Abortion Influencing Factors apart from Ethical Consideration - Coursework Example

Abortion – influencing factors apart from ethical consideration The issue of abortion often raises ethical dilemmas and problems in moral decision-making in the minds of people. However what often tend to escape our attention is the biological changes that the body undergoes after abortion. In order to take the suitable decision regarding abortion it is important to understand the signs, diagnosis, nursing care, medication, pathophysiology and estimable consequences. This paper takes into account all these aspects in order to give a clear picture about the process involved in abortion and its outcomes. For this purpose the paper review several journal articles and books in order to collect information with respect to these aspects. A clear picture always helps in better evaluation of a situation. Therefore, these obviously lead to better and appropriate decisions with respect to abortion. Introduction The word abortion means the medical termination of the fetus from uterus of woman. As a result of it, the fetus is terminated; precisely the fetus is killed in the woman’s womb and then removed from there. A little flicker of light joy may answer in grim consequences; particularly the woman has the larger liability, as she is the one who has to bear the child in her. A couple should be prepared always before getting into any sexual attachment and should be well aware about the consequences that may come out as an aftermath. Hence, while a conception is not intended- the proper processes of contraception must be followed by either of them. The circumstances of abortion may also take place from the problem of an eventual failure of contraceptive in some cases. Occurrence of ruptured condom during the intercourse, missing the dosage of regular oral pill, or a failure from timely withdrawal etc. can also result in an abortion. Abortion not only takes in the worries of an inconvenient conception, but the after effect and the mental condition of a woman prior to the abortion is extremely important issue. In many cases the physical effects left by an abortion is fatal for a woman, especially in her future planning of a conception. Apart from the ethical issues involved in a decision concerning abortion, there are other aspects like pathophysiology, diagnosis, signs and symptoms, medications, nursing care, medical interventions and measurable outcome, which needs to be considered before such a decision is taken. Pathophysiology The term pathophysiology refers to a mechanical and hormonal transformation in the health system of an individual after an ailment or some other kind of abnormal syndrome. It is generally a temporary phase in a human body. Pregnancy brings several alterations in a woman’s body. The hormones such as estrogen, progesterone start to discharge during the pregnancy at a high level. They are essential, for the sustenance of the child in the mother’s body. The HCG (Human Chorionic Gonadotropin) hormone has a very effective function in the post fertility period in a woman’s body, especially during the initial trimester of the pregnancy. Therefore when the pregnancy is stopped or aborted, a temporary misbalance in the hormonal level retains in a woman’s body. This is a phase of pathophysiology that is temporary, but may create some confusion in the initial stage. According to the pathophysiological conditions, abortion could be categorized in the following manner: threatened abortion, inevitable abortion, missed abortion, spontaneous abortion, habitual or recurrent abortion, incomplete abortion etc. (Alexander, Fawcett & Runciman, 2006, pp. 292-295). The pathophysiological effects of these different abortions vary accordingly and they are often extremely painful for the woman. For instance, the inevitable abortion comprises of the pathophysiological conditions of “vaginal blood loss”, “strong uterine contractions”, “pain”, “dilation of cervix” etc. (Alexander, Fawcett & Runciman, 2006, p.293). On the other hand, a missed abortion refers to the intrauterine death of a fetus, which was not medically or manually taken out. (Alexander, Fawcett & Runciman, 2006, p.294). A spontaneous abortion occurs naturally due to some hormonal problems, uterine abnormality etc. factors. Therefore it would not be wrong to opine that different types of abortion take in distinct conditions of pathophysiology. Diagnosis: The situation of an abortion may arise from many critical health circumstances. Therefore it is necessary to go through a proper and specified diagnosis process from the beginning of the pregnancy. This diagnosis takes in “… a sample of amniotic fluid in early pregnancy. This generally contains enough viable cells derived from the foetus which can be used to set up a tissue culture in which further actively dividing cells are produced.” (Harris, 1975, p. 8) In a critical case of pregnancy a properly organized diagnosis help to determine if an abortion is