ehealthyland.com

Abortion, when legally performed in developed countries, is among the safest procedures in medicine.In such settings, risk of maternal death is between 0.2–1.2 per 100,000 procedures. In comparison, by 1996, mortality from childbirth in developed countries was 11 times greater.Unsafe abortions (defined by the World Health Organization as those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities) carry a high risk of maternal death and other complications. For unsafe procedures, the mortality rate has been estimated at 367 per 100,000.
Physical health

Surgical abortion methods, like most minimally invasive procedures, carry a small potential for serious complications.

Surgical abortion is generally safe and the rate of major complications is low but varies depending on how far pregnancy has progressed and the surgical method used. Concerning gestational age, incidence of major complications is highest after 20 weeks of gestation and lowest before the 8th week. With more advanced gestation there is a higher risk of uterine perforation and retained products of conception, and specific procedures like dilation and evacuation may be required.

Concerning the methods used, general incidence of major complications for surgical abortion varies from lower for suction curettage, to higher for saline instillation. Possible complications include hemorrhage, incomplete abortion, uterine or pelvic infection, ongoing intrauterine pregnancy, misdiagnosed/unrecognized ectopic pregnancy, hematometra (in the uterus), uterine perforation and cervical laceration. Use of general anesthesia increases the risk of complications because it relaxes uterine musculature making it easier to perforate.

Women who have uterine anomalies, leiomyomas or had previous difficult first-trimester abortion are contraindicated to undertake surgical abortion unless ultrasonography is immediately available and the surgeon is experienced in its intraoperative use. Abortion does not impair subsequent pregnancies, nor does it increase the risk of future premature births, infertility, ectopic pregnancy, or miscarriage.

In the first trimester, health risks associated with medical abortion are generally considered no greater than for surgical abortion.

Mental health:No scientific research has demonstrated that abortion is a cause of poor mental health in the general population. However there are groups of women who may be at higher risk of coping with problems and distress following abortion. Some factors in a woman’s life, such as emotional attachment to the pregnancy, lack of social support, pre-existing psychiatric illness, and conservative views on abortion increase the likelihood of experiencing negative feelings after an abortion. The American Psychological Association (APA) concluded that abortion does not lead to increased mental health problems.

Some proposed negative psychological effects of abortion have been referred to by anti-abortion advocates as a separate condition called “post-abortion syndrome.” However, the existence of “post-abortion syndrome” is not recognized by any medical or psychological organization.

Perforation:Sometimes the tools of an abortion are accidentally pushed through the wall of the uterus during an abortion. If the instrument damages one of your internal organs, it may be necessary to do major surgery to repair the damage. This complication can cause extensive bleeding.

Infection:The uterus is susceptible to infection after an abortion especially if parts of the fetus or placenta are accidentally left inside of you. Infections are even more of a risk if you have Chlamydia or Gonorrhea. Symptoms are pain and fever. This is generally treated with antibiotics, but sometimes another curettage procedure must be used. If untreated, a very serious infection can develop and could result in infertility.

Hemmorage:Sometimes women bleed during an abortion or a few days afterwards. With a medical abortion, bleeding lasts 13-15 days or more. Occasionally it is necessary to receive a transfusion to replace the lost blood. Sometimes a second curettage procedure or a hysterectomy is needed to stop the bleeding.

Opponents of legal of abortion claim that abortion is not a safe medical procedure because it can lead to a psychiatric condition, described as ‘post-abortion syndrome’ (PAS). The development of this claim is discussed, followed by a review of psychological effects prepared by an expert committee convened by the American Psychological Association. It was found that the period of greatest psychological stress occurs immediately before the abortion decision is made and that ‘legal abortion of an unwanted pregnancy in the first trimester does not pose a severe psychological hazard for the vast majority of women’. The article also reviews European studies about the relationship between abortion and mental health, and factors contributing to rare negative reactions to abortion.

Following the discussion of mental health effects, summaries are provided of research about the health effects of abortion on adolescents, barriers to abortion, comparison of medical and surgical abortion, effects of denied abortion on children born unwanted, and the system of abortion provision in the Netherlands.

All of these issues are presented in the context of a discussion at the start of the article of reproductive decision-making, contraceptive effectiveness and practice, reasons for ending an unplanned pregnancy, and emergency contraception.