{"id":128,"date":"2020-08-12T20:35:55","date_gmt":"2020-08-12T20:35:55","guid":{"rendered":"https:\/\/brooksidepress.org\/basic_obgyn\/?page_id=128"},"modified":"2021-05-09T20:44:47","modified_gmt":"2021-05-09T20:44:47","slug":"34-pregnancy-termination","status":"publish","type":"page","link":"https:\/\/brooksidepress.org\/pa_obgyn\/overview\/34-pregnancy-termination\/","title":{"rendered":"34. Pregnancy Termination"},"content":{"rendered":"<p><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/dwO0zkBXyLQ\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\">\ufeff<\/span><\/iframe><\/p>\n<p>Duration = 6:10<\/p>\n<input type='hidden' bg_collapse_expand='69e9b5543f0c69054446764' value='69e9b5543f0c69054446764'><input type='hidden' id='bg-show-more-text-69e9b5543f0c69054446764' value='Show Transcript'><input type='hidden' id='bg-show-less-text-69e9b5543f0c69054446764' value='Hide Transcript'><button id='bg-showmore-action-69e9b5543f0c69054446764' class='bg-showmore-plg-button bg-blue-button  '   style=\" color:#ffff;\">Show Transcript<\/button><div id='bg-showmore-hidden-69e9b5543f0c69054446764' ><\/p>\n<p>00:00<br \/>\nAPGO educational topic number 34<br \/>\n00:02<br \/>\npregnancy termination unintended<br \/>\n00:04<br \/>\npregnancies refer to mistimed<br \/>\n00:06<br \/>\nunwanted or unplanned pregnancies 50% of<br \/>\n00:10<br \/>\npregnancies in the United States are<br \/>\n00:11<br \/>\nunintended and 43% of these pregnancies<br \/>\n00:14<br \/>\nend in terminations 3 out of 10 women<br \/>\n00:17<br \/>\nwill have a pregnancy termination by the<br \/>\n00:19<br \/>\nage of 45 the objectives of this video<br \/>\n00:22<br \/>\nare to provide non-directive counseling<br \/>\n00:23<br \/>\nto patients surrounding pregnancy<br \/>\n00:25<br \/>\nincluding unintended pregnancy to list<br \/>\n00:28<br \/>\nsurgical and non-surgical methods of<br \/>\n00:30<br \/>\npregnancy termination to identify<br \/>\n00:32<br \/>\npotential complications of pregnancy<br \/>\n00:33<br \/>\ntermination and to describe the public<br \/>\n00:36<br \/>\nhealth impact of the legal status of<br \/>\n00:37<br \/>\nabortion there are many terms used to<br \/>\n00:40<br \/>\ndescribe a termination of pregnancy<br \/>\n00:41<br \/>\ninduced abortion therapeutic abortion<br \/>\n00:44<br \/>\nand elective abortions all describe a<br \/>\n00:46<br \/>\ntermination of pregnancy pregnancy<br \/>\n00:48<br \/>\ntermination can occur in the first or<br \/>\n00:50<br \/>\nsecond trimester of pregnancy the first<br \/>\n00:52<br \/>\ntrimester is defined as up to<br \/>\n00:53<br \/>\napproximately 12 weeks gestation and the<br \/>\n00:55<br \/>\nsecond trimester is defined as<br \/>\n00:57<br \/>\napproximately 13 weeks to 26 weeks<br \/>\n00:59<br \/>\ntermination of pregnancy is the most<br \/>\n01:01<br \/>\nregulated medical procedure in the<br \/>\n01:03<br \/>\nUnited States each state has different<br \/>\n01:05<br \/>\nlaws and regulations about abortions<br \/>\n01:07<br \/>\nincluding how late in the pregnancy and<br \/>\n01:09<br \/>\nabortion can be performed a summary of<br \/>\n01:11<br \/>\nthese laws can be found at the<br \/>\n01:13<br \/>\nGuttmacher Institute website when caring<br \/>\n01:15<br \/>\nfor women with unintended pregnancy it<br \/>\n01:17<br \/>\nis important to provide non-directive<br \/>\n01:19<br \/>\ncounseling the American College of<br \/>\n01:22<br \/>\nObstetricians and Gynecologists<br \/>\n01:23<br \/>\nrecommends physicians who are not<br \/>\n01:25<br \/>\nwilling to provide specific reproductive<br \/>\n01:27<br \/>\nservices should have referral processes<br \/>\n01:29<br \/>\nin place to provide for transfer of care<br \/>\n01:31<br \/>\nin a timely manner