ABORTION Termination of a pregnancy before birth, resulting in the death of the fetus. It may be either spontaneous or induced.

BRIEF HISTORY Abortion has been widely known, practised and debated since ancient times. Prehistory to 5th Century v Egyptian Ebers Papyrus first recorded evidence of induced abortion in 1550 BCE. v A Chinese record documents the number of royal concubines who had abortions in China between the years 515 and 500 BCE. According to Chinese folklore, the legendary Emperor Shennong prescribed the use of mercury to induce abortions nearly 5000 years ago v The ancient Greek relied upon the herb silphium. SILPHIUM an abortifacient and contraceptive. v Ancient Hebrews had laws against abortion, but they permitted it in case where the mother s life was at risk. v In Rome, abortion was forbidden and sometimes severely punished by the jurisprudence. 5th Century to 18th Century v pre-quickening and post-quickening abortion. QUIKENING a term used to describe a fetus that could be detected through its movement. Normally occurred after the third month of pregnancy. v Sanskrit An 8th century Sanskrit text instructs women wishing to induce an abortion to sit over a pot of steam or stewed onions. v The technique of massage abortion, involving the application of pressure to the pregnant abdomen and girding of the abdomen with a restrictive belt. 19th Century to Present v 19th century medicine saw advances in the fields of surgery, anaesthesia, and sanitation. v The 20th century saw improvements in abortion technology, increasing its safety, and reducing its side-effects. Vacuum devices, first described in medical literature in the 19th century, allowed for the development of suctionaspiration abortion. PHILIPPINE LAW ON ABORTION Revised Penal Code of the Philippines Art. 256. Intentional abortion. Any person who shall intentionally cause an abortion shall suffer:

The penalty of reclusion temporal, if he shall use any violence upon the person of the pregnant woman. 2. The penalty of prision mayor if, without using violence, he shall act without the consent of the woman. 3. The penalty of prision correccional in its medium and maximum periods, if the woman shall have consented. Art. 258. Abortion practiced by the woman herself of by her parents. The penalty of prision correccional in its medium and maximum periods shall be imposed upon a woman who shall practice abortion upon herself or shall consent that any other person should do so. Any woman who shall commit this offense to conceal her dishonor, shall suffer the penalty of prision correccional in its minimum and medium periods.

If this crime be committed by the parents of the pregnant woman or either of them, and they act with the consent of said woman for the purpose of concealing her dishonor, the offenders shall suffer the penalty of prision correccional in its medium and maximum periods. Art. 259. Abortion practiced by a physician or midwife and dispensing of abortives. The penalties provided in Article 256 shall be imposed in its maximum period, respectively, upon any physician or midwife who, taking advantage of their scientific knowledge or skill, shall cause an abortion or assist in causing the same. Any pharmacist who, without the proper prescription from a physician, shall dispense any abortive shall suffer arresto mayor and a fine not exceeding 1,000 pesos. The act is criminalized by the Revised Penal Code of the Philippines, which was enacted in 1930 and remains in effect today. Articles 256, 258 and 259 of the Code mandate imprisonment for the woman who undergoes the abortion, as well as for any person who assists in the procedure, even if they be the woman's parents, a physician or midwife. Article 258 further imposes a higher prison term on the woman or her parents if the abortion is undertaken "in order to conceal [the woman's] dishonor".

TYPES OF ABORTION Spontaneous abortion or miscarriages is a type of abortion that occur without medical or other intervention. About 25% of all pregnancies result in miscarriages, women older than 35 or younger than 17 years old and couples who have difficulty in achieving pregnancy; and women who have had at least two miscarriages has a higher chance of experiencing miscarriage. About 90% of miscarriages occur during the first trimester (first three months, or 12 weeks of pregnancy). Some cases of miscarriages happen even before a woman realizes that she is pregnant, and she even may not realize that she has aborted. Symptoms of Miscarriage: v A typical 10th week miscarriage is characterized by a very heavy menstrual period. A pregnant woman may experience several days of bleeding and cramps before the contents of the uterus are removed, followed by a short period of bleeding until the lining of the uterus heals. v Miscarriage after the 12th week is like a mild version of the labor of during childbirth, with strong contractions that dilate the cervix and expel the fetus. v Miscarriages between the 13th and 24th weeks (second trimester) are most often caused by faulty attachment of the placenta to the walls of the uterus or from a weak cervix that dilates too soon. Medical names of the various stages of actual or possible miscarriages: v Threatened abortion is a condition of pregnancy, occurring before the 20thweek of gestation, the patient usually experiences vaginal bleeding with or without some cramps, and the cervix is closed. Bed rest is usually the only treatment needed. In a few cases the symptoms disappear and the rest of the pregnancy is normal. v Inevitable abortion is when the bleeding continues and becomes heavy, it usually means that the cervix is dilating and the contents of the uterus are being expelled. Pregnant women will experience lower abdominal cramping and bleeding. v Complete abortion is when all the contents are expelled. There is no treatment other than rest is usually needed. All of the tissues that came out should be saved for examination by a doctor to make sure that the abortion is complete. The laboratory examination of the saved tissue may determine the cause of abortion. v Incomplete abortion is a name given to abortion where the uterus retains part or all of the placenta. Bleeding may occur because part of the placenta may adhere to the uterine wall and the uterus does not contract to seal the large blood vessels that feed the placenta. The usual treatment is a drug that induces labor by stimulating uterine