needed. This diagnostic treatment is made on few particular categories: “i) Chromosome abnormalities in which the diagnosis is based on cytogenetic techniques, ii) X linked disorders in which specific diagnosis is not yet possible, but where the determination of the sex of the foetus is the guide for action, iii) Metabolic disorders, the so called ‘inborn errors of metabolism’, in which the diagnosis depends on assay of a specific enzyme or some other bio chemical characteristic, iv) malfunctions such as anencephaly and spina bifida where the estimation of ά- foetoprotein in amniotic fluid is informative.” (Harris, 1975, p. 11) The determining factors of an abortion may be obtained from the diagnosis based on such diagnostic process. Ultrasound is an effective tool to find out the condition of a fetus in the womb at present. The skeletal malformation, dwarfism, neural tube defects etc. could be easily determined by ultrasound system. (Alexander, Fawcett & Runciman, 2006, p.234). Signs and Symptoms: Different instances of abortion comprise various signs and symptoms in them. As discussed before, there are various categories of abortion. Each of them arise from distinct circumstances, therefore the signs and symptoms to vary from each other. For instance in a case of a missed abortion, vaginal spotting or bleeding or pain in lower abdomen or back at the time of the death of a fetus, losing weight, persistent amenorrhea etc. (Varney, Kriebs & Gegor, 2004, p.609), can be some of the prominent symptoms. In the case of a spontaneous abortion, vaginal bleeding, cervical dilation, uterine cramping, ruptured membranes etc., could be observed (Domino, 2006, p.4). In most of the abortion cases the incidence of bleeding is common. Therefore it can be opined as common symptom in various abortion cases. The recurrence of spontaneous abortions can lead to habitual cases of abortion. Great care should be taken to the women experiencing such difficulties in their pregnancy. Medications: Abortion consists of several methods. At present medically induced abortion is a popular and safe to a certain period of pregnancy. A study reveals the following statistics: “…45% of women of reproductive age in the United States have at least one abortion, and most are done at less than 8 weeks’ gestational age, it is important to evaluate the safety of offering medical abortions in these community settings” (Prine, Lesnewski, Berley & Gold, 2003, pp. 290- 295). Mifepristone and misoprostol are the key drugs that are used in a medically induced abortion. Least difficulties of medical abortion are fitting into the frame of common family practice The medication of an abortion depends on the factor that whether it is infected or non-infected. In the case of an incomplete but non-infected abortion the medications used are depending on the fact if the cervix is closed or opened. If the cervix is closed then “the cervix and vagina should be tightly packed with gauze and ½ cc. pituitrin given every four hours.” (Burgess, n.d., p. 701) If the cervix is found open, then “… the patient should be given an anaesthetic, and the remaining placenta” (Burgess, n.d., p.701) is “gently loosened by the finger and removed with an ovum forcep.” (Burgess, n.d., p.701) The PAS or post abortion syndromes consist generally of temporary psychosomatic disturbances, such as sleeping disorder, depression, nightmares etc. (Kreig, 2007, p.11). These problems should be taken care under the observation and counseling of the psychologists, and medications should be used accordingly. Anti infection drugs should also be used to prevent the infection in a post abortion period, which could cause high fever too. Nursing care: “Risk factors for immediate physical complications from abortion include uterine abnormalities, multiple gestation, cardiovascular disease, renal disease, asthma, epilepsy, diabetes, venereal infection, intoxication or drug use, obesity, and other pre-existing conditions.” (Reardon, 1992, pp. 2-3) - Abortion does not consist of only the medical or surgical procedures in the entire issue. Post abortion care and nursing are two important factors as well. Experienced medical faculties and properly trained nurses should intervene in the entire issue of an abortion, as it is an extremely serious issue in a woman’s life and future. In the United States America the “mortality rates per 1000, 000 abortions area as follows: fewer that 8 weeks, 0.5 %; 11-12 weeks, 2.2; 16-20 weeks, 14 %, and more than 21 weeks, 18 %.” (Gaufberg, 2010) Many of these cases emerge from carelessness of the medical group (doctors and nurses) and sometimes from the negligence of the patients. Most of these abortion mortalities are caused by septicemia. Utter nursing care and medical observation should be provided to any woman in pro and post abortion period. Abortion is intricately related to the internal uterine system of the body, so an infection may later cause grave outcomes. Measurable outcomes: Abortion has certainly