Clinics in obstetrics and gynaecology
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Clin Obstet Gynaecol · Mar 1986
Comparative StudyRole of abortion in control of global population growth.
No nation desirous of reducing its growth rate to 1% or less can expect to do so without the widespread use of abortion. This observational study, based on the experience of 116 of the world's largest countries, supports the contention that abortion is essential to any national population growth control effort. The principal findings are: Except for a few countries with ageing populations and very high contraceptive prevalence rates, developed countries will need to maintain abortion rates generally in the range of 201-500 abortions per 1000 live births if they are to maintain growth rates at levels below 1%. ⋯ The data in this report suggest that actual alternatives are high death rates of infants and children or widespread use of contraception and abortion. African nations tend to have the very lowest abortion rates and the very highest infant and child death rates. To avoid a world with deteriorating social, economic and political stability, with the concomitant loss of personal and national security, we must ensure that safe abortion is made available to all who wish to use this service.
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This chapter reminds those who provide abortion services that crises are inevitable in the medical, counselling and administrative areas of the facility. After more than 10 years of providing safe, legal abortions, the author notes that the different types of crises that occur are already known and that it is possible to prepare for them. Indeed, it is necessary to prepare for a crisis before it occurs. ⋯ When a medical crisis, as listed, has occurred, the patient should be rapidly transported to the hospital and observed there for a suitable period of time. A medical crisis must be treated as the life-threatening event that it is, regardless of personal ego damage, social disruptions and/or financial considerations. The more personnel trained in cardiopulmonary resuscitation, the better.
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Clin Obstet Gynaecol · Mar 1986
Surgical techniques of uterine evacuation in first- and second-trimester abortion.
Induced abortion is an ancient procedure. Vacuum curettage is a recent innovation and is demonstrably superior to other methods for first-trimester abortions. Patient selection, patient preparation and the necessary instruments are described. ⋯ Evacuation is by means of large-bore vacuum cannula system and large ovum forceps. General anaesthesia is avoided because it increases the risk of perforation and haemorrhage. Adjuncts to D&E are described: intraoperative real-time ultrasound, intracervical vasopressin, two days' treatment with laminaria tents, and Hern's technique combining laminaria with intra-amniotic infusion of urea prior to D & E.
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Abortion is a universal phenomenon, occurring throughout recorded history and at all levels of societal organization. Techniques are highly varied, as are the circumstances under which it is practised. The status of and attitudes towards abortion in Western civilization are variable and have, in most cases, been changing. ⋯ More recent polls demonstrate little attitudinal change since 1972-1973: between 80% and 90% of Americans approve of abortion in the case of poor health, a seriously defective fetus, or rape, and between 40% and 50% indicate approval for all other reasons as well. Only 10% of the American population would like to see abortion prohibited under all circumstances. Sociodemographic analyses indicate that individuals who disapprove of abortion differ from those who approve of its availability in that they are more likely to be Roman Catholic or fundamentalist Protestant; are, in general, more strongly committed to organized religion; are on the traditional/conservative end of the spectrum with regard to women's role in life, premarital sex, sex education and civil liberties; and tend to have achieved a relatively low educational level. 'Pro-life' and 'pro-choice' activists tend to be women who are completely different from one another in sociodemographic characteristics and in overall values, particularly as these relate to traditional versus modern female roles.