequent preeclampsia, it is unclear whether a pregnancy ending in miscarriage or induced abortion confers any protection. In this issue of the Journal, Parker et al. (Am J Epidemiol. 2015;182(8):663-669) examine whether, in nulliparous women, a history of induced abortion is associated with a lower risk of preeclampsia in a later pregnancy, focusing on the hypothesis that endometrial injury facilitates later implantation. The authors take advantage of data obtained by linking several Finnish population-based registries that include detailed data on induced abortions, although information on miscarriages was of lower quality. Parker et al. found a modest reduction in risk among women with a history of induced abortion. However, there was little evidence that risk differed between women who had medical abortions and those who had surgical abortions (the latter of which is presumably associated with a higher degree of injury). History of miscarriage was not associated with preeclampsia risk. Although the study by Parker et al. adds to the evidence that suggests that women with a history of induced abortion have a lower risk of preeclampsia, it is difficult to evaluate whether the observed association is due to having had a previous pregnancy (however short) versus none, to confounding, or to an actual effect of induced abortion. PMID:26377956
Prata, Ndola; Bell, Suzanne; Holston, Martine; Gerdts, Caitlin; Melkamu, Yilma
The high demand for abortion related services in Addis Ababa, Ethiopia indicates a reliance on abortion to control fertility and highlights an opportunity to increase access to contraceptives and improve post-abortion care. We analyzed the medical records of 1,200 women seeking abortion related services. Logistic regression was used to determine factors associated with use of modern or long-acting contraceptive post-abortion. Multivariate results illustrate that women aged 40-44, students, employed women, receipt of services in private clinics, number of children, and number of previous abortions were significantly associated with the odds of adopting any modern contraceptive post-abortion. The odds of choosing a long-active contraceptive method were significantly and positively associated with being age 25-29, attaining secondary or higher education, and number of children. Improved services and information along with reliable access to modern and long-acting contraceptives can reduce the need to use abortion to control fertility among women in Addis. PMID:22574492
Background A system providing disabled persons with control of various assistive devices with the tongue has been developed at Aalborg University in Denmark. The system requires an activation unit attached to the tongue with a small piercing. The aim of this study was to establish and evaluate a safe and tolerable procedure for medical tongue piercing and to evaluate the expected and perceived procedural discomfort. Methods Four tetraplegic subjects volunteered for the study. A surgical protocol for a safe insertion of a tongue barbell piercing was presented using sterilized instruments and piercing parts. Moreover, post-procedural observations of participant complications such as bleeding, edema, and infection were recorded. Finally, procedural discomforts were monitored by VAS scores of pain, changes in taste and speech as well as problems related to hitting the teeth. Results The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections. No bleeding, infection, embedding of the piercing, or tooth/gingival injuries were encountered; a moderate edema was found in one case without affecting the speech. In two cases the piercing rod later had to be replaced by a shorter rod, because participants complained that the rod hit their teeth. The replacements prevented further problems. Moreover, loosening of balls was encountered, which could be prevented with the addition of dental glue. No cases of swallowing or aspiration of the piercing parts were recorded. Conclusions The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting. The procedure represented several precautions in order to avoid risks in these susceptible participants with possible co-morbidity. No serious complications were encountered, and the procedure was found tolerable to the participants. The procedure may be used in future studies with tongue piercings being a prerequisite for similar systems, and this may include insertion in an out-patient setting. PMID:24684776
Gerhardt, A J
The worldwide trend towards liberalizing abortion laws has resulted in reduced abortion-related mortality in areas where legal abortion is accessible. In countries considering abortion reform, policy-makers and health care providers have a responsibility to ensure that provisions of any new law can be met. Preparations underway to prepare for South Africa's new abortion law can serve as a guideline for such action. A new abortion law calls for policy changes that may include 1) developing new standards, protocols, and guidelines for abortion care services; 2) ensuring provision of adequate trained staff willing to provide abortions; 3) streamlining administrative regulations to avoid delays; 4) establishing regulations and mechanisms for drug and equipment supply and distribution; 5) restructuring the health system to accommodate provision of abortion services; 6) allocating funds for new abortion services; and 7) reviewing and revising security measures. In addition, health professionals will require training in abortion provision, staff will need information updates about aspects of the legislation, and administrators and providers in a position to impede provision of services must be made aware of the affect of unsafe abortion on maternal health. Researchers should document the effect of the new law on women's health, the provision of reproductive health services, and the community. IEC (information, education, communication) activities will be required to inform the public about the new law and services, establish sex education programs in schools and health facilities, and mobilize family planning organizations and programs to help reduce the incidence of repeat abortions. PMID:12292776
Storeng, Katerini T.; Ouattara, Fatoumata
In Burkina Faso, abortion is legally restricted and socially stigmatised, but also frequent. Unsafe abortions represent a significant public health challenge, contributing to the country's very high maternal mortality ratio. Inspired by an internationally disseminated public health framing of unsafe abortion, the country's main policy response has been to provide post-abortion care (PAC) to avert deaths from abortion complications. Drawing on ethnographic research, this article describes how Burkina Faso's PAC policy emerged at the interface of political and moral negotiations between public health professionals, national bureaucrats and international agencies and NGOs. Burkinabè decision-makers and doctors, who are often hostile to induced abortion, have been convinced that PAC is ‘life-saving care’ which should be delivered for ethical medical reasons. Moreover, by supporting PAC they not only demonstrate compliance with international standards but also, importantly, do not have to contend with any change in abortion legislation, which they oppose. Rights-based international NGOs, in turn, tactically focus on PAC as a ‘first step’ towards their broader institutional objective to secure safe abortion and abortion rights. Such negotiations between national and international actors result in widespread support for PAC but stifled debate about further legalisation of abortion. PMID:25132157
Storeng, Katerini T; Ouattara, Fatoumata
In Burkina Faso, abortion is legally restricted and socially stigmatised, but also frequent. Unsafe abortions represent a significant public health challenge, contributing to the country's very high maternal mortality ratio. Inspired by an internationally disseminated public health framing of unsafe abortion, the country's main policy response has been to provide post-abortion care (PAC) to avert deaths from abortion complications. Drawing on ethnographic research, this article describes how Burkina Faso's PAC policy emerged at the interface of political and moral negotiations between public health professionals, national bureaucrats and international agencies and NGOs. Burkinabè decision-makers and doctors, who are often hostile to induced abortion, have been convinced that PAC is 'life-saving care' which should be delivered for ethical medical reasons. Moreover, by supporting PAC they not only demonstrate compliance with international standards but also, importantly, do not have to contend with any change in abortion legislation, which they oppose. Rights-based international NGOs, in turn, tactically focus on PAC as a 'first step' towards their broader institutional objective to secure safe abortion and abortion rights. Such negotiations between national and international actors result in widespread support for PAC but stifled debate about further legalisation of abortion. PMID:25132157
Henshaw, S K
Researchers comparing 1st and repeat abortion patients directly, have found that the latter were using methods that are only slightly or no more effective than those used by 1st-abortion patients at the time they became pregnant. It is here argued that such direct comparisons are not appropriate because repeat patients are not typical of all women who have ever had an abortion. Most women who use effective methods consistently after a 1st abortion, will never appear in the repeat abortion statistics. Therefore, in terms of contraceptive use, repeat abortion patients overrepresent women who use no method or the least effective method. This point is illustrated using 1981-82 data collected by the Minnesota Department of Health on virtually all the state's residents obtaining abortions in the state during a 2-year period. A total of 22,070 women obtained 1st abortions and 8734 women repeat abortions. The data is collected by method used and shows the monthly contraceptive failure rate per woman, the number of users per failure, the estimated % distribution of women at risk of a 1st abortion, the acutal distribution of those obtaining a 1st abortion, and the estimated distribution of women at risk of a repeat abortion. Comparisons of these statistics show that of the women exposed to the risk of abortion, those acutally obtaining one are disproportionately using no cotraceptives (70%) or the least effective method. The pill and sterilization were the methods used most commonly by the group exposed to the risk of a repeat abortion. By contrast, at the time of the 1st abortion, only 5% of women had been using the pill and less than 1% had depended on sterilization. Only 9% of women at risk of a repeat abortion used no method, compared with 70% before the 1st abortion. Thus although women who have an abortion tend to be relatively poor contraceptive users, after the abortion, they use methods at least as effective as those used by women at risk of a 1st abortion. The data suggest a marked improvement in contraceptive practice subsequent to a 1st abortion. While a number of factors may contribute to this improvement, it is probable that the abortion experience and the contraceptive services offered at the time of the abortion play an important role in improving contraceptive practice. PMID:6723942
A. Shimizu; Xiang-Rong Zhou; J. Hasegawa; J. Toriwaki
Presents an expert system for three dimensional image processing. In analyzing three dimensional gray images, e.g. CT images, a process for extraction of interest regions from each image is frequently required. However, it is difficult to construct all extinction procedure with parameters optimized for each purpose. The proposed system can automatically construct a three dimensional object extraction procedure based on
...determines that such records are not exempt from disclosure, NACIC will, after consultation with the Director of Medical Services, CIA, determine: (1) Which records may be sent directly to the requester and (2) Which records should not be sent...
...determines that such records are not exempt from disclosure, NACIC will, after consultation with the Director of Medical Services, CIA, determine: (1) Which records may be sent directly to the requester and (2) Which records should not be sent...
...determines that such records are not exempt from disclosure, NACIC will, after consultation with the Director of Medical Services, CIA, determine: (1) Which records may be sent directly to the requester and (2) Which records should not be sent...
Hennipin County District Court Judge William Posten issued a decision on June 16 striking down Minnesota's near ban on abortion coverage for low-income women. Ruling in Women of the State of Minnesota vs. Haas-Steffen, Judge Posten found that the state Constitution's rights of privacy and equality are more protective of women's reproductive choices than the corresponding federal rights. Holding that "the state's selective funding of childbirth over abortion impinges on an indigent woman's fundamental right to decide for herself whether to continue or terminate her pregnancy," the state district court permanently enjoined enforcement of the measure. Minnesota must now cover all medically necessary abortions for women receiving Medicaid. For more than 15 years, the statutes and regulations invalidated by Judge Posten have limited abortion coverage to cases of life endangerment or reported rape or incest. State officials have indicated that they will seek a stay and expedited review of Judge Posten's decision from the Minnesota Supreme Court. Filed on March 8, 1993, the Minnesota case is one of 5 such lawsuits brought by CRLP. Last December, in a similar case, the West Virginia Supreme Court struck down that state's ban on Medicaid coverage for abortions. Similar CRLP cases are still pending in Florida, Texas, and Montana. Plaintiffs--a class of Minnesota Medicaid-eligible women seeking abortions, Dr. Jane Hodgson, Pro-Choice Resources, Women's Health Center, Midwest Health Center for Women, and Meadowbrook Women's Clinic, on behalf of themselves and the women they serve--are represented by CRLP's Simon Heller, Janet Benshoof, and Lenora Lapidus, along with Minnesota attorney Linda Ojala. PMID:12345511
, the University Occupational Health Consultant and Occupational Health Nurse, and third party medical consultantsPolicies, Procedures and Guidelines Complete Procedure Title: Procedure Number: McMaster University
Butler, Kevin D.
Improvement initiatives in the areas of guidance, flight control, and mission operations provide increased capability for successful East Coast Abort Landings (ECAL). Automating manual crew procedures in the Space Shuttle's onboard guidance allows faster and more precise commanding of flight control parameters needed for successful ECALs. Automation also provides additional capability in areas not possible with manual control. Operational changes in the mission concept allow for the addition of new landing sites and different ascent trajectories that increase the regions of a successful landing. The larger regions of ECAL capability increase the safety of the crew and Orbiter.
Examines a film entitled "Whose Choice?" which chronicles the struggle to protect and extend existing abortion rights through the campaigns set in motion by the James White Abortion (Amendment) Bill (1975). (MH)
Harden, Jeni; Purcell, Carrie; Row-Dewar, Neneh
The primary aim of this qualitative study was to gain insight into the views of young people from contrasting socioeconomic backgrounds about abortion and access to abortion services. The study set out to assess the ...
Abortable Reader-Writer Locks are No More Complex Than Abortable Mutex Locks Dartmouth Computer on designing abortable mutual exclusion locks, and fairly efficient algorithms of O(log n) RMR complexity have). The abort feature is just as important for a reader-writer lock as it is for a mutual exclusion lock
Kageyama, Kyoko; Jimba, Koichi; Hashimoto, Satoru
Code of civil procedure is started when a plaintiff appeals to the law. Conversely, if a suit is not appealed, it is not started. We explain the essential principles of the code of civil procedure, and present systems associated with expediting trials (a brief, preliminary oral arguments, preparatory proceedings, inquiry to opponent, organized proceedings, technical adviser system, etc.). Amendment of law is repeated for the purpose of aiming suitably expediting trials. We should utilize the present code of civil procedure suitably, and expect the quick conclusion of trials. PMID:23697208
Of 881 Chinese handwritten volumes with medical texts of the 17th through mid-20th century held by Staatsbibliothek zu Berlin and Ethnologisches Museum Berlin-Dahlem, 48 volumes include prescriptions for induced abortion. A comparison shows that these records are significantly different from references to abortion in Chinese printed medical texts of pre-modern times. For example, the percentage of recipes recommended for artificial abortions in handwritten texts is significantly higher than those in printed medical books. Authors of handwritten texts used 25 terms to designate artificial abortion, with the term da tai [see text], lit.: "to strike the fetus", occurring most frequently. Its meaning is well defined, in contrast to other terms used, such as duo tai [see text], lit: "to make a fetus fall", xia tai [see text], lit. "to bring a fetus down", und duan chan [see text], lit., to interrupt birthing", which is mostly used to indicate a temporary or permanent sterilization. Pre-modern Chinese medicine has not generally abstained from inducing abortions; physicians showed a differentiating attitude. While abortions were descibed as "things a [physician with an attitude of] humaneness will not do", in case a pregnancy was seen as too risky for a woman she was offered medication to terminate this pregnancy. The commercial application of abortifacients has been recorded in China since ancient times. A request for such services has continued over time for various reasons, including so-called illegitimate pregnancies, and those by nuns, widows and prostitutes. In general, recipes to induce abortions documented in printed medical literature have mild effects and are to be ingested orally. In comparison, those recommended in handwritten texts are rather toxic. Possibly to minimize the negative side-effects of such medication, practitioners of folk medicine developed mechanical devices to perform "external", i.e., vaginal approaches. PMID:24195336
... cue-TAYN-ee-us) coronary intervention (PCI) or balloon angioplasty, is a procedure used to remove a ... brain (carotid angioplasty). A small tube with a balloon attached is threaded into the narrowed or blocked ...
Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn
The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects…
Aborting a Message Flowing Through Social Communities Cindy Hui, Malik Magdon-Ismail, William A in designing a useful abort mechanism. Index Terms--agent-based simulation, information diffusion, information investigate the aborting of a message that is currently diffusing through a network, with the purpose
Aborting a Message Flowing Through Social Communities Cindy Hui Rutgers University Piscataway, New that incorporate group structures and the distribution of trust in designing a useful abort mechanism. Index Terms is spreading and we wish to spread a counter rumor. We investigate the aborting of a message that is currently
Patterson, Maggie Jones; Hall, Megan Williams
Contributes to rhetoric, moral reasonings scholarship, and journalism scholarship by examining public rhetoric on abortion and American popular media coverage (1940s to 1990s). Finds that the feminine means of moral reasoning has emerged into the foreground of discourse on abortion. Compares emergence of a common-ground rhetoric on abortion with a…
Describes an undergraduate Psychology of Social Problems course. The course focuses on the psychological aspects of legal abortion for adolescents and women, the consequences of denied abortions on unwanted children, and psychological ramifications of alternatives to abortion. Summarizes student evaluations of the course. (CFR)
Robbins, James M.
Measured psychological sequelae to induced abortion among women pregnant out of wedlock, using the Minnesota Multiphasic Personality Inventory and questions specific to willingness to repeat abortion under similar circumstances. Analyses indicated no relation between objective and subjective indicators. Affectivity after induced abortion had…
Allgeier, A.R.; And Others
Students (N=118) were classified as pro-choice, anti-abortion, or mixed on the basis of their responses to 10 fictitious case histories of women who requested abortion. Attitudinal differences are discussed in the context of the public controversy over abortion. (Author/CM)
Gipson, Jessica D.; Becker, Davida; Mishtal, Joanna Z.; Norris, Alison H.
