Abstract
Pregnancy termination, or abortion, is an essential component of sexual and reproductive health, relevant to the management of both unwanted pregnancies and pregnancy loss. Options for pregnancy termination include procedural and medication-based methods, both of which are safe and effective. The choice of method is dependent upon the patient’s preferences and the gestational age of the pregnancy, as well as any preexisting medical conditions.
The following chapter covers the provision of abortion care, comprised of counseling pregnant people about their reproductive options, educating them about abortion methods, obtaining informed consent, providing the abortion procedure or medications, managing expectations for pain and side effects, identifying complications, and providing postabortion contraceptive counseling.
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References
ACOG Committee Opinion No. 385: The limits of conscientious refusal in reproductive medicine. Obstet Gynecol. 2007;110(5):1203–8. https://doi.org/10.1097/01.AOG.0000291561.48203.27.
Altshuler AL, Nguyen BT, Riley HEM, Tinsley ML, Tuncalp Ö. Male partners’ involvement in abortion care: a mixed-methods systematic review. Perspect Sex Reprod Health. 2016;48(4):209–19. https://doi.org/10.1363/psrh.12000.
Butt K, Lim K, Lim K, Bly S, Butt K, Cargill Y, Davies G, Denis N, Hazlitt G, Morin L, Ouellet A, Salem S. Determination of gestational age by ultrasound. J Obstet Gynaecol Can. 2014;36(2):171–81. https://doi.org/10.1016/S1701-2163(15)30664-2.
Committee Opinion No. 700: Methods for Estimating the Due Date. Obstet Gynecol. 2017;129(5):e150–4. https://doi.org/10.1097/AOG.0000000000002046.
Drumm JE, Clinch J, Mackenzie G. The ultrasonic measurement of fetal Crown-Rump length as a method of assessing gestational age. BJOG: Int J Obstetr Gynaecol. 1976;83(6):417–21. https://doi.org/10.1111/j.1471-0528.1976.tb00856.x.
Dzuba IG, Castillo PW, Bousiéguez M, Lugo Hernández EM, Castañeda Vivar JJ, Sanhueza Smith P. A repeat dose of misoprostol 800 mcg following mifepristone for outpatient medical abortion at 64–70 and 71–77 days of gestation: a retrospective chart review. Contraception. 2020a;102(2):104–8. https://doi.org/10.1016/j.contraception.2020.05.012.
Dzuba IG, Chong E, Hannum C, Lichtenberg ES, Lugo Hernández EM, Ngoc N, Thi N, Patel A, Rzayeva G, Sanhueza Smith P, Tsertsvadze G, Winikoff B. A non-inferiority study of outpatient mifepristone-misoprostol medical abortion at 64–70 days and 71–77 days of gestation. Contraception. 2020b;101(5):302–8. https://doi.org/10.1016/j.contraception.2020.01.009.
Goldberg AB, Dean G, Kang M-S, Youssof S, Darney PD. Manual versus electric vacuum aspiration for early first-trimester abortion: a controlled study of complication rates. Obstet Gynecol. 2004;103(1):101–7. https://doi.org/10.1097/01.AOG.0000109147.23082.25.
Gould H, Foster DG, Perrucci AC, Barar RE, Roberts SCM. Predictors of abortion counseling receipt and helpfulness in the United States. Womens Health Issues. 2013;23(4):e249–55. https://doi.org/10.1016/J.WHI.2013.05.003.
Hsia JK, Lohr PA, Taylor J, Creinin MD. Medical abortion with mifepristone and vaginal misoprostol between 64 and 70 days’ gestation. Contraception. 2019;100(3):178–81. https://doi.org/10.1016/j.contraception.2019.05.006.
Jones HE, O’Connell White K, Norman WV, Guilbert E, Lichtenberg ES, Paul M. First trimester medication abortion practice in the United States and Canada. PLoS One. 2017;12(10):e0186487. https://doi.org/10.1371/journal.pone.0186487.
Keeling J, Birch L. The prevalence rates of domestic abuse in women attending a family planning clinic. J Fam Plann Reprod Health Care. 2004;30(2):113–4. https://doi.org/10.1783/147118904322995500.
Low N, Mueller M, van Vliet HA, Kapp N. Perioperative antibiotics to prevent infection after first-trimester abortion. Cochrane Database Syst Rev. 2012. https://doi.org/10.1002/14651858.CD005217.pub2.
Medical Management of First-Trimester Abortion. Contraception. 2014;89(3):148–61. https://doi.org/10.1016/j.contraception.2014.01.016.
Medication Abortion Up to 70 Days of Gestation. Obstet Gynecol. 2020;136(4):e31–47. https://doi.org/10.1097/AOG.0000000000004082.
