Consequences of Abortion

Globally, abortion is a crucial public health problem. It entails the removal of a fetus or an embryo from the womb leading to or due to its death. Medically, abortion is defined as the termination or miscarriage of it attains twenty weeks of gestation or of a fetus that is less than 500 grams, in cases where the fetus is termed nonviable (Pourreza, and Batebi, 2011). Abortion can be either induced or spontaneous. On one hand, spontaneous abortion or miscarriage results from natural or accidental causes which include chronic diseases coinciding with the pregnancy, numerical or structural chromosome aberration, and other environmental factors among others (Pourreza, and Batebi, 2011). According to the World Health Organization, averagely, fifty-six million safe and unsafe induced abortions were carried out yearly between 2010 and 2014. This accounted for approximated 25% of all pregnancies. In addition, the rate of abortion was lower in developed countries than in developing countries (WHO, 2018). It is for these reasons that induced abortion is a highly politicized topic across the globe which has seen many countries impose regulation to control it. As a result, many women have been forced to carry it out illegally, that is, engaging in criminal abortion. On the other hand, in other situation, the woman is subjected to different criterion depending on the country and are only allowed to proceed with the abortion if they meet the requirement. Such abortions are performed according to the law and are referred to as medical abortions. Nevertheless, irrespective of whether the abortion is criminal or medical, it has well-defined physical, psychological and emotional side effects that torment the women who subjected themselves or are subjected into the procedure.

Physical Effects of Abortion

Every abortion entails numerous physical consequences that vary depending on the method of abortion used and the timescale of its examination. In this light, abortion has both short-term and long-term physical complications.

Short-term Physical Health Complications

According to Gauthier, 2015, women experience menstrual-like cramps as well as prolonged virginal bleeding in the first two weeks after the abortions. In instances where the abortion is carried out using Misoprostol, the woman generally experiences vomiting, fever, diarrhea, and nausea whose incidence rate is dependent on dosage regimen (Gauthier, 2015). Women who undergo medical abortions particularly under the care of an inexperienced abortionist, they experience incomplete abortion which is demonstrated by a combination of long-term bleeding and severe pain. According to Lin et al., 2018, such women are usually subjected to a secondary painful procedure known as vacuum aspiration to sack out the remnants of the pregnancy out of their uterus. In addition, a medical abortion has a higher rate of failure as compared to surgical abortion. Even though rare, hemorrhaging occurs in some instances in both surgical and medical abortions to the point of warranting the woman a blood transfusion. Such complications call for fluid replenishment as well as uterine evacuation. Moreover, women who have undertaken medical abortion may experience uterine rupture and virginal infections. After examining the 2009-2010 Californian abortion date, Upadhyay et al., 2015, reported that out of the 55000 cases of abortions, 2.1% of the women had minor abortion-related complications.

According to Willke et al., 2017, the immediate physical health complications in women who undertake surgical abortion include incomplete abortion, uterine perforations, hemorrhage and infections. In severe cases, they experience cervical lacerations, embolism as well as death (Gauthier, 2015). As Lin et al., 2018, an aborting woman is more likely to experience incomplete abortion as the gestational period increases. While examining 4000 thousand women subjected to surgical abortion in 2013, Kara et al., 2013, established that early abortions, approximately 6 weeks old, had lower risks as compared to older abortions with more than 20 weeks of gestational age (Gauthier, 2015). These low risks are the reason why the medical community regards early-pregnancy surgical abortion safe. As such, it is recommended to carry out the majority of the abortions before the pregnancy turns 8 weeks old to minimize the physical health complications (Lin et al., 2018). The aborting woman undertaking surgical abortion may also experience abortion failure, which entails the continuation of the pregnancy (Lin et al., 2018). This risk increases in women who have undertaken previous abortions. According to Kara et al., 2013, previous surgical abortions increased the risk of incomplete abortion by 16%. In addition, women gestating more than one fetus were more likely to experience failed surgical abortion than those gestating a single fetus.

Long-term Physical Health Complications

While the short-term physical complications are manageable and treatable, they eventually lead to more serious long-term physical health complications. One of these long-term abortion-related complications is sterility (Gauthier, 2015). According to Lin et al., 2018, 3-5% of aborted women are rendered inadvertently sterile by the latent morbidity of the operation. In addition, women suffering from venereal diseases at the time of abortion have a higher risk of sterility (Gerdts et al., 2016). Cervical lacerations are common, particularly in surgical abortions. According to Kara et al., 2013, 22% of aborted women incurred lacerations and the risk of suffering a cervical damage doubled in women younger than 17 years since their cervixes are still developing. Irrespective of whether this cervical damage is microscopic or macroscopic, it permanently weakens the cervix, making it incompetent cervix. As a result, it is not able to bear the weight of future wanted pregnancies, as it will open prematurely culminating into a miscarriage (Gauthier, 2015). According to Lin et al., 2018, cervical damages from previous induced abortion increase the risk of labour complications, premature birth as well as a miscarriage of future pregnancies by 300-500%.

