The word abortion comes from the Latin abortus , which in turn is derived from the aboriginal term . This concept was used to refer to the opposite of orior, that is to say, the opposite of being born.
Definition
An abortion is the termination of a pregnancy . It is the death and expulsion of the fetus before five months of pregnancy. After this date, and until 28 weeks of pregnancy it is called immature labor and preterm labor if it is more than 28 weeks. Complete abortion is said when the placenta and membranes are delivered with the fetus . There is placental retention when only the fetus is expelled and uterine remains are said to be present when only part of the product of conception is expelled. Sometimes it is difficult to really distinguish what has been expelled, given the alterations suffered not only by the fetus , but also by the placentaand membranes .
History of abortion
In ancient times, performing abortions was a widespread method of birth control . It was later restricted or banned by most religions, but it was not considered an illegal action until the 19th century . Abortion was prohibited to protect women from surgical interventions that at that time were not without risk; the only situation in which its practice was allowed was when the mother’s life was in danger. Abortion was also sometimes allowed when there were risks to maternal health. During the 20th century, legislation has liberalized the termination of pregnanciesunwanted in various medical, social or particular situations. Abortions by the express will of the mother were first legalized in post-revolutionary Russia in the 1920s ; later they were allowed in Japan and in some countries of Eastern Europe after World War II .
In the late 1960s the decriminalization of abortion spread to many countries. The reasons for these legal changes were of three types:
- The Infanticide and maternal mortality associated with the practice of illegal abortions.
- The world overpopulation .
- The rise of the feminist movement .
By 1980 , 20% of the world’s population lived in countries where the legislation only allowed abortion in situations of risk to the mother’s life.
Another 40% of the world’s population resided in countries where abortion was allowed in certain supposed risks to maternal health, situations of rape or incest , the presence of congenital or genetic alterations in the fetus or in special social situations ( single mothers or with low income).
Another 40% of the world’s population resided in countries where abortion was liberalized with the only conditions of the legal deadlines for its performance.
The justification put forward by feminist groups is:
I decide if I abort or not because it is my body.
It is worth emphasizing that the product of conception is a living being, it does not belong to the body of the mother that houses it.
The practice of abortion in Cuba
The practice of voluntary abortion in Cuba is not illegal. It is an institutionalized health service , so there is a significant number of hospitals and other accredited units for this procedure with duly qualified and trained personnel.
Legal acceptance
Not to abuse, as long as you have a responsible action. The truth is that the right to have high-quality abortion services and to opt for voluntary abortion based on the free right of the woman or the couple to decide on their reproduction , is an achievement of Cuban women in their fight for it. full exercise of equality between the genders achieved since the early 1960s.
This legal acceptance also took into account the need to reduce complications due to the widespread and indiscriminate practice of illegal abortions , highly risky, which was accepted and tolerated in the country, with the result of high maternal mortality and high rates of mutilations. and complications.
Current situation
The voluntary abortions that are made up half of those who were 12 years ago and menstrual regulation decrease significantly, as well as interruptions under 20 years.
It is estimated that around 20 percent of abortions are related to contraceptive failure , and a similar percentage could be prevented by the decision of the partner or the woman if she practices conscious contraception.
Unavoidable practice
The sex education and efforts to promote responsible behavior against the relationships, specifically sex based on mutual respect, understanding and love certainly possible to avoid unwanted pregnancies and untimely ending in abortion. The other way is to have better contraceptive services and a greater variety of contraceptives .
Adequate clinical conditions
Although it is a relatively simple and safe procedure, the truth is that it is a risky procedure, which is done blindly and can have complications even in the best services and the best hands.
Types of abortion
Abortion can be spontaneous or induced. The fetuses expelled with less than 0.5 kg or 20 weeks gestation are considered abortions.
Spontaneous abortion
It is estimated that 25% of all human pregnancies end in miscarriage , and three-quarters of abortions occur in the first three months of pregnancy . Some women have a certain predisposition to having abortions, and with each successive abortion the chances of the pregnancy reaching term decrease. The causes of miscarriage are not exactly known. In half of the cases, there is alteration of the development of the embryo or of the placental tissue , which can be the consequence of disorders of the germ cells themselves or of an alteration of the implantation of the developing ovum .
It can also be the consequence of alterations in the maternal environment. It is known that some serious vitamin deficiencies can cause abortions in experimental animals. Some women who have had repeated abortions suffer from hormonal disturbances . Other miscarriages can result from abnormal maternal conditions, such as acute infectious diseases, systemic diseases such as nephritis , diabetes, or severe trauma . The malformations and uterine tumors can also be the cause; the anxiety extreme and other mental disordersthey can contribute to premature expulsion of the fetus .
The most common symptom of a threatened miscarriage is vaginal bleeding , accompanied or not by intermittent pain . However, a quarter of pregnant women have small blood losses during the early stages of pregnancy, and of these 50% carry the pregnancy to term. Treatment for a situation of risk of miscarriage consists of taking bed rest. In women with multiple abortions, bed rest may be necessary throughout the pregnancy. Treatment with vitamins and hormones can also be effective. Sometimes uterine abnormalities must be surgically corrected if they cause recurrent miscarriages.
In a miscarriage , the contents of the uterus can be expelled in whole or in part; However, sometimes, the dead embryo can remain inside the uterus for weeks or months: this is the so-called delayed abortion . Most physicians recommend surgical excision of any embryonic or placental remains to eliminate the chances of infection or irritation of the uterine lining.
Induced abortion
Induced abortion is the deliberate termination of pregnancy by removing the fetus from the uterine cavity . Depending on the gestation period in which it is performed, one or the other of the following four surgical interventions is used : Suction or aspiration can be performed during the first trimester (up to the twelfth week). Using successive dilators to gain access to the uterine cavity through the cervix (neck of the uterus), a flexible tube connected to a vacuum pump called a cannula is inserted to remove the uterine contents.. It can be done in a period of time ranging from five to ten minutes in outpatients.
A curette (metal spoon-shaped instrument) is then inserted to scrape off any remaining uterine lining. The suction method, introduced in China in 1958, soon replaced the previous method of dilation and curettage (in which the curette is used to remove the fetus). During the first part of the second trimester the termination of pregnancy can be performed by a special curettage-aspiration technique sometimes combined with forceps , called dilation and evacuation (ED). The patient must remain admitted to the hospital since there may be bleeding and discomfort after the intervention.
From the 15th week of gestation, the method used is saline infusions . This technique uses a hypodermic needle or a fine tube to remove a small amount of amniotic fluid from the uterus through the abdominal wall . This liquid is slowly replaced by a 20% concentrated saline solution . Between 24 and 48 hours , uterine contractions begin to occur , which cause the expulsion of the fetus and the patient may leave the hospital a day or two later.
The late – term abortions performed by hysterotomy : it is a surgery greater, similar to caesarean but made through an incision smaller at the bottom of the stomach . As an alternative to these procedures, there is a pill called RU-486 that blocks the hormone progesterone and is effective in the first 50 days of pregnancy. The RU-486 was developed in France and in 1988 its use was legalized.
First trimester abortions are relatively simple and safe when performed under appropriate clinical conditions. The risks of complications increase in parallel with the age of the pregnant woman and consist of infections, lesions of the cervix , uterine perforation and bleeding . There are specific clinical situations in which an induced abortion , even a late one, poses a lower risk to the patient than the termination of the pregnancy.
Risks
The most common are the persistence of ovular remains, the so-called incomplete abortion , with a high incidence of infection , hemorrhagic complications are also frequent and traumatic injuries such as uterine perforations. Sometimes the evolution of these complications can endanger the life of the woman.