Nearly 20% of the 208 million pregnancies that occur annually are aborted. More than half of these (21.6 million) are unsafe, resulting in 47,000 abortion-related deaths each year. Accurate reports on the prevalence of abortion, the conditions under which it occurs, and the experiences women have in obtaining abortions are essential to addressing unsafe abortion globally. It is difficult, however, to obtain accurate and reliable reports of attitudes and practices given that abortion is often controversial and stigmatized, even in settings where it is legal. To improve the understanding and measurement of abortion, specific considerations are needed throughout all stages of the planning, design, and implementation of research on abortion: Establishment of strong local partnerships, knowledge of local culture, integration of innovative methodologies, and approaches that may facilitate better reporting. This paper draws on the authors’ collaborative research experiences conducting abortion-related studies using clinic- and community-based samples in five diverse settings (Poland, Zanzibar, Mexico City, the Philippines, and Bangladesh). The purpose of this paper is to share insights and lessons learned with new and established researchers to inform the development and implementation of abortion-related research. The paper discusses the unique challenges of conducting abortion-related research and key considerations for the design and implementation of abortion research, both to maximize data quality and to frame inferences from this research appropriately. PMID:21530843
...full term or to have an elective abortion. If an inmate chooses to have an abortion, she shall sign a statement to that effect. The inmate shall sign a written...Clinical Director shall arrange for an abortion to take place. [51 FR...
...full term or to have an elective abortion. If an inmate chooses to have an abortion, she shall sign a statement to that effect. The inmate shall sign a written...Clinical Director shall arrange for an abortion to take place. [51 FR...
Zaidi, Shahida; Begum, Ferdousi; Tank, Jaydeep; Chaudhury, Pushpa; Yasmin, Haleema; Dissanayake, Mangala
Since 2008, the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences has contributed to ensuring the substitution of sharp curettage by manual vacuum aspiration (MVA) and medical abortion in selected hospitals in participating countries of South-Southeast Asia. This initiative facilitated the registration of misoprostol in Pakistan and Bangladesh, and the approval of mifepristone for "menstrual regulation" in Bangladesh. The Pakistan Nursing Council agreed to include MVA and medical abortion in the midwifery curriculum. The Bangladesh Government has approved the training of nurses and paramedics in the use of MVA to treat incomplete abortion in selected cases. The Sri Lanka College of Obstetricians and Gynaecologists, in collaboration with partners, has presented a draft petition to the relevant authorities appealing for them to liberalize the abortion law in cases of rape and incest or when lethal congenital abnormalities are present. Significantly, the initiative has introduced or strengthened the provision of postabortion contraception. PMID:24743025
Raab, G Gregory; Parr, David H
This paper, the second of 3 that discuss the reimbursement challenges facing new medical device technology in various issues of this journal, explains the key aspects of coverage that affect the adoption of medical devices. The process Medicare uses to make coverage determinations has become more timely and open over the past several years, but it still lacks the predictability that product innovators prefer. The continued uncertainty surrounding evidence requirements undermines the predictability needed for optimal product planning and innovation. Recent steps taken by the Centers for Medicare and Medicaid Services to provide coverage in return for evidence development should provide patients with access to promising new technologies and procedures while generating important evidence concerning their effectiveness. PMID:17412167
Edström, Karin G. B.
In recent years many authors have claimed that the combination of tubal sterilization and induced abortion carries too high a morbidity and that the two operations should preferrably be performed separately. As this standpoint has serious practical consequences for many women undergoing abortion, a review of the literature was undertaken to see whether there are any data supporting it. No direct comparison of the morbidity accompanying the combined procedure and the total morbidity from the two procedures performed with an interval could be found. Indirect evidence suggests that the effect of an interval between the operations—if any—is negligible compared with the influence upon morbidity of factors such as methods of sterilization and abortion, health status, and age. To gain direct information on the problem, a multicentre study has been designed by the Task Force on Sequelae and Complications of Induced Abortion. The outlines of this study are briefly described. PMID:770028
Shamshiri-Milani, Hourieh; Pourreza, Abolghasem; Akbari, Feizollah
Introduction Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. Materials and Methods A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. Results There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. Conclusion It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights. PMID:23926489
Background Medical knowledge encompasses both conceptual (facts or “what” information) and procedural knowledge (“how” and “why” information). Conceptual knowledge is known to be an essential prerequisite for clinical problem solving. Primarily, medical students learn from textbooks and often struggle with the process of applying their conceptual knowledge to clinical problems. Recent studies address the question of how to foster the acquisition of procedural knowledge and its application in medical education. However, little is known about the factors which predict performance in procedural knowledge tasks. Which additional factors of the learner predict performance in procedural knowledge? Methods Domain specific conceptual knowledge (facts) in clinical nephrology was provided to 80 medical students (3rd to 5th year) using electronic flashcards in a laboratory setting. Learner characteristics were obtained by questionnaires. Procedural knowledge in clinical nephrology was assessed by key feature problems (KFP) and problem solving tasks (PST) reflecting strategic and conditional knowledge, respectively. Results Results in procedural knowledge tests (KFP and PST) correlated significantly with each other. In univariate analysis, performance in procedural knowledge (sum of KFP+PST) was significantly correlated with the results in (1) the conceptual knowledge test (CKT), (2) the intended future career as hospital based doctor, (3) the duration of clinical clerkships, and (4) the results in the written German National Medical Examination Part I on preclinical subjects (NME-I). After multiple regression analysis only clinical clerkship experience and NME-I performance remained independent influencing factors. Conclusions Performance in procedural knowledge tests seems independent from the degree of domain specific conceptual knowledge above a certain level. Procedural knowledge may be fostered by clinical experience. More attention should be paid to the interplay of individual clinical clerkship experiences and structured teaching of procedural knowledge and its assessment in medical education curricula. PMID:23433202
Lang, Elvira V.; Berbaum, Kevin S.; Faintuch, Salomao; Hatsiopoulou, Olga; Halsey, Noami; Li, Xinyu; Berbaum, Michael L.; Laser, Eleanor; Baum, Janet
Medical procedures in outpatient settings have limited options of managing pain and anxiety pharmacologically. We therefore assessed whether this can be achieved by adjunct self-hypnotic relaxation in a common and particularly anxiety provoking procedure. 236 women referred for large core needle breast biopsy to an urban tertiary university-affiliated medical center were prospectively randomized to receive standard care (n=76), structured empathic attention (n= 82), or self-hypnotic relaxation (n=78) during their procedures. Patients’ self-ratings at 10 minute-intervals of pain and anxiety on 0–10 verbal analog scales with 0=no pain/anxiety at all, 10=worst pain/anxiety possible, were compared in an ordinal logistic regression model. Women’s anxiety increased significantly in the standard group (logit slope = 0.18, p < 0.001), did not change in the empathy group (slope = ?0.04, p = 0.45), and decreased significantly in the hypnosis group (slope = ?0.27, p < 0.001). Pain increased significantly in all three groups (logit slopes: standard care = 0.53, empathy = 0.37, hypnosis = 0.34; all p < 0.001) though less steeply with hypnosis and empathy than standard care (p = 0.024 and p = 0.018 respectively). Room time and cost were not significantly different in an univariate ANOVA despite hypnosis and empathy requiring an additional professional: 46 minutes/$161 for standard care, 43 minutes/$163 for empathy, and 39 minutes/$152 for hypnosis. We conclude that, while both structured empathy and hypnosis decrease procedural pain and anxiety, hypnosis provides more powerful anxiety relief without undue cost and thus appears attractive for outpatient pain management. PMID:16959427
Swanson, Kara W
This article analyzes the comparative history of the law and practice of abortion and assisted reproduction in the United States to consider the interplay between medical paternalism and legal paternalism. It supplements existing critiques of paternalism as harmful to women's equality with the medical perspective, as revealed through the writings of Alan F. Guttmacher, to consider when legal regulation might be warranted. PMID:26242953
Consedine, Nathan S.; Windsor, John A.
Mismatches between the needs of public health systems and student interests have led to renewed study on the factors predicting career specializations among medical students. While most work examines career and lifestyle values, emotional proclivities may be important; disgust sensitivity may help explain preferences for careers with greater and…
Patrick, Luke E.; Altmaier, Elizabeth M.; Kuperman, Samuel; Ugolini, Kathleen
Tested the reliability and validity of a structured admission interview to a public medical school residency program. Found that interrater agreement was good; moderate-to-low correlations between interview scores and other admission criteria suggested that the interview provided additional useful information and accounted for a substantial…
Agro, Gerlandino; Rosenthal, Joseph
The manual is the result of several years' effort toward developing a methodology to depict program resources-funding. The guidelines were developed based on a 1975 feasibility study and tested in seven medical colleges. It is hoped that the guidelines will be useful in analyzing the fiscal mechanisms for funding of the individual resources…
Penbegul, Necmettin; Atar, Murat; Kendirci, Muammer; Bozkurt, Yasar; Hatipoglu, Nam?k Kemal; Verit, Ayhan; Kad?oglu, Ates
In recent years, day by day, robotic surgery applications have increase their role in our medical life. In this article, we reported the discovery of the first primitive robotic applications as automatic machines for the sensitive calculation of liquids such as blood in the literature. Al-Jazari who wrote the book "Elcâmi 'Beyne'l - 'ilm ve'l - 'amel en-nâfi 'fi es-s?naâ 'ti'l - hiyel", lived in Anatolian territory between 1136 and 1206. In this book that was written in the twelfth century, Al-Jazari described nearly fifty graphics of robotic machines and six of them that were designed for medical purposes. We found that some of the robots mentioned in this book are related to medical applications. This book reviews approximately 50 devices, including water clocks, candle clocks, ewers, various automata used for amusement in drink assemblies, automata used for ablution, blood collection tanks, fountains, music devices, devices for water lifting, locks, a protractor, a boat-shaped water clock, and the gate of Diyarbakir City in south-east of Turkey, actually in northern Mesopotamia. We found that automata used for ablution and blood collection tanks were related with medical applications; therefore, we will describe these robots. PMID:25641458
Knudsen, L B; Mabeck, C E; Tanska, I
A Danish study of birth and abortion statistics for the years 1976-1979 shows that, although the absolute incidence of deliveries and induced abortions has steadily declined during this period, the percentage of deliveries (65%) and induced abortions (25-27%) compared to the number of conceptions has remained constant. Between 1976-1978, induced abortion became relatively more frequent among those under 20 years of age and less frequent among those 25-39 years of age, even though the actual number of abortions has decreased for all age groups. PMID:7404824
Vitner, Dana; Machtinger, Ronit; Baum, Micha; Goldenberg, Motti; Schiff, Eyal; Seidman, Daniel S
The success rates of medical termination of pregnancy in two time periods (2000-2001 and 2002-2003) were compared to assess the effectiveness of medical abortion introduction to a large academic tertiary medical center. The success rates were markedly reduced over time (87.0% vs. 79.3%) probably owing to the difficulty in defining clear sonographic criteria for treatment failure and the complexity of a follow-up program implemented at a large teaching hospital by a broad staff with widely varying experience and knowledge of the new procedure. PMID:18675971
Fazel, Reza; Krumholz, Harlan M.; Wang, Yongfei; Ross, Joseph S.; Chen, Jersey; Ting, Henry H.; Shah, Nilay D.; Nasir, Khurram; Einstein, Andrew J.; Nallamothu, Brahmajee K.
Background Growing use of imaging procedures in the United States has raised concerns about exposure to low-dose ionizing radiation in the general population. Methods We identified 952,420 non-elderly adults in 5 healthcare markets across the United States between July 1, 2005 and December 31, 2007. Utilization data were used to determine cumulative effective doses of radiation from imaging procedures in millisieverts (mSv) and to calculate population-based rates of “moderate” (>3 to 20 mSv per year), “high” (>20 to 50 mSv per year) and “very-high” (>50 mSv per year) doses. Results During the study period, 655,613 (68.8%) individuals underwent at least 1 imaging procedure associated with radiation exposure. The mean effective dose from imaging procedures was 2.4 mSv per person per year (std dev, 6.0 mSv); however, a wide distribution was noted with a median effective dose of 0.1 mSv per person per year (interquartile range, 0.0 to 1.7). Overall, the annual rate for moderate effective doses in the study population was 193.8 per 1000 enrollees, while high and very-high doses occurred at annual rates of 18.6 per 1000 enrollees and 1.9 per 1000 enrollees, respectively. In general, effective doses of radiation from imaging procedures increased with advancing age and were higher in women. Computed tomography and nuclear medicine scans accounted for 75.4% of the total effective dose and 81.8% occurred in non-hospitalized settings. Conclusions Imaging procedures are an important source of ionizing radiation in the United States and can lead to high radiation doses in patients. PMID:19710483
Soller, P C
Drugs that induce miscarriage may eventually replace traditional surgical abortions in the first three months of pregnancy. In particular, a panel that recently evaluated international drug tests, determined that a specific two-drug combination was safe and effective when used early in pregnancy. The combination included a relatively new compound called RU 486 that induced abortions and has been tested in Europe as a 'morning after' pill. The other drug, prostaglandin, is older, and already on the market. The new twist is that together the drugs can be used as low doses that cause few side-effects, and that in combination, they have approximately a 95 percent success rate in causing abortion during the first three months of pregnancy. Should women be denied this new birth control option on social rather than medical grounds? In most countries cultural, religious and legal considerations will inevitably influence the decision on whether or not to approve RU 486. Concern for women's reproductive health should also be a factor. Moreover, politics should not infringe on sound medical practice, nor should access to a major medical advance be restricted purely on the basis of an emotional debate. PMID:1943510
Gianfelice-Wendt, E.; /Fermilab; Bartmann, W.; Boccardi, A.; Bracco, C.; Bravin, E.; Goddard, B.; Hofle, W.; Jacquet, D.; Jeff, A.; Kain, V.; Meddahi, M.; /CERN
The presence of significant intensities of un-bunched beam is a potentially serious issue in the LHC. Procedures using damper kickers for cleaning both the Abort Gap (AG) and the buckets targeted for injection, are currently in operation at flat bottom. Recent observations of relatively high population of the AG during physics runs brought up the need for AG cleaning during luminosity operation. In this paper the results of experimental studies performed in October 2011 are presented.
Bartmann, W; Bracco, C; Bravin, E; Goddard, B; Höfle, W; Jacquet, D; Jeff, A; Kain, V; Meddahi, M; Roncarolo, F; Uythoven, J; Valuch, D; Gianfelice-Wendt, E
The presence of significant intensities of un-bunched beam is a potentially serious issue in the LHC. Procedures using damper kickers for cleaning both the Abort Gap (AG) and the buckets targeted for injection, are currently in operation at flat bottom. Recent observations of relatively high population of the AG during physics runs brought up the need for AG cleaning during luminosity operation. In this paper the results of experimental studies performed in October 2011 are presented.
Greenberg, D S
The abortion issue has infested national politics since 1973, now it returns to haunt the US presidential election politics. However, rather than serving as a customary rallying cause for Republicans, it is now a millstone around the neck of their candidate, Governor George Bush, who seeks a broad ideological span of voters to win his candidacy. Bush expressed strong anti-abortion sentiments to attract the die-hard right-to-life vote in the hard-fought primary campaign. For many years, the anti-abortion language in the US remains strident, however, it is clear that most voters support, or at least tolerate, the availability of abortion services. In his presidential campaign, Bush shied away from endorsing a constitutional amendment to ban abortion, and declared his opposition to any exceptions to an abortion ban. He is now on the record with numerous anti-abortion declarations, and holds endorsements from the pro-life camp. PMID:10791389
Dadlez, E M; Andrews, William L
The contention that abortion harms women constitutes a new strategy employed by the pro-life movement to supplement arguments about fetal rights. David C. Reardon is a prominent promoter of this strategy. Post-abortion syndrome purports to establish that abortion psychologically harms women and, indeed, can harm persons associated with women who have abortions. Thus, harms that abortion is alleged to produce are multiplied. Claims of repression are employed to complicate efforts to disprove the existence of psychological harm and causal antecedents of trauma are only selectively investigated. We argue that there is no such thing as post-abortion syndrome and that the psychological harms Reardon and others claim abortion inflicts on women can usually be ascribed to different causes. We question the evidence accumulated by Reardon and his analysis of data accumulated by others. Most importantly, we question whether the conclusions Reardon has drawn follow from the evidence he cites. PMID:19594725
Rocca, Corinne H.; Kimport, Katrina; Roberts, Sarah C. M.; Gould, Heather; Neuhaus, John; Foster, Diana G.
