Annotated Bibliography
According to WHO (World Health Organization), over 70 000 women lose their lives due to ineffective and unsafe termination of pregnancy. These numbers are affected by different factors, such as the legal barriers and resource limitations to find safe and effective means for the termination of pregnancy. Resources include hospitals where one can get the necessary help and information from practitioners, affordable and reliable medical treatments and methods of pregnancy termination, and essential tools such as ultrasounds to detect any complications. Pregnancy termination has also been met with stigmatization from most societies in different parts of the world, including attitudes by the service providers. These shortcomings to adequate and safe termination of pregnancies have brought significant health issues to patients who have undergone the process of pregnancy termination. These issues include further complications mainly classified into three; injury due to surgical procedures, incomplete abortions, and infections that may cause significant damage, such as infertility or death. Further complications include intrauterine adhesions that cause the linkage of products from an incomplete abortion, excessive bleeding, and septic shock, among others. Without ensuring that the termination procedure has been done right safely and effectively, the chances of health issues become radically higher. This can be done especially with no or limited legal barriers to pregnancy termination. The following articles look into the factors that lead to health issues after pregnancy termination and can be referenced in knowing how to deal with the problem.
Bibliography: Termination of Pregnancy
Cameron, S., Glasier, A., Chen, Z., Johnstone, A., Dunlop, C., & Heller, R. (2012). Effect of contraception provided at the termination of pregnancy and incidence of subsequent termination of pregnancy. BJOG: An International Journal of Obstetrics & Gynecology, 119(9), 1074-1080. doi: 10.1111/j.1471-0528.2012.03407.x
The need for contraception for women has been seen as necessary even after pregnancy termination. This paper determines the cases of subsequent abortion after the index pregnancy termination within two years, with the method of contraception used in the claims. With data being used from 986 women in Edinburgh hospital, UK, the study showed that 12.3% of these women had come back for a subsequent termination within two years. Furthermore, the paper’s findings showed that the women who undergo abortion should immediately take up intrauterine contraception or progesterone-only implants, as compared to oral contraceptive pills, to avoid another termination and higher chances of complications.
Heller, R., Purcell, C., Mackay, L., Caird, L., & Cameron, S. (2016). Barriers to accessing a termination of pregnancy in a remote and rural setting: a qualitative study. BJOG: An International Journal of Obstetrics & Gynecology, 123(10), 1684-1691. doi: 10.1111/1471-0528.14117
This study looks into the safety and equitability of women in local and remote regions from Scotland and identifies the barriers against accessing proper termination of pregnancy services. This involved interviewing women who had undergone termination of pregnancy within eight months from October 2014 and lived in the Scottish Highlands and the Western Isles. The legal setting of this study dictates that abortion should only happen where two doctors agree that it is necessary and that the procedure should be done under less than 64 days of gestation. The interviews were semi-structured to create room for unanticipated issues that the women would have wanted to address. These issues and the anticipated ones allowed the study to develop a thematic analysis of the problems that combated the women during the process of acquiring the termination of their pregnancy, and thus eventually risking their health and safety. They mainly compose the lack of trained providers creating distance to quality service delivery, lack of prompt referrals, and stigma associated with the service, including from the service providers, which all affect the access of safe and equitable termination process. (words: 185).
Jelinska, K., & Yanow, S. (2018). Putting abortion pills into women’s hands: realizing the full potential of medical abortion. Contraception, 97(2), 86-89. Doi: /10.1016/j.contraception.2017.05.019
Prescription of medically insured abortion pills has been considered convenient and adequate compared to surgical means of abortion that can lead to accidental damage of the womb or any other reproductive part. This paper aims to show the necessity of access for women to take this option that may be much safer without the high risk of complications. Furthermore, this study shows easier use of medical abortion pills for pregnancies of low gestation periods with the growth in telemedicine, which helps women at the privacy and comfort of their homes receiving treatment, despite the laws present in different areas. The paper also concludes on the need for further activism to provide more accessibility to abortion pills that have been reduced due to the different propaganda surrounding them.
Kopp Kallner, H., Gomperts, R., Salomonsson, E., Johansson, M., Marions, L., & Gemzell-Danielsson, K. (2014). The efficacy, safety, and acceptability of medical termination of pregnancy provided by standard care by doctors or by nurse-midwives: a randomized controlled equivalence trial. BJOG: An International Journal of Obstetrics & Gynecology, 122(4), 510-517. doi: 10.1111/1471-0528.12982
Where the safety and effectiveness of abortion may vary due to different factors and variables such as resource limitation and legal barriers, this study compares the effectiveness of pregnancy termination by both doctors and midwives or nurses, where the provision of pregnancy termination by nurses of midwives is weighed in effectiveness and safety. A total of 1180 women were examined, counseled, and treated, while measures of usefulness and safety were rated primary or secondary outcomes of pregnancy termination. Primary results determined the efficacy of the pregnancy termination, consisting of practical completion of medical termination without the need of vacuum aspiration. In contrast, secondary measures selected safety as they included outcomes with the need for hospitalization and blood transfusion. However, the study’s findings show that the provision of the service by nurses or midwives is both effective and can be safely administered to women. (words: 153)
Mentula, M., Männistö, J., Gissler, M., Heikinheimo, O., & Niinimäki, M. (2018). Intrauterine adhesions following an induced termination of pregnancy: a nationwide cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 125(11), 1424-1431. doi: 10.1111/1471-0528.15216
Intrauterine adhesions (IUAs) are one of the complications that come about after an abortion, which prove a greater risk of later pregnancy miscarriage or infertility. Unfortunately, IUA remains to have limited options for its treatment. This study focuses on a nationwide study in Finland to analyze the incidences of IUA and the variables that cause it. The data was outsourced from the Finland Abortion Registry with a focus on cases of intrauterine adhesion. However, the study’s findings showed minimal issues of IUA, ranging from 1-2 points per ten thousand pregnancy terminations. Some of the risk factors that the study guides of developing IUAs were trauma to a patient after stop and continual surgical treatment of remaining products of incomplete termination, after the initial procedure either through surgical or medical means.
Sajadi-Ernazarova, K. R., & Martinez, C. L. (2021). Abortion complications. StatPearls.
This study is done to review the complications of abortions and evaluate the different cases of abortions. The study shows the severity of different kinds of difficulties and the risk factors present during pregnancy termination that would lead to these complications. The study shows that most complications concerning abortions are labaled as common and nonlife threatningn. The study also covers the minor and major concerns about abortions depending on how they are done and carried out. The data from this study is generated from previous study papers and general information. It includes the methods by which professionals can detect and treat these complications. It further concludes that sharing data with the professional community and patient education decreases the morbidity rate.
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