Jump to content
Bear

Abortion

Recommended Posts

Just a thought.

If a fetus is a parasite because it depends on it's mother, how is a newborn not a parasite by this definition, a newborn without it's mother will certainly die so using this reasoning a newborn should be able to be killed for convenience's sake. In fact with this reasoning until a baby is able to be weaned, it would be fine to kill it.

A parasitic organism is wholly biologically dependent on the host and is physically attached. A baby is not.

 

Infinis: I believe not all parasitic relationships are detrimental to the host? Some have little to no effect on the host, and I'm sure there are the odd one or two that are beneficial both ways...

 

A fetus that is over 22 weeks old could be hand-reared, abortions for them are done as well.

No. A fetus that is 23weeks old is underdeveloped; it is not simply an immature human like a baby/child/teenager, but is biologically unable to independently support life. Preme babies of that age require artificial life support of some description or another to allow for organs to develop into a state where it can independently perform the necessities of life. It's a vast difference between providing food and shelter, and artificial surrogacy.

Edited by Kestra15

Share this post


Link to post

You will note that that abortion was attempted at 7 and a half months. That is no where near the usual time frame when most abortions are performed, nor are they performed that late-term anymore with the exception of the mother's life being in danger, or if the fetus has a serious defect from which it cannot recover.

 

Procedures are no longer what they were back in 1977, nearly 40 years ago, and imo, shouldn't be used as a measuring stick for today's procedures and policies.

Share this post


Link to post

Hi i saw this while looking thru these post.Take a look at this and see what you all think then.

 

http://julieroys.com/gianna-jessen-asks-co...what-were-mine/

38 years ago medical practice was vastly different than it is today. At 7.5 months abortions are not performed unless the mother's life is in danger or the child will die shortly after birth.

 

This sentence caught my attention:

"Within the first year after my birth, I was used as an expert witness in a case where an abortionist had been caught strangling a child to death after being born alive."

I'm honestly wondering how a child less than a year old can be used as a witness? Specifically an "expert" witness? A child that age can usually do nothing more than babble nonsense.

Edited by sparkle10184

Share this post


Link to post
A parasitic organism is wholly biologically dependent on the host and is physically attached. A baby is not.

 

Infinis: I believe not all parasitic relationships are detrimental to the host? Some have little to no effect on the host, and I'm sure there are the odd one or two that are beneficial both ways...

A symbiotic relationship between two organisms in which one organism benefits while the other derives neither benefit nor harm is known as a commensal relationship, not a parasitic one. In a parasitic relationship, the host organism is always harmed.

 

(I am very strongly pro-choice btw, but I thought this should be clarified)

Share this post


Link to post

UGH Gianna Jessen. I really dislike her. =\

 

“If abortion is about women’s rights, then what were mine?”  Gianna Jessen asked a  House Judiciary Committee that question today — and with good reason.  Thirty-eight years ago, Jessen miraculously survived a saline abortion.

 

(Not only women can get pregnant.)

 

A fetus is not sentient. It has no personhood. Always the convenient argument of forgetting the pregnant person[/s] IS a person with rights. A fetus doesn't exist in stasis. It exists within a human being.

 

We cannot take organs from a corpse without permission. Why is it pregnant people are suddenly the exception from bodily autonomy???

 

This morning, she told her remarkable story to a House Judiciary Committee investigating Planned Parenthood’s practice of harvesting and selling the body parts of aborted babies — even from those that may have been born alive.

 

We've discussed this above. None of this is true. It's certainly not true that PP delivers babies and harvests their body parts. I can honestly only eye roll at this baseless claim and fear mongering technique.

 

late-term saline abortion.

 

This method of abortion burns the baby inside and out, blinding and suffocating the child, who is then born dead, usually within 24 hours.

 

A "saline abortion" is more technically referred to as an "instillation abortion" and I don't believe the above information is not exactly accurate.