Background Arguments that abortion causes women emotional harm are used to regulate abortion, particularly later procedures, in the United States. However, existing research is inconclusive. We examined women’s emotions and reports of whether the abortion decision was the right one for them over the three years after having an induced abortion. Methods We recruited a cohort of women seeking abortions between 2008-2010 at 30 facilities across the United States, selected based on having the latest gestational age limit within 150 miles. Two groups of women (n=667) were followed prospectively for three years: women having first-trimester procedures and women terminating pregnancies within two weeks under facilities’ gestational age limits at the same facilities. Participants completed semiannual phone surveys to assess whether they felt that having the abortion was the right decision for them; negative emotions (regret, anger, guilt, sadness) about the abortion; and positive emotions (relief, happiness). Multivariable mixed-effects models were used to examine changes in each outcome over time, to compare the two groups, and to identify associated factors. Results The predicted probability of reporting that abortion was the right decision was over 99% at all time points over three years. Women with more planned pregnancies and who had more difficulty deciding to terminate the pregnancy had lower odds of reporting the abortion was the right decision (aOR=0.71 [0.60, 0.85] and 0.46 [0.36, 0.64], respectively). Both negative and positive emotions declined over time, with no differences between women having procedures near gestational age limits versus first-trimester abortions. Higher perceived community abortion stigma and lower social support were associated with more negative emotions (b=0.45 [0.31, 0.58] and b=-0.61 [-0.93, -0.29], respectively). Conclusions Women experienced decreasing emotional intensity over time, and the overwhelming majority of women felt that termination was the right decision for them over three years. Emotional support may be beneficial for women having abortions who report intended pregnancies or difficulty deciding. PMID:26154386
B. R. Sharma
A great variety of mishaps can occur during or following the administration of anesthesia and operative or investigational procedures that do not necessarily convey an error of judgment or negligence on the part of the surgeon or the anesthetist. However, all deaths occurring during the course of anesthesia and surgery or within a reasonable period thereafter (commonly referred to as
Human reproductive cloning (HRC) has not yet resulted in any live births. There has been widespread condemnation of the practice in both the scientific world and the public sphere, and many countries explicitly outlaw the practice. Concerns about the procedure range from uncertainties about its physical safety to questions about the psychological well-being of clones. Yet, key aspects such as
Howard, Ellen; Kharibian, Gloria
To test the hypothesis that a standard library system could be designed for hospital departmental libraries, a system was developed and partially tested for four departmental libraries in the Washington University School of Medicine and Associated Hospitals. The system from determination of needs through design and evaluation, is described. The system was limited by specific constraints to control of the monograph collection. Products of control include catalog cards, accessions list, new book list, location list, fund list, missing book list, and discard book list. Sample data form and pages from a procedure manual are given, and conversion from a manual to an automated system is outlined. The question of standardization of library records and procedures is discussed, with indications of the way in which modular design, as utilized in this system, could contribute to greater flexibility in design of future systems. Reference is made to anticipating needs for organizing departmental libraries in developing regional medical library programs and to exploring the role of the departmental library in a medical library network. PMID:5054309
Eisuke Hanada; Kyoko Takano; Yasuaki Antoku; Kouji Matsumura; Yoshiaki Watanabe; Yoshiaki Nose
Problems involving electromagnetic interference (EMI) with electronic medical equipment are well-documented. However, no systematic investigation of EMI has been done. We have systematically investigated the causes of EMI. The factors involved in EMI were determined as follows: 1) Electric-field intensity induced by invasive radio waves from outside a hospital. 2) Residual magnetic-flux density at welding points in a building. 3)
Ilboudo, Patrick G C; Greco, Giulia; Sundby, Johanne; Torsvik, Gaute
Little is known about the costs and consequences of abortions to women and their households. Our aim was to study both costs and consequences of induced and spontaneous abortions and complications. We carried out a cross-sectional study between February and September 2012 in Ouagadougou, the capital city of Burkina Faso. Quantitative data of 305 women whose pregnancy ended with either an induced or a spontaneous abortion were prospectively collected on sociodemographic, asset ownership, medical and health expenditures including pre-referral costs following the patient’s perspective. Descriptive analysis and regression analysis of costs were performed. We found that women with induced abortion were often single or never married, younger, more educated and had earlier pregnancies than women with spontaneous abortion. They also tended to be more often under parents’ guardianship compared with women with spontaneous abortion. Women with induced abortion paid much more money to obtain abortion and treatment of the resulting complications compared with women with spontaneous abortion: US$89 (44 252 CFA ie franc of the African Financial Community) vs US$56 (27 668 CFA). The results also suggested that payments associated with induced abortion were catastrophic as they consumed 15% of the gross domestic product per capita. Additionally, 11–16% of total households appeared to have resorted to coping strategies in order to face costs. Both induced and spontaneous abortions may incur high expenses with short-term economic repercussions on households’ poverty. Actions are needed in order to reduce the financial burden of abortion costs and promote an effective use of contraceptives. PMID:24829315
Samandari, Ghazaleh; Wolf, Merrill; Basnett, Indira; Hyman, Alyson; Andersen, Kathryn
Unsafe abortion's significant contribution to maternal mortality and morbidity was a critical factor leading to liberalization of Nepal's restrictive abortion law in 2002. Careful, comprehensive planning among a range of multisectoral stakeholders, led by Nepal's Ministry of Health and Population, enabled the country subsequently to introduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that contributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate attention to the key areas of policy, health system capacity, equipment and supplies, and information dissemination. Important elements of this successful model of scaling up safe legal abortion include: the pre-existence of postabortion care services, through which health-care providers were already familiar with the main clinical technique for safe abortion; government leadership in coordinating complementary contributions from a wide range of public- and private-sector actors; reliance on public-health evidence in formulating policies governing abortion provision, which led to the embrace of medical abortion and authorization of midlevel providers as key strategies for decentralizing care; and integration of abortion care into existing Safe Motherhood and the broader health system. While challenges remain in ensuring that all Nepali women can readily exercise their legal right to early pregnancy termination, the national safe abortion program has already yielded strong positive results. Nepal's experience making high-quality abortion care widely accessible in a short period of time offers important lessons for other countries seeking to reduce maternal mortality and morbidity from unsafe abortion and to achieve Millennium Development Goals. PMID:22475782
Ilboudo, Patrick G C; Greco, Giulia; Sundby, Johanne; Torsvik, Gaute
Little is known about the costs and consequences of abortions to women and their households. Our aim was to study both costs and consequences of induced and spontaneous abortions and complications. We carried out a cross-sectional study between February and September 2012 in Ouagadougou, the capital city of Burkina Faso. Quantitative data of 305 women whose pregnancy ended with either an induced or a spontaneous abortion were prospectively collected on sociodemographic, asset ownership, medical and health expenditures including pre-referral costs following the patient's perspective. Descriptive analysis and regression analysis of costs were performed. We found that women with induced abortion were often single or never married, younger, more educated and had earlier pregnancies than women with spontaneous abortion. They also tended to be more often under parents' guardianship compared with women with spontaneous abortion. Women with induced abortion paid much more money to obtain abortion and treatment of the resulting complications compared with women with spontaneous abortion: US$89 (44 252 CFA ie franc of the African Financial Community) vs US$56 (27 668 CFA). The results also suggested that payments associated with induced abortion were catastrophic as they consumed 15% of the gross domestic product per capita. Additionally, 11-16% of total households appeared to have resorted to coping strategies in order to face costs. Both induced and spontaneous abortions may incur high expenses with short-term economic repercussions on households' poverty. Actions are needed in order to reduce the financial burden of abortion costs and promote an effective use of contraceptives. PMID:24829315
Samuel W. Calhoun
This article focuses on three of the atrocities committed by Philadelphia abortion provider Kermit Gosnell: his shameful, destructive treatment of women; his brutal killing of born-alive infants; and his performance of illegal post-viability abortions. Pro-choicers and pro-lifers alike should unite in condemning, stopping, and preventing these abuses. Women seeking abortions need the protection of medically appropriate health and safety regulations;
Dissel, Adam F.
NASA goals are set on resumption of human activity on the Moon and extending manned missions to Mars. Abort options are key elements of any system designed to safeguard human lives and stated requirements stipulate the provision of an abort capability throughout the mission. The present investigation will focus on the formulation and analysis of possible abort modes during the Earth departure phase of manned Mars interplanetary transfers. Though of short duration, the departure phase encompasses a mission timeline where failures have frequently become manifest in historical manned spacecraft necessitating the inclusion of a departure phase abort capability. Investigated abort modes included aborts to atmospheric entry, and to Earth or Moon orbit. Considered interplanetary trajectory types included conjunction, opposition, and free-return trajectory classes. All abort modes were analyzed for aborts initiated at multiple points along each of these possible departure trajectories across all launch opportunities of the fifteen-year Earth-Mars inertial period. The consistently low departure velocities of the conjunction trajectories facilitated the greatest abort capability. An analysis of Mars transportation architectures was performed to determine the amount of available delta V inherent in each candidate architecture for executing departure aborts. Results indicate that a delta V of at least 4 km/s is required to achieve a continuous departure phase entry abort capability with abort flights less than three weeks duration for all transfer opportunity years. Less demanding transfer years have a corresponding increase in capability. The Earth orbit abort mode does not become widely achievable until more than 6 km/s delta V is provided; a capacity not manifest in any considered architecture. Optimization of the Moon abort mode resulted in slight departure date shifts to achieve improved lunar alignments. The Moon abort mode is only widely achievable for conjunction transfers during the optimum transfer years and delta V values greater than 4 km/s. A lesser delta V potential of 3 km/s is sufficient to enable entry aborts during the least demanding transfer opportunity years. Extensive abort capability is achievable for high delta V capable Mars architectures. Less propulsively capable architectures achieve moderate abort capability during favorable opportunity years.
The Roman Catholic Church has held the most absolute and extreme position against abortion taken by any religious group. Opposition to abortion by US Catholic bishops has been unflagging since Roe vs. Wade was decided. The current strategy embraced by the bishops is to restrict access to abortion as a prelude to attaining a complete ban on the procedure. The bishops, of course, have a political and constitutional right to champion public policy issues. This ability is limited only by the laws regarding tax-exempt status which make it impossible for the bishops to endorse political candidates. Opponents of the positions of the bishops, in turn, have a right to challenge their positions. The bishops, acting jointly as the United States Catholic Conference (USCC), express their own opinions, not the opinions of the 53 million US Catholics and have been criticized by both conservative and progressive groups in the church. Since women can not become Catholic bishops, or even priests, they are excluded from meetings of the USCC. Catholic lay groups have expressed the view that there is more than one legitimate Catholic position regarding abortion and have even filed briefs in favor of retaining the decision reached in Roe vs. Wade. The bishops, however, are able to draw on a multitude of institutions to further their view and have enhanced the operations of their 28 statewide lobbying offices as the abortion battle has shifted to the states. The Webster decision signaled a return of the bishops to a prominent position in the anti-abortion campaign. Prior to Webster, they kept their distance from the Protestant religious right. With Webster, the bishops felt the time was right to press hard to further restrictions to access to abortion. As they began to apply pressure, a pro-choice backlash developed, with leading Catholic politicians adopting strong pro-choice positions. The bishops reacted by taking such aggressive actions as denouncing certain politicians by name. This behavior caused even more alienation of middle-of-the-road Catholics from the bishops' position. The bishops tried to recover by hiring a professional public relations firm and the pollster used by the Reagan administration. The public relations firm was dismissed within a year. Religious observers wonder why the church is so adamantly against abortion in every circumstance, despite the beliefs of its members. In fact, in 1974, the Congregation for the Doctrine of the Faith noted the church's opposition to abortion but fell short of calling it murder and was honest about the church's ambiguity over the personhood of a fetus or at what stage in development the creator endows a fetus with a soul. This question has been debated by theologians since the early centuries of the church. Even the current Pope favors the term "that which is in the process of becoming" when discussing a fetus. In addition, church history and positions regarding the possibility of a "just war" make the church's adherence to the impossibility of a "just abortion" hard to justify. This hard-line position has removed the church from a position in which it could help women and society understand the values which must underly every decision to have an abortion. PMID:8274867
Epstein, Nancy E.
Background: The impact of early mobilization on perioperative comorbidities and length of stay (LOS) has shown benefits in other medical/surgical subspecialties. However, few spinal series have specifically focused on the “pros” of early mobilization for spinal surgery, other than in acute spinal cord injury. Here we reviewed how early mobilization and other adjunctive measures reduced morbidity and LOS in both medical and/or surgical series, and focused on how their treatment strategies could be applied to spinal patients. Methods: We reviewed studies citing protocols for early mobilization of hospitalized patients (day of surgery, first postoperative day/other) in various subspecialties, and correlated these with patients’ perioperative morbidity and LOS. As anticipated, multiple comorbid factors (e.g. hypertension, high cholesterol, diabetes, hypothyroidism, obesity/elevated body mass index hypothyroidism, osteoporosis, chronic obstructive pulmonary disease, coronary artery disease and other factors) contribute to the risks and complications of immobilization for any medical/surgical patient, including those undergoing spinal procedures. Some studies additionally offered useful suggestions specific for spinal patients, including prehabilitation (e.g. rehabilitation that starts prior to surgery), preoperative and postoperative high protein supplements/drinks, better preoperative pain control, and early tracheostomy, while others cited more generalized recommendations. Results: In many studies, early mobilization protocols reduced the rate of complications/morbidity (e.g. respiratory decompensation/pneumonias, deep venous thrombosis/pulmonary embolism, urinary tract infections, sepsis or infection), along with the average LOS. Conclusions: A review of multiple medical/surgical protocols promoting early mobilization of hospitalized patients including those undergoing spinal surgery reduced morbidity and LOS. PMID:24843814
Meyers, C; Woods, R D
Access to abortion services in the United States continues to decline. It does so not because of significant changes in legislation or court rulings but because fewer and fewer physicians wish to perform abortions and because most states now have "conscientious objection" legislation that makes it easy for physicians to refuse to do so. We argue in this paper that physicians have an obligation to perform all socially sanctioned medical services, including abortions, and thus that the burden of justification lies upon those who wish to be excused from that obligation. That is, such persons should have to show how requiring them to perform abortions would represent a serious threat to their fundamental moral or religious beliefs. We use current California law as an example of legislation that does not take physicians' obligations into account and thus allows them too easily to declare conscientious objection. PMID:8731539
Brown, Harold O
France's Assemblee Nationale and Senate passed a "time-limit solution" abortion law on December 20, 1974. Abortion is permitted on demand by a physician in a hospital during the 1st 10 weeks of pregnancy. The tone of the law stresses the concept of respect for life and suggests the undesirability of abortion. The developing child is recognized as a human being whose life has begun. The woman herself is responsible for her distress is sufficient to warrant abortion. Further provisions insure that the woman is as well-informed as possible concerning medical risks and possibilities of adoption and requires consultation with an information, consultation, or family counseling service, family planning center, or other social service organization. French scientists, physicians, magistrates, and religious leaders opposed the permissive law. The victory of the proabortionists was created by the political decision of the Socialists and Communists to impose party discipline and to require a unanimous vote for liberalization. PMID:11663656
Tartabini, P. V.; Striepe, S. A.; Powell, R. W.
Mars trajectory design options were examined that would accommodate a premature termination of a nominal manned opposition class mission for opportunities between 2010 and 2025. A successful abort must provide a safe return to Earth in the shortest possible time consistent with mission constraints. In this study, aborts that provided a minimum increase in the initial vehicle mass in low Earth orbit (IMLEO) were identified by locating direct transfer nominal missions and nominal missions including an outbound or inbound Venus swing-by that minimized IMLEO. The ease with which these missions could be aborted while meeting propulsion and time constraints was investigated by examining free return (unpowered) and powered aborts. Further reductions in trip time were made to some aborts by the addition or removal of an inbound Venus swing-by. The results show that, although few free return aborts met the specified constraints, 85% of each nominal mission could be aborted as a powered abort without an increase in propellant. Also, in many cases, the addition or removal of a Venus swing-by increased the number of abort opportunities or decreased the total trip time during an abort.
Williams, S J; Pullum, T W
Several models used to study the effectiveness of abortion in population limitation are examined. The Keyfitz model, based on the probability that an individual woman will conceive in a given month, is extended and public implications of legal abortions are discussed. A model more appropriate for a population of women rather than a single woman can be developed by relating the probability of conception and the sterile intervals to the number of birth and the number of women in the population. The effectiveness of abortion as a birth control method is studied using this model and includes: 1) abortion effectiveness combined with efficient contraception (95% effective); 2) the sensitivity of abortion to gestation when a contraceptive of lower efficiency is used; 3) these effects modified for prolonged lactation; 4) the effect of changing the monthly probability of conception and the monthly efficiency of contraception. Abortion later in pregnancy is advantageous when efficient contraception is absent. The effectiveness of abortion to gestation is approximately the same whether lactation is included or absent, although abortion is more effective at all gestations and for all contraceptives efficiencies in the absence of lactation. The sensitivity of the effectiveness of abortion to the probability of conception decreases as monthly effectiveness of contraception increases. The probability of conception and the monthly effectiveness of contraception are difficult parameters to measure in the population. The effect of abortion averaged over the entire population at risk of pregnancy is different from its effect on certain subgroups. For U.S. females the probability of conception may be between .06 and .16, and from the model it is indicated that the effectiveness of abortion would be from 1 to 1.13 abortions per live birth. The application of the model suggests that the expenditures for abortion services in this population are a reasonable investment, although investment for efficient contraception is also suggested. PMID:1188406
Purvis, Dara E
One thread of abortion criticism, arguing that gender equality requires that men be allowed to terminate legal parental status and obligations, has reinforced the stereotype of men as uninterested in fatherhood. As courts facing disputes over stored pre-embryos weigh the equities of allowing implantation of the pre-embryos, this same gender stereotype has been increasingly incorporated into a legal balancing test, leading to troubling implications for ART and family law. PMID:26242955
Tan, Y. [Brookhaven National Lab. (BNL), Upton, NY (United States). Collider-Accelerator Dept.; Perlstein, S. [Brookhaven National Lab. (BNL), Upton, NY (United States). Collider-Accelerator Dept.
