M1P4.pdf

1/9/24, 2:49 AM Realizeit for Student Abortion Abortion sits at the intersection of issues such as public health, human rights, reproductive justice, and bodily autonomy. It has remained controversial for decades. Abortion is defined as the expulsion of an embryo or fetus before it is viable (Webs...

1/9/24, 2:49 AM Realizeit for Student Abortion Abortion sits at the intersection of issues such as public health, human rights, reproductive justice, and bodily autonomy. It has remained controversial for decades. Abortion is defined as the expulsion of an embryo or fetus before it is viable (Webster et al., 2018). The practice of abortion is legal in the United States. Abortion can be a medical or surgical procedure. The purpose of abortion is to terminate a pregnancy. One in four women will end a pregnancy by abortion at some time in their reproductive lives. Globally, more than one fifth of all known pregnancies end in abortion (McBride & Keys, 2018). Both medical and surgical abortions are safe and legally protected in the United States; an abortion is considered a woman’s constitutional right based on the fundamental right to privacy. Of abortions, 89% occur in the first 12 weeks of pregnancy (Guttmacher Institute, 2019b). Since the landmark U.S. Supreme Court decision Roe v. Wade protected a woman’s right to abortion in 1973, debate has continued over how and when abortions are provided. Every state has laws regulating some aspects of abortion, and many have passed restrictions such as parental consent or notification requirements, mandated counseling and waiting periods, and limits on funding for abortion. Each state addresses these matters independently, and the laws that are passed or enforced are legislative decisions and a function of the political system. Although opponents of abortion continue to be a part of the current debates, recently they have refocused their attention on “regulation legislation” among the states to reduce the number of abortions not medically necessary (McBride & Keys, 2018). Surgical Abortion Two types of surgical abortion are available: vacuum aspiration or dilation and evacuation (D&C). Method selection is based on gestational age. It is an ambulatory procedure done under local anesthesia. The cervix is dilated prior to surgery and then the products of conception are removed by suction evacuation. The uterus may gently be scraped by curettage to make sure that it is empty. The entire procedure lasts about 10 minutes. The overall risk of complications is less than 1% for surgical termination (Magowan et al., 2019). The major risks and complications in the first trimester are infection, retained tissue or hemorrhage, uterine perforation, retained products of conception, or cervical tear (Webster et al., 2018). For women whose blood is Rh-negative, RhoGAM is indicated prior to the start of either medical or surgical termination. Medical Abortion Medical abortions are achieved through administration of medication either vaginally or orally. The administration of medication occurs in the clinic or doctor’s office, may require more than one office visit, and costs between $500 and $800 (Planned Parenthood, 2020b). The most common regimen in the United States involves the use of two different medications, mifepristone and misoprostol. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=lqf9HhURQ5RqpgqAkzH2zUraqIasLrohurDGqXpGq6QB9gdqiPJLc88OmWKG9Kloy4LbjaH… 1/2 1/9/24, 2:49 AM Realizeit for Student Mifepristone blocks progesterone, which is essential to the development of pregnancy. Misoprostol, taken 24 to 48 hours later, works to empty the uterus by causing cramping and bleeding. A follow-up visit is scheduled later to confirm the pregnancy was terminated via ultrasound or blood test (Henry J. Kaiser Foundation, 2018). Complications of medical abortions include incomplete expulsion of uterine contents, uterine infection, and heavy bleeding (McBride & Keys, 2018). A recent Cochrane Systematic Review showed no difference in complication rates between medical and surgical abortions in the first trimester (Webster et al., 2018). The assessment of the woman with an unintended pregnancy should be performed with cautious sensitivity. It is essential to explore the women’s feelings about pregnancy before congratulating or consoling her. The encounter should be guided by the feelings of the client, not by the assumptions and values of the nurse. Abortion can be an emotional, deeply personal issue. Considerate and sensitive communication is key in dealing with cases of termination of pregnancy. Provide support and accurate information. If you feel unable to actively participate in the care of a woman undergoing an abortion for personal, religious, or ethical reasons, you still have the professional responsibility to ensure that the woman receives the nursing care and help she requires. This may necessitate a transfer to another area or a staffing reassignment. Nurses must keep in mind that all women have the right to have access to unbiased, factual information about available reproductive health choices, whether they seek to end or start a pregnancy, from which they can then make informed decisions about their own reproductive health. https://herzing.realizeithome.com/RealizeitApp/Student.aspx?Token=lqf9HhURQ5RqpgqAkzH2zUraqIasLrohurDGqXpGq6QB9gdqiPJLc88OmWKG9Kloy4LbjaH… 2/2