Q 19. 1 What does the term “abortion” mean?
Abortion means expulsion of a pregnancy before the fetus (baby) is viable (capable of survival outside the womb). This contrasts with the lay view, which usually assumes that “an abortion” means that the pregnancy has been deliberately terminated. A spontaneous abortion (Q12.1) means that the pregnancy has been lost as a result of a natural process. Many of us find the terms “miscarriage” or “early pregnancy loss” to be more user friendly.
In the UK there are strict “legal” criteria that permit a doctor to terminate a pregnancy. When a pregnancy is terminated by someone who is not medically qualified the termination is illegal (illegal abortion).
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Two doctors must sign the appropriate form in advance of termination of pregnancy indicating which of the following criteria pertains:
• The continuance of the pregnancy would involve risk to the life of the pregnant woman greater than if the pregnancy were terminated.
• The termination is necessary to prevent grave permanent injury to the physical or mental health of the pregnant woman.
• The pregnancy has not exceeded its 24th week and that the continuance of the pregnancy would involve risk greater than if the pregnancy were terminated, of injury to the physical or mental health of the pregnant woman.
• The pregnancy has not exceeded its 24th week and that the continuance of the pregnancy would involve risk, greater than if the pregnancy were terminated, of injury to the physical or mental health of any existing child(ren) of the family of the pregnant woman.
• There is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped.
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Thirty years ago our ability to diagnose serious inherited disorders or anatomical abnormality (deformity) before birth was very limited. Technological advances, particularly the combination of blood screening tests and ultrasound now allow us to exclude many, but by no means all, of these problems. The question of screening for foetal abnormality is never an easy one. Some would find the thought of caring for a handicapped child intolerable whereas others believe the practice of pregnancy termination is unacceptable (Q19.15). It is only feasible to provide a brief account of the principles, benefits and risks here. Other sources of information are provided in Q19.16 and Q19.17.
When screening indicates that the fetus has a serious defect, there are two options. Many couples elect to continue the pregnancy and the obstetrician in collaboration with the paediatrician can counsel on what is to be expected and the treatment options for the baby. Other couples decide that they do not wish the pregnancy to continue and termination can be arranged. Counselling may be offered to provide support for you to come to terms with a decision to discontinue a planned pregnancy. You will also need advice on the chance of recurrence in another pregnancy. Your gynaecologist may be able to supply you with this information or otherwise arrange for you to see a clinical geneticist.
Down’s syndrome (mongolism), which is associated with typical facial features and reduced mental ability, is due to an extra chromosome 21 (Q2.5). This syndrome is more common with increasing maternal age. A definitive diagnosis can only be reached from genetic (laboratory gene) evaluation of foetal cells obtained either from the amniotic fluid (the fluid around the baby during pregnancy) or from placental type cells (chorionic villus sampling). We used to offer all mothers aged 37 years or more the option of amniocentesis; at the age of 37, the chance of having a Down’s baby is about 1 in 250 pregnancies. Amniotic fluid is obtained (amniocentesis) by introducing a fine needle through the abdominal wall and uterus, usually with local anaesthetic, under ultrasound control. There is an approximately 1% risk that this may cause miscarriage. The fetal cells are cultured in preparation for analysis of the chromosomes (genes). The culture may take two weeks or more. Recently molecular biological techniques such as “FISH” (fluorescence in situ hybridisation) have been introduced. These techniques involve a more direct analysis of genetic material and provisional results can be provided within hours rather than weeks.
As the majority of babies are born to women younger than 37, most babies with Down’s syndrome were missed by the age-related screening programme. Blood tests, including the triple or quadruple tests, could modify the risk for each pregnancy. Some women aged 37 years or more may find that the test shows that their risk is relatively low so that they would be happy to decline amniocentesis whereas for some younger women the test may show that their risk is greater than would have been indicated from their age and they may elect to have further investigation.