In an attempt to discover any pattern to prefire events, abort prefire kicker data from 2007 to the present day have been recorded. With the 2014 operations concluding, this comprises 8 years of prefire data. Any activities that the Pulsed Power Group did to decrease prefire occurrences were recorded as well, but some information may be missing. The following information is a compilation of the research to date.
Moreau, Caroline; Trussell, James; Desfreres, Julie; Bajos, Nathalie
Objectives The abortion rate varies greatly within the French overseas territories including the Caribbean island of Guadeloupe and La Réunion in the Indian Ocean. We compare women’s contraceptive paths surrounding an abortion in both territories. Methods The data for this study are part of a nationally representative survey of women undergoing abortion in France in 2007. The analysis included 1211women from Guadeloupe and 1531 from La Réunion. Results Results show differences in women’s use of contraception before the abortion by study location. Women in Guadeloupe were more likely not to have used contraception in the month they conceived (40% vs. 32%, p < 001). Among those using no contraception or less effective contraception before the abortion, 74% in Guadeloupe and 86% in La Réunion received a prescription for a very effective method such as a hormonal method or intrauterine device after the procedure. In both settings, women with no health insurance or a government health plan were 70% less likely to have received a prescription for a very effective method. Conclusions While this study shows a significant increase in the prescription of very effective methods, it also indicates the ineffectiveness of the health care system in closing the gap in the pre-abortion contraceptive disparities observed between Guadeloupe and La Réunion. PMID:20465401
Putintsev, V A; Bogomolov, D V; Fedulova, M V; Gribunov, Iu P; Kul'bitski?, B N
This paper is devoted to the novel computer technologies employed in the studies of histological preparations. These technologies allow to visualize digital images, structurize the data obtained and store the results in computer memory. The authors emphasize the necessity to properly document digital images obtained during forensic-histological studies and propose the procedure for the formulation of electronic documents in conformity with the relevant technical and legal requirements. It is concluded that the use of digital images as a new study object permits to obviate the drawbacks inherent in the work with the traditional preparations and pass from descriptive microscopy to their quantitative analysis. PMID:23405466
Tait, Alan R.; Voepel-Lewis, Terri; Chetcuti, Stanley J.; Brennan-Martinez, Colleen; Levine, Robert
Introduction Standard print and verbal information provided to patients undergoing treatments is often difficult to understand and may impair their ability to be truly informed. This study examined the effect of an interactive multimedia informational program with in-line exercises and corrected feedback on patients’ real-time understanding of their cardiac catheterization procedure. Methods 151 adult patients scheduled for diagnostic cardiac catheterization were randomized to receive information about their procedure using either the standard institutional verbal and written information (SI) or an interactive iPad-based informational program (IPI). Subject understanding was evaluated using semi-structured interviews at baseline, immediately following catheterization, and 2 weeks after the procedure. In addition, for those randomized to the IPI, the ability to respond correctly to several in-line exercises was recorded. Subjects’ perceptions of, and preferences for the information delivery were also elicited. Results Subjects randomized to the IPI program had significantly better understanding following the intervention compared with those randomized to the SI group (8.3 ± 2.4 vs 7.4 ± 2.5, respectively, 0–12 scale where 12 = complete understanding, P<0.05). First-time correct responses to the in-line exercises ranged from 24.3% – 100%. Subjects reported that the in-line exercises were very helpful (9.1 ± 1.7, 0–10 scale, where 10 = extremely helpful) and the iPad program very easy to use (9.0 ± 1.6, 0–10 scale, where 10 = extremely easy) suggesting good clinical utility. Discussion Results demonstrated the ability of an interactive multimedia program to enhance patients’ understanding of their medical procedure. Importantly, the incorporation of in-line exercises permitted identification of knowledge deficits, provided corrected feedback, and confirmed the patients’ understanding of treatment information in real-time when consent was sought. PMID:24552970
Franz, Wanda; Reardon, David
Compared adolescent and adult reactions to abortion among 252 women. Compared to adults, adolescents were significantly more likely to be dissatisfied with choice of abortion and with services received, to have abortions later in gestational period, to feel forced by circumstances to have abortion, to report being misinformed at time of abortion,…
In Sri Lanka, women do not have access to legal abortion except under life-saving circumstances. Clandestine abortion services are, however, available and quite accessible. Although safe specialist services are available to women who can afford them, others access services under unsafe and exploitative conditions. At the time of this writing, a draft bill that will legalize abortion in instances of rape, incest, and fetal abnormalities awaits approval, amid opposition. In this article, I explore the current push for legal reform as a solution to unsafe abortion. Although a welcome effort, this amendment alone will be insufficient to address the public health consequences of unsafe abortion in Sri Lanka because most women seek abortions for other reasons. Much broader legal and policy reform will be required. PMID:23327236
The regularly published abortion statistics are insufficiently detailed to make it easy to assess the significance of increases or decreases in the annual number of abortions. Numbers of abortions are related only to a few broad age groups of the women at risk, the size of those age groups is not normally stated, and the age and marital status groupings employed differ from those used for comparable data about trends in child bearing. By matching demographic data on trends in pregnancies which are deliberately terminated (abortion) and those which are not (fertility), this note attempts a) to assess the true impact of abortion among women living in England and Wales during 1973-76, and b) to consider whether the annual volume of abortions may increase over the next decade and what such an increase might signify. PMID:633307
In Sri Lanka, women do not have access to legal abortion except under life-saving circumstances. Clandestine abortion services are, however, available and quite accessible. Although safe specialist services are available to women who can afford them, others access services under unsafe and exploitative conditions. At the time of this writing, a draft bill that will legalize abortion in instances of rape, incest, and fetal abnormalities awaits approval, amid opposition. In this article, I explore the current push for legal reform as a solution to unsafe abortion. Although a welcome effort, this amendment alone will be insufficient to address the public health consequences of unsafe abortion in Sri Lanka because most women seek abortions for other reasons. Much broader legal and policy reform will be required. PMID:23327236
Krishnan, Shweta; Dalvie, Suchitra
Although unsafe abortion continues to be a leading cause of maternal mortality in many countries in Asia, the right to safe abortion remains highly stigmatized across the region. The Asia Safe Abortion Partnership, a regional network advocating for safe abortion, produced an animated short film entitled From Unwanted Pregnancy to Safe Abortion to show in conferences, schools and meetings in order to share knowledge about the barriers to safe abortion in Asia and to facilitate conversations on the right to safe abortion. This paper describes the making of this film, its objectives, content, dissemination and how it has been used. Our experience highlights the advantages of using animated films in addressing highly politicized and sensitive issues like abortion. Animation helped to create powerful advocacy material that does not homogenize the experiences of women across a diverse region, and at the same time emphasize the need for joint activities that express solidarity. PMID:26278840
Hernandez, Cory D
Abortion is a loaded, controversial, and divisive sociocultural and political term, concept, and debate. Yet little empirical research has been conducted to examine what effects abortion rights legislation and court cases ...
Ersig, Anne L.; Kleiber, Charmaine; McCarthy, Ann Marie; Hanrahan, Kirsten
Purpose Assessment of children’s anxiety in busy clinic settings is an important step in developing tailored interventions. This article describes the construct validation of the Children’s Anxiety Meter-State (CAM-S), a brief measure of state anxiety. Design and Methods Existing data were used to investigate the associations between child self-reports of anxiety, parent reports of child anxiety, and observed child distress during an intravenous procedure. Results Children’s (n = 421) CAM-S scores were significantly associated with all parent measures and observed distress ratings. Practice Implications Findings support the use of the CAM-S for assessment of child anxiety in clinical settings. PMID:24094126
Ahmed S Yassin; Diane Cordwell
ObjectiveMany studies have shown a disappointing periabortion contraceptive uptake. This study investigated whether the provision of dedicated and targeted contraception counselling at the pre-abortion assessment visit can improve the post-abortion contraception uptake.MethodsThe study comprised a 3-month prospective reaudit of the abortion clinic.ResultsOf the 104 women seen during the re-audit period, 96% received post-abortion contraception. The majority (73%) of the women
Rajamani, Sriram K.
; aborted transactions must have side-effects to be able to test for success (commit) or failure (abortAn AbortAn Abort--Aware Model ofAware Model of Transactional ProgrammingTransactional Programming An abort-aware semantics for transactions · Part 2: TSMs = Transactional State Machines A finite
BLEIL, Maria E.; ADLER, Nancy E.; PASCH, Lauri A.; STERNFELD, Barbara; REIJO-PERA, Renee A.; CEDARS, Marcelle I.
Objective To characterize the backgrounds of women who have repeat abortions. Study Design In a cross-sectional study of 259 women (M=35.2±5.6 years), the relation between adverse experiences in childhood and risk of having 2+ abortions versus 0 or 1 abortion was examined. Self-reported adverse events occurring between ages 0-12 were summed. Results Independent of confounding factors, women who experienced more abuse, personal safety, and total adverse events in childhood were more likely to have 2+ versus 0 abortions (OR=2.56, 95% CI=1.15-5.71; OR=2.74, 95% CI=1.29-5.82; OR=1.59, 95% CI=1.21-2.09) and versus 1 abortion (OR=5.83, 95% CI=1.71-19.89; OR=2.23, 95% CI=1.03-4.81; OR=1.37, 95% CI=1.04-1.81). Women who experienced more family disruption events in childhood were more likely to have 2+ versus 0 abortions (OR=1.75, 95% CI=1.14-2.69) but not versus 1 abortion (OR=1.16, 95% CI=0.79-1.70). Conclusions Women who have repeat abortions are more likely to have experienced childhood adversity than those having 0 or 1 abortion. PMID:21074137
Lopez, Ramon; Lacey, Steven E; Lippert, Julia F; Liu, Li C; Esmen, Nurtan A; Conroy, Lorraine M
Prior investigation on medical laser interaction with tissue has suggested device operational parameter settings influence laser generated air contaminant emission, but this has not been systematically explored. A laboratory-based simulated medical laser procedure was designed and pilot tested to determine the effect of laser operational parameters on the size-specific mass emission rate of laser generated particulate matter. Porcine tissue was lased in an emission chamber using two medical laser systems (CO2, ? = 10,600 nm; Ho:YAG, ? = 2100 nm) in a fractional factorial study design by varying three operational parameters (beam diameter, pulse repetition frequency, and power) between two levels (high and low) and the resultant plume was measured using two real-time size-selective particle counters. Particle count concentrations were converted to mass emission rates before an analysis of variance was used to determine the influence of operational parameter settings on size-specific mass emission rate. Particle shape and diameter were described for a limited number of samples by collecting particles on polycarbonate filters, and photographed using a scanning electron microscope (SEM) to examine method of particle formation. An increase in power and decrease in beam diameter led to an increase in mass emission for the Ho:YAG laser at all size ranges. For the CO2 laser, emission rates were dependent on particle size and were not statistically significant for particle ranges between 5 and 10 µm. When any parameter level was increased, emission rate of the smallest particle size range also increased. Beam diameter was the most influential variable for both lasers, and the operational parameters tested explained the most variability at the smallest particle size range. Particle shape was variable and some particles observed by SEM were likely created from mechanical methods. This study provides a foundation for future investigations to better estimate size-specific mass emission rates and particle characteristics for additional laser operational parameters in order to estimate occupational exposure, and to inform control strategies. PMID:25587187
Decision ambivalence is a key concept in abortion literature, but has been poorly operationalised. This study explored the concept of decision ambivalence via an Abortion Decision Balance Sheet (ADBS) articulating reasons both for and against terminating an unintended pregnancy. Ninety-six women undergoing an early abortion for psychosocial…
Center for Disease Control (DHEW/PHS), Atlanta, GA.
This report summarizes information received from collaborators in state health departments, hospitals, and other pertinent sources regarding abortions reported to the Center for Disease Control for the April-June quarter of 1971. Data in tabular and narrative form are given for abortion ratios by state, reported abortions by menstrual weeks of…
Karen M. Lodl; Ann McGettigan; Janette Bucy
A review of the literature on the psychosocial consequences of abortion reveals that abortion can be a positive experience for the majority of women, but it can be emotionally stressful for a smaller group. The sources of stress are attributed to ambivalence, lack of social support, and inadequate coping skills. A model for post-abortion support groups is proposed which would
Helen Roberts; Martha Silva; Sylvia Xu
BackgroundMany misconceptions still prevail about the appropriateness of use of the intrauterine device (IUD), particularly for younger women. This study examines the factors associated with post abortion IUD use as compared to the combined oral contraceptive pill (COC). It then examines the effect of type of post abortion contraception with the likelihood of seeking subsequent abortions.
Meyer, L; Petersson, B H
The records of all women applying for permission to have an abortion performed after the 12th week of pregnancy during a one-year period in the County of Aarhus were continuously reviewed, and the women who had the abortion performed due to psychosocial reasons were interviewed with a questionnaire at the time of the abortion and again four months later. Of the 76 women who applied for permission for a late abortion the following were excluded from the study: 31 who had the abortion because a malformed child was suspected, six women who did not have the abortion although permission had been given, five women who did not receive permission, four who were under 18 years of age, one who had a miscarriage, 10 who were from another country of origin and did not understand Danish and finally four women who were allowed an abortion on a medical indication and who were either in hospital or in jail. Fifteen women were questioned concerning their age, length of pregnancy and psychological and social histories and were asked to fill out a depression scale. The data showed that none of them had planned their pregnancy and they had had no symptoms of pregnancy until the time at which they applied for the abortion. None of them regretted the abortion afterwards; half of the women were under psychological strain at the time of application, and a few of them had even more psychological symptoms four months after the abortion. Although they had many social problems, physical complications and psychological problems only a few of the women had seen a doctor in the four month period between the abortion and the follow-up. PMID:8759996
Contreras, Xipatl; van Dijk, Marieke G; Sanchez, Tahilin; Smith, Patricio Sanhueza
This study examines the experiences and opinions of health-care professionals after the legalization of abortion in Mexico City in 2007. Sixty-four semistructured interviews were conducted between 1 December 2007 and 16 July 2008 with staff affiliated with abortion programs in 12 hospitals and 1 health center, including obstetricians/gynecologists, nurses, social workers, key decisionmakers at the Ministry of Health, and others. Findings suggest that program implementation was difficult because of the lack of personnel, space, and resources; a great number of conscientious objectors; and the enormous influx of women seeking services, which resulted in a work overload for participating professionals. The professionals interviewed indicate that the program improved significantly over time. They generally agree that legal abortion should be offered, despite serious concerns about repeat abortions. They recommend improving family planning campaigns and post-procedure contraceptive use, and they encourage the opening of primary health-care facilities dedicated to providing abortion services. PMID:21972671
Rademaker, Guido; Jenne, Jürgen W; Rastert, Ralf; Röder, Daniel; Schad, Lothar
Novel methods for hyperthermia tumor therapy, such as high-intensity focused ultrasound (HIFU) or laser-induced thermotherapy (LITT), require accurate non-invasive temperature monitoring. Non-invasive temperature measurement using magnetic resonance imaging (MRI) is based on the analysis of changes in longitudinal relaxation time (T1), diffusion coefficient (D), or water proton resonance frequency (PRF). The purpose of this study was the development and comparative analysis of the three different approaches of MRI temperature monitoring (T1, D, and PRF). Measurements in phantoms (e.g., ultrasound gel) resulted in the following percent changes: T1-relaxation time: 1.98%/degree C; diffusion coefficient: 2.22%/degree C; and PRF: -0.0101 ppm/degree C. All measurements were in good agreement with the literature. Temperature resolutions could also be measured from the inverse correlation of the data over the whole calibration range: T1: 2.1 +/- 0.6 degrees C; D: 0.93 +/- 0.2 degree C; and PRF: 1.4 +/- 0.3 degrees C. The diffusion and PRF methods were not applicable in fatty tissue. The use of the diffusion method was restricted due to prolonged echo time and anisotropic diffusion in tissue. Initial tests with rabbit muscle tissue in vivo indicated that MR thermometry via T1 and PRF procedures is feasible to monitor the local heating process induced by HIFU. The ultrasound applicators in the MR scanner did not substantially interfere with image quality. PMID:14562541
NASA's vision for space exploration (February 2004) calls for development of a new crew exploration vehicle, sustained lunar operations, and human exploration of Mars. To meet the challenges of planned sustained operations as well as the limited communications between Earth and the crew (e.g., Mars exploration), many systems will require crews to operate in an autonomous environment. It has been estimated that once every 2.4 years a major medical issue will occur while in space. NASA's future travels, especially to Mars, will begin to push this timeframe. Therefore, now is the time for investigating technologies and systems that will support crews in these environments. Therefore, this summer two studies were conducted to evaluate the technology and systems that may be used by crews in future missions. The first study evaluated three commercial Indoor Positioning Systems (IPS) (Versus, Ekahau, and Radianse) that can track equipment and people within a facility. While similar to Global Positioning Systems (GPS), the specific technology used is different. Several conclusions can be drawn from the evaluation conducted, but in summary it is clear that none of the systems provides a complete solution in meeting the tracking and technology integration requirements of NASA. From a functional performance (e.g., system meets user needs) evaluation perspective, Versus performed fairly well on all performance measures as compared to Ekahau and Radianse. However, the system only provides tracking at the room level. Thus, Versus does not provide the level of fidelity required for tracking assets or people for NASA requirements. From an engineering implementation perspective, Ekahau is far simpler to implement that the other two systems because of its wi-fi design (e.g., no required runs of cable). By looking at these two perspectives, one finds there was no clear system that met NASA requirements. Thus it would be premature to suggest that any of these systems are ready for implementation and further study is required.
