Transcript Manual Vacuum Aspiration

Abortion Procedures
February 22, 2006
Manual Vacuum Aspiration
► One
of three forms of vacuum aspiration:
 MVA, EVA (electronic) and D&C
 Key Distinction: MVA uses an IPAS manual
syringe
► Used
through first 14 weeks after last
period
► Vacuum Aspirations account for 90%
MVA: The Procedure
► Speculum
inserted
► Possible injection of numbing medication in/near
cervix
► Dilation:
 Increasingly thick rods
 Absorbent Dilators- take in fluid/stretch cervix (generally overnight)
 Medication
► Tube
inserted into uterus via cervix
► Hand-held pump flushes uterus
MVA: Relatively Speaking
► Considered
to be one of the safer forms of
abortion
► Procedure is 5-15 minutes long (others take
longer)
► 99.5% Effective
 Procedure is repeated for the 0.5% failures
► Lower
Cost
► Quieter than a machine pump
► Can remove full gestational sac
MVA: Side Effects
► Despite
being a ‘safer’ method, MVA still
has its side effects:
 Abdominal cramping/pain
 Bleeding
►Several
days of heavy bleeding
►Spotting for up to 6 weeks
 Rare, but more severe, complications:
►Uterine/Cervical
►Pelvic
Infection
►Excess Bleeding
perforation
MVA in Moldova
► Moldova
is located between Russia and Romania
 50 Years of Legal Abortion
 NAF funds the improvement of their abortions
► Began
the MVA Project in Moldova in 2002
Dilation and Curettage (D&C)
► Curettage:
Using a loop-shaped knife to remove
tissue from the uterus
► Common gynecological surgical procedure
 Following miscarriages,
 To treat excessive mentral flow
► Used
for first trimester abortions
► As an independent procedure: May use the knife
to dismember the body, followed by cleaning out
the uterus.
► Often involves dilation followed by suction of the
contents of the uterus
D&C: Why It’s Uncommon
► Considered
a relatively risky abortion procedure
► Asherman’s
Syndrome: excess tissue seals the
uterus shut
► WHO
recommends D&C only if vacuum
aspiration unavailable
► 1972:
D&C accounted for 23.4% of abortions
► 2002: D&C accounted for 2.4%
Dilation and Evacuation (D&E)
► Surgical
procedure
► Most
common second trimester abortion
procedure, 12-24 weeks
 Baby doubles in size from weeks 11-13, and
becomes too large to extract with suction
aspiration techniques
D&E: Procedure
► Dilation
of cervix (1-2 days)
► Forceps
inserted, baby dismembered (10-15 mins)
 Conical rods or absorbent dilators
 twisting of limbs, spine snapped, skull crushed
► Body
may be reassembled outside of uterus to
ensure completion
► Possible
empty
ultrasound to confirm that the uterus is
D&E: For the Mother
► Sedatives,
painkillers, general anesthesia,
numbing injections to the cervix during
procedure
► Possible Complications:
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Perforation of uterus
Cervical laceration
Incomplete removal
Infection
Inability to become pregnant
Hemorrhage
Medical Abortion (RU-486)
Three steps
► First, either a dose of mifepristone in tablet form or an
injection of methotrexate is given.
►
 Mifepristone blocks the hormone progesterone. Without
progesterone, the lining of the uterus breaks down, ends
pregnancy in the uterus, and causes vaginal bleeding.
 Methotrexate stops pregnancy in the uterus. It also stops those
that develop in a fallopian tube — ectopic pregnancies.
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Second, another medication called misoprostol is taken
in tablet form. This causes the uterus to contract and
empty with vaginal bleeding.
Third, the woman must return to the clinician for followup to make sure the abortion is complete.
Available first 63 days of pregnancy (9 weeks)
RU-486: How it Works
►
Most women who use mifepristone have the abortion
within four hours of taking misoprostol. About 10
percent of women who use mifepristone have the
abortion before they take misoprostol — as early as a
day after taking mifepristone. For others, bleeding
begins within 24 hours of taking misoprostol. The
process usually takes about a week.
►
About 50 percent of women who use methotrexate have
the abortion the same day they take misoprostol — as
early as five days after taking the methotrexate. It
happens within a week for another 35–40 percent. The
whole process can take up to 14 days.