Meirik O, Huong NTM, Piaggio G, Bergel E, von Hertzen H. Complications of first-trimester abortion by vacuum aspiration after cervical preparation with and without misoprostol: a multicentre randomised trial. Lancet. 2012;379(9828):1817–24. https://doi.org/10.1016/S0140-6736(11)61937-5.
Mifeprex (mifepristone) Information | FDA. (n.d.). Retrieved March 14, 2022, from https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information
Miller E, Jordan B, Levenson R, Silverman JG. Reproductive coercion: connecting the dots between partner violence and unintended pregnancy. Contraception. 2010;81(6):457–9. https://doi.org/10.1016/J.CONTRACEPTION.2010.02.023.
National Abortion Federation. 2020 clinical policy guidelines. 2020. https://prochoice.org/store/clinical-policy-guidelines/.
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Care Services; Board on Population Health and Public Health Practice; Committee on Reproductive Health Services: Assessing the Safety and Quality of Abortion Care in the US. The safety and quality of abortion care in the United States. National Academies Press; 2018. https://doi.org/10.17226/24950.
Nguyen BT, Hebert LE, Newton SL, Gilliam ML. Supporting women at the time of abortion: a mixed-methods study of male partner experiences and perspectives. Perspect Sex Reprod Health. 2018;50(2):75–83. https://doi.org/10.1363/psrh.12059.
Oh JS, Wright G, Coulam CB. Gestational sac diameter in very early pregnancy as a predictor of fetal outcome. Ultrasound Obstet Gynecol. 2002;20(3):267–9. https://doi.org/10.1046/j.1469-0705.2002.00774.x.
Practice Bulletin No. 135: Second-Trimester Abortion. Obstet Gynecol. 2013;121(6):1394–406. https://doi.org/10.1097/01.AOG.0000431056.79334.cc.
Prevention of Infection After Gynecologic Procedures. Obstet Gynecol. 2018;131(6):e172–89. https://doi.org/10.1097/AOG.0000000000002670.
Ralph LJ, Foster DG, Kimport K, Turok D, Roberts SCM. Measuring decisional certainty among women seeking abortion. Contraception. 2017;95(3):269–78. https://doi.org/10.1016/J.CONTRACEPTION.2016.09.008.
Raymond EG, Grimes DA. The comparative safety of legal induced abortion and childbirth in the United States. Obstet Gynecol. 2012;119(2, Part 1):215–9. https://doi.org/10.1097/AOG.0b013e31823fe923.
Raymond EG, Weaver MA, Louie KS, Tan Y-L, Bousiéguez M, Aranguré-Peraza AG, Lugo-Hernández EM, Sanhueza P, Goldberg AB, Culwell KR, Kaplan C, Memmel L, Sonalkar S, Jamshidi R, Winikoff B. Effects of depot medroxyprogesterone acetate injection timing on medical abortion efficacy and repeat pregnancy. Obstet Gynecol. 2016;128(4):739–45. https://doi.org/10.1097/AOG.0000000000001627.
Sawaya GF, Grady D, Kerlikowske K, Grimes DA. Antibiotics at the time of induced abortion: the case for universal prophylaxis based on a meta-analysis. Obstet Gynecol. 1996;87(5 Pt 2):884–90.
Sisson G, Ralph L, Gould H, Foster DG. Adoption decision making among women seeking abortion. Womens Health Issues. 2017;27(2):136–44. https://doi.org/10.1016/j.whi.2016.11.007.
Sonalkar S, Ogden SN, Tran LK, Chen AY. Comparison of complications associated with induction by misoprostol versus dilation and evacuation for second-trimester abortion. Int J Gynaecol Obstet. 2017;138(3):272–5. https://doi.org/10.1002/IJGO.12229.
Thompson A, Singh D, Ghorashi AR, Donovan MK, Ma J, Rikelman J. The disproportionate burdens of the mifepristone REMS. Contraception. 2021;104(1):16–9. https://doi.org/10.1016/j.contraception.2021.05.001.
Vargas J, Diedrich J. Second-trimester induction of labor. Clin Obstet Gynecol. 2009;52(2):188–97. https://doi.org/10.1097/GRF.0b013e3181a2b5d5.
White K, Carroll E, Grossman D. Complications from first-trimester aspiration abortion: a systematic review of the literature. Contraception. 2015;92(5):422–38. https://doi.org/10.1016/J.CONTRACEPTION.2015.07.013.
WHO. Safe abortion: technical and policy guidance for health systems. 2012. https://pubmed.ncbi.nlm.nih.gov/23700650/
Wingo E, Ralph LJ, Kaller S, Biggs MA. Abortion method preference among people presenting for abortion care. Contraception. 2021;103(4):269–75. https://doi.org/10.1016/j.contraception.2020.12.010.
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Koltun-Baker, E., Heyrana, K.J., Myo, M., Nguyen, B.T. (2023). Pregnancy Termination. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-031-14881-1_99
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DOI: https://doi.org/10.1007/978-3-031-14881-1_99
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