Faúndes, Anibal; Shah, Iqbal H
Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal condition for abortion is met. The present article aims to contribute to a better understanding that one can be in favor of greater access to safe abortion services, while at the same time not be "in favor of abortion," by reviewing the evidence that indicates that criminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates. PMID:26433508
...2012-04-01 2012-04-01 false Vacuum abortion system. 884.5070 Section 884.5070...Therapeutic Devices § 884.5070 Vacuum abortion system. (a) Identification. A vacuum abortion system is a device designed to...
...2013-04-01 2013-04-01 false Vacuum abortion system. 884.5070 Section 884.5070...Therapeutic Devices § 884.5070 Vacuum abortion system. (a) Identification. A vacuum abortion system is a device designed to...
...2014-04-01 2014-04-01 false Vacuum abortion system. 884.5070 Section 884.5070...Therapeutic Devices § 884.5070 Vacuum abortion system. (a) Identification. A vacuum abortion system is a device designed to...
...2011-04-01 2011-04-01 false Vacuum abortion system. 884.5070 Section 884.5070...Therapeutic Devices § 884.5070 Vacuum abortion system. (a) Identification. A vacuum abortion system is a device designed to...
...2010-04-01 2010-04-01 false Vacuum abortion system. 884.5070 Section 884.5070...Therapeutic Devices § 884.5070 Vacuum abortion system. (a) Identification. A vacuum abortion system is a device designed to...
...2010-04-01 false Metreurynter-balloon abortion system. 884.5050 Section 884...884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to...
Keogh, Sarah C.; Kimaro, Godfather; Muganyizi, Projestine; Philbin, Jesse; Kahwa, Amos; Ngadaya, Esther; Bankole, Akinrinola
Background Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence. Objectives To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar). Methods A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology. Results In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15–49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone. Conclusions The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies. PMID:26361246
Santi, Louis M.; Butas, John P.; Aguilar, Robert B.; Sowers, Thomas S.
The J-2X is an expendable liquid hydrogen (LH2)/liquid oxygen (LOX) gas generator cycle rocket engine that is currently being designed as the primary upper stage propulsion element for the new NASA Ares vehicle family. The J-2X engine will contain abort logic that functions as an integral component of the Ares vehicle abort system. This system is responsible for detecting and responding to conditions indicative of impending Loss of Mission (LOM), Loss of Vehicle (LOV), and/or catastrophic Loss of Crew (LOC) failure events. As an earth orbit ascent phase engine, the J-2X is a high power density propulsion element with non-negligible risk of fast propagation rate failures that can quickly lead to LOM, LOV, and/or LOC events. Aggressive reliability requirements for manned Ares missions and the risk of fast propagating J-2X failures dictate the need for on-engine abort condition monitoring and autonomous response capability as well as traditional abort agents such as the vehicle computer, flight crew, and ground control not located on the engine. This paper describes the baseline J-2X abort subsystem concept of operations, as well as the development process for this subsystem. A strategy that leverages heritage system experience and responds to an evolving engine design as well as J-2X specific test data to support abort system development is described. The utilization of performance and failure simulation models to support abort system sensor selection, failure detectability and discrimination studies, decision threshold definition, and abort system performance verification and validation is outlined. The basis for abort false positive and false negative performance constraints is described. Development challenges associated with information shortfalls in the design cycle, abort condition coverage and response assessment, engine-vehicle interface definition, and abort system performance verification and validation are also discussed.
Munro, Malcolm G
Leiomyomas are such common tumors of the uterus that at least two-thirds of women will have at least one by the age of 50. Despite this high incidence, we know relatively little about their cause, growth and development, and contribution to the genesis of reproductive disorders. The prevalence of lesions puts women with associated butun related symptoms at risk for unnecessary and/or unsuccessful interventions,especially if they have not been carefully evaluated and counseled. Indeed, because the majority of leiomyomas do not cause symptoms, when a woman presents with AUB, infertility, pelvic pain, or vague abdominal complaints, it is possible if not likely that the cause of the problem exists elsewhere. The other overwhelming impression that can be gleaned is this: when leiomyomas are the cause of the symptoms,particularly in women desiring to preserve fertility, the tumors have already and frequently induced irreparable harm, a circumstance that cries out for a strategy of early detection and interventions designed to minimize morbidity.Fortunately, because of the efforts of a few, we are just beginning to understand the potential molecular mechanisms by which leiomyomas may contribute to reproductive tract symptoms such as AUB, infertility, and pregnancy loss, work that may contribute to the development of more specific medical therapeutic techniques and strategies. The use of increasingly precise and accessible imaging for diagnosis,combined with the application of customized intrauterine drug-releasing systems or minimally invasive and highly accurate targeted ablative technologies that minimize collateral damage, may provide women the opportunity to avoid the mutilating,painful, expensive, and frequently unsuccessful surgical interventions of today that are applied to end-stage disease.For the present, clinicians should evaluate any woman with reproductive tract symptoms and leiomyomas carefully and with skepticism, ensuring that they have done all that is necessary to determine if the lesion or lesions are related to the problem. If leiomyomas are the suspected or known cause, clinicians must also be prepared to offer or otherwise provide access to the complete spectrum of care that the patient deserves, regardless of the limitations of the clinician’s training, experience,or institutional environment. Such an approach will limit the number of unnecessary and ineffective interventions and, it is hoped, minimize morbidity while optimizing quality of life for affected women. PMID:22134018
It is impossible to eliminate abortion, and therefore it must be evaluated in all its medical, moral, religious, as well as, unfortunately, convenience aspects. From a religious viewpoint, abortion is inadmissible; there are, however, social, emotional and psychological problems. Many countries have solved the problem of abortion more or less satisfactorily. Conditions in Italy, however, are rather special, as a resllt of a range of factors, not least of which is a powerful religious pressure which conditions many expressions of private and social life. The physician involved in this problem is confronted with very difficult decisions from the viewpoint of conscienc e, morality, and professional ethics. Abortion requests cannot be granted unconditionally and abortions of convenience must be drastically rejected. On the other hand, in many cases humane considerations demand a solution, and in very exceptional cases abortion is appropriate. But it is impossible to draw up a document to codify rigidly invidual cases, and the physician must rely on his own scientific knowledge, perhaps supported by that of a competent colleague, and on his professional cons cience. A thorough program of prevention of damaging or dangerous pregnancies is recommended, by means of health and sex education. Knowledge of both pharmaceutical and mechanical contraceptives must be popularized at all levels. PMID:4732982
Mark, Alice G; Wolf, Merrill; Edelman, Alison; Castleman, Laura
Unsafe abortion causes approximately13% of all maternal deaths worldwide, with higher rates in areas where abortion access is restricted. Because safe abortion is so low risk, if all women who needed an abortion could access safe care, this rate would drop dramatically. As women's health providers and advocates, obstetrician/gynecologists can support abortion access. By delivering high-quality, evidence-based care ourselves, supporting other providers who perform abortion, helping women who access abortion in the community, providing second-trimester care, and improving contraceptive uptake, we can decrease morbidity and mortality from unsafe abortion. PMID:26433507
The abort analysis for the cycle 3 Operational Flight Profile (OFP) for the Space Transportation System 1 Flight (STS-1) is defined, superseding the abort analysis previously presented. Included are the flight description, abort analysis summary, flight design groundrules and constraints, initialization information, general abort description and results, abort solid rocket booster and external tank separation and disposal results, abort monitoring displays and discussion on both ground and onboard trajectory monitoring, abort initialization load summary for the onboard computer, list of the key abort powered flight dispersion analysis.
Nickerson, Adrianne; Manski, Ruth; Dennis, Amanda
We explored how low-income abortion clients in states where public funding was and was not available perceived the role of public funding for abortion. From October 2010 through February 2011, we conducted 71 semi-structured in-depth telephone interviews with low-income abortion clients in Arizona, Florida, New York, and Oregon. Women reported weighing numerous factors when determining which circumstances warranted public funding. Though most women generally supported coverage, they deviated from their initial support when asked about particular circumstances. Respondents felt most strongly that abortion should not be covered when a woman could not afford another child or was pregnant outside of a romantic relationship. Participants used disparaging language to describe the presumed behavior of women faced with unintended pregnancies. In seeking to discredit "other" women's abortions, women revealed the complex nature of abortion stigma. We propose that women's abortion experiences and subsequent opinions on coverage indicated three distinct manifestations of abortion stigma: women (1) resisted the prominent discourse that marks women who have had abortions as selfish and irresponsible; (2) internalized societal norms that stereotype women based on the circumstances surrounding the abortion; and (3) reproduced stigma by distancing themselves from the negative stereotypes associated with women who have had abortions. PMID:25068780
Millner, Vaughn S.; Hanks, Robert B.
Induced abortion is one of the most controversial moral issues in American culture, but counselor value struggles regarding abortion are seldom addressed in counseling literature. This article considers the conflictual nature of the ethical principles of autonomy, fidelity, justice, beneficence, and nonmaleficence as they can occur within the…
Smith, Elizabeth M.
Concerned professionals in various parts of the country have formed crisis-oriented counseling services to meet the needs of women who request abortions. This article presents information obtained from a sample of women seeking abortions and discusses the counselor's role in the decision making process. (Author)
Hamrick, Michael H.; And Others
A college survey showed strong support by a majority for legalized abortion, governmental support of abortion and family planning services, voluntary sterilization, and sex education and birth control information and/or services in the schools. Important differences of opinion among subgroups were, however, indicated. (Author/MJB)
Cohen, I Glenn
This commentary on Madeira's paper complicates the relationships between commodification, consumption, abortion, and assisted reproductive technologies (ARTs) she draws in two ways. First, I examine under what conditions the commodification of ARTs, gametes, and surrogacy lead to patients becoming consumers. Second, I show that there are some stark difference between applying commodification critiques to ART versus abortion. PMID:26242952
Eschenbach, David A
Worldwide, abortion accounts for approximately 14% of pregnancy-related deaths, and septic abortion is a major cause of the deaths from abortion. Today, septic abortion is an uncommon event in the United States. The most critical treatment of septic abortion remains the prompt removal of infected tissue. Antibiotic administration and fluid resuscitation provide necessary secondary levels of treatment. Most young physicians have never treated septic abortion. Many obstetrician-gynecologists experience, or plan to experience, global health activities and will likely care for women with septic abortion. Thus, updated knowledge of the pathophysiology, clinical presentation, microbes, and proper treatment is needed to optimally treat this emergency condition when it exists. The pathophysiology of septic abortion involves infection of the placenta, especially the maternal villous space that leads to a high frequency of bacteremia. Symptoms and signs range from mild to severe. The microbes involved are usually common vaginal bacteria, including anaerobes, but occasionally potentially very serious and lethal infection is caused by bacteria that produce toxins. The primary treatment is early curettage to remove infected and devitalized tissue even in the face of continued fetal heart tones. Important secondary treatments are the administration of fluids and antibiotics. Updated references of sepsis and septic shock are reviewed. PMID:25932831
Sommers, Paul M.; Thomas, Laura S.