many outcomes, whereas some of them are temporary, others are serious and can be permanent. Repetition of abortions can harm the uterine system permanently and hence future chance of conception may be doomed. The temporary damage may comprise of a brief stop in conception. This mostly happens due to the psychological paralysis that the trauma of an abortion brings in a woman. Abortion refers to the annihilation of an unborn fetus from mother’s womb. This method cannot be completely trouble- free or harmless to the woman. In this context, Atrash & Hog (1990) observes: “Anecdotal reports have implicated abortion in causing sterility, menstrual disorders, psychiatric sequelae, and increased premature births, tubal pregnancies, stillbirths, birth defects and spontaneous abortions. Except when an infection complicates induced abortion, there is no evidence of an association of abortion with secondary infertility or ectopic pregnancy. The risk of midtrimester spontaneous abortion, premature delivery and low birthweight is not higher in the subsequent 1st term pregnancy.” (Atrash & Hog, 1990, p.391-405) This is specially in case of the women who undergo dilation and curettage process may get permanent cervical or uterine defect and may result in low weight birth of the future baby. The need for proper medical care is therefore more important as it involves the entire life of the woman, as conventionally motherhood brings completeness in a woman. The risk of abortion could be dire for a woman in other ways too; a tendency to develop a breast cancer in the later part of age is possible as a consequence to an abortion. (Wright & Kartz, 2006, p.3) Conclusion: An instant of light enjoyment may lead to a calamitous penalty; particularly the woman has the larger liability as she bears the child inside her body. All the couples should be at all times aware about the results, before getting into a sexual soiree. In any case of abortion, the outcome on ethical ground is not simple or easy. It is not as smooth as medically well-equipped people of the modern world perceive it often. Neither of the “pro-life activists” nor the “pro-choice activists” can make a sensibly dependable theory on the issue of abortion without dumping other standpoints, which are strongly and widely held. Therefore, if a pregnancy is not planned then the appropriate ways of contraception must be adopted by either of the couple. The need for abortion can also crop up from the problem of an eventual failure in contraceptive measures. The hitch of a ruptured condom, a mistaken omission of a regular dose of oral pill etc., can also appear as the issues of a number of abortions. Consequently it could be clearly marked that in this kind of cases a pregnancy is not likely or deliberate or mostly not reasonable, on mental position or sometimes on societal terms. An abortion is inevitable in these circumstances. Furthermore, the most of vital thing is that, it concerns two lives- that of the mother and the child. As a result, it should not be taken in light terms. The psychological weight of an abortion leaves an everlasting scratch mark on the woman’s psyche that she bears throughout her life. References: Alexander, M., F., Fawcett, J., N. & Phyllis J. Runciman. (2006). Nursing practice: hospital and home: the adult. London: Elsevier Health Sciences. Atrash, H., K. & C. J. Hogue. (Jun. 1990). The effect of pregnancy termination on future reproduction. Baillières Clinical Obstetrics and Gynaecology, 4(2), pp. 391- 405. Retrieved on: July 31, 2010, from: http://www.ncbi.nlm.nih.gov/pubmed/2225607vb Burgess, H., C. (N.D.). Treatment of Abortion. The Canadian Medical Association Journal. Pp. 701-702. Retrieved on: July 31, 2010 from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1707540/pdf/canmedaj00443-0063.pdf Domino, F., J. (2006). Five minute clinical consult. New York: Lippincott Williams & Wilkins. Gaufberg, S., V. (Feb. 2010). Abortion, Complications. Medscape. Retrieved on: July 31, 2010, from : http://emedicine.medscape.com/article/795001- overview (accessed on July 31, 2010) Harris. (1975). Prenatal diagnosis and selective abortion. Harvard University Press. Kreig, S. (2007). Abortion in the United States of America. GRIN Verlag. Kriebs, J., M. & C. L. Gegor. (2004). Varney’s midwifery. Sudbury: Jones & Bartlett Learning. Prine, L., Lesnewski, Berley, N. & M. Gold. (2003). Medical Abortion in Family Practice: A Case Series. American Board of Family Practice. 16, pp. 290- 295. Retrieved on: July 31, 2010 from: http://www.jabfm.org/cgi/content/full/16/4/290 Reardon, D., C. (Sept.1992). Abortion Risk Factors: An Avenue for new Pro- Life/ Pro-Woman Laws. Life and Learning IX. 53(3). Retrieved on: July 31, 2010, from: http://www.uffl.org/vol%209/reardon9.pdf Wright, A., A. & I. T. Kratz. (July. 2006). Roe versus Reality- Abortion and Women’s Health. The New England Journal of Medicine. 355(1). Retrieved on: July 31, 2010 from: http://www.nejm.org/doi/pdf/10.1056/NEJMp068083 Read More