避孕與流產英文精解-Contr課件

ContraceptionandAbortionContraceptionandAbortionAgendaDiscussHistoryandConsiderationsAssociatedwithMethodsDiscussContraceptionMethodsDiscussAbortionAgendaDiscussHistoryandConsClassExercise:ContraceptionValuesClarificationCompletethehandoutentitled“ContraceptionValuesClarification.Afteryouhavecompletedthehandout,discussyourresponseinsmallgroups.ClassExercise:ContraceptionIntroductionMajorityofU.S.pregnanciesarenotplannedandmostarearesultofnotusingcontraceptionFactorsincreasingmotivationtousecontraception:goodcommunicationwithpartner,lowercost,effectivenessrates,frequencyofintercourse,motivationtoavoidpregnancy,sideeffects,opennessaboutsexualityIntroductionMajorityofU.S.pContraception:HistoryContraceptioninAncientTimesContraceptionintheU.S.:1800sandEarly1900sContraceptionOutsidetheU.S.Contraception:HistoryContraceContraceptioninAncientTimesAncientGreeks:magic,superstition,herbsEgyptians:fumigatingfemalegenitalia,tamponsoakedinherballiquid&honey,insertingamixtureofcrocodilefeces,sourmilk,&honeySouthAfrica:insertvegetableseedpodsAfrica:insertagrassycervicalplugPersia:insertalcoholsoakedspongesGreece:insertemptypomegranatehalvesContraceptioninAncientTimesContraceptionintheU.S.:1800sandEarly1900sConcerninearly1800swastocurbpovertybycontrollingfertility1873Comstocklawsprohibiteddispersinginformationaboutcontraceptives,includingbydoctorsContraceptionintheU.S.:180ContraceptionuseisaffectedbySocialissues–e.g.desiredfamilysizeEconomicissuesKnowledge&misinformationReligionGenderroles&power–insomeareas,menmakethecontraceptivedecisions;forsomeitistheresponsibilityofbothContraceptionuseisaffectedChoosingaMethodofContraceptionFDAApprovalProcessLifestyleIssuesChoosingaMethodofContracepFDAApprovalProcessTheU.S.FoodandDrugAdministration(FDA)mustformallyapprovethemethod10-14yearprocesstodevelopanewcontraceptivedrugDrugcompanysubmitsanewdrugapplicationdemonstratingsafetyinanimaltests&adesiretoconducthumantrialsFDAApprovalProcessTheU.S.FFDAApprovalProcess3phasesPhase1:20-80volunteerstotesteffectivenessPhase2:severalhundredtotesteffectiveness,sideeffects,risksPhase3:hundredstothousandsaretestedforgeneralizationAnimaltrialsareconductedthroughouttheprocessFDAApprovalProcess3phasesClassDiscussion:LifestyleIssuesAssociatedwithContraceptiveThefollowingfactorsseemtobeassociatedwithchoosingacontraceptivemethod:Ownhealth&risksNumberofsexualpartnersFrequencyofintercourseRiskofacquiringaSTIResponsibilitylevelMethodcostAdvantages&disadvantagesofthemethodDiscussinfluenceofeach.ClassDiscussion:LifestyleIsContraceptionMethodsContraceptionMethodsBarrierMethods:CondomsandCaps

PreventspermfromenteringtheuterusBarrierMethods:CondomsTheDiaphragmTheContraceptiveSpongeTheCervicalBarriersBarrierMethods:CondomsandCCondoms1850–latexcondomsavailableintheU.S.$10-$15/dozenNon-expiredcondomisrolledontoanerectpenis(foreskinpulledback),?