No public funds are saved by forbidding the use of federal funds for abortions among poor women. The future public cost of an unwanted birth is estimated for 1978 to be almost 100 times the cost of an abortion. (Author/RM)
Brooke R. Johnson; Mihai Horga; Laurentia Andronache
Romanian women have commonly used abortion (both legal and clandestine) to prevent unwanted births. We introduce this paper with a brief summary of the recent history of abortion in Romania, then we combine quantitative data from a previous report ( Johnson et al., Lancet 341, 875, 1993) of the research with women's own words about the following issues: their decisions
BACKGROUND: Recent changes in the membership of the U.S. Supreme Court have led some state policymakers to consider the possibility that Roe v. Wade could be overturned and regulation of abortion returned to the states. Some state legislatures are considering banning abortion under all or virtually all circumstances; these measures are widely viewed as an attempt to provoke a legal
Thanks to initiatives since 1994, most reproductive health programmes for refugee women now include family planning and safe delivery care. Emergency contraception and post-abortion care for complications of unsafe abortion are recommended, but provision of these services has lagged behind, while services for women who wish to terminate an unwanted pregnancy are almost non-existent. Given conditions in refugee settings, including high levels of sexual violence, unwanted pregnancies are of particular concern. Yet the extent of need for abortion services among refugee women remains undocumented. UNFPA estimates that 25-50% of maternal deaths in refugee settings are due to complications of unsafe abortion. Barriers to providing abortion services may include internal and external political pressure, legal restrictions, or the religious affiliation of service providers. Women too may be pressured to continue pregnancies and are often unable to express their needs or assert their rights. Abortion advocacy efforts should highlight the specific needs of refugee women and encourage provision of services where abortion is legally indicated, especially in cases of rape or incest, and risk to a woman's physical and mental health. Implementation of existing guidelines on reducing the occurrence and consequences of sexual violence in refugee settings is also important. Including refugee women in international campaigns for expanded access to safe abortion is critical in addressing the specific needs of this population. PMID:12369319
Goto, A; Fujiyama-Koriyama, C; Fukao, A; Reich, M R
In this study, recent trends in the incidence of induced abortion are analyzed in order to identify the target population and its requirements for family planning policy in Japan. Abortion statistics from 1975 to 1995 from the Ministry of Health and Welfare are reviewed. The abortion rate (the number of cases of induced abortion per 1,000 women per year) for women younger than 20 increased during the study period. The abortion ratio (number of cases per 1,000 live births) remained the highest among women aged 40-44. An increase in the abortion ratio was seen in the two youngest groups (younger than 20 and 20-24), especially among those who were born after 1955. The proportion of abortions experienced by women younger than 25 increased from 18 percent between 1976 and 1980 to 30 percent between 1991 and 1995, and a slight increase was also observed among women aged 40-44. The proportion of abortions performed after eight weeks of a pregnancy for the two youngest groups remained higher than that for older age groups during 1975-95. The analysis demonstrates that women younger than 25 should be the principal concern of family planning policy in Japan. Further investigations on unintended pregnancy are recommended. PMID:11198067
Almost 2 decades after the Supreme Court's landmark decision in Roe v. Wade, nurses' refusal to assist in abortions is still in question. There are about 1.6 million abortions a year. If Congress passes the Freedom of Choice Act, American women will be guaranteed continued access to abortion. But the effect of new regulations on 2 million nurses is the issue. Title VI of the Civil Rights Act of 1964 protects those who refuse to participate in abortions because of their religious beliefs. Several states have also enacted laws giving the right to health care workers to refuse to participate on ethical grounds. In Florida a staffer at an ambulatory care center was demoted after refusing to assist in an abortion. The appeals court ruled in the nurse's favor, stating that she should have been given a different assignment. Nurses who oppose abortion are advised by attorneys not to accept jobs where they are likely to be expected to assist in them. A New York City nurse refused to assist in an abortion and was reassigned to an administrative position, which she contested. The arbitrator restored her to her original position indicating that if the Freedom of Choice Act is passed it will not eliminate a nurse's right not to assist. In 1988 the so-called gag rule was issued barring caregivers at 4000 federally funded family planning clinics serving nearly 5 million women/year from recommending abortion to patients. PMID:1465543
This publication seeks to explain the many facets of adolescent abortion: teenagers' need for access to safe abortion; the need for confidentiality in order to ensure safety; the real intent and effect of parental involvement laws; and the roles of parents and the state in safeguarding the health of pregnant teenagers. The first section looks at…
Ikeako, LC; Onoh, R; Ezegwui, HU; Ezeonu, PO
Background: Unsafe abortion accounts for a greater proportion of maternal deaths, yet it is often not adequately considered in discussions around reducing maternal mortality. Aim: The aim of this study is to determine the pattern of unsafe abortion and the extent to which unsafe abortion contributes to maternal morbidity and mortality in our setting as well as assess the impact of post-abortion care. Subjects and Methods: A descriptive study of patients who were admitted for complications following induced abortions between January 1, 2001 and December 31, 2008 at the Federal Medical Center, Abakaliki South East of Nigeria with data obtained from case records. Results: Out of the 1,562 gynecogical admissions, a total of 83 patients presented with the complications arising from induced abortion. The age group 20-24 years was mostly affected and adolescents constituted 32.5% (27/83). Nearly 15.7% (13/83) of these patients died while the remaining 84.3% (70/83) had various complications, which were mainly septicemia 59.0% (49/83), anemia 47.0% (39/83), peritonitis 41.0% (34/83), hemorrhages 34.9% (29/83) and uterine perforation 30.1% (25/83). During the study, there were 38 gynecological deaths and abortion related death accounted for 34.2% (13/38) of these gynecological deaths. 84.3% (70/83) of the patients had no documented evidence of counseling on family planning and 59.0% (49/83) were not aware of the different methods of contraception. Conclusion: Unsafe abortion remains one of the most neglected sexual and reproductive health problems in developing countries today despite its significant contribution to maternal mortality and morbidity. Solutions and remedies include prevention of unplanned and unwanted pregnancies by sex education and access to safe and sustainable family planning methods. PMID:24971223
Daniel, Sharon; Koren, Gideon; Lunenfeld, Eitan; Bilenko, Natalya; Ratzon, Ronit; Levy, Amalia
Background: Spontaneous abortion is the most common complication of pregnancy. Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used during pregnancy. Published data are inconsistent regarding the risk of spontaneous abortion following exposure to NSAIDs. Methods: We performed a historical cohort study involving all women who conceived between January 2003 and December 2009 and who were admitted for delivery or spontaneous abortion at Soroka Medical Center, Clalit Health Services, Israel. A computerized database of medication dispensation was linked with 2 computerized databases containing information on births and spontaneous abortions. We constructed time-varying Cox regression models and adjusted for maternal age, diabetes mellitus, hypothyroidism, obesity, hypercoagulation or inflammatory conditions, recurrent miscarriage, in vitro fertilization of the current pregnancy, intrauterine contraceptive device, ethnic background, tobacco use and year of admission. Results: The cohort included 65 457 women who conceived during the study period; of these, 58 949 (90.1%) were admitted for a birth and 6508 (9.9%) for spontaneous abortion. A total of 4495 (6.9%) pregnant women were exposed to NSAIDs during the study period. Exposure to NSAIDs was not an independent risk factor for spontaneous abortion (nonselective cyclooxygenase [COX] inhibitors: adjusted hazard ratio [HR] 1.10, 95% confidence interval [CI] 0.99–1.22; selective COX-2 inhibitors: adjusted HR 1.43, 95% CI 0.79–2.59). There was no increased risk for specific NSAID drugs, except for a significantly increased risk with exposure to indomethacin (adjusted HR 2.8, 95% CI 1.70–4.69). We found no dose–response effect. Interpretation: We found no increased risk of spontaneous abortion following exposure to NSAIDs. Further research is needed to assess the risk following exposure to selective COX-2 inhibitors. PMID:24491470
Granberg, D; Burlison, J
The political opponents of legal abortion achieved considerable gains in the 1980 American elections. A president who was committed to a strong antiabortion position was elected, and antiabortion candidates prevailed in six out of seven Senate races that pitted supporters against opponents of legal abortion and in seven out of nine similar confrontations in the House races. However, it is not clear that abortion was an overriding or decisive factor in determining those outcomes. Democrats and Republicans, Carter voters and Reagan voters did not differ significantly in their attitudes toward abortion. The presidential voter groups were divided on several other issues, and along income and racial lines, to a far greater extent than they were on abortion. Voters were not likely to name abortion as one of the more important problems facing the nation. Carter supporters rated abortion as more important than did Reagan supporters. Although the party platforms and the presidential candidates were clearly differentiated in their abortion stands, these differences were not well communicated to the citizenry. When voters attempted to describe the position of each candidate on abortion, they displayed a great deal of uncertainty, error and confusion. In the key Senate races, those who voted for the prochoice candidates held more liberal abortion attitudes than those who voted for the right-to-life candidates. This difference, although statistically significant, was not great, and was smaller than the differences related to several other issues--such as attitudes toward the role of government, women's rights and economic policies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:6653742
The 1977-78 Alan Guttmacher Institute survey of US abortion providers is analyzed to find out how available abortion services are in the US, and ways are suggested to remedying existing inequities. 8 of 10 US counties were found to have no hospital, clinic, or physician providing any abortions at all in 1977, and in all but 5% of US counties services were not adequate to meet the need. As a result, more than a million women in need of abortion services were unable to obtain them in their own counties, and 506 thousand could not obtain them at all. Services were most conspicuously absent in rural or other sparsely settled counties. Some women who wanted abortions could travel from a county without a provider to one nearby with available services, but some 324 thousand women in need lived in places where there was no provider and no neighboring county with a provider large enough to serve them. The great majority of these counties had hospitals and obstetrician-gynecologists who could have provided abortion services if they had been willing to do so. Restrictive laws as well as inaccessibility played a role in inhibiting abortion service provision. Strategies for improving abortion service options include initiating new clinic services in counties populous enough to support them; organizing part time or satellite clinic facilities, or adding abortion services to outpatient hospital services; organizing referral services, advertising and publicity to inform women of available service options in other counties; and reminding doctors of the position of their professional organizations that abortion should be provided equitably as a basic component of health services. PMID:7364033
Background Induced abortion is a common medical intervention. Whether psychological sequelae might follow induced abortion has long been a subject of concern among researchers and little is known about the relationship between posttraumatic stress disorder (PTSD) and induced abortion. Thus, the aim of the study was to assess the prevalence of PTSD and posttraumatic stress symptoms (PTSS) before and at three and six months after induced abortion, and to describe the characteristics of the women who developed PTSD or PTSS after the abortion. Methods This multi-centre cohort study included six departments of Obstetrics and Gynaecology in Sweden. The study included 1457 women who requested an induced abortion, among whom 742 women responded at the three-month follow-up and 641 women at the six-month follow-up. The Screen Questionnaire-Posttraumatic Stress Disorder (SQ-PTSD) was used for research diagnoses of PTSD and PTSS, and anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Measurements were made at the first visit and at three and six months after the abortion. The 95% confidence intervals for the prevalence of lifetime or ongoing PTSD and PTSS were calculated using the normal approximation. The chi-square test and the Student’s t-test were used to compare data between groups. Results The prevalence of ongoing PTSD and PTSS before the abortion was 4.3% and 23.5%, respectively, concomitant with high levels of anxiety and depression. At three months the corresponding rates were 2.0% and 4.6%, at six months 1.9% and 6.1%, respectively. Dropouts had higher rates of PTSD and PTSS. Fifty-one women developed PTSD or PTSS during the observation period. They were young, less well educated, needed counselling, and had high levels of anxiety and depressive symptoms. During the observation period 57 women had trauma experiences, among whom 11 developed PTSD or PTSS and reported a traumatic experience in relation to the abortion. Conclusion Few women developed PTSD or PTSS after the abortion. The majority did so because of trauma experiences unrelated to the induced abortion. Concomitant symptoms of depression and anxiety call for clinical alertness and support. PMID:24364878
Quan, Zhe-Feng; Tian, Ming; Chi, Ping; Li, Xin; He, Hai-Li
Background and purpose: Dexamethasone is known to produce analgesic effects, but the optimal analgesic dosage of dexamethasone remains unclear, especially in patients without postoperative use of other analgesics. The purpose of this study was to explore the effective analgesic dose of dexamethasone in day surgery patients undergoing painless abortion. Methods: 287 patients undergoing painless abortion were randomly assigned to one of four groups: control group receiving saline and dexamethasone groups receiving 0.1, 0.15, or 0.2 mg/kg dexamethasone. Drugs were intravenously injected 30 min before induction of anesthesia. All patients underwent the same anesthesia procedure using propofol and remifentan. The visual analogue scale (VAS) scores and occurrence of nausea, vomiting and drug-induced side effects were recorded at 1, 2 and 24 h after operation. Results: There were no significant differences in patient’s clinical characteristics, surgical features and frequency of occurrence of nausea and vomiting among the four groups (P > 0.05). The VAS scores at rest and during coughing at 2 h after operation (time of discharge from the hospital) were significantly lower in patients receiving 0.2 mg/kg dexamethasone compared with control patients (P < 0.05). Conclusion: Intravenous injection of 0.2 mg/kg dexamethasone before induction of anesthesia can significantly reduce the VAS scores at 2 h after painless abortion. PMID:25232399
Udry, J R; Kovenock, J; Morris, N M
Most research on abortion has focused on women's characteristics at the time of the procedure, but individuals' behavior may also be shaped by their experiences from younger ages. This study uses longitudinal data on 351 California white women aged 27-30 in 1990-1991 to identify characteristics in childhood and adolescence that predict who will have a nonmarital first pregnancy and, of those who do, which women will seek an abortion. Bivariate analyses reveal that psychosocial characteristics indicating a strong sense of autonomy, such as feeling it is important not to be tied down and engaging in socially undesirable behavior, are significantly associated with the likelihood of having a nonmarital first pregnancy (odds ratios of 1.7 and 1.5, respectively), but family characteristics are not. However, among women who have a first pregnancy out of wedlock, the odds of having an abortion are mostly influenced by family rather than psychological characteristics, particularly having been a good student and having a well-educated mother (2.0 and 1.7). PMID:8827147
Smirnova, G A; Pogorel'tsev, V I; Fa?zrakhmanova, F M
Free radical oxidation processes are a cause of ageing, cancer, cataract, etc. Antioxidants are agents that are able to suppress these processes. They create a system that determines the antioxidant capacity (AOC) of living tissue. The effect of various drugs on this system is of importance. A PDK-1 diagnostic coulonometer, an AOC-measuring device, has been developed by the Polyclinic Research Department, KRC, Russian Academy of Sciences. Medical abortion with mifepriston and misoprostol does not change the blood level of AOC significantly. The maximum baseline value of AOC is observed in repeat pregnancy nulliparas. PMID:19827191
Many universities oppose federal regulations that bar government-supported health clinics from providing information about abortion to their clients. They say the rules place unreasonable constraints on medical facilities, including campus health clinics and teaching hospitals. Federal courts are divided on the issue. (MLW)
Burnhill, Michael S.; And Others
High numbers of repeat abortions at a medical school clinic prompted clinic personnel to develop an experimental fertility control counseling program. Counseling objectives included the following: (1) to engender rapport and trust; (2) to assess the patient's past contraceptive use and psychosocial history; (3) to improve patient's knowledge of…
Yarmohammadi, Hassan; Zargaran, Arman; Vatanpour, Azadeh; Abedini, Ehsan; Adhami, Siamak
Since the dawn of medicine, medical rights and ethics have always been one of mankind's concerns. In any civilisation, attention paid to medical laws and ethics depends on the progress of human values and the advancement of medical science. The history of various civilisations teaches that each had its own views on medical ethics, but most had something in common. Ancient civilisations such as Greece, Rome, or Assyria did not consider the foetus to be alive and therefore to have human rights. In contrast, ancient Persians valued the foetus as a living person equal to others. Accordingly, they brought laws against abortion, even in cases of sexual abuse. Furthermore, abortion was considered to be a murder and punishments were meted out to the mother, father, and the person performing it. PMID:24304111
Grossman, Daniel; Ellertson, Charlotte; Grimes, David A; Walker, Dilys
Routine follow-up visits after abortion are intended to confirm that the abortion is complete and to diagnose and treat complications. Many clinicians also take advantage of the follow-up visit to provide general reproductive health care: discussing contraceptive plans and providing family planning services; diagnosing sexually transmitted infections; performing a Pap test or discussing abnormal Pap results. We reviewed the evidence related to the routine postabortion follow-up visit. Other than mifepristone medical abortion performed at 50 days of gestation or later and methotrexate medical abortion, we found little evidence that mandatory follow-up visits typically detect conditions that women themselves could not be taught to recognize. In addition, the natural history of the most severe complications after abortion-infection and unrecognized ectopic pregnancy-have time courses inconsistent with the usual timing of the follow-up visit. Costs associated with this visit can be great. These include travel expenses, lost wages, child-care expenses, privacy and emotional burdens for women, and scheduling disruptions and the related opportunity costs caused by "no-shows" for the provider. Follow-up appointments should be scheduled for those women likely to benefit from a physical examination. For the remainder of women, simple instructions and advice about detecting complications, possibly coupled with telephone follow-up, might suffice. Although arguably valuable in their own right, counseling, family planning services, or sexually transmitted infection diagnosis and treatment should not be so inflexibly bundled with postabortion care. Protocols that require in-person follow-up after abortion may not make the best use of a women's time or abilities, or of the medical system. PMID:15051567
Abadie, Marc J.; Berndt, Jon S.; Burke, Laura M.; Falck, Robert D.; Gowan, John W., Jr.; Madsen, Jennifer M.
An important element in the design of NASA's Crew Exploration Vehicle (CEV) is the consideration given to crew safety during various ascent phase failure scenarios. To help ensure crew safety during this critical and dynamic flight phase, the CEV requirements specify that an abort capability must be continuously available from lift-off through orbit insertion. To address this requirement, various CEV ascent abort modes are analyzed using 3-DOF (Degree Of Freedom) and 6-DOF simulations. The analysis involves an evaluation of the feasibility and survivability of each abort mode and an assessment of the abort mode coverage using the current baseline vehicle design. Factors such as abort system performance, crew load limits, thermal environments, crew recovery, and vehicle element disposal are investigated to determine if the current vehicle requirements are appropriate and achievable. Sensitivity studies and design trades are also completed so that more informed decisions can be made regarding the vehicle design. An overview of the CEV ascent abort modes is presented along with the driving requirements for abort scenarios. The results of the analysis completed as part of the requirements validation process are then discussed. Finally, the conclusions of the study are presented, and future analysis tasks are recommended.
