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When does contraception become abortion?

All the methods considered so far prevent the fertilization of the egg by the sperm, hence avoiding conception. These are clearly methods of contraception.

Other contraceptive devices work after the egg has become fertilized but before or shortly after implantation in the uterus, These devices do not prevent fertilization but stop the development of the fertilized egg. Some allow fertilization to occur but prevent the fertilized egg from implanting itself in the uterus or expel it shortly after. These types of devices or methods can be considered agents that interrupt rather than prevent pregnancy. Some experts associate pregnancy with implantation of the embryo in the uterus, By this definition, all methods that act prior to implantation are considered contraceptives. Methods that dislodge the implanted embryo constitute forms of abortion.

Did You Know?

The IUD was developed in the 1930s but only became available in the 1960s. With 50 million users worldwide, it is second to the Pill in women's choice of contraceptives. But in the United States, it is used by less than 5 percent of women.

The IUD, or intrauterine device, is a small object about the size of a small paper clip that a physician inserts in the uterus. Many types of IUDs have been used in the past, but because certain designs can cause infection, only one model is available in the United States.

This model is a plastic “T-shape” with a nylon thread or tail attached to the bottom of it. This “tail” trails out of the cervix to the vagina, allowing a woman to check that the IUD is still in place.

Figure 8.1 Intrauterine device.

What Do You Think?

Some people argue that these devices are not contraceptives (which prevent fertilization) but are more like agents that cause abortion or interrupt the progress of the pregnancy. What is your opinion?

An IUD releases the hormone progesterone. This is the same hormone contained in the Pill. Even without the progesterone, the IUD works as a contraceptive device, though exactly how is still unclear. Through irritation of the uterine wall, the IUD may change the uterine lining like the progesterone does, thus preventing implantation. Or if implantation occurs, the IUD may dislodge the fertilized egg from the wall of the uterus.

The two most common negative side effects of the IUD are irregular menstrual periods and pelvic pain. Menstrual periods tend to be heavier when a woman has an IUD in her uterus. In addition, pelvic inflammatory disease (PID) tends to be more common for women who use the IUD. PID is a serious infection of the reproductive tract often leading to infertility. For this reason, many single women who have never had children do not use this method. Therefore, this is not typically a method used by young people.

Unlike the Pill or barrier methods that depend on the user for the method to be effective, the IUD's success depends on the proper placement by a health-care professional. The IUD has an ideal failure rate of 0.8%, and a typical failure rate of 4%.

Another way of preventing implantation is to take hormones or chemicals after sexual intercourse. Such chemicals are often called the “morning after” pill. A fairly new drug called RU 486 interrupts pregnancy in most cases if it is taken within 10 days of a missed period and then is followed by an injection of progesterone. Some people consider a chemical or drug such as RU 486 an agent that causes abortion rather than a contraceptive device.

Abortion

Some pregnancies result in a miscarriage. A miscarriage is the natural elimination of a fetus before it is viable. Miscarriages often occur between the 12th and 28th weeks of a pregnancy. Miscarriages can result from a variety of causes such as a defective embryo, Although a miscarriage is a type of natural abort ion, the term abortion usually refers to the intentional interruption (termination) of a pregnancy. There are many different reasons given for aborting an embryo or fetus. In some cases, an abort ion may be necessary to save the pregnant woman's life. In other cases, the pregnancy may have resulted from rape. Tests may show that the fetus has a serious defect. Or the pregnant woman may decide she does not want to have a child at this time.

Medically speaking, an abortion performed by a physician early in the pregnancy is a safe and quick procedure. In most abortions, either the embryo is taken out of the uterus by a suction tube, or the mother is given an injection that causes the uterus to expel the embryo or fetus from the body. The chances of a pregnant woman dying from abortion in the first trimester, which is when most abortions occur, are less than her dying as a result of complications of pregnancy carried to full term. Abortions were illegal before 1973. At that time some women tried to perform their own abortions or sought an abortion from untrained abortionists. Before the legalization of abortions, 1 in 3,000 women died each year in the United States because of botched illegal abortions. Now only 1 in 167,000 die as a result of legal abortions.