Psychological and Emotional Effect of Abortion

Abortion entails severe physiological and emotional effects. Understandably, the decision to procure an abortion is by no means an easy one. This is moreso in teenagers who face the crisis of choosing the abortion over their bodily physical changes. As reported by Willke et al., 2017, unwanted pregnancy inflicts internal distress in women, particularly the teenagers, as they fear parental rejection and social stigmatism of having a baby out of wedlock. Ironically, researchers have established a feeling of relief among young population of aborted women. Many women use contraception as a mean of birth control globally. Women who use contraceptives, by definition, do not want to conceive or bear children. As such, the first reaction they express after undertaking an abortion is relief of having averted the undesirable situation. Such relief is, however, not the case in women who have been forced to procure an abortion. Psychiatrists have indicated this temporary relief is usually followed by a condition known as an emotional paralysis (Gauthier, 2015). The aborted woman experiences post-abortion numbness that makes her unable to express or feel her own emotions. Her primary focus is fixated on having escaped the ordeal and she is virtually out of touch with her feelings (Gerdts et al., 2016).

Aborted women also experience Post-Traumatic Stress Disorder, which overwhelms their normal defence mechanisms leading to loss of control, intense fear, helplessness, and feelings. When the cause of the post-traumatic disorder is abortion, physicians refer to it as Post-Abortion Syndrome (Gauthier, 2015). Women usually experience these syndromes for a number of reasons. In most cases, women are repeated victims of domineering abuse or are forced to abort by their husbands, parents or boyfriends will experience post-abortion syndrome. However, in most cases, women view abortion as a violent killing of their unborn child irrespective of having compelling reasons to obscure an abortion. In addition, the anxiety, as well as the pain and guilt, are entangled with their view of violent termination of their pregnancies. Some women have equated the pain inflicted to them by the abortionists as they invade their body to rape. According to Willke et al., 2017, women who have experienced sexual assault have a higher risk of developing the post-abortion disorder. In addition, they also identified a 19% rate of post-traumatic stress disorder among women who had procured an abortion 3-5 years ago.

According to Pourreza, and Batebi, 2011, 30-50% of aborted women report experiencing short-term and long-term sexual dysfunctions, starting immediately after the abortion. The complication involves loss of sexual pleasure, sex or male aversion, or increased pain during intercourse. Aborted women also have been reported to increased smoking. As Coleman et al., 2009 report, aborted women are twice as likely to smoke heavily and suffer the corresponding health risks. They are reported to carry on with the smoking in the subsequent pregnancies risking the health of the fetus as well (Gerdts et al., 2016). In Addition, abortion leads to drug abuse. According to research carried out by Willke et al., 2017, first time-aborted women were 3.9 times more likely to abuse drugs and alcohol compared to those with zero abortion.

Other mental complications include child neglect and abuse. As a result of increased depression, drug abuse, violent behavior and other effects linked to abortions, aborted women experience reduced maternal bond with their children. As a result, they are more likely to abuse or neglect them than those who had never procured an abortion. In addition, due to reduced emotional attachment, they end up getting divorced or developing chronic relationship problems. They are also likely to abort future pregnancies. According to Coleman et al., 2009, women who have previously aborted are 4-times more likely to procure an abortion as compared to those who have never procured one.

Abortion Mortality

Besides physical, psychological and emotional effects, Abortion also results in death. Researchers have reported that many women die as a result of the abortion procedures as opposed to gynecological causes. These deaths are higher among aborted women than in women who have given birth or to those who have never been pregnant. Aborted women are forced to deal with suicidal ideations as well as suicidal attempts in extreme cases. According to Gerdts et al., 2016, almost 60% of women suffering from post-abortion sequelae have experienced suicidal ideation while 28% have attempted suicide at least once. According to a recent Finish-Based study, aborted women registered a mortality rate for the post-abortion suicide of 21.8 per 100, 000 compared to 3.3/100000 and 10.2/100000 in pregnancies resulting in birth and among non-pregnant women respectively (Pike, 2017). Even though deaths arising directly from abortion are rare, the risk of death increases as the gestation period increases. Unfortunately, there is no official data on abortion related-death. On the contrary, the deaths are expressed as a maternal mortality proportion and are often underestimated (Pike, 2017).

Ethics of Abortion

Abortion remains to be a hotly contested issue and an ethical dilemma in almost every part of the world. Many countries are divided between legalizing and prohibiting it. This is mainly because of the right to life, which states that every person has an inherent right to life. As such, no one has the right to take the life of another being. Much of the debate regarding abortion is based around the question of who is a human? It is very difficult to identify the point at which a fetus becomes a person. Some people argue that a developing fetus becomes human only when it is capable and viable of existing independently outside the uterus. Others consider the fetus to be a person when its brain starts to develop, which raises the analogy of brain death. As such, abortion and its system of decision making are a significant ethical consideration. According to Patil et al., 2014, there is a distinctive difference between killing something and preventing it from coming into existence. Abortions denies the fetus existence so does the killing.

Abortion is a controversial issue in both medical and social ethics. The opponents of abortion retaliate that the fetus is a human, as such, killing it as abortion does is morally wrong. Staunch opposition of abortion requires women are intentionally or unintentionally pregnant to endure the entire process irrespective of the risk involved. On the other hand, the proponents of abortion argue that abortion is morally justified, and no woman is under obligation to bear a child if it will harm her life or be a hindrance to success. It is paramount to take into consideration the physiological, emotional, and physical effects as well as its mortality while evaluating its ethics. As much as regarding abortion to morally right will increase the abortion rates, compelling women to carry risky pregnancies or bear unwanted children is ethical despotism. Since women are born free, that freedom must incorporate the freedom to such a difficult and extremely personal choice (Patil et al., 2014). It is ethically wrong to force women to also undertake abortion as these subjects them into increased suffering in the form of physical, mental, and emotional complications.

Abortion is not only an important public health problem, but also an ethical dilemma. Irrespective of whether it is criminal or legal, abortion has severe physical, mental, and emotional complications. Physically, abortion results in severe bleeding, infections, and cervical complications among others that endanger the health of the mother as well as her future pregnancies. Some of the physical and emotional complications include post-abortion syndrome, anxiety, depression, drug abuse, child abuse and neglect, and relationship problems among others. In severe cases, abortion results in the direct and indirect deaths of the women. From an ethical perspective, abortion is a very controversial issue. It is very important to balance between the right of the mother and the fetus in deciding whether or not abortion is ethical. Even though legalizing abortion may increase its rate, it will be ethically wrong to compel women to endure the increasing suffering resulting from bearing an unwanted child or risky pregnancy.

References

Coleman, P. K., Coyle, C. T., Shuping, M., & Rue, V. M. (2009). Induced abortion and anxiety, mood, and substance abuse disorders: Isolating the effects of abortion in the national comorbidity survey.  Journal of psychiatric research ,  43 (8), 770-776.

Gauthier, S. (2015).  The impact of induced abortion on women's physical, mental and psychosocial health  (Doctoral dissertation).

Gerdts, C., Dobkin, L., Foster, D. G., & Schwarz, E. B. (2016). Side effects, physical health consequences, and mortality associated with abortion and birth after an unwanted pregnancy.  Women's Health Issues ,  26 (1), 55-59.

Kara, F., Dogan, N. U., Bati, S., Demir, S., Durduran, Y., & Celik, C. (2013). Early surgical abortion: safe and effective.  The European Journal of Contraception & Reproductive Health Care ,  18 (2), 120-126.

Lin, T. B., Hsieh, M. F., Hou, Y. C., Hsueh, Y. L., Chang, H. P., & Tseng, Y. T. (2018). Long-term physical health consequences of abortion in Taiwan, 2000 to 2013: A nationwide retrospective cohort study.  Medicine ,  97 (31).

Patil, A. B., Dode, P., & Ahirrao, A. (2014). Medical Ethics in Abortion.  Indian Journal of Clinical Practice ,  25 (6), 544-548.

Pike, G. (2017). Abortion and Women’s Health.

Pourreza, A., & Batebi, A. (2011). Psychological consequences of abortion among the post-abortion care-seeking women in Tehran.  Iranian Journal of Psychiatry ,  6 (1), 31.

Upadhyay, U. D., Desai, S., Zlidar, V., Weitz, T. A., Grossman, D., Anderson, P., & Taylor, D. (2015). Incidence of emergency department visits and complications after abortion.  Obstetrics & Gynecology ,  125 (1), 175-183.

WHO. (2018). Preventing unsafe abortion. Retrieved October 23, 2018, from http://www.who.int/news-room/fact-sheets/detail/preventing-unsafe-abortion

Willke, J. C., Willke, B. H., Davis, J. J., & Reardon, D. C. (2017). The After Effects of Abortion. Retrieved October 23, 2018, from https://www.abortionfacts.com/reardon/the-after-effects-of-abortion