The Department of Defense is publishing this final rule to revise the definition of ``unlabeled or off-label drug'' to ``off-label use of a drug or device.'' This provision codifies the coverage of those medically necessary indications for which there are demonstrations from medical literature, national organizations, or technology assessment bodies that the off-label use is safe and effective and in accordance with nationally accepted standards of practice in the medical community. Additionally, this rule removes the partial list of examples of unproven drugs, devices, and medical treatments or procedures proscribed in TRICARE regulations. We are removing the partial list from the regulation but will maintain the partial list in the TRICARE Policy Manual at www.tricare.mil. PMID:22737762
Santee, B; Henshaw, S K
Abortion statistics are flawed by the lack of consistency in reporting gestational age. Several methods are generally used, and the number of abortions occurring before 12 weeks changes considerably depending upon the method used to determine gestational age. Pregnancy can be measured from the beginning of last menstruation or from fertilization, which is 14 days after the 1st day of the last menstrual period. Neither method accurately records pregnancy as determined by specialists in embryology and fetal development. Pregnancy actually begins with implantation, which begins 6-7 days after fertilization and ends 10-14 days later. Completion of fertilization and implantation occurs as much as 28 days after the 1st day of the last menstrual period. A report of an 8-week pregnancy is actually 6 weeks from fertilization and 4-5 weeks from implantation. The Centers for Disease Control and other abortion data collecting agencies use the 1st day of the last menstrual period. Statistics generally show that 50% of abortions occur before 8 weeks of gestation and 90% by 12 weeks. When gestation is considered at fertilization, 78% of abortions occur under 9 weeks, while 52% of abortions under 9 weeks are performed with data beginning at the 1st day of the last menstrual period. For abortions occurring under 12 weeks, 95% beginning at fertilization and 90% occur at the 1st day of the last menstrual period. 2/1000 vs. 5/1000 abortions occur under 20 weeks for data beginning at fertilization vs. at the onset of the last period. It is important to report abortion data accurately and to specify the method used to determine the gestational time period. PMID:1526273
Schäfer-Somi, S; Aksoy, O A; Beceriklisoy, H B; Einspanier, A; Hoppen, H O; Aslan, S
The aim of the present study was to investigate the effects of two medications on two subsequent abortions and plasma hormone concentrations of dogs. For this purpose, two groups of bitches (n=5 each), received the antiprogesterone aglepristone (Alizine) at 10mg/kg body weight on two subsequent days around day 30 after mating. In group II, the antiprolactin cabergoline (Galastop) was additionally administered po at 5 microg/kg body weight until the start of abortion. The plasma concentrations of relaxin, progesterone (P4) and estradiol-17beta (E2) were measured before, during and after each abortion. During the next cycle after the abortion, the same bitches were mated again and in pregnant animals, induction of abortion was performed as before. During the third cycle, pregnant bitches were allowed to whelp. Termination of first pregnancy occurred significantly earlier after the combined treatment (6.8 versus 10.6 days, p<0.05). In both groups and during both abortions, relaxin varied between individuals; however, there was a continuous decrease after the abortions and no significant differences between groups (p>0.05). In one bitch with high relaxin concentrations before treatment (11.6 ng/ml), a cystic endometrial hyperplasia was diagnosed. In the aglepristone only group, P4 concentrations increased significantly after the first application (p<0.05), then decreased continuously until day 45 after the beginning of abortion. In the combined group, there was a continuous decrease until day 45 (p>0.05). At this time, P4 concentrations between 0.47 and 84.9 nmol/l were measured in both groups. The level of E2 over time was not influenced by any medication. We therefore note that the two medications mainly influenced plasma concentrations of P4 in different ways, probably due to specific treatment-hormone interactions. However, all measurements fell within the range considered normal. PMID:17719622
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On Avoiding Spare Aborts in Transactional Memory Idit Keidar Dept. of Electrical Engineering a theory for un- derstanding aborts in transactional memory systems (TMs). Existing TMs may abort many transactions that could, in fact, commit without violating correctness. We call such unnecessary aborts spare
Examined feelings of well-being in 217 women who had abortions. Results suggest that, compared to women who have not had abortions, those who choose abortion feel more negatively. Of women choosing abortion, those who are already mothers are most likely to be depressed and lonely, followed by those from lower educational and socioeconomic…
The availability of abortion provides insurance against unwanted pregnancies since abortion is the only birth control method which allows women to avoid an unwanted birth once they are pregnant. Restrictive state abortion policies, which increase the cost of obtaining an abortion, may increase women's incentive to alter their pregnancy avoidance…
Uythoven, J; Bravin, E; Goddard, B; Hemelsoet, GH; Höfle, W; Jacquet, D; Kain, V; Mazzoni, S; Meddahi, M; Valuch, D
To minimise the beam losses at the moment of an LHC beam dump the 3 ?s long abort gap should contain as few particles as possible. Its population can be minimised by abort gap cleaning using the LHC transverse damper system. The LHC Run 1 experience is briefly recalled; changes foreseen for the LHC Run 2 are presented. They include improvements in the observation of the abort gap population and the mechanism to decide if cleaning is required, changes to the hardware of the transverse dampers to reduce the detrimental effect on the luminosity lifetime and proposed changes to the applied cleaning algorithms.
Mortality by abortion has continuously decreased over the past fifty years in Chile. In fact, maternal death as a result of an induced abortion has become an exceptionally rare phenomenon in epidemiological terms (a risk of 1 in 4 million pregnant women of fertile age or 0.4 per 100,000 life births for abortion of any type, excluding ectopic pregnancy). After abortion became illegal in 1989, deaths related to abortion continued to decrease from 10.8 to 0.39 per 100,000 live births. This scientific fact challenges the common notion that less permissive abortion laws lead to greater mortality associated with abortion. PMID:26103709
Motaghi, Zahra; Keramat, Afsaneh; Shariati, Mohammad; Yunesian, Masud
Background About 46 million induced abortions occur in the world annually. The studies have reported 80000 cases of induced abortions in Iran annually. Objectives This qualitative study was conducted to identify the causes of unsafe abortion in Iran from the standpoint of three groups of experts, women with a history of abortion or unwanted pregnancy and service providers. Patients and Methods A total of 72 in-depth semi structured interviews were conducted in 2012 in Tehran and Shahroud. After coordination with 8 experts, sampling from them was done using the Snowballing method in their offices. Sampling from 28 married and 10 engaged women with a history of unwanted pregnancy or unsafe abortion and 12 providers was done in health care centers and a in number of gynecologists’ and midwives’ offices. Sampling from women with a history of unwanted pregnancy or unsafe abortion such as single women, HIV positive women and drug users, and women who had sexual intercourse for money was started by referring to the social rehabilitation center for women and continued using the snowballing method due to difficulties in accessing them. Participants were from different ethnic groups including Fars, Gilaks, Mazandarani, Arab, Azerbaijani, and Lor. Content analysis was performed on collected data. Results Based on the results of the interviews, participants have abortion for following reasons: 1. Wanted pregnancy (sub categories: fetal abnormalities, Concern about fetal health and lack of trust to prenatal diagnostic methods, Fetal sex, Lack of independent and free decision making regarding pregnancy in women, 2. Unwanted pregnancy (sub-categories: Socio-economic factors, Beliefs and feelings, Lack of information about family planning) 3. Predisposing factors (sub-categories: Lack of information on religious aspects of abortion, Easy access to easy abortion methods). Some people, despite having unwanted pregnancy due to social, economic, cultural and family grounds, continued their pregnancy and did not have an abortion for the following reasons: Religious beliefs, Beliefs (fear of punishment in the afterlife and believing in fate) , Attachment to the unborn baby, Influence of the other people’s opinions (physician, mother or spouse) Late diagnosis of pregnancy, Unsuccessful abortion attempts (Self-treatment, Unsuccessful medical abortion), Economic weakness and arbitrary treatment. Conclusions In the present study, women who continued their pregnancy despite being unwanted were also interviewed. Although they had the same social, economic, cultural, and family problems as women with a history of unsafe abortion and had easy access to abortion, analysis showed that the difference in religious beliefs between the two groups was the most important factor that led women to choose two different approaches. The authors believe that in-depth analysis of people’s beliefs and opinions in this regard and correction of false beliefs plays a crucial role in decreasing the rate of unsafe abortion. PMID:24719694
Martin, P A
The decision of the US Supreme Court in Roe vs. Wade called upon a woman's right to privacy to assert a woman's right to a previability abortion in a framework based upon a consideration of the trimester of the pregnancy. A state policy or abortion law would only survive a constitutional challenge if it passed the exacting test of serving a "compelling state interest." The Court's decision in Roe grew out of an analysis which ignored the possibility that women as individuals would be able to arrive at an abortion decision for themselves. Instead, a physician's right to exercise medical judgement and perform a first-trimester abortion upon request was upheld. The decision of the Court in Planned Parenthood of Southeastern Pennsylvania vs. Casey upheld the constitutionality of abortion but allowed states to impose abortion regulations which would only be invalid if they imposed an "undue burden" upon women. In Casey, the Court linked the abortion decision to the concept of liberty embodied in the 14th Amendment. Thus, the abortion decision is seen as solely a woman's rather than a medical decision undertaken only with the guidance of a physician. The Court acknowledged that its ruling in Roe was sound and that there was no compelling reason to overturn it. This allowed the Court to maintain its legitimacy and, thus, its authority and sense of responsibility to the people who had acted in good faith under Roe. The new "undue burden" test was applied to the Pennsylvania statutes, and the real experiences of individual women were called into play to explain why spousal notification would pose an undue burden but the informed consent requirement would not. This test will likely continue to reflect the real experiences of women and reveal the underpinnings of state regulations (such as the "repugnant" view of a woman's status within a marriage forwarded by the proposed spousal consent requirement). Unlike Roe, which resulted in delineation and polarization of the "prochoice" and "prolife" positions in the abortion debate, the "undue burden" test may achieve reconciliation of these views in light of the commonality of women's experience. PMID:8293219
Lie, Mabel LS; Robson, Stephen C; May, Carl R
Background Although abortion or termination of pregnancy (TOP) has become an increasingly normalized component of women's health care over the past forty years, insufficient attention has been paid to women's experiences of surgical or medical methods of TOP. Objective To undertake a narrative review of qualitative studies of women's experiences of TOP and their perspectives on surgical or medical methods. Methods Keyword searches of Medline, CINAHL, ISI, and IBSS databases. Manual searches of other relevant journals and reference lists of primary articles. Results Qualitative studies (n = 18) on women's experiences of abortion were identified. Analysis of the results of studies reviewed revealed three main themes: experiential factors that promote or inhibit the choice to seek TOP; experiences of TOP; and experiential aspects of the environment in which TOP takes place. Conclusion Women's choices about TOP are mainly pragmatic ones that are related to negotiating finite personal and family and emotional resources. Women who are well informed and supported in their choices experience good psychosocial outcomes from TOP. Home TOP using mifepristone appears attractive to women who are concerned about professionals' negative attitudes and lack of privacy in formal healthcare settings but also leads to concerns about management and safety. PMID:18637178
Diniz, Debora; Madeiro, Alberto
This paper analyzes the illegal trade in misoprostol, the medication predominantly used for abortion in Brazil. The study analyzed ten cases that came to the attention of the Public Prosecution Service for the Federal District between 2004 and 2010. The cases were organized into three categories: 1. women's stories; 2. profile of the vendors; 3. maternal mortality cases. The research was reviewed by an ethics committee. The main outcomes were: 1. young women in steady relationships use misoprostol in the home or with the assistance of drug vendors. Of the seven women indicted, three were reported on arrival at the public hospital to finalize abortion; 2. the drug vendors work at the community drugstore and are local agents for the sale of misoprostol. They instruct women on how to use the drug and how to prevent infections, but refuse to provide them with care in case of emergency. Traffickers operate via the internet and have a larger inventory of drugs; 3. there were two cases of maternal mortality due to the combination of high risk methods, such as a vaginal probe and misoprostol. The main causes for maternal mortality are the delay in seeking medical care, as the women fear criminal prosecution, and the combined use of misoprostol with high risk methods. PMID:22872341
Mandel, R; Whay, H R; Nicol, C J; Klement, E
Animals allocate time and effort to a range of core (e.g., sleeping, feeding, drinking) and "luxury" (e.g., playing, exploring) activities. A luxury activity is characterized by low resilience and, as such, will be reduced when time or energy resources are limited, including under conditions of stress or discomfort. One seemingly luxurious activity available to cows on an increasing number of dairy farms is rubbing against an automated brush. The current study examined the effect of distance from food, heat load, and an intrusive medical procedure (i.e., artificial insemination and transrectal pregnancy examination) on the resilience of brush usage. The probability of using the brush decreased significantly when food was located distantly from the brush (mean=0.53) compared with days when food was located closer to the brush (mean=0.81). Brush usage also decreased at high temperature and humidity levels, with an average decrease of 0.062 brushing events for an increase of 1 temperature-humidity index unit (95% confidence interval=-0.93-0.030). In addition, a significant reduction of approximately 50% in brushing activity was observed on days of artificial insemination compared with the preceding 3d and the following 3d. These findings show that brush usage is a low resilience activity that reduces under a range of conditions. It may thus have the potential to be used as an indicator of a range of health and welfare problems in cows. Further research should be conducted to assess the sensitivity and specificity of this suggested tool and its possible contribution to the early detection of morbidity. PMID:23958014
Combs, Michael W; Welch, Susan
Patterns of black and white support for abortion from 1972-80 in the US were examined in order to investigate the significance of race in attitudes toward abortion, analyze the extent to which other factors such as religious practice (religiosity) and demographic characteristics affect these racial differences; and determine what changes, if any, occurred in the salience of race on abortion attitudes during this 9-year period. The General Social Survey (GSS) conducted from 1972-80 were used. These surveys, done annually with the exception of 1979, use national samples of approximately 1500 respondents each year. A modified probability sampling design was used in 1972 through 1974, full probability sampling in 1977-80, and a combination of the 2 in 1975 and 1976. 6 standard questions tapping abortion attitudes were asked in each of these surveys. From these 6 items an additive scale was created, with values ranging from 0, when abortion was opposed in every case, to 6, where approval was given for abortion in each case. This scale was used as a dependent variable in the analyses. There was a great deal of public stability in public attitudes toward abortion. This was particularly the case for the health, rape, and birth defect items, where little change was evident in either race, except for increased black support for abortion when the mother's health is threatened. For the other items, support by blacks appears to have increased during this time, while support by whites dropped slightly. The amount of convergence was not statistically significant. Blacks remained significantly less likely to favor abortion in all 6 instances, they were, by 1978-80, almost equally unlikely to oppose abortion in all cases (9% for whites, 12% for blacks). The mean number of abortion items supported by blacks increased from 3.1 in 1972-74 to 3.3 in 1978-80; white support dropped from 4.0 to 3.9 in 1978-80 (though returning to 4.0 in 1980). Much of the difference in support of abortion, though not all, was due to the different demographic characteristics of blacks and whites, and the greater degree of religiosity of blacks. Most of the factors hypothesized to affect black attitudes appeared to do so: education; income; urban and northern residence; and lesser religiosity where each related to greater support for abortion. There was no direct evidence to support or refute the legitimacy of the "abortion as black genocide" argument, but the fact that opposition to abortion comes from the seemingly more traditional segment of the black community seems to provide some indirect evidence that the argument does not account for the greater black opposition to abortion. PMID:11655604
Bawa, Bhupinder; Bai, Jianfa; Whitehair, Mike; Purvis, Tanya; Debey, Brad M
Nocardia spp. are recognized as a cause of bovine mastitis, cutaneous or subcutaneous abscesses, pneumonia, and disseminated disease. Abortion caused by Nocardia spp. is uncommon, and only a few sporadic cases have been reported in horses, pigs, and cattle. In all previous reports, of nocardial abortion, the causative agent was identified as Nocardia asteroides. The current report describes an aborted bovine fetus that was infected with Nocardia farcinica. Placenta, abomasal fluid, lung, liver, and kidney specimens from a late-term bovine abortion were submitted to the Kansas State Veterinary Diagnostic Laboratory. The gross findings included purulent exudate in the placenta and numerous abscesses in lung. Histologically, there was necrotizing and suppurative placentitis, pyogranulomatous pneumonia, and nephritis with numerous intralesional branching and filamentous, Gram-positive bacteria. Nocardia farcinica was isolated by bacteriology, and the bacteriology result was confirmed by 2 established polymerase chain reaction protocols and by DNA sequencing. PMID:20093696
Lowit, Alison; Bhattacharya, Sohinee; Bhattacharya, Siladitya
Abortion has been legalised in most of the Western world for the past four decades. In areas where abortion practices are legal and easy to access, the risk of short-term complications is very low. As most women requesting induced abortion (IA) are young, potential adverse effects on subsequent reproductive function are important to them. This review investigates obstetric performance following IA and highlights methodological problems associated with research in this area. Some data suggest that IA may be linked with an increased risk of low birth weight, miscarriage and placenta previa but could be protective for pre-eclampsia. Current evidence also suggests an association between IA and pre-term birth. Large prospective cohort studies, which permit meaningful subgroup analyses, are needed to provide definitive answers on outcomes following alternative methods of IA and the impact of gestational age at abortion on future obstetric outcomes. PMID:20362515
A limited number of epidemiological studies have evaluated the potential association between exposure to DBPs in drinking water and adverse reproductive outcomes. Reproductive effects that have been studied include, for example, spontaneous abortions, congenital defects, low birt...
Roberts, Sarah C M; Foster, Diana Greene
The negative health consequences of tobacco use are well documented. Some research finds women receiving abortions are at increased risk of subsequent tobacco use. This literature has methodological problems, most importantly, inappropriate comparison groups. This study uses data from the Turnaway Study, a longitudinal study of women who all sought, but did not all receive, abortions at 30 facilities across the United States. Participants included women presenting just before an abortion facility's gestational age limit who received abortions (Near Limit Abortion Group, n = 452), just after the gestational limit who were denied abortions (Turnaways, n = 231), and who received first trimester abortions (First Trimester Abortion Group, n = 273). This study examined the association between receiving versus being denied an abortion and subsequent tobacco use over 2-years. Trajectories of tobacco use over 2 years were compared using multivariate mixed effects regression. Women receiving abortion maintained their level of tobacco use over 2 years. Women denied abortion initially had lower levels of tobacco use than women receiving abortion, but increased their tobacco use from 1 week through 12-18 months post-abortion seeking and then decreased their use by 2 years post-abortion seeking. Baseline parity modified these associations. Receiving an abortion was not associated with an increase in tobacco use over time. Overall, women who carry unwanted pregnancies to term appear to demonstrate similar cessation and resumption patterns to other pregnant women. PMID:24880251
Stigma taints individuals with a spoiled identity and loss of status or discrimination. This article is the first to examine the stigma attached to abortion and surrogacy and consider how law may stigmatize women for failing to conform to social expectations about maternal roles. Courts should consider evidence of stigma when evaluating laws regulating abortion or surrogacy to determine whether these laws are based on impermissible gender stereotyping. PMID:26242937
Williams-Hayes, Peggy; Bosworth, John T.