 

From wiki: Instillation abortion is performed by injecting a chemical solution consisting of either saline, urea, or prostaglandin through the abdomen and into the amniotic sac. The cervix is dilated prior to the injection, and the chemical solution induces uterine contractions which expel the fetus.[1] Sometimes a dilation and curettage procedure is necessary to remove any remaining tissue.[2]

 

Instillation methods can require hospitalization for 12 to 48 hours.[2] In one study, when laminaria were used to dilate the cervix overnight, the time between injection and completion was reduced from 29 to 14 hours.[3]

 

Once in common practice, abortion by intrauterine instillation has fallen out of favor, due to its association with serious adverse effects and its replacement by procedures which require less time and cause less physical discomfort.[11]

 

Saline is in general safer and more effective than the other intrauterine solutions because it is likely to work in one dose. Prostaglandin is fast-acting, but often requires a second injection, and carries more side effects, such as nausea, vomiting, and diarrhea.[2]

 

Instillation of either saline or prostaglandin is associated with a higher risk of immediate complications than surgical D&C.[12] Dilation and evacuation is also reported to be safer than instillation methods.[13] One study found that the risk of complications associated with the injection of a combination of urea and prostaglandin into the amniotic fluid was 1.9 times that of D&E.[13]

 

The rate of mortality reported in the United States between 1972 to 1981 was 9.6 per 100,000 for instillation methods. This is in comparison to rates of 4.9 per 100,000 for D&E and 60 per 100,000 for abortion by hysterotomy and hysterectomy.[13]

 

There have been at least two documented cases of unsuccessful instillation abortions that resulted in live births.[14]

 

From columbia.edu: Instillation Procedures

 

Uterine contractions are induced by injecting saline or prostaglandin into the amniotic fluid through the abdomen.

Can take a long time and be emotionally difficult for women.

Must take place in a hospital

Not recommended if D & E is available.

Mortality rates for D & E are 2.5 times lower than instillation methods.24

 

The only things I could find on the fetus being burned up (no strong evidence fetuses can feel pain) were from propaganda sites. Nothing trustworthy. I am interested on more info on this procedure, though, if anyone has a good source!

 

And, as said above, our medical procedures have evolved a bit since then.

 

Thankfully, the abortionist was not at work yet. Had he been there, he would have ended my life with strangulation, suffocation, or leaving me there to die.

 

Abortion doctors don't typically commit infanticide (and those that do will likely face the justice system as they deserve), which is what Jessen is describing in order to get people riled up and angry.

 

Planned Parenthood is not ashamed of what they have done or continue to do.

 

Because, believe it or not, providing cheap healthcare to those that need it is a good thing.

 

themurder of over 50 million children in the womb.

 

Abortion is not the same as murder. Again, the misuse of words in propaganda to rile people up and make them angry without telling them the facts.

 

I wonder how many lives have been lost in our silence, while we make sure we are lauded among men and do not offend anyone?

 

Lawl, I don't even know what to do with this. It's so left field, I have no idea where it even came from. Sounds like internalized misogyny and possibly racism, though.

 

How many children have died, and been dismembered, and their parts sold, for our ego, our convenience, and our promiscuity?

 

Sex shaming always goes towards showing a speaker is misogynistic (in this case, very internalized).

 

f abortion is about women’s rights, then what were mine? You continuously use the argument, “If the baby is disabled, we need to terminate the pregnancy,” as if you can determine the quality of someone’s life. Is my life less valuable due to my Cerebral Palsy?

 

Ableism in reproductive rights discourse is actually a valid concern. However, the answer isn't to ban abortion. It's to confront ableism, educate, and make change about the way we think about disabled people. As well, healthcare needs to be attainable and affordable for everyone.

 

Planned Parenthood uses deception, the manipulation of language and slogans, such as “a woman’s right to choose,” to achieve their monetary aims.

 

PP is non-profit. The money they make goes towards making sure they can continue to offer healthcare services to those who need it.