physicians should<br \/>\n01:34<br \/>\nalso give advance notice of their<br \/>\n01:35<br \/>\npersonal moral commitments and should<br \/>\n01:37<br \/>\nnot advocate or argue their positions to<br \/>\n01:39<br \/>\npatients the American Academy of Family<br \/>\n01:41<br \/>\nPhysicians states that a woman who is<br \/>\n01:43<br \/>\nconsidering an elective abortion should<br \/>\n01:45<br \/>\nbe adequately informed about the<br \/>\n01:47<br \/>\npotential health risks of abortion and<br \/>\n01:49<br \/>\ncontinued pregnancy the physician should<br \/>\n01:51<br \/>\nprovide the patient with information<br \/>\n01:53<br \/>\nabout financial and other assistance<br \/>\n01:55<br \/>\navailable to both her and the child the<br \/>\n01:57<br \/>\navailability of licensed or regulated<br \/>\n01:59<br \/>\nadoption agencies if she chooses not to<br \/>\n02:01<br \/>\nkeep the child the availability of safe<br \/>\n02:04<br \/>\nlegal abortion services if she chooses<br \/>\n02:06<br \/>\nnot to continue the pregnancy or the<br \/>\n02:09<br \/>\nphysician should identify resources<br \/>\n02:10<br \/>\nwhere such information can be obtained<br \/>\n02:13<br \/>\nmedical termination of pregnancy is one<br \/>\n02:15<br \/>\nof the options in the first trimester it<br \/>\n02:17<br \/>\nis most commonly used up to 63 days or<br \/>\n02:19<br \/>\nnine weeks of gestation remember that we<br \/>\n02:22<br \/>\nuse menstrual dating for pregnancies so<br \/>\n02:24<br \/>\nthis is the 63 days after the first day<br \/>\n02:27<br \/>\nof her last menstrual period 25% of<br \/>\n02:30<br \/>\nterminations prior to nine weeks<br \/>\n02:31<br \/>\nestimate gestational age our medical<br \/>\n02:33<br \/>\nterminations the combination medication<br \/>\n02:36<br \/>\nregiment of mytha Prestone and<br \/>\n02:37<br \/>\nmisoprostol are most commonly used in<br \/>\n02:39<br \/>\nthe United States and Western Europe<br \/>\n02:41<br \/>\nMiha Priss tone is a progesterone<br \/>\n02:44<br \/>\nantagonist and stops the growth of the<br \/>\n02:45<br \/>\npregnancy and misoprostol is a<br \/>\n02:47<br \/>\nprostaglandin analogue that causes<br \/>\n02:49<br \/>\nuterine cramping and expulsion of the<br \/>\n02:51<br \/>\nproducts of conception<br \/>\n02:53<br \/>\nthis combination regimen is 92%<br \/>\n02:56<br \/>\neffective up to 49 days gestation with a<br \/>\n02:59<br \/>\nmedical termination women should be<br \/>\n03:01<br \/>\ncounseled that they will experience<br \/>\n03:02<br \/>\nbleeding that is heavier than a menses<br \/>\n03:04<br \/>\nand cramping at home complications from<br \/>\n03:06<br \/>\nmedical terminations are rare and<br \/>\n03:08<br \/>\ninclude bleeding and the need for urgent<br \/>\n03:10<br \/>\nsurgical interventions approximately 1%<br \/>\n03:12<br \/>\nof women will need an urgent surgical<br \/>\n03:14<br \/>\ncurettage after a medical termination<br \/>\n03:16<br \/>\ninfection and the need for narcotic pain<br \/>\n03:18<br \/>\nmedications are also rare complications<br \/>\n03:20<br \/>\nremember that for all terminations of<br \/>\n03:23<br \/>\npregnancy the woman&#8217;s RH type should be<br \/>\n03:24<br \/>\ndetermined and rhogam should be<br \/>\n03:26<br \/>\nadministered to Rh negative women let&#8217;s<br \/>\n03:28<br \/>\nmove now to surgical termination of<br \/>\n03:30<br \/>\npregnancy for this procedure the cervix<br \/>\n03:33<br \/>\nis progressively dilated and the<br \/>\n03:35<br \/>\nproducts of conception are aspirated<br \/>\n03:37<br \/>\nfrom the uterus vacuum aspiration and<br \/>\n03:40<br \/>\ndilation and curettage are the most<br \/>\n03:41<br \/>\ncommonly utilized surgical modalities<br \/>\n03:43<br \/>\nthey are equally