This viewgraph presentation is an overview of the Launch Abort System (LAS) for the Constellation Program. The purpose of the paper is to review the planned tests for the LAS. The program will evaluate the performance of the crew escape functions of the Launch Abort System (LAS) specifically: the ability of the LAS to separate from the crew module, to gather flight test data for future design and implementation and to reduce system development risks.
Hisel, L M
This document summarizes a sample of significant activities and events undertaken by Roman Catholics in response to the US Supreme Court's Roe vs. Wade decision legalizing induced abortion. The summaries begin with the 1966 creation of the National Right to Life Committee and cover opposition of Catholic bishops to the Roe decision, the organization of the National Committee for a Human Life Amendment (NCHLA), the mock investiture of a female pope by Catholics for a Free Choice, dismissal of a pro-life priest from the Jesuits, excommunication of various women because of their work with pro-choice agencies or ones that provided abortion services, meetings of the National Conference of Catholic Bishops (NCCB) with presidential candidates, NCHLA lobbying for the Hyde Amendment, open letters and advertisements published by CFC, the effort of Abortion Rights Mobilization to strip the Catholic church of its tax-exempt status, the Vatican order for all priests to leave political office, actions taken by nuns to support the pro-choice position, the proposal of the "seamless garment" argument under the principle of the "consistent ethic of life," initiation of the post-abortion reconciliation project, the actions of Catholic politicians, the filing of amicus curiae briefs, support of bishops for Operation Rescue, forums on abortion conducted by an Archbishop, the Catholic Statement on Pluralism and Abortion, targeting by bishops of pro-choice candidates for sanctions and excommunication, testimony and lobbying in opposition of the Freedom of Choice Act, false accusations about the 1994 International Conference on Population and Development leveled by bishops, lobbying by bishops in support of a ban on late-term abortions, lobbying to increase the access of low-income women to abortion, and consideration by the bishops of reinstituting "meatless Fridays" to express Catholic opposition to "attacks on human life and dignity." PMID:12178893
Hohmann, Sophie A; Lefèvre, Cécile A; Garenne, Michel L
The paper proposes a socioeconomic framework of supply, demand, and regulation to explain the development of sex-selective abortion in several parts of the world. The framework is then applied to three countries of southern Caucasus (Armenia, Azerbaijan, and Georgia) where sex-selective abortion has developed since the collapse of the Soviet Union. The authors argue that sex-selective abortion cannot be explained simply by patriarchal social systems, sex discrimination, or son preference. The emphasis is put on the long-term acceptability of abortion in the region, on acceptability of sex-screening by both the medical establishment and by the population, on newly imported techniques of sex-screening, and on the changing demand for children associated with the major economic and social changes that followed the dismantlement of the Soviet Union. PMID:25349481
Since the Supreme Court's 1973 decision in Roe v. Wade, abortion has occupied a lot of the Court's time and energy. Beyond the legalization of the procedure, the Court has had to wrestle with several related issues, as well. Ranging from parental consent laws to waiting periods, from state-and federal-funding denials to procedural regulations, the Court has ruled on many
In order to determine the attitudes of doctors to abortion in India, a questionnaire was prepared and distrubited to 161 members of the Bombay Obstetric and Gynaecological Society. 94 (58.4%) of the doctors responded to the questionaire; 59.6% of whom were women and 39.4% men. 76.7% had postgraduate qualifications in obstetrics and gynecology. 64.9% of the doctors said that they had at some time carried out an abortion. In the event that the abortion law might be liberalized, 29.8% said that they would conduct abortions and that they would refer their patients elsewhere; 22.3% said that they would do the abortions but that they would not refer their patients elsewhere; 21.3% said that they would not do the operation but that they would refer patients; and 21.3% said that they would neither do the operation nor would they refer patients to others. These findings indicate that if the abortion law were liberalized, there might not be sufficient skilled persons who would be prepared to carry out the operation or even to refer cases to others. PMID:12256844
Harris, Lisa H
It is common to think of scientific research and the knowledge it generates as neutral and value free. Indeed, the scientific method is designed to produce "objective" data. However, there are always values built into science, as historians of science and technology have shown over and over. The relevant question is not how to rid science of values but, instead, to ask which values and whose values belong? Currently, antiabortion values consistently determine US research policy. Abortion research is declared illegitimate in covert and overt ways, at the level of individual researchers and research policy broadly. Most importantly, federal policy impedes conduct of both basic and clinical research in abortion. However, it is not just research in abortion that is deemed "illegitimate;" research in infertility and in vitro fertilization is as well. Federal funding of any reproductive health research agenda that would pose more than minimal risk to a fetus or embryo is banned. This leaves unanswered scientific questions about abortion, infertility, miscarriage and contraception among other areas. Since moral ground is occupied not just by abortion opponents but also by people who support abortion rights, there is at the very least a competing moral claim to consider changing federal research funding policy. Women and families deserve access to knowledge across the spectrum of reproductive health issues, whether they seek to end or start a pregnancy. Thus, research funding is an issue of reproductive justice. PMID:23815965
Penney, G. C.; Glasier, A.; Templeton, A.
OBJECTIVES--To assess and improve the quality of care provided to women undergoing induced abortion. DESIGN--Two rounds of prospective, criterion based case note review audit. SETTING--Ten NHS gynaecology units throughout Scotland. SUBJECTS--2004 patient episodes of abortion care identified consecutively during two rounds of audit. The first round comprised 967 cases and the second round 1037. INTERVENTIONS--Dissemination of results from the first round of audit and recommendations for change in the form of a written report and at postgraduate meetings in participating hospitals. MAIN OUTCOME MEASURES--Improvements in quality of care as assessed against 16 previously agreed criteria, both overall across the 10 study hospitals and within individual hospitals. RESULTS--Overall, four significant improvements occurred: increased availability of early medical abortion, decreased utilisation of surgical abortion at very early gestation, increased use of mifepristone priming before second trimester medical abortion, and increased provision of follow up. At the individual hospital level 42 of 150 elements of care studied were "close to optimal" at the time of the first round of audit, rising to 54 at the second round (NS). A total of 31 significant improvements in individual elements of care occurred, but 11 significant deteriorations also occurred (at the P < 0.05 level). CONCLUSIONS--The prospective multicentre audit proved feasible and achieved the aims of any form of audit in terms of identifying deficiencies and variations in care. The audit results prompted objective review of local abortion services in participating hospitals. At least for some elements of care in some hospitals significant improvements were detectable. PMID:8044060
Korenbrot, C C; Brindis, C; Priddy, F
Abortion rates rose following the expanded legalization of abortion by the Supreme Court decision in Roe v. Wade. As a result, the impact of the restriction on Federal funding of abortions under the Hyde Amendment in 1977 was not clear. However, abortion rates had plateaued by 1985, when State funding of Medicaid abortions was restricted in Colorado, North Carolina, and Pennsylvania. Analysis of statewide data from the three States indicated that following restrictions on State funding of abortions, the proportion of reported pregnancies resulting in births, rather than in abortions, increased in all three States. In 1985, the first year of State restrictions on the use of public funds for abortion, Colorado, North Carolina, and Pennsylvania recorded 1.9 to 2.4 percent increases in the proportion of reported pregnancies resulting in live births, after years of declining rates. With adjustments for underreporting of abortion, there was an overall 1.2 percent rise in the proportion of pregnancies resulting in live births in those States. Nationally the proportion rose only 0.4 percent. By 1987, the three States had experienced increases above 1984 levels of 1.6 to 5.9 percent in the proportion of reported pregnancies resulting in live births. The experiences of the three States can be used in projecting an expected increase in the proportions of reported pregnancies resulting in live births, rather than in abortions, for similar States. A projection for California, for example, showed that an increase could be expected in the first year of restrictions on the use of public funds for abortion of at least 4,000 births, which could be expected largely to affect women of low income. PMID:2124355
Nebot Del Busto, E; Holzer, EB; Zamantzas, C; Kruk, G; Nordt, A; Sapinski, M; Nemcic, M; Orecka, A; Jackson, S; Roderick, C; Skaugen, A
The Beam Loss Monitoring system (BLM) for the LHC consists of about 3600 Ionization Chambers (IC) located around the ring. Its main purpose is to request a beam abort when the measured losses exceed a certain threshold. The BLM detectors integrate the measured signals in 12 different time intervals (running from 40us to 83.8s) enabling for a different set of abort thresholds depending on the duration of the beam loss. Furthermore, 32 energy levels running from 450GeV to 7TeV account for the fact that the energy density of a particle shower increases with the energy of the primary particle, i.e. the beam energy. Thus, a set of ! 3600 × 12 × 32 = 1.3 · 106 thresholds must be handled. These thresholds are highly critical for the safety of the machine and depend to a large part on human judgment, which cannot be replaced by automatic test procedures. The BLM team has defined well established procedures to compute, set and check new BLM thresholds, in order to avoid and/or find non-conformities due to manipulat...
El-Tagy, Ahmed; Sakr, Ezzat; Sokal, David C; Issa, Adel Hakim
This nonrandomized observational clinical study evaluated the safety and acceptability of intrauterine device insertion either immediately or 2 weeks after abortion, according to the patient's preference. Participants were 300 women with first-trimester abortions who agreed to immediate or delayed insertion. End points were bleeding patterns, pregnancy, expulsion, perforation, infection and device removal at 2, 6 and 10 weeks after insertion, and acceptance rates before and after counseling procedures were improved. The overall initial acceptance rate was 35.8%, and the actual acceptance rate was 31.7%. After counseling procedures were improved, the initial and actual acceptance rates increased substantially (17.7% vs. 44.3% and 10.2% vs. 42.0%, respectively). Bleeding, expulsion rates and pain did not differ significantly between the immediate and delayed insertion groups after IUD insertion. No pregnancies, perforations or cases of pelvic inflammatory disease were recorded in either group. Immediate post-abortal insertion offers the advantage of being a painless procedure. The quality of counseling is critical to improving acceptance of post-abortion contraception. PMID:12618259
For a long time in human history, global population growth was checked by infant mortality, which ranged from 30-50% and did not start sinking until the beginning of the 1800s in the west. Child murder in the west was prohibited by law around the 1100-1200s, but it continued secretly. Among private people, induced abortion was allowed. In the holy scripts of Hinduism and Brahminism, abortion was prohibited. Hippocrates wrote that doctors should not give women abortifacient. The church father Augustinus stated that it was not within human power to discern when the soul entered the body, a circumstance that forbid abortion. A church meeting in 305 A.D. distanced itself from abortion, and this has been the stand of the Catholic Church ever since. In Sweden, exposing a child to the elements was practiced until the end of the 1200s, when it became prohibited. Protestants punished child murder by death. During 1759-78, 217 women were executed for child-killing. From the 1400s, church law punished abortion, and later, capital and punishment was meted out for it, but a distinction was made if the fetus was alive or stillborn. The law in 1734 punished abortion by the death of all concerned. The death penalty was abolished in 1864. In 1896, Anna Linholm reported to the policy in Uppsala that a midwife had been practicing clandestine abortions. Some of her patients were admitted to hospital for hemorrhaging. She was sentenced to hard labor. During 1851-1903, a total of 1408 abortions were reported to the health service. 90% of these became known because of death caused by obduction. Phosphorus was used for abortion in 1271 cases, arsenic in 62, and mechanical aids in 8 cases. About 1//2 of all female suicides at the end of the 1800s was performed by pregnant women who ate phosphorus. Almost all were unmarried, and 56% carried it out after the 5th month of pregnancy. In 1901, phosphorus was prohibited in Swedish homes. In 1875, free abortions became available. However, the ethical question about whether and when a fetus has a soul is more contemporary and relevant than ever. PMID:1618684
Mayrhofer, M; Wächter, M; Sachs, G
Two-stage winged space access vehicles consisting of a carrier stage with airbreathing turbo/ram jet engines and a rocket propelled orbital stage which may significantly reduce space transport costs and have additional advantages offer a great potential for mission safety improvements. Formulating the nominal mission and abort scenarios caused by engine malfunctions as an optimal control problem allows full exploitation of safety capabilities. The shaping of the nominal mission has a significant impact on the prospective safety. For this purpose, most relevant mission aborts are considered together with the nominal mission, treating them as an optimization problem of branched trajectories where the branching point is not fixed. The applied procedure yields a safety improved nominal trajectory, showing the feasibility of the included mission aborts with minimum payload penalty. The other mission aborts can be separately treated, with the initial condition given by the state of the nominal trajectory at the time when a failure occurs. A mission abort plan is set up, covering all emergency scenarios. PMID:16480117
Smith, Richard; Marinuzzi, John
The Abort Region Determinator (ARD) is a console program in the space shuttle mission control center. During shuttle ascent, the Flight Dynamics Officer (FDO) uses the ARD to determine the possible abort modes and make abort calls for the crew. The goal of the Rule-based Abort region Determinator (RB/ARD) project was to test the concept of providing an onboard ARD for the shuttle or an automated ARD for the mission control center (MCC). A proof of concept rule-based system was developed on a LMI Lambda computer using PICON, a knowdedge-based system shell. Knowdedge derived from documented flight rules and ARD operation procedures was coded in PICON rules. These rules, in conjunction with modules of conventional code, enable the RB-ARD to carry out key parts of the ARD task. Current capabilities of the RB-ARD include: continuous updating of the available abort mode, recognition of a limited number of main engine faults and recommendation of safing actions. Safing actions recommended by the RB-ARD concern the Space Shuttle Main Engine (SSME) limit shutdown system and powerdown of the SSME Ac buses.
Fluegel Dougherty, Amanda M; Cornish, Todd E; O'Toole, Donal; Boerger-Fields, Amy M; Henderson, Owen L; Mills, Ken W
Brucella abortus RB51 is the vaccine strain currently licensed for immunizing cattle against brucellosis in the United States. Most cattle are vaccinated as heifer calves at 4-12 months of age. Adult cattle may be vaccinated in selected high-risk situations. Two herds of pregnant adult cattle in the brucellosis-endemic area of Wyoming were vaccinated with a standard label dose (1.0-3.4 × 10(10) organisms) of RB51. Reproductive losses in the vaccinated herds were 5.3% (herd A) and 0.6% (herd B) and included abortions, stillbirths, premature calves, and unbred cows (presumed early abortion). Brucella abortus was cultured from multiple tissues of aborted and premature calves (7/9), and from placenta. Isolates were identified as B. abortus strain RB51 by standard strain typing procedures and a species-specific polymerase chain reaction. Bronchopneumonia with intralesional bacteria and placentitis were observed microscopically. There was no evidence of involvement of other infectious or toxic causes of abortion. Producers, veterinarians, and laboratory staff should be alert to the risk of abortion when pregnant cattle are vaccinated with RB51, to potential human exposure, and to the importance of distinguishing field from vaccinal strains of B. abortus. PMID:23942901
Grimes, D A
According to abortion statistics collected by the Centers for Disease Control, between 1.3 and 1.6 million legal abortions were performed in the United States in 1981. The number of abortions performed each year appears to have plateaued. This brief paper summarizes recent trends in the provision of abortion services and describes the demographic characteristics of women who undergo legal abortions in the United States. Women who obtain abortions tend to be young, white, unmarried, and early in their reproductive careers. Most abortions are performed by suction curettage in the first trimester of pregnancy. The majority of women who obtain abortions do so in their state of residence, and non-hospital facilities have emerged as the principal providers of abortion services in the United States. PMID:3875459
We study the collision avoidance between two aircraft flying in the same vertical plane: a host aircraft on a glide path and an intruder aircraft on a horizontal trajectory below that of the host aircraft and heading in the opposite direction. Assuming that the intruder aircraft is uncooperative, the host aircraft executes an optimal abort landing maneuver: it applies maximum thrust setting and maximum angle of attack lifting the flight path over the original path, thereby increasing the timewise minimum distance between the two aircraft and, in this way, avoiding the potential collision. In the presence of weak constraints on the aircraft and/or the environment, the angle of attack must be brought to the maximum value and kept there until the maximin point is reached. On the other hand, in the presence of strong constraints on the aircraft and the environment, desaturation of the angle of attack might have to take place before the maximin point is reached. This thesis includes four parts. In the first part, after an introduction and review of the available literature, we reformulate and solve the one-subarc Chebyshev maximin problem as a two-subarc Bolza-Pontryagin problem in which the avoidance and the recovery maneuvers are treated simultaneously. In the second part, we develop a guidance scheme (gamma guidance) capable of approximating the optimal trajectory in real time. In the third part, we present the algorithms employed to solve the one-subarc and two-subarc problems. In the fourth part, we decompose the two-subarc Bolza-Pontryagin problem into two one-subarc problems: the avoidance problem and the recovery problem, to be solved in sequence; remarkably, for problems where the ratio of total maneuver time to avoidance time is sufficiently large (?5), this simplified procedure predicts accurately the location of the maximin point as well as the maximin distance.