-inchemptyspaceatthetipWater-basedlubricantsforlatexcondomsCondomgraspedatbasewhenwithdrawingLatexcondomshavelowerratesofslippage&breakage,andofferbetterSTIprotectionCondoms1850–latexcondomsavCondomsIn1994,femalepolyurethane/nonlatexcondomswereavailable$2each7incheslongwith2flexibleringsInnerringsqueezedandinsertedclosetothecervixOuterringliesoutsidethevaginaAdequatelubricationisnecessaryCondomsIn1994,femalepolyureCondomsEffectivenessratesLatexcondoms:85-98%Femalecondoms:79-95%Latex&polyurethaneprotectagainstSTItransmissionLambskincondomsblocksperm,butcontainholeslargeenoughforvirusestopassthroughHeatcandamagecondomsCondomsEffectivenessratesCondomsAdvantages:STIprotectionEncouragesmaleparticipationInexpensiveNoprescriptionnecessaryCanreduceprematureejaculationCanreducepostcoitaldripNomedicalsideeffectsCondomsAdvantages:CondomsDisadvantages:ReducesspontaneityCanreducesensationFemalecondomscanbedifficulttouse,uncomfortable,noisyFemale&malecondomsshouldneverbeusedtogetherPopularinsomecountries,notusedinothersCondomsDisadvantages:TheDiaphragmNotwidelyused,almost0%in2002MadeoflatexorsiliconeManysizesandshapes;afittingbyahealthcareproviderisnecessary$20-$35diaphragm,$13spermicidaljelly/cream,officevisitchargeTheycanlastformanyyearsTheDiaphragmNotwidelyused,Diaphragmscomeinavarietyofdifferentshapesandsizesandmustbefittedbyahealth-careprovider.避孕與流產英文精解Contr課件TheDiaphragmDiaphragmrimiscoveredinspermicidaljelly&atablespoonofjellyisplacedinthedome;itisfoldedinhalfandinsertedintothevaginawiththefrontrimtuckedunderthepubicboneItshouldnotbefelt&shouldcoverthecervixItcanbeinsertedupto6hourspriortointercourseLeftinforatleast6-8hours,nomorethan24Afteruseitiswashedwithsoap&waterTheDiaphragmDiaphragmrimisInstructionsforproperinsertionofadiaphragm.避孕與流產英文精解Contr課件TheDiaphragm84-94%effective,lowerforthosewhohavegivenbirthAdvantages:IncreasesspontaneitySomeSTI&PIDprotectionReducesriskofcervicaldysplasia&cancerDoesnotaffecthormonallevelsRelativelyinexpensiveTheDiaphragm84-94%effective,TheDiaphragmDisadvantages:PhysicianfittingandprescriptionInsertion&removalinvolvestouchingthegenitalsIncreasedriskoftoxicshocksyndromeandurinarytractinfectionPostcoitaldripLowusageoutsidetheU.S.TheDiaphragmDisadvantages:TheContraceptiveSpongeTheTodaycontraceptivespongewastakenoffthemarketforadecadeduetoissueswiththemanufacturingplant;reintroducedin2005AvailableoverthecounterinonesizeThespongecoversthecervix&containsspermicide;itblocks,absorbs,&deactivatesspermOneboxof3spongesis$13TheContraceptiveSpongeTheToTheTodaycontraceptivespongewasbackonthemarketinlate2005intheUnitedStates.避孕與流產英文精解Contr課件TheDiaphragmSpongeismoistenedwithwatertoactivatethespermicide,foldedinhalf,&insertedtocoverthecervixCanbeinsertedupto24hoursinadvance,withintercourseoccurringasmanytimesasdesirableinthattimeperiodMustbeleftinatleast6hoursafterintercourse75-89%effectivenessratesTheDiaphragmSpongeismoistenInstructionsforproperinsertionofacontraceptivesponge.避孕與流產英文精解Contr課件TheDiaphragmAdvantages:NoprescriptionnecessaryCanhaveintercourseseveraltimeswithin24hoursIncreasesexualspontaneityDonotaffecthormonallevelsDisposableTheDiaphragmAdvantages:TheDiaphragmDisadvantages:Increasedriskoftoxicshocksyndrome&urinarytractinfectionCannotbeusedwhilemenstruatingRequirestouchingofthegenitalsHighexpenseiffrequentlyusedSomemencanfeelitLowusageratesinotherculturesTheDiaphragmDisadvantages:TheCervicalBarriersThimble-shaped,siliconebarriersthatfitoverthecervixBlockentrancetotheuterus&deactivatespermwiththespermicideFittingbyahealthcareproviderisnecessaryTwotypes:FemCapLea’sShieldTheCervicalBarriersThimble-sTheFemCapisasiliconecupshapedlikeasailor’shatthatfitssecurelyoverthecervix.避孕與流產英文精解Contr課件Lea’sShieldisasiliconecupwithaone-wayvalveandaloopforeasierremoval.