contractions, a surgical procedure called curettage can also be done to remove the remaining material from the uterus, the goal of this treatment is to prevent prolonged bleeding or infection. v Missed abortion - is a case in which an intrauterine pregnancy is present but is no longer developing normally. Before widespread use of ultrasonography, the term missed abortion was applied to pregnancies with no uterine growth over a prolonged period of time, typically 6 weeks after its (fetus) death. A missed abortion is usually indicated by the disappearance of the signs of pregnancy except for the continued absence of menstrual periods. Missed abortions are usually treated by induction of labor by dilation (or dilatation) and curettage (D & C).

Induced abortion this type of abortion uses drugs or instruments to stop the normal course of pregnancy. DIFFERENT METHODS / TECHNIQUES FOR PERFORMING ABORTION v Menstrual Extraction (endometrial or vacuum aspiration). This method is used for most abortions performed during the first trimester. It is done by suctioning out the lining of the uterus (endometrium) through a thin opening of the undilated cervix. It is a method used after a woman has just missed a period, or anytime up to about the eight week or pregnancy. It can be performed safely in the doctor's office and has a very low rate of mortality. v Dilation and Evacuation (D & E) (also called vacuum suction or suction curettage) and Dilation and Curettage (D & C). This method is commonly used for late first trimester or early second trimester abortions. In this method suction is used to remove the fetus and placenta. The cervix is first dilated under local anesthesia using a suction tube that is firm, and a stronger suction is used than in menstrual extraction. Another way of dilating the cervix is the use of a type of dried seaweed, called laminaria, which expands as it absorbs moisture. Some doctors use a hollow, spoon-shaped knife, or curette, to ensure that all the placental tissues are removed by scraping the uterine walls. If curettes are used throughout the procedure instead of suction, the method is called dilation and curettage (D&C). Before the 12th week of pregnancy, D&E is preferred over D&C because it does not require general anesthesia, causes less discomfort and is less costly. D&C can be used up to the 12thweek of pregnancy. The mortality rate for both D&E and D&C is approximately 3 per 100,000 abortions. v Prostaglandin or Saline Administration. This method is done by injecting prostaglandins or saline solution through the uterine wall and into the amniotic sac holding the fetus to induce labor and delivery of a nonviable fetus. This procedure is commonly used for second trimester abortions. Prostaglandins may cause nausea, elevated temperatures, and vomiting but are safer than the saline solution. Mortality rate for second trimester abortions performed by this method is approximately 20 per 100,000 abortions. v Hysterotomy. This method is similar to caesarian section, the uterus is opened through a small abdominal incision and the fetus is removed. Hysterotomy is usually performed only when other methods have failed repeatedly; it is performed under general anesthesia. It is used between the 12th and the 24th week of pregnancy. This method has the greatest risk of complications out of all the abortion procedures; maternal mortality rate is approximately 200 per 100,000 abortions.

REASONS FOR ABORTION Pregnancies result from rape or incest, and women who are victims of these assaults often seek abortions. emotionally unprepared to enter parenthood and raise a child. Sometimes people enter into a casual sexual relationship that leads to pregnancy with no prospect of marriage. Many young women in high school or college find themselves pregnant and must choose between continuing the education they need to survive economically and dropping out to have a baby. they are too young or do not have a reliable partner with whom to raise a child. a woman must have an abortion to survive a pregnancy. 26.6 % - Want to postpone childbearing 21.3 % - Cannot afford a baby

14.1% - Have a relationship issue or partner does not want a child 12.2% - too young 10.8% - child will disrupt education or career 7.9% - do not want more child 3.3% - risk to fetal health 2.8% - risk to maternal health RELIGIOUS VIEWS Christians are against Abortion. In certain Muslim societies, a young couple from feuding families must wait five years or more to have a child, with the result of numerous abortions in order to observe this family rule. The two positions: The Pro-Life position: Anti-abortion, believes abortion is murder and should be stopped. The Pro-Choice position: Believes that decision to abort is one of personal liberty and thus should be legal. Two possible subpositions: One may believe that abortion is wrong but, for whatever reason, is something that should be up to every individual to decide. The issue becomes an individual or personal decision. One may believe there is nothing wrong with abortion or that, while abortion is wrong, it can be outweighed by other considerations.