Ultrasound undertaken at around eleven weeks into the pregnancy with particular reference to the back of the baby’s neck (nuchal translucency) may provide a valuable guide to the risk of Down’s syndrome. It has been shown that ultrasound is more accurate than the blood test screening and it also has the advantage of screening five weeks before the quadruple test leading to earlier diagnosis or, hopefully, reassurance. Interest is now focusing on a combination of ultrasound and early blood test screening.
The spina bifida group of defects, and heart and limb defects may be demonstrated by ultrasound. Some families are prone to inherited disorders and many of these can be detected by specific screening techniques.
Screening tests are discussed in Q32.9.
References:
Screening for trisomy 21: The significance of a positive second trimester serum screen in women screen negative after a nuchal translucency scan (2001-3351)
Antenatal screening for Down’s syndrome in assisted reproductive pregnancies. (1999-2851)
Screening for Down’s syndrome: Experience of two district general hospitals having different screening strategies. (1999 – 2554)
Screening for Down’s syndrome: Changes in marker levels and detection rates between first and second trimesters (1997-1758)
Nuchal translucency and screening for Down’s syndrome (1996-1669)
Nuchal translucency measurements: Frequency distribution and changes with gestation in a general population (1996-1678)
Screening for Down’s syndrome: Experience in an inner city health district (1996-1679)
Screening for trisomy 21 in twin pregnancies by maternal age and fetal nuchal translucency thickness at 10-14 weeks of gestation (1996-1563)
Serum screening for Down’s syndrome between 8 and 14 weeks of pregnancy (1996-1283)
Screening for fetal trisomies by maternal age and fetal nuchal translucency thickness at 10 to 14 weeks of gestation (1995-1009)
Prevalence of neural tube defects in South Australia, 1966-1991: Effectiveness and impact of prenatal diagnosis (1993-324)
Fetal nuchal translucency: Ultrasound screening for chromosomal defects in first trimester of pregnancy (1992-343)
Ultrasonographically detectable markers of fetal chromosomal abnormalities (1992-345)
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page
Q 19. 3A What is Tay Sacks Disease and should we test for it?
The tragedy of a Tay-Sacks baby is that at birth and for the first few months the baby seems entirely healthy. The child’s health gradually deteriorates with progressive destruction of the nervous system leading to physical and mental problems, including paralysis, blindness and generalised debility until the child dies usually before the age of four.
A Tay-Sacks baby cannot produce an enzyme called hexosaminidase. This enzyme is an essential catalyst in the body’s breakdown of a group of chemicals called mucopoly-saccharides.
Q 19.3B We have no family history of Tay-Sacks. Why should we consider screening?
The majority of babies afflicted by Tay-Sacks are born into families who have no history of the condition.
Q 19.3C How common is Tay-Sacks Disease?
Approximately 1 baby in 2,250 born to couples of Eastern European Jewish (Ashkenazi) descent is born with Tay-Sacks Disease. This compares to an incidence in the rest of the population of 1:225,000 and one in 22,500 where one parent is Jewish.
Q 19.3D If we are healthy, how can we possibly transmit the disease to our child?
Tay-Sacks is an auto-somal recessive condition; the affected child must have received the abnormal gene from both parents. Carriers of the condition have one normal and one abnormal gene and they have enough hexosaminidase to function normally.
Q19.3E What are the chances of us having child affected with Tay-Sacks disease?
In the Ashkenazi population, 1 in 25 individuals are carriers for Tay-Sacks. This results in one couple in 625 with both partners being carriers. As each partner of carrier couples has a 1 in 2 chance of giving the abnormal chromosome to their child, 1 in 4 of their children statistically are likely to have the disease; 1 in 2 of their children will be carriers and 1 in 4 will have entirely normal hexosaminidase genes.
Q19.3F Can Tay-Sacks Disease be prevented?
There is no treatment available for an affected child. For those couples with both partners known to be carriers, tests can be performed in early pregnancy. If the test proves to be positive then there is an option for the pregnancy to be discontinued.
Q19.3G When should screening be considered?