避孕與流產英文精解Contr課件TheCervicalBarriers$15-75pluscostofspermicideLeftinplacefor8hoursafterintercourseAfteruse,itiswashedwithsoap&waterNottobeusedduringmenstruation86%effectivenessrate,lowerforthosewhohavehadchildrenTheCervicalBarriers$15-75plTheCervicalBarriersAdvantages:Leftinplaceforupto48hoursDonotaffecthormonallevelsImmediatelyeffectiveNotpermanentOne-wayreleasevalveinLea’sShieldreducesriskoftoxicshocksyndromeTheCervicalBarriersAdvantageTheCervicalBarriersDisadvantages:AbnormalPapsmearsIncreasedriskofurinarytractinfectionsIncreasedvaginalodorsCervicaldamageIncreasedpostcoitaldripFittingisnecessarySomemalepartnersfeelit&maydislodgeitTheCervicalBarriersDisadvantTheCervicalBarriersWidelyusedinEnglandLea’sShieldisavailableoverthecounterinGermany,Austria,Switzerland,&CanadaTheCervicalBarriersWidelyusHormonalMethodsforWomen:ThePill,thePatch,andMoreChanginghormonallevelscandeterproductionofova,fertilization,andimplantationHormonalMethodsforWomen:ThHormonalMethodsforWomen:ThePill,thePatch,andMoreCombined-HormoneMethodsBirthControlPillsHormonalRingHormonalPatchProgestin-OnlyMethodsSubdermalImplantsHormonalInjectiblesHormonalMethodsforWomen:ThCombined-HormoneMethodsCombinationofestrogen&progesteroneCanrepressovulationandthickencervicalmucusCombined-HormoneMethodsCombinBirthControlPillsFederallyapprovedin1960MostpopularcontraceptiveintheU.S.andaroundtheworldMoststudiedtypeofmedicationCombinationbirthcontrolpillsare$12-25permonthDesignedtomimicamenstrualcycle,with21daysofhormonesandoneoffweekBleedingismedicallyinducedBirthControlPillsFederallyaBirthControlPillsSometake2to3packsofactivepillsinarowtoreducethenumberofmenstrualperiodsSeasonale–84-dayactivepillwith7-dayplaceboReducingperiodscanhelpthosewithheavybleedingandcramping60%ofwomenprefertonothaveaperiodBirthControlPillsSometake2BirthControlPillsIncreaseinestrogen&progesteronepreventthepituitaryfromsendinghormonestoripentheovariesCervicalmucusthickens&endometriumbuildupisminimalThebodyistrickedintothinkingitispregnantMayexperienceothersignsofpregnancythatusuallydisappearwithinafewmonthsBirthControlPillsIncreaseinBirthControlPillsInitiallyprescribedalow-doseestrogenpill;increasedifbreakthroughbleedingoccursMonophasicpillscontainthesamedoseofhormonesineachpillMultiphasicpillsvaryinhormoneamountTriphasilpillshave3sets,eachweekthehormonaldosageincreases92-99.7%effectiveNeedtotakeiteachdayatthesametimeBirthControlPillsInitiallypBirthControlPillsAdvantages:HigheffectivenessrateDoesn’tinterferewithspontaneityReducedmenstrualflow,cramps,&PMSIncreasedmenstrualregularityReducedriskofovariancysts,uterine&breastfibroids,facialacne,ovarian&endometrialcancers,PID,benignbreastdiseaseBirthControlPillsAdvantages:BirthControlPillsDisadvantages:NoSTIprotectionFemale’sresponsibility;takendailyCanbeexpensiveLowereffectivenessifoverweightNotappropriateforsmokersUsedthroughouttheworld,althoughnotpopulareverywhere;someplaceshaveitoverthecounterBirthControlPillsDisadvantagHormonalRingNuvaRingintroducedin2003Plasticringinsertedintothevaginaonceamonthfor3weeks,removedfor1weekAffectsthebodyascombinationpillsdoBodyheat&moistureactivateaconstantdoseofestrogen&progesterone;lowerdosethanpills$30-35permonth99.7%effectiveHormonalRingNuvaRingintroducTheNuvaRingisinserteddeepintothevagina;moistureandheatcauseittotime-releasehormonesthatinhibitovulation.