GRSJ224/womenandreprodcution

ABORTIONS: STEP BY STEP

An abortion can be described as a deliberate termination of a pregnancy. Before 1969, abortions were considered a criminal act in Canada.
The initial decriminalization of abortions did not come easy, as the procedure could not be performed unless it was completed in a hospital, and approved by 3 different accredited physicians on a therapeutic abortion committee who all came to a conclusion that it was necessary in order to protect a woman’s health.
January 28th 1988, Canada's Supreme Court revokes Canada's abortion law, joining a small number of countries without a law restricting abortions
Although Canada has come a long way over the past 50 years regarding women’s reproductive rights, there is still quite a long way to go. It was not until 2017 that the most internationally recognized medical abortion method, mifepristone, became available in Canada. Although having been been introduced in the late 1980’s, in countries such as France, and China, Canada proved to be late in providing this alternative option for it’s women.

Before becoming legal and being accepted, access to a safe abortion was scarce for women.
After being denied help of a medical professional, some women who were not in the position to feel the ability to continue their pregnancy would attempt to terminate the fetus by themselves. This can be referred to as a self-induced abortion.
Most of the self-induced abortions would be deemed unsafe for both the mother and the fetus.
Examples of self-induced abortion techniques include: the use of drugs and alcohol during pregnancy, physical exertion aiming towards miscarriage (ie. throwing themselves down the stairs), and the notorious "coat hanger" technique.
In cultures outside of North America, self-induced abortion techniques can differ (ie. In India, it is more common for a women to terminate her pregnancy by lifting heavy weights, or through the consumption of dried henna powder.

Surgical abortions are most commonly performed during the first trimester, usually between 12-14 weeks; however, if necessary the procedure can be completed up to 20 weeks.
The surgical abortion method involves vacuuming of the uterus, to clear it of it's contents, under local and sometimes general anaesthetics.
Less than 1 in 100 women will experience complications after a surgical abortion, making it one of the safest medical operations.
The most common complications include: infection, blood clots in uterus, bleeding in the uterus, or an incomplete abortion.
Recovery varies between patients, however, the woman is normally able to return to her normal life after resting one day following the procedure.

The option to terminate a pregnancy medically is provided to women who are less than 7 weeks pregnant, which is known as a medical abortion.
The two medications used on Canada to terminate pregnancy are methotrexate, and misoprostol.
A medical abortion is completed in two phases: methotrexate is the first of the two medications taken, which causes the initial stop to the pregnancy. Patients are then instructed by the clinic when to take the misoprostol in order to initiate the emptying of the uterus.
Strong cramps, and heavy bleeding is is expected after the second stage of the abortion.
Recovery symptoms tend to mimic a severe period, and may include additional nausea, vomiting, fever, and/or chills.

The motivation behind a woman's decision to have an abortion can vary between women and their cultures.
A woman may feel that she is deviating societal norms if she should have a child at an early age, be a single mother, or not have the means to support a child.
Others may feel that their decision is based more on a personal factor, in that they may not want a child at that point in their life, is a victim of sexual abuse, or feels that her relationship does not provide a strong enough foundation to start a family.
In some cases it may be a situation of a medical judgment for the sake of the mother's life.

It is currently estimated that approximately 1 in 3 Canadian women will have an abortion in her lifetime, most likely performed in during her first trimester. It's important to address the emotional weight that may follow after an abortion.
Post-Abortion Syndrome is considering being linked to a type of Post Traumatic Stress Disorder, seeing as women can have triggers, grief, and go through depression, experience anxiety, or anger towards the situation.
Abortions can be especially traumatic if: the woman is under pressure to chose to have the abortion, the woman has little to no social support, the woman is susceptible to depression and anxiety.

Abortion. (2017). Journal of Midwifery & Women's Health, 62(3), 383. doi:10.1111/jmwh.12634
Costescu, D., Guilbert, E., Bernardin, J., Black, A., Dunn, S., Fitzsimmons, B., . . . Society of Obstetricians and Gynecologists of Canada. (2016). Medical abortion. Journal of Obstetrics and Gynaecology Canada, 38(4), 366-389. doi:10.1016/j.jogc.2016.01.002
Kelly, K. (2014). The spread of 'post abortion syndrome' as social diagnosis. Social Science & Medicine, 102, 18-25. doi:10.1016/j.socscimed.2013.11.030
Richer, K., Canada. Parliamentary Information and Research Service, & Canadian Government EBook Collection. (2008). Abortion in canada: Twenty years after R. v. morgentaler. Ottawa: Parliamentary Information and Research Service.
Sensoy, N., Dogan, N., Sen, K., Aslan, H., & Baser, A. (2015). Unwanted pregnancy and traditional self-induced abortion methods known among women aged 15 to 49. Journal of the Pakistan Medical Association, 65(5), 452-456.
Yonke, Nicole, MD, MPH, & Leeman, Lawrence M., MD, MPH. (2013). First-trimester surgical abortion technique. Obstetrics and Gynecology Clinics, 40(4), 647-670. doi:10.1016/j.ogc.2013.08.006