Ideally, screening should be performed before pregnancy and some would advocate before marriage. Only one partner requires screening and if negative then there is no chance of the child having the disease. Should the first partner prove to be positive then the second partner requires screening.
Counselling should be offered to at risk couples when they seek advice before contemplating a pregnancy, for example when requesting contraception, or fertility investigation and during early antenatal care.
The author has counselled many at risk couples and recently found a husband and wife who were both carriers for the disease. Typically, there was no relevant family history. Unfortunately, the fetus tested positive for the disease and, at the couples request, the pregnancy was terminated. There were no problems in the next pregnancy.
Q 19.3H How is screening undertaken.
In the London area, a blood sample is sent by the local laboratory to Guy’s Hospital.
Screening tests are discussed in Q32.9.
Q 19. 4 How frequently is pregnancy termination performed?
Legal abortion is the most frequently performed operation in the UK with about half these operations being undertaken within the NHS. Forty per cent of women in the UK will have had a pregnancy terminated by the age of 45 years. It has been estimated that worldwide 150,000 pregnancies are terminated each day (about one million each week and 350 million each year)! In some countries, such as Russia, more pregnancies are terminated than continue. Many Russian women will have between three and eight pregnancy terminations. There were 10 million terminations in China in 1987. Since the fall of communism in Romania, nearly four out of every five pregnancies are terminated. There are currently about six billion people in the world. This is increasing by 1 billion every ten years.
Q 19. 5 Why do unplanned pregnancies occur?
Perhaps one of the most frustrating problems for gynaecologists is the number of pregnancy terminations that occur when effective contraception seems to be so readily available: in the UK contraception is available without charge. There are a number of reasons for this. Many people, particularly the young and therefore the most vulnerable, find contraception an embarrassing issue. Love-making involves intimacy, spontaneity, immediacy and of course pleasure. Most forms of contraception require preparation and discussion and every method carries an element of risk or at the least appears an imposition or intrusion. Biology is about life and continuation of the species. Perhaps we have to understand that one of nature’s strongest driving forces can prove stronger than reason.
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Start by confirming that you really are pregnant. Pregnancy tests available from your chemist are very accurate. The test may become positive within eight days of conception or about six days before your next period is due. If your period is a few days late, arrange for a test and if it is positive see your general practitioner. For further advice see
Q 19. 7 Should I terminate my pregnancy for social reasons?
This must be one of the most difficult decisions a woman ever faces. When there is doubt careful counselling may help. The counsellor cannot make the decision for you. The purpose of counselling is to help you sort out the facts and decide for yourself the best option for you.
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page
Q 19. 8 How can my pregnancy be terminated?
This will depend on the duration of the pregnancy, and your choice when there are options.
In the UK pregnancy duration is calculated from the first day of the last menstrual period (LMP). The majority of pregnancy terminations are performed before the 13th week. Medical abortion (Q19.10) may be an option at less than nine weeks. Vacuum curettage (suction termination – Q19.9) may be used up to 13 weeks. From 13 weeks to 20 weeks the cervix can be dilated and the uterus emptied (dilatation and evacuation). Medical induction of labour is an option from 13 to 24 weeks. Sometimes the obstetrician may recommend hysterotomy (like a mini-Caesarean section) beyond 20 weeks.
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
In the UK this is usually carried out under general anaesthesia but some employ local anaesthetics. It is usually a day-case procedure. The cervix (neck of the womb) is gently stretched (dilated). A special suction catheter is then introduced through the cervix into the cavity of the womb. The catheter is connected to a suction pump and the womb is carefully emptied.
References:
Antibiotic prophylaxis to prevent post-abortal upper genital tract infection in women with bacterial vaginosis: Randomised controlled trial (2001-3272)
Comparison of vaginal misoprostol and gemeprost as pre-treatment in first trimester pregnancy interruption. (1999 – 2704)
Oral misoprostol versus mifepristone for cervical dilatation before vacuum aspiration in first trimester nulliparous pregnancy: A double blind prospective randomised study (1996-1495)
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page
Q 19. 10 What is a medical abortion?
Medical abortion (the medical termination of pregnancy) involves terminating a pregnancy without a surgical procedure. Progesterone is essential for the maintenance of pregnancy. Mifepristone (RU486) is a progesterone antagonist (Q33.18). Three tablets of Mifepristone are followed by a vaginal pessary 36-48 hours later. Mifepristone appears to be a safe drug with few side-effects.
Q 19. 11 What will happen to me if I have a medical abortion?
You will need to take the Mifepristone tablets at the unit supervising the pregnancy termination. After a couple of hours, you may go home and continue with your usual activities. There is a 40% chance of bleeding during the next two days and a 2% chance that you will miscarry during this time. Thirty-six to 48 hours after taking the Mifepristone, you will be admitted and given a vaginal pessary. There is a 70% chance that you will miscarry during the following 4 hours. Should nothing happen within eight hours of the pessary, you may be allowed home and a scan arranged a few days later.
References:
Medical termination of pregnancy at 63 to 83 days gestation. (1999 – 2703)
Q 19. 12 How do medical and surgical pregnancy termination compare?
Medical termination in the UK can only be used before nine completed weeks of pregnancy. It avoids the surgical complications and it may seem more like a ‘natural’ or spontaneous miscarriage. Surgical termination requires one visit for the treatment whereas a second visit is required with the medical protocol. There is some encouraging evidence that medical termination of pregnancy may be effective beyond the ninth week.
References:
Medical abortion or vacuum aspiration? Two year follow up of a patient preference trial (1997-2743)
Q 19. 13 What are the chances of medical termination failing?
Usually the womb empties itself completely after medical termination. Once in every twenty five cases, the uterus may only partially empty; the doctors are likely to recommend an E.R.P.C (evacuation of retained products of conception – like a D & C but specific for miscarriage (Q12.8). Medical abortion only fails once in a hundred pregnancies.
References:
Nonsurgical mid-trimester termination of pregnancy: A review of 500 consecutive cases. (1999 – 2713)
Q 19. 14 What are the risks of pregnancy termination?
The general risks of surgical procedures are described in Q4.21. A number of specific complications of pregnancy termination are quoted, but research has shown that the risks are low and not as worrying as the anti-abortion lobby tends to suggest. The risks increase as the pregnancy becomes more advanced. The concerns include the risk of reduced fertility, future miscarriage and depressive illness. There are a number of difficulties in evaluating the incidence of these complications. For example, a significant number of those seeking pregnancy termination are at increased risk of pelvic infection (Q20.2).
The uterus is soft during pregnancy and it can be perforated either during dilation of the cervix or during suction with the possibility of damaging other structures in the pelvis including the bowel and the bladder.
The cervix may tear during dilatation. As instruments are introduced through the lower genital tract into the uterus there is a risk of pelvic infection (Q20.2) which is increased if some pregnancy products are inadvertently retained. There is evidence that prophylactic (preventative) antibiotics reduce the risk. Some clinicians advocate taking swab tests from the neck of the womb and administering antibiotics only if bacteria are cultured. This protocol allows identification of sexually transmitted disease and facilitates contact tracing, thus reducing the incidence of sexually transmitted disease.
The commonest cause of pregnancy related deaths worldwide remains pregnancy termination. The number of women dying each day from termination complications is about 500 (1 in 300 of all pregnancy terminations, including those undertaken without medical supervision). My generation of British gynaecologists has been spared the tragic sight of women dying due to illegal termination. It is pertinent to point out that in the three years before the Abortion Act of 1967, ninety-eight women died as a result of back-street abortions.
During my first weekend on call as a senior house officer in gynaecology, we were looking after a woman who had a surgical termination of pregnancy carefully performed by an accomplished consultant. The patient was married and the couple had no child. They had wished to delay parenthood for social reasons. During the operation there was bleeding and despite the team’s best efforts, a life-saving hysterectomy was necessary.