 

We often hear that if Planned Parenthood were to be defunded, there would be a health crisis among women without the services they provide. This is absolutely false. Pregnancy resource centers are located nationwide as an option for the woman in crisis. All of their services are free and confidential, and they can be reached by texting: “HELPLINE” to 313131.

 

Absolutely not a valid argument. CPCs/crisis pregnancy centers/pregnancy centers are pro life and do not offer healthcare services. They are there to convince pregnant people to carry to term. Not only is adoption NOT an alternative to abortion (which people get because they don't want to be pregnant, not only simply because they don't want a child themselves), but PP also offers services such as STD testing and treatment, cancer screenings, offering contraceptives, and some other odds and ends health services. These are available to people with lower incomes who can't afford other healthcare services.

 

Google some of the stuff CPCs pull. It's quite terrifying and not at all healthcare in any sense of the word. (Such as giving out blatant misinformation, forcing people who come in for help to watch terrible videos meant to guilt them, etc.) exposing-cpcs at tumblr is a good resource for some of the stuff CPCs pull.

 

Planned Parenthood receives $500 million dollars of taxpayer money a year, to primarily destroy and dismember babies.

 

*rubs temples*

 

Do not tell me these are not children. A heartbeat proves that. So does 4-d ultrasound.

 

Literally not true.

 

An elephant has a heartbeat. Doesn't prove it is human or a child.

 

The 4d ultrasound just shows you the developmental progress of the fetus.

Edited by SockPuppet Strangler

Share this post


Link to post
A symbiotic relationship between two organisms in which one organism benefits while the other derives neither benefit nor harm is known as a commensal relationship, not a parasitic one. In a parasitic relationship, the host organism is always harmed.

 

(I am very strongly pro-choice btw, but I thought this should be clarified)

I stand corrected smile.gif

Share this post


Link to post

UGH Gianna Jessen. I really dislike her. =\

 

 

 

(Not only women can get pregnant.)

 

A fetus is not sentient. It has no personhood. Always the convenient argument of forgetting the pregnant person[/s] IS a person with rights. A fetus doesn't exist in stasis. It exists within a human being.

 

We cannot take organs from a corpse without permission. Why is it pregnant people are suddenly the exception from bodily autonomy???

 

 

 

We've discussed this above. None of this is true. It's certainly not true that PP delivers babies and harvests their body parts. I can honestly only eye roll at this baseless claim and fear mongering technique.

 

 

 

A "saline abortion" is more technically referred to as an "instillation abortion" and I don't believe the above information is not exactly accurate.

 

From wiki: Instillation abortion is performed by injecting a chemical solution consisting of either saline, urea, or prostaglandin through the abdomen and into the amniotic sac. The cervix is dilated prior to the injection, and the chemical solution induces uterine contractions which expel the fetus.[1] Sometimes a dilation and curettage procedure is necessary to remove any remaining tissue.[2]

 

Instillation methods can require hospitalization for 12 to 48 hours.[2] In one study, when laminaria were used to dilate the cervix overnight, the time between injection and completion was reduced from 29 to 14 hours.[3]

 

Once in common practice, abortion by intrauterine instillation has fallen out of favor, due to its association with serious adverse effects and its replacement by procedures which require less time and cause less physical discomfort.[11]

 

Saline is in general safer and more effective than the other intrauterine solutions because it is likely to work in one dose. Prostaglandin is fast-acting, but often requires a second injection, and carries more side effects, such as nausea, vomiting, and diarrhea.[2]

 

Instillation of either saline or prostaglandin is associated with a higher risk of immediate complications than surgical D&C.[12] Dilation and evacuation is also reported to be safer than instillation methods.[13] One study found that the risk of complications associated with the injection of a combination of urea and prostaglandin into the amniotic fluid was 1.9 times that of D&E.[13]

 

The rate of mortality reported in the United States between 1972 to 1981 was 9.6 per 100,000 for instillation methods. This is in comparison to rates of 4.9 per 100,000 for D&E and 60 per 100,000 for abortion by hysterotomy and hysterectomy.[13]

 

There have been at least two documented cases of unsuccessful instillation abortions that resulted in live births.[14]

 

From columbia.edu: Instillation Procedures

 

    Uterine contractions are induced by injecting saline or prostaglandin into the amniotic fluid through the abdomen.