For some women, abortion brings up complex psychological problems such as feelings of regret, sadness, or grief. Other women experience relief and do not seem to suffer serious or long-term emotional problems.

Debate Should the government pay for abortions for mothers on welfare who have no insurance?

Currently, abortions are legal everywhere in the United States during the first trimester and with some possible restrictions in the second trimester. However, each state has its own laws about who pays for the abortion (the person or the government). The issue of abortion becomes even more controversial when mothers on welfare seek an abortion but can't pay for it themselves. About 1 million women have abortions each year in the United States. (About 50 million abortions per year are reported worldwide.)

Debate The following are two statements about abortion. Discuss each statement. Then debate the issue of abortion.

  1. If you can 't trust a woman with a choice, how can you trust her with a child?
  2. Babies should have a choice abortion is murder.

In the United States, a quarter of all pregnancies and about half of all unintended pregnancies end with an abortion. The majority of abortions are performed on women younger than 25 years, many of them teenagers. About 8 in 10 abortions involve unmarried women.

Any discussion of abortion raises legal, religious, ethical, and moral issues. Feelings about abortion differ from country to country and within different cultures. For example, abortion is illegal in some countries, but legal in others. The most serious difference of opinion about abortion in the United States involves the moral and legal aspects of abortion, Public opinion is divided over this issue, and many people feel very strongly about it.

Those who are opposed to abortion are usually said to be pro-life. They consider abortion a form of infanticide, similar to the killing of children. Some people would like to see all abortions made illegal. Others feel exceptions should be made in special cases such as to save the mother's life or for a rape victim who becomes pregnant. Still others feel abortion should be allowed, but only up to a certain point in a pregnancy, such as within the first trimester.

Those in favor of keeping abortion an option for all women are usually said to be pro-choice. Pro-choice advocates believe that women should be able to decide for themselves and obtain legal abortions in safe environments.

People on both sides of this debate have compelling arguments that are based on deeply held beliefs and values. As with many issues in a democracy, everyone is entitled to express his or her views on this matter.

What Do You Think?

Would you vote for or against a candidate for the Senate based only on his or her position on abortion? How might voting in this manner affect our system of government?

The majority of abort ions are performed to end pregnancies that are the result of a contraceptive failure on the part of a couple. Typically, this means failure to abstain from sex, failure to take the necessary contraceptive precautions, or failure to think clearly before embarking on the path to parenthood. There are, of course, exceptions. In some cases, a woman may become pregnant because of the failure of the contraceptive device over which she has no control. Remember, no contraceptive method is foolproof. Other women are made pregnant against their will as a result of rap e. There are cases in which pregnancy threatens the woman's health or even life, or the fetus shows a serious abnormality.

Activity 8-1: What Are the Issues?

Introduction

Consider these scenarios:

  • A woman is raped and later discovers that she is pregnant.
  • A pregnant woman feels she is not yet prepared to give birth and raise a child.
  • The pregnant daughter of an abusive parent was told that she would be beaten “within an inch of your life” if she-ever got pregnant.
  • A doctor warns a pregnant mother that giving birth again could be fatal to her.
  • A pregnant woman is told by her boyfriend that she must get an abortion or he will leave her.

What should these individuals do? Is abortion ever justified? Who decides?

Materials

  • Activity Report

Procedure

Step 1 Write your thoughts on this topic: “Is it ever okay to have an abortion? Explain why or why not.” These are your private thoughts. Do not worry about grammar or spelling or even about writing your name on the paper. Give this question some serious thought and write about 50 words. Just writing “Yes” or “No” or “Because” is not answering the question.

Step 2 Now, take your written response to the question and put it away. You will refer to this paper at the end of the activity.

Step 3 Read the introduction again. Each of the sentences involving a pregnant woman is called a scenario. Think of at least one more realistic scenario involving a pregnant woman. Write this scenario down and give it to your teacher when it is requested.

Step 4 Your teacher will now give instructions for a class discussion on the issue of abortion.

Write a letter to someone who is contemplating an abortion. In your letter, discuss your personal views about abortion.

Review Questions

  1. What are two common side effects of the IUD?
  2. At what point in a pregnancy do abortions become illegal in this country?
  3. What does pro-life mean? What does pro-choice mean?

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