Abortion - elective or therapeutic; Elective abortion
Elective or therapeutic abortion is the deliberate termination of a pregnancy.
Causes, incidence, and risk factors
Elective abortions are those initiated by personal choice. Therapeutic abortions are those recommended by the health care provider to protect the mother’s physical or mental health. In the United States, one legal abortion occurs for every four live births.
Early pregnancy symptoms include:
- Breast tenderness
- Breast swelling
- Discoloration of breast areola
- Light-headedness or dizziness
- Missed periods
Signs and tests
A pelvic examination is performed to confirm pregnancy and estimate the weeks of gestation. A serum HCG blood test may be performed to confirm pregnancy. A vaginal or abdominal ultrasound may be used to determine gestational age and location.
Most elective abortions take place between 8 and 12 weeks of gestation. The traditional procedure consists of dilating the cervix and removing the contents of the uterus by suctioning the inner walls of the uterus.
Recently, medications have become available to terminate an early pregnancy (prior to 7 weeks of gestation). These medications include mifepristone, methotrexate, misoprostol, or a combination of these medications. Most women who use medication do so because of a desire to avoid anesthesia and surgery if at all possible.
Side effects of medication may include nausea, vomiting, diarrhea, warmth or chills, headache, more visits to the doctor’s office, prolonged vaginal bleeding, and more aware of cramping than with surgical abortion. With medication, passage of the products of conception most likely will occur at home, but some women may still require surgical evacuation (D and E) to complete the abortion. The success rate has been shown to be around 95%.
Legally performed abortions are relatively safe. Complications rarely occur. A first trimester legal abortion is physically safer for a woman than giving birth.
Excessive loss of blood, uterine perforation and infection, and an incomplete abortion are the most frequent complications. These complications are rare when the procedure is performed by a competent provider in an adequate facility.
Teenagers may not be aware that they are pregnant until the second trimester and could increase the danger to their own lives with second trimester abortions. Infection resulting from the procedure occurs most commonly in women who have a preexisting gonorrheal or chlamydial infection.
Calling your health care provider
Call for an appointment with your health care provider if an unplanned pregnancy occurs and you want information about the choice of elective abortion.
Call your health care provider if an elective or therapeutic abortion has been performed and vaginal bleeding continues beyond what was predicted, or if you continue to have symptoms of pregnancy or severe pain. Excessive bleeding can cause shock. Continued pain or pregnancy symptoms may indicate a possible ectopic or tubal pregnancy.
Call your health care provider if signs of infection develop, including persistent fever, foul odor to vaginal drainage, vaginal drainage that looks like pus, or abdominal pain or tenderness.
Improved methods of contraception can help prevent many unplanned pregnancies. This includes education related to abstinence, or, in the case of chosen sexual activity, contraception education.
Contraceptive methods do not always prevent pregnancy - unplanned pregnancies occur even when couples practice adequate methods of contraception to the best of their abilities.
Sometimes, a woman chooses to terminate a pregnancy that results from a sexual assault, one that endangers her health, or one in which the fetus is abnormal.
by Harutyun Medina, M.D.
All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.