    Can take a long time and be emotionally difficult for women.

    Must take place in a hospital

    Not recommended if D & E is available.

    Mortality rates for D & E are 2.5 times lower than instillation methods.24

 

The only things I could find on the fetus being burned up (no strong evidence fetuses can feel pain) were from propaganda sites. Nothing trustworthy. I am interested on more info on this procedure, though, if anyone has a good source!

 

And, as said above, our medical procedures have evolved a bit since then.

 

 

 

Abortion doctors don't typically commit infanticide (and those that do will likely face the justice system as they deserve), which is what Jessen is describing in order to get people riled up and angry.

 

 

 

Because, believe it or not, providing cheap healthcare to those that need it is a good thing.

 

 

 

Abortion is not the same as murder. Again, the misuse of words in propaganda to rile people up and make them angry without telling them the facts.

 

 

 

Lawl, I don't even know what to do with this. It's so left field, I have no idea where it even came from. Sounds like internalized misogyny and possibly racism, though.

 

 

 

Sex shaming always goes towards showing a speaker is misogynistic (in this case, very internalized).

 

 

 

Ableism in reproductive rights discourse is actually a valid concern. However, the answer isn't to ban abortion. It's to confront ableism, educate, and make change about the way we think about disabled people. As well, healthcare needs to be attainable and affordable for everyone.

 

 

 

PP is non-profit. The money they make goes towards making sure they can continue to offer healthcare services to those who need it.

 

 

 

Absolutely not a valid argument. CPCs/crisis pregnancy centers/pregnancy centers are pro life and do not offer healthcare services. They are there to convince pregnant people to carry to term. Not only is adoption NOT an alternative to abortion (which people get because they don't want to be pregnant, not only simply because they don't want a child themselves), but PP also offers services such as STD testing and treatment, cancer screenings, offering contraceptives, and some other odds and ends health services. These are available to people with lower incomes who can't afford other healthcare services.

 

Google some of the stuff CPCs pull. It's quite terrifying and not at all healthcare in any sense of the word. (Such as giving out blatant misinformation, forcing people who come in for help to watch terrible videos meant to guilt them, etc.) exposing-cpcs at tumblr is a good resource for some of the stuff CPCs pull.

 

 

 

*rubs temples*

 

 

 

Literally not true.

 

An elephant has a heartbeat. Doesn't prove it is human or a child.

 

The 4d ultrasound just shows you the developmental progress of the fetus.

I am curious then!

 

At what point would a fetus be considered to become sentient?

AND perhaps there IS no real agreement on that and the very confusion on that point is WHY the whole thing causes so many disagreements?

Edited by Silverswift

Share this post


Link to post
I am curious then!

 

At what point would a fetus be considered to become sentient?

I've heard a fetus can perceive things as early as 19 weeks, though most sources say sometime early in the third trimester (I don't really have exact info, looking at fetal development stuff gives me panic attacks). And as far as I know no one is sure whether they're consciously perceiving anything at all.

 

Sentience of the fetus doesn't really matter in the abortion debate though - sentient or not, it's still using someone else's body to survive.

Share this post


Link to post

Since a fetus is not a human being by these definitions.

 

So someone in a coma or has Alzheimer or is a newborn or depends on life support should be killed, because by this definition itt is perfectly okay to kill them.

DO not dance around this or say this is not the same.

A fetus is not a parasite. Nothing majorly bad will likely happen to you with proper nutrition.

By the way, ectopic pregnