RESEARCH ON ABORTION
Statement of Purpose
This study proposes to look into the complications that women experienced after undergoing surgical abortion under the guidance of medical professionals. It will examine their post-abortion experiences and complications. Specifically, the researchers will examine if these women experienced both medical and psychological complications. This study will focus on female American citizens all over the country who have had surgical abortions under the guidance of health care professionals.
Significance of the Study
Statistics show that women in their reproductive years have high awareness about contraception yet their use of such was low, therefore there are many who resort to induced abortion as an option for birth control without regard of the complications that occur as a result of the procedure. For this reason, the researcher wants to study on the complications and the level of complications that occur after undergoing abortion, specifically the type of abortion is surgical. Not to be included are women who underwent abortion without the assistance of medical professionals, women who had medical abortions, and women have had spontaneous abortions.
Determining the levels of induced abortion and post abortion complications in various states is essential because of the consequences these experiences have for women’s health.
Operational Definitions
Bronchoconstriction – is the constriction of the airways in the lungs due to the
tighting of surrounding smooth muscle, with consequent coughing, wheezing, and shortness of breath.
Coagulopathy – term for a defect in the body’s mechanism for blood clotting.
Induced abortion – the termination of pregnancy by doing something to it, it could
be performed by medical professionals, and at extremes, can be self-induced.
Medical abortion – induced abortion with a regimen of mifepristone followed by a
prostaglandin analogue.
Spontaneous abortions – also called miscarriage; loss of a fetus during
pregnancy due to natural causes.
Surgical abortion – induced abortion with the use of surgical equipments and
procedures.
Therapeutic abortion – induced abortion that is performed when the pregnancy is
presenting serious complications to the mother’s health.
Thrombophlebitis – a blood clot (thrombus) inside an inflamed vein.
Uterine synechiae – an adhesion, or a fibrous scar in the uterine cavity, also
referred to as “amniotic sheets” or “amniotic folds.”
Review of the Literature
In developing countries each year more than half a million women die from maternal causes. Nearly all of these deaths could be prevented. Efforts to prevent maternal deaths from one major cause — complications of unsafe abortion — are crucial but inadequate in most of the world. As many as 53 million pregnancies are estimated to be terminated by induced abortion each year worldwide (2002). Providing appropriate medical care immediately could save many thousands of women’s lives. Offering family planning could prevent many future unintended pregnancies and unsafe abortions ( 1997).
Unsafe abortion is fraught with many complications, including pelvic sepsis, septicemia, hemorrhage, renal failure, uterine perforation and other genital tract injuries, gastro-intestinal tract injuries. Where emergency expert treatment for these is not available, death will result (2002).
But even if abortions are performed under the guidance of health care professionals – be it medical or surgical abortion, there are still slim chances of the woman undergoing abortion to have complications. No matter how safe the procedure is, there are no guarantees that there will be no complications for the mother afterwards.
One study focused on women’s responses to abortion over an extended time. The findings of the study show that abortion(s) was/were not a time-limited event; instead thoughts, emotions, and insights about the meaning of these experiences were on-going in the part of the women, as life events unfolded. Difficulties with subsequent pregnancies, life milestones, and mundane occurrences involving friends’ children were common triggers for recurring thoughts about past abortions. These recurrent thoughts had characteristics of avoidance or suppression and intrusion (2006).
Women are classified as having complications if they had any of the following events: failed medical abortion, bleeding requiting transfusion, infection requiring intravenous antibiotics, retained products of conception requiring dilation and curettage, organ injury requiring additional surgery, cervical laceration requiring repair and hospital readmission (London, 2003).
The five main causes of maternal mortality are summarized as hemorrhage, obstructed labor, infection, pregnancy-induced hypertension, and complications of unsafe abortion. Many countries are undertaking programs to reduce deaths from the other four causes, but few provide adequate emergency medical care that would reduce maternal deaths from abortion complications. Even fewer provide family planning services and counseling to women treated for abortion complications ( 1997).
The Research Question
This research was designed to gather and analyze data in an attempt to answer the main question: What are the kinds of abortion complications that women experienced after induced abortion? Furthermore, this study will also examine if these complications experienced are solely medical in nature or also psychological.