避孕與流產英文精解Contr課件HormonalRingAdvantages:HigheffectivenessDoesn’tinterferewithspontaneityReducesmenstrualflow,cramps,PMSIncreasesmenstrualregularityProtectionfromovarian&endometrialcancerandovariancystsFertilityrestoreduponremovalHormonalRingAdvantages:HormonalRingDisadvantages:ComfortabletouchinggenitalsNoSTIprotectionSideeffectsthattypicallydisappearwithregularuse:breakthroughbleeding,weightchange,breasttenderness,nausea,moodchanges,changesinsexualdesire,increasedvaginalirritation&dischargeNodataoncross-culturaluseHormonalRingDisadvantages:HormonalPatchOrthoEvrapatchisathin,peachcoloredstickerattachedtotheskinwithtime-releasedhormonesPlacedonbuttock,stomach,oruppertorsofor3weeks,nopatchforthe4thweekAffectsthebodyascombinationpillsdo$30-35permonth99.7%effective,lowerifweighmorethan198poundsHormonalPatchOrthoEvrapatchTheOrthoEvrapatchiswornonthebuttock,abdomen,oruppertorsoforthreeweekseachmonth.避孕與流產英文精解Contr課件HormonalPatchAdvantages:HigheffectivenessDoesn’tinterferewithspontaneityReducesmenstrualflow,cramps,PMSIncreasesmenstrualregularityProtectionfromovarian&endometrialcancerandovariancystsHormonalPatchAdvantages:HormonalPatchDisadvantages:NoSTIprotectionSideeffectssimilartohormonalringSkinirritationChangeinvision,discomforttocontactwearersCollectslintNearlyimpossibletoconcealfrompartnerNodataoncross-culturaluseHormonalPatchDisadvantages:Progestin-OnlyMethodsDonotcontainestrogenandcanbeusedbywomenthatcannottakeestrogen,suchasthosewhoarebreastfeeding&smokersOvertime,mayeliminateperiodsMaycauseslightweightgain,bloatedness,&breasttendernessProgestin-OnlyMethodsDonotcProgestin-OnlyMethodsMinipill/POPs(progestin-onlypills)InhibitovulationandthickenmucusFewersideeffectsthancombinationpills92-99.7%effectiveMoreexpensivethancombinationpillsCancauseirregularbleedingHigherrateofectopicpregnanciesifgetpregnantwhiletakingtheminipillProgestin-OnlyMethodsMinipillSubdermalImplantsConstantdoseofprogestinistimereleasedforupto5yearsNorplantisnolongeravailableJadelleisFDAapprovedbutnotmarketedintheU.S.2siliconecylindersimplantedintheforearmina10minuteprocedure;$500+Implanonisasingle-rodapprovedin2004FertilityrestoreduponremovalSubdermalImplantsConstantdosSubdermalImplantsSuppressesovulation,thickenscervicalmucus,unreceptiveendometrium99.95%effective,decreasesafterthe3rdyearLowereffectivenessratesifover154poundsAdvantages:Effective,long-lasting,reversibleSimpleimplantationprocedureNoestrogensideeffectsDecreasedmenstrualflow,crampingSubdermalImplantsSuppressesoSubdermalImplantsDisadvantages:Expensiveimplantationfees,armpain,painfulremoval,possiblescarringIrregularbleeding,crampingHeadaches,nausea,dizziness,weightchange,rash,acne,hairgrowthorlossVisionproblemsPopularinSouthAfricaSubdermalImplantsDisadvantageHormonalInjectiblesDepo-medroxyprogesteroneacetate(Depo-Provera)–syntheticprogesteroneMostpopularnon-oralcontraceptiveInjectedintothearmorbuttockmuscleevery3months$30-125perinjectionWorkswithin24hoursFertilityresumes10monthsafterlastinjectionHormonalInjectiblesDepo-medroHormonalInjectibles97-99.7%effectiveAdvantages:LonglastinginjectionModeratelyexpensiveNoestrogenDecreasedmenstrualflow&crampingDecreasedriskofendometrial&ovariancancersAllowsforspontaneityHormonalInjectibles97-99.7%eHormonalInjectiblesDisadvantages:Officevisitsevery3monthsIrregularbleedingFatigue,dizziness,weakness,headachesAppetiteincreasesDecreaseinbonedensityRiskofliver,cervical,andbreastcancersLongreturntofertilityLowusageratesinmanycountriesHormonalInjectiblesDisadvantaChemicalMethodsforWomen:SpermicidesSpermicidescomeasfoams,gels,suppositories,creams,foamingtablets,films,andcapsulesInsertedintovaginawithapplicatororfinger10-30minutespriortointercourse$5-10overthecounterCanalsohelpreduceSTIsLikelytoseemicrobicidesintroducedthatwillprotectfromHIV&otherSTIsChemicalMethodsforWomen:SpChemicalMethodsforWomen:Spermicides71-82%effectiveEffectivenessisreducediftamponsordouchesareusedwithin6-8hoursFoamismoreeffectivethanothervarietiesAdvantages:OverthecounterProvidelubricationSomeprotectionfromSTIsNoserioussideeffectsChemicalMethodsforWomen:SpChemicalMethodsforWomen:SpermicidesDisadvantages:UsedeachtimeIncreasedpostcoitaldripMayproduceallergicreactions,skinirritationsIncreasedriskofurinarytractinfectionsUnpleasanttasteWidelyusedinsomecountries,andnotusedmuchinothercountriesChemicalMethodsforWomen:SpIntrauterineMethodsforWomen:IUDsandIUSsIntrauterineDevice(IUD)ParaGardCopperT–canbeleftinfor12yearsIntrauterineSystem(IUS)Mirena–IUDthatcontainstime-releasedprogestin;canbeleftinfor5yearsMostIUD&IUSusersare35orolder$150-300plusofficevisitIntrauterineMethodsforWomenIntrauterineMethodsforWomen:IUDsandIUSsIUDs&IUSscreateaslightinfectionintheuterusthatobstructsspermmobilityProgesteronefromtheIUSalsoaffectstheendometrium,hamperingimplantationHealthcareprovidersinserttheIUDEachmonththewomanmustcheckforthestringtoassureitisstillinplace99.2-99.9%effective,lowerifneverpregnantIntrauterineMethodsforWomenInsertionofanIUD.避孕與流產英文精解Contr課件IntrauterineMethodsforWomen:IUDsandIUSsAdvantages:LeastexpensivemethodovertimeAllowsforspontaneityDecreasesmenstrualflow(Mirena)LonglastingeffectsIntrauterineMethodsforWomenIntrauterineMethodsforWomen:IUDsandIUSsDisadvantages:NoSTIprotectionRiskofuterineperforationandPIDIrregularbleedingPainfulinsertion&removalIncreasedmenstrualflowandcrampingMaybeexpelledfromuterusMaycausediscomforttothepartnerWidelyusedthroughmostoftheworldIntrauterineMethodsforWomenNaturalMethodsforWomenandMenNaturalFamilyPlanningandFertilityAwarenessWithdrawalAbstinenceNaturalMethodsforWomenandNaturalFamilyPlanningandFertilityAwarenessInvolvesawomanchartinghermenstrualperiodsanddeterminingovulationbydailymonitoringofbasalbodytemperatureandcheckingcervicalmucusBodytemperaturerises0.4-0.8°Fbeforeovulation&remainselevateduntilmenstruationCervicalmucusisthin,stretchyduringovulationNaturalFamilyPlanningandFeNaturalFamilyPlanningandFertilityAwarenessAbstinenceispracticedduringovulationOraformofbirthcontrolisusedduringovulation(fertilityawareness)MostlyusedbywomenspacingpregnanciesthatarenotasconcernedaboutpreventionOvulationkitscanalsobeused75-99%effectiveNaturalFamilyPlanningandFeNaturalFamilyPlanningandFertilityAwarenessAdvantages:UsefulifothermethodsarenotacceptableforreligiousreasonsInexpensiveEducatesaboutthemenstrualcycleEncouragespartnercommunicationNosideeffectsNaturalFamilyPlanningandFeNaturalFamilyPlanningandFertilityAwarenessDisadvantages:NoSTIprotectionRestrictsspontaneityLoweffectivenessTakestime&commitmentSeveralcyclesneedtoberecordedbeforeitisreliableWidelyusedinmanycountries,particularlyCatholiccountriesNaturalFamilyPlanningandFeWithdrawalAlsocalledcoitusinterruptusJustbeforeejaculation,themalewithdrawshispenisandejaculatesoutsideofthewoman73-96%effectiveSpermmayremaininurethrafrompreviousejaculations&impregnatewithoutthemaleejaculatinginsideofthewomanWithdrawalAlsocalledcoitusiWithdrawalAdvantages:UsefulifothermethodsarenotacceptableforreligiousreasonsNocostsGoodifcouplesaren’tconcernedaboutpreventionWithdrawalAdvantages:WithdrawalDisadvantages:NoSTIprotectionLoweffectivenessMayleadtoprematureejaculationMaybestressfulRequirestrust&restraintWidelyusedinmanycountriesWithdrawalDisadvantages:AbstinenceRefrainingfromsexualintercourse100%effectiveProtectsagainstSTIsAbstinenceRefrainingfromsexuPermanent(Surgical)MethodsAwomanmaybefertileuntil50-51yearsAmanmaybefertilemostofhislifeSterilizationinoneofthesafest&mosteffectivecontraceptivemethodsSurgerythatistypicallyirreversibleTwotypes:FemaleSterilizationMaleSterilizationPermanent(Surgical)MethodsAFemaleSterilizationAlsocalledtubalsterilizationorgetting“tubestied”AsmallincisionismadeunderthenavelorlowerintheabdomenBothFallopiantubesareblockedthroughcauterization,rings,bands,clips,plugs,orclamps,orthetubesmaybecutThisprocedureusesgeneralanesthesiaasoutpatientsurgeryorafterchildbirthFemaleSterilizationAlsocalleEssureisapermanentmethodofcontraception.避孕與流產英文精解Contr課件FemaleSterilizationAwomanstillovulates,buttheeggcan’tentertheuterus$2000-5000Risks:anesthesiasideeffects,bleeding,infection,injurytootherorgansReducesriskofovariancancerMostwidelyusedbirthcontrolmethodintheworldFemaleSterilizationAwomanstMaleSterilizationAvasectomyimpedesthetravelofspermthroughthevasdeferensCheaper,safer,&simplerthantubalsterilizationTwo?to?inchincisionsaremadeinthescrotumandthevasdeferensissnipped,clipped,orcauterizedunderlocalanesthesia20minuteprocedureThemanejaculatessemenwithoutspermMaleSterilizationAvasectomyInavasectomy,eachvasdeferensisclipped,cut,orcauterized.Avasclipusesaflexibleplasticcliptoblockthevasdeferens.避孕與流產英文精解Contr課件MaleSterilizationAftersurgery,spermfor20moreejaculationsremainsSpermcountsarechecked2-3monthslatertochecksterility$300-750Risks:swelling,bruising,internalbleeding,infection99-99.9%effectiveMaleSterilizationAftersurgerPermanent(Surgical)MethodsAdvantages:HigheffectivenessPermanentAllowsforspontaneityDisadvantages:Expensive,irreversiblesurgeryNoSTIprotectionWidelyusedthroughouttheworldPermanent(Surgical)MethodsAdAbortionTheAbortionDebateWhyDoWomenHaveAbortions?AbortionProceduresReactionstoAbortionTeensandAbortionCross-CulturalAspectsofAbortionAbortionTheAbortionDebateClassExercise:AbortionAfertilizedeggisahumanbeingfromthemomentthespermandeggunite.Therightsofthefetusalwaystakeprecedenceovertherightsofthemother.Parentalconsentshouldberequiredforteenagersseekingabortion.Spousalconsentshouldberequiredformarriedwomenseekingabortion.Isupportawoman’srighttochooseinanyandallcircumstances.Isupportawoman’srighttochooseifthepregnancyresultedfromarape.Isupportawoman’srighttochooseifthepregnancyresultedfromcontraceptivefailure.ClassExercise:AbortionAfertExercise(cont.)Ibelieveabortionisjustifiedifthewomanfeelsthatsheisnotreadyforthischild.Ibelieveabortionisjustifiedifaseriousbirthdefecthasbeendetectedviaamniocentesis.Ibelieveabortionisjustifiedifthecouplealreadyhas5childrenandthewomanunexpectedlybecomespregnantagain.Ibelieveabortionisjustifiedifparentsoftwoboysdiscovertheyarepregnantagainwithathirdboy,andtheywerereallyhopingforagirl.Ibelieveabortionshouldbelegal.Thereshouldbeamandatory24-hourwaitingperiodforallwomenseekinganabortion.Adoptioncouldsolvetheproblemof“unwantedchildren.”Exercise(cont.)IbelieveaborTheAbortionDebatePro-LifeversusPro-ChoiceHistoricalPerspectivesLegalversusIllegalAbortionsTheAbortionDebatePro-LifevePro-LifeversusPro-ChoicePro-lifesupporters:anembryoatanystageofdevelopmentisapersonandabortingafetusismurderPro-choicesupporters:itisawoman’schoiceandthegovernmentshouldnotcontrolherbodyNogenderdifferencesinabortionattitudesPro-LifeversusPro-ChoicePro-HistoricalPerspectives

AbortionhasbeenpracticedthroughouttimeinmanysocietiesReligionhasdeterminedattitudesformostofwesternhistoryIn1965,allU.S.statesbannedabortionwithsomeexceptionsIllegal(back-alley)abortionswereoftenperformedinunsanitaryconditionsandproducedmanycomplications,evendeathHistoricalPerspectives

AbortiHistoricalPerspectives

In1973,Roev.Wadeprotectedawoman’srighttohaveanabortioninthe1sttrimester2ndtrimesterabortionsregulatedbystates3rdtrimesterabortionscanbelimitedorbannedbystates,unlessawomanisatriskIn1992,theSupremeCourtgavestatestherighttorestrictabortionsthroughwaitingperiods,mandatorycounseling,parentalconsent,publicfundinglimitationsHistoricalPerspectives

In197HistoricalPerspectives

In1994,SupremeCourtbarredanti-abortiondemonstratorsfromgettingwithin36feetofanabortionclinicLouisianahasthemostrestrictionsNewYork,California,&WashingtonstatehavebeenmostprotectiveoftheirabortionlawsHistoricalPerspectives

In199LegalversusIllegalAbortionsSincelegalizationin1973,deathsfromabortiondecreasedsignificantlyLegalversusIllegalAbortionsWhyDoWomenHaveAbortions?BabywouldinterferewithlifegoalsLackfinancialresourcesPoorrelationshipwiththefatherDon'twantotherstoknowtheyhadsexPartnerand/orfamilypressureFetaldeformityorrisktomother’shealthRape54%ofwomenwhohadanabortionusedcontraceptionwhentheybecamepregnantWhyDoWomenHaveAbortions?BaAbortionProceduresOneofthemostcommonsurgicalproceduresintheU.S.;mostperformedinabortionclinicsSurgeryinvolvesrisksMostseriousrisksareuterineperforation,hemorrhaging,cervicallaceration,infection,complicationswithanesthesia,deathRisksincreasewiththeuseofgeneralanesthesiaandthefurtheralongthepregnancyisAbortionProceduresOneoftheAbortionProceduresFirst-trimesterSurgicalAbortionSecond-trimesterSurgicalAbortionMedicalAbortionMifepristone(RU-486)MethotrexateAbortionProceduresFirst-trimeFirst-TrimesterSurgicalAbortionVacuumaspiration–before14weeksgestationUsuallyanoutpatientsurgerywithlocalanesthesia88%ofabortionsWomanliesonexaminingtable,feetinstirrupsSpeculumisplacedinthevagina,cervixisanesthetized,&dilationrodsopenthecervixFirst-TrimesterSurgicalAbortFirst-TrimesterSurgicalAbortionAcannulathatisattachedtoavacuumaspiratorisputintothecervix,thecontentoftheuterusisemptiedTakes4-6minutes,withafewhourstayafterAftersheneedstorest,bleedingandcrampingislikelyRisks:excessivebleeding,infection,uterineperforationFirst-TrimesterSurgicalAbortSecond-TrimesterSurgicalAbortionBetween14-21weeks11%ofabortionsReasonsforalateabortion:medicalcomplications,fetaldeformity,divorce/maritalproblems,miscalculationofduedate,financialorgeographicproblemsSecond-Trimest