There has been a recent suggestion that pregnancy termination may be associated with an increased risk of breast cancer later in life.
References:
Induced abortion is not a cause of subsequent preterm delivery in teenage pregnancies. (1998 – 2903)
Preventing infective sequelae of abortion (1997-2067)
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Termination of pregnancy (induced abortion) probably began well before written history. There is a fundamental clash between the rights of a woman who does not wish her pregnancy to continue and the sanctity of life coupled with the rights of the unborn child.
Before 1967, it was illegal to terminate (abort) a pregnancy in the UK. The case of a fourteen-year old girl who was raped by officers of the Royal Horse Guards in 1938 illustrates the difficulty. The parents sought an abortion for their daughter. Understandably, they argued that the baby would remind their daughter of her frightening experience. The girl was admitted to hospital under the care of Mr Aleck Bourne, a gynaecologist in London. He agreed that termination of the pregnancy was in the girl’s best interest and undertook the procedure risking a twenty-year prison sentence. The judge at the Old Bailey accepted that, although the operation had not been performed to save life, it preserved the girls mental and physical health. The jury found in favour of the gynaecologist. This case was undoubtedly a big step on the road to the Abortion Act of 1967. It is noteworthy that Aleck Bourne eventually became a member of the Society for the Protection of the Unborn Child because of his concerns that the Abortion Act would lead to abortion on demand.
Some believe that politicians should represent the will of society and should provide acceptable legislation. Others argue that abortion is a medical matter and that doctors should decide according to their individual conscience what is appropriate in partnership with the patient. Religious authorities differentiate between body and soul but do not agree on the time when the fetus is given a soul. Some believe this is at conception, others at forty days and yet others around the time of childbirth. The pro-abortion lobby argues that the woman has the right to choose and the anti-abortion lobby that the unborn child is entitled to protection. Those involved must be allowed to make up their own minds and others should offer support as well as tolerance.
The majority of us would feel that the medical profession has a fundamental duty to help women in such horrendous circumstances as rape but the dilemma is where do we draw the line. In 1969, when I was a medical student, I observed the tremendous care that one of the consultants took in deciding whether the circumstances described by patients requesting pregnancy termination were adequate. Three years later, now as a qualified member of his team, it was apparent to me that the same consultant accepted pregnancy termination virtually on demand. He had concluded that it was impossible to differentiate on social grounds whether it was justifiable to agree to an individual’s request.
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page
Q 19. 16 Could I have some useful Web sites?
Evaluation of the quality of Web sites is discussed in Q4.27. You may find that several general women’s health sites may help you (Q4.28). The following are more specialised Web sites on topics found in this chapter
Associations:
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page
Q 19. 17 Where can I obtain more information ?
Q 19. 1 What does the term “abortion” mean?
Q 19. 2 What are the legal criteria that permit doctors to terminate a pregnancy in the UK?
Q 19. 3 How could we tell if there is a substantial risk that if the child were born it would suffer from such physical abnormalities as to be seriously handicapped?
Q 19. 3A What is Tay Sacks and should we test for it?
Q 19. 4 How common is pregnancy termination?
Q 19. 5 Why do unwanted pregnancies occur?
Q 19. 6 I think I may be pregnant and I do not want to have a baby now. What should I do?
Q 19. 7 Should I terminate my pregnancy for social reasons?
Q 19. 8 How can my pregnancy be terminated?
Q 19. 9 What does a suction (surgical) termination of pregnancy involve?
Q 19. 10 What is a medical abortion?
Q 19. 11 What will happen to me if I have a medical abortion?
Q 19. 12 How do medical and surgical pregnancy termination compare?
Q 19. 13 What are the chances of medical termination failing?
Q 19. 14 What are the risks of pregnancy termination?
Q 19. 15 Why is there debate about the ethics of pregnancy termination?
Q 19. 16 Could I have some useful Web sites?
Q 19. 17 Where can I obtain more information?
Women’s Health – Home Page