►
In some cases, bleeding may occur for up to four weeks
RU-486: Side Effects
►
Can cause serious birth defects if pregnancy continues
►
Bleeding as if a heavy period
►
Strong cramps
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Temporary abdominal pain
►
Feel uncomfortably warm
►
Have fever and chills
►
Feel nauseous or vomit
►
Diarrhea
Saline Abortions
(Saline Amniocentesis)
►A
needle is inserted through the mother’s
abdomen and 50-250 ml (as much as a cup) of
amniotic fluid is replaced with a solution of
concentrated salt.
► The baby breathes and swallows the solution,
and usually dies 1 to 2 hours later from salt
poisoning, dehydration, hemorrhages of the
brain and other organs, and convulsions.
► The baby’s skin is often stripped or burned off
by the salt solution.
► The mother goes into labor about 33 to 35 hours
delivers a dead baby
► Used after 16 weeks
Complications for the Mother
► Hypertonic
saline may initiate a condition in
the mother called "consumption
coagulopathy" (uncontrolled blood clotting
throughout the body) with severe
hemorrhaging as well as other serious side
effects on the central nervous system
► Seizures, coma, or death may also result
from saline inadvertently injected into the
woman’s vascular system
Partial-Birth Abortion (D&X)
►
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This form of abortion takes
place in the fifth and sixth
months of pregnancy, or
approximately 20-26 weeks
With the help of an
ultrasound, the abortion
doctor grabs the baby’s legs
with forceps and repositions
the child in the birth canal in
the breech position, legs
first
Partial-Birth Abortion
► The abortionist delivers
the entire child, except
for the head, which he
purposely leaves in the
canal so the medical
definition of “birth” does
not occur
Partial-Birth Abortion
► With a scissors, the
abortion doctor
punctures the base of the
living baby’s skull and
spreads the scissor blades
apart to widen the hole
Partial-Birth Abortion
► A catheter is inserted into
the resulting hole, and
the contents of the child’s
skull is sucked out,
causing him or her a
brutal, painful death
► The collapsed head is
then removed from the
birth canal
The Tragedy
► When the child is partially delivered, he or she is often
kicking and moving his or her arms, very obviously a
person and very obviously alive
► Like most abortion procedures, partial-birth is only
performed on a child who has serious mental or physical
disabilities about 20% of the time; in at least 80% of
cases, the mother simply chooses abortion because the
child is unwanted
► By the time the baby is killed, he or she is only inches
from a medical definition of live birth, and nearly all
victims of partial-birth abortion are viable at the time of
the procedure—adoption would be a perfectly plausible
solution if the mother couldn’t care for the child
Despite What They Say…
►
This procedure is NEVER necessary to protect the mother’s health; in
fact, it is likely to be painful and is potentially damaging to her
fertility.
 Labor is induced by artificially dilating the cervix over a period of three days,
which could result in the condition known as Incompetent Cervix and interfere
with the woman’s ability to have children in the future
 The child is partially-delivered in the breech position, a position undesirable
for safe live births—maneuvering the baby into this position can cause uterine
rupture
 Surgical instruments are inserted into the birth canal, increasing risks of
infection or uterine puncture
 Regardless of pro-choice claims to the contrary, partial-birth abortion is
definitely not the safest method for the mother
References
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http://www.optionline.org/abortion.html
http://www.absoluteastronomy.com/reference/dilation_and_curettag
e
http://www.thedoctorslounge.net/gynecology/diseases/abortion.htm
http://www.answers.com/topic/dilation-and-curettage
http://www.nrlc.org/abortion/ASMF/asmf5.html
http://www.webmd.com/hw/womens_conditions/tw1469.asp
http://en.wikipedia.org/wiki/Dilation_and_evacuation
► Reproductive

Health Tech. Project:
http://www.rhtp.org/abortion/mva/default.asp
► Planned
Parenthood:
 http://plannedparenthood.com/pp2/portal/files/portal/medicalinfo/abortion/pubabortion-surgical.xml#1097785696224::8279011707666963798
► FWHC
Services:
 http://www.fwhc.org/abortion/ab-procedures.htm
► National
Abortion Foundation:
 http://www.prochoice.org/international/training/moldova.html