Health effects of Abortion...
Early-term surgical abortion is a simple procedure. When performed before the 16th week by competent doctors — or, in some states, nurse practitioners, nurse midwives, and physician assistants — it is safer than childbirth.[20][21]
Abortion methods, like most surgical procedures, carry a small risk of potentially serious complications. These risks include: a perforated uterus,[22][23] perforated bowel[24] or bladder,[citation needed] septic shock,[25] sterility,[26] and death.[27] The risk of complications can increase depending on how far pregnancy has progressed,[28][29] but remains less than complications that may occur from carrying pregnancy to term.[21]
Assessing the risks of induced abortion depends on a number of factors. First, there are relative health risks of induced abortion and pregnancy, which are both affected by wide variation in the quality of health services in different societies and among different socio-economic groups, a lack of uniform definitions of terms, and difficulties in patient follow-up and after-care. The degree of risk is also dependent upon the skill and experience of the practitioner; maternal age, health, and parity;[29] gestational age;[29][28] pre-existing conditions; methods and instruments used; medications used; the skill and experience of those assisting the practitioner; and the quality of recovery and follow-up care.
In the United Kingdom, the number of deaths directly due to legal abortion between the years of 1991 and 1993 was 5, compared to 3 deaths following spontaneous miscarriage and 8 deaths caused by ectopic pregnancy during the same time frame.[30] In the United States, during the year 1999, there were 4 deaths due to legal abortion, 10 due to miscarriage, and 525 due to pregnancy-related reasons.[31][32]
Some practitioners advocate using minimal anaesthesia so the patient can alert them to possible complications. Others recommend general anaesthesia, to prevent patient movement, which might cause a perforation. General anaesthesia carries its own risks, including death, which is why public health officials recommend against its routine use.
Dilation of the cervix carries the risk of cervical tears or perforations, including small tears that might not be apparent and might cause cervical incompetence in future pregnancies. Most practitioners recommend using the smallest possible dilators, and using osmotic rather than mechanical dilators after the first trimester.
Instruments that are placed within the uterus can, on rare occasions, cause perforation[28] or laceration of the uterus, and damage structures surrounding the uterus. Laceration or perforation of the uterus or cervix can, again on rare occasions, lead to more serious complications.
Incomplete emptying of the uterus can cause hemorrhage and infection. Use of ultrasound verification of the location and duration of the pregnancy prior to abortion, with immediate follow-up of patients reporting continuing pregnancy symptoms after the procedure, will virtually eliminate this risk. The sooner a complication is noted and properly treated, the lower the risk of permanent injury or death.
In rare cases, abortion will be unsuccessful and pregnancy will continue. An unsuccessful abortion can result in delivery of a live neonate, or infant. This, termed a failed abortion, is very rare and can only occur late in pregnancy. Some doctors have voiced concerns about the ethical and legal ramifications of letting the neonate die. As a result, recent investigations have been launched in the United Kingdom by the Confidential Enquiry into Maternal and Child Health (CEMACH) and the Royal College of Obstetricians and Gynaecologists, in order to determine how widespread the problem is and what an ethical response in the treatment of the infant might be.[33]
Unsafe abortion methods (e.g. use of certain drugs, herbs, or insertion of non-surgical objects into the uterus) are potentially dangerous, carrying a significantly elevated risk for permanent injury or death, as compared to abortions done by physicians.
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: 17 years ago