Methodology
Sample
Respondents of the study will be selected through non-probability purposive sampling from a list of women who have undergone abortion in recognized hospitals and clinics throughout the country. The kind of abortion these women went could both be induced for therapeutic reasons or otherwise, as long as it is performed under the supervision of a health care professional. Basically, these women will be those who have undergone surgical abortions only, not medical abortions. These surgical abortions should have been performed between the years 2000 to 2005.
A total of 50 women will be selected all over the country. The age range of the respondents will be from 20 to 40 years old, regardless of educational attainment, occupation, socio-economic status, religious affiliation, and marital status.
Procedures for Data Collection
After making the questions, the researchers conducted a pre-testing at a local hospital. Prior to the testing, the following steps were followed:
Then, the researchers did the actual data collection following these steps:
Study Design
In studying the experiences of complications of these women who have undergone induced abortion, the researchers used qualitative study utilizing questionnaires. This research design is best suited because this study does not talk about the cause-and-effect on complications of abortion.
The researchers used a questionnaire (with simple/dichotomous items and multiple choices) in obtaining the information relevant to this study. In a questionnaire using closed-ended questions, the investigator offered two alternative replies of true or false from which the subjects chose the one that matched the appropriate answer. In administering the tool, respondents gathered self-reported information through self-administration of questions in a paper-pencil format. A follow-up interview was done.
This method is useful in collecting data for this study for the following reasons: (1) subjects were asked to respond to the same set of questions, in the same order, (2) they had the same set of options for their responses, (3) it is economical.
Data Analysis
Data gathered from the questionnaires will be tabulated and applied statistical treatment. A constant comparative method of analysis was used. The analysis was conducted as the data was obtained. The information gathered was coded and the data constructed into categories or themes by analyzing information in relation to the research questions. Profiles and brief essays of the participants’ experiences were also created from the results obtained in the study.
Results and Conclusions
Results of the study show that immediate complications of abortion include uterine perforations, hemorrhage and surgical lacerations. Hypertonic saline instillation may cause consumption coagulopathy with severe hemorrhage, as well as adverse Central Nervous System effects. Complications of prostaglandin instillation include hypertension, tachycardia, bronchoconstriction, nausea, vomiting, and diarrhea, slowly healing cervical-vaginal fistulas may also develop.
In all therapeutic abortions, respondents mentioned that a part of the placenta may be retained, causing bleeding problems, infection, and thrombophlebitis. Some of the respondents answered that there may sometimes be late complications from the procedure. Late complications may include a possible increased incidence of premature labor in subsequent pregnancies, sensitization of Rh-negative mothers, and possibly an increased incidence of sterility, especially in patients who become infected and possibly in other who develop uterine synechiae.
When the respondents are asked of any psychologic problems after the procedure, most of them answered there are no psychologic problems at all. Which gives the researchers the conclusion that the psychologic problems associated with abortion are somewhat obscured today. Before induced abortions are easily and openly obtainable, it was thought that women had an induced abortion would feel extremely guilty and experience attendant psychologic difficulties. However, today it is evident that psychologic problems are fewer or more subtle than was anticipated, and women who have induced abortions appear to be remarkably free of psychologic difficulties.
The levels of these complications that occur in abortions performed under the supervision of health care professionals are compounded when performed under unsafe conditions without guidance of health care professionals.
Generalizations
The goal of this survey research is to offer generalizations about the larger population using the information collected from the sample. It is of paramount importance to ensure that the sample is representative of the population at large, in this case women who have undergone therapeutic abortions. The sample of women involved in this study is believed to be representational of all the women who have undergone therapeutic abortion nation wide. It is therefore assumed that the results of the survey would be very similar when conducted within a larger survey population.
Implications
By knowing what complications can occur in women after undergoing abortions, individuals and groups can provide appropriate medical care and services immediately which could save many thousands of women’s lives, not only in the United States but throughout the world.
Limitations
The main limitation of this study is primarily that these complications that are gathered in the study are those that are experienced only by women who have undergone safe abortions performed by medical professionals. It does not mirror the complications that were experienced by women who have undergone unsafe abortions. Furthermore, these complications are also focused only to those women who have undergone surgical abortions, not medical abortions.
Suggestions for Future Research
While the survey may provide a significant amount of information concerning the complications of women who underwent abortion experienced, it is limited in scope. Further research could be done on women who had unsafe abortions and the level of complications could be compared between the two groups.
Credit:ivythesis.typepad.com
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