Attitudes towards abortion in the world is differently – in some countries it is banned, in others it can be done by the women’s request. For about 65% of women in the world abortion is legally available, about 8% of women live in countries where abortion is strictly prohibited.
Contraception (the use of various contraceptive methods), and sterilization leads to complications on average substantially less than an abortion, especially among young women. Therefore, contraception and sterilization (for women who do not desire to be pregnant in the future) is more preferable for the prevention of unintended pregnancies, while abortion should be conducted only in situations where more secure methods of contraception have failed.
Abortion is performed as a method which includes removal of the contents of the uterus through the vagina (surgical evacuation) and the use of drugs that stimulate contractions of the uterus, as the result the embryo (fertilized egg) is banished. The choice of procedure depends on the duration of pregnancy.
Surgical evacuation via the vagina is used for abortion in approximately 97% of cases and almost always in cases when the duration of pregnancy is less than 12 weeks . This method is called vacuum-abortion, vacuum aspiration (vacuum excochleation). If it is done in the first 4-6 weeks of pregnancy, the cervix should be expanded only slightly, sometimes for women that is pregnant not the first time and laboring women extension is not required. The most frequently used tools – a small flexible tube with a plastic or metal cannula at the end attached to a vacuum generator (usually a mechanical pump), but sometimes manual, rarely – Vacuum Fillers. The tip is inserted through the cervical canal into the uterine cavity, then gently and carefully remove its contents. Sometimes this procedure does not allow to stop pregnancy, especially on the early stages.
At 7-12 weeks of pregnancy in the cervix is usually has to be expanded, because a large suction tube with a tip is used. To reduce the risk of damaging the cervix, the doctor instead of using mechanical dilators (extenders) may use kelp (dried seaweed stems) or similar items that absorb water. Laminaria are inserted into the cervical canal and left in it, at least for 4-5 hours, usually at night. Because kelp absorb large amounts of water, they expand and stretch the cervical canal.
For pregnancies over 12 weeks, usually used method of dilation (expansion) and evacuation. To remove fetus or a part of it, aspirate and special tools (aborttsang, curette) are used, then gently scrape the uterus to make sure that all tissue removed. Expansion and evacuation instead of drugs are increasingly used in the later stages of pregnancy for its termination, because the chance of dangerous complications is lower.
To cause an abortion, sometimes drugs such as mifepristone (RU 486) and prostaglandins are used, especially after 16 weeks of pregnancy, since the expansion of the cervix and removing the ovum at this stage often leads to dangerous complications – such as damage to the uterus or bowel. Mifepristone may also be used soon after conception. Prostaglandins (drugs that stimulate contractions of the uterus) designate in the form of vaginal suppositories or injections. Side effects include nausea and vomiting, diarrhea, flushing of the face and fainting. For some women, prostaglandins may provoke asthma attacks.
Mifepristone in combination with a prostaglandin is a very effective meansof abortions for less than 7 weeks of pregnancy. This drug blocks the action of progesterone in the uterus, resulting in prostaglandin operates more efficiently. This drug is currently available (by prescription) only in Europe.
To prevent pregnancy after unprotected sexual act is sometimes the oral contraceptives can be used with a high dose of hormones, but they are not always effective. Take the medication should be within 72 hours. Side effects include nausea and vomiting.