effective with similar<br \/>\n03:45<br \/>\ncomplication rates second trimester<br \/>\n03:48<br \/>\nterminations are more rare 6.2 percent<br \/>\n03:50<br \/>\nof terminations the United States took<br \/>\n03:52<br \/>\nplace between 13 and 15 weeks and 4%<br \/>\n03:54<br \/>\noccurred after 16 weeks circumstances<br \/>\n03:57<br \/>\nleading to a second trimester<br \/>\n03:59<br \/>\ntermination of pregnancy include delayed<br \/>\n04:01<br \/>\nrecognition of pregnancy a delay in<br \/>\n04:03<br \/>\nobtaining insurance or referral and<br \/>\n04:05<br \/>\ndifficulty finding a provider poverty<br \/>\n04:08<br \/>\nlower education level and having<br \/>\n04:10<br \/>\nmultiple disruptive life events have<br \/>\n04:12<br \/>\nbeen associated with higher levels of<br \/>\n04:13<br \/>\nseeking a second trimester determination<br \/>\n04:15<br \/>\nin addition adolescents are more likely<br \/>\n04:18<br \/>\nto obtain abortions later in pregnancy<br \/>\n04:19<br \/>\namong women under the age of 15 one out<br \/>\n04:22<br \/>\nof five abortions is performed after 13<br \/>\n04:25<br \/>\nweeks both medical and<br \/>\n04:26<br \/>\nof Labor and the surgical dilation and<br \/>\n04:28<br \/>\nevacuation procedures are available for<br \/>\n04:30<br \/>\nsecond trimester determinations over all<br \/>\n04:33<br \/>\nabortions are very safe procedures with<br \/>\n04:35<br \/>\nless than 1% risk of major complications<br \/>\n04:37<br \/>\nthese complications include infection<br \/>\n04:40<br \/>\nbleeding and damage to the uterus<br \/>\n04:42<br \/>\ncomprehensive contraception counseling<br \/>\n04:44<br \/>\nis a part of abortion counseling to<br \/>\n04:45<br \/>\nprevent future unplanned pregnancies we<br \/>\n04:48<br \/>\nwill conclude by discussing the public<br \/>\n04:50<br \/>\nhealth impacts of the legalization of<br \/>\n04:52<br \/>\nabortion between 1966 and 1969 women had<br \/>\n04:56<br \/>\naccess to legal abortion services in<br \/>\n04:58<br \/>\neleven states in 1973 the Supreme<br \/>\n05:01<br \/>\nCourt&#8217;s decision in Roe versus Wade<br \/>\n05:03<br \/>\nlegalized abortion throughout the<br \/>\n05:05<br \/>\ncountry it is very difficult to know<br \/>\n05:08<br \/>\nexactly how many abortions were<br \/>\n05:09<br \/>\nperformed prior to Roe vs. Wade but the<br \/>\n05:12<br \/>\ncharacteristics of women obtaining legal<br \/>\n05:14<br \/>\nabortions changed greatly after the<br \/>\n05:15<br \/>\nruling the proportion of women having<br \/>\n05:18<br \/>\nabortions who were non-white increased<br \/>\n05:20<br \/>\nthe proportion of women having abortions<br \/>\n05:22<br \/>\nwho were unmarried increased and the<br \/>\n05:25<br \/>\nproportion of abortions performed<br \/>\n05:27<br \/>\nearlier in the pregnancy increased prior<br \/>\n05:29<br \/>\nto 1970 one out of four abortions was<br \/>\n05:32<br \/>\nperformed at 13 weeks gestation or later<br \/>\n05:34<br \/>\n10 years later that proportion changed<br \/>\n05:36<br \/>\nto 1 out of 10 the hospitalization of<br \/>\n05:40<br \/>\nwomen with complications from illegal<br \/>\n05:42<br \/>\nabortions decreased gradually after Roe<br \/>\n05:44<br \/>\nversus Wade this concludes the aapko<br \/>\n05:46<br \/>\nvideo on pregnancy termination we have<br \/>\n05:48<br \/>\nreviewed surgical and non-surgical<br \/>\n05:49<br \/>\nmethods of pregnancy termination discuss<br \/>\n05:52<br \/>\npotential complications and describe the<br \/>\n05:54<br \/>\npublic health impact of the legalization<br \/>\n05:56<br \/>\nof abortion<br \/>\n06:09<br \/>\nyou<\/p>\n<p><\/div>\n<hr>\n","protected":false},"excerpt":{"rendered":"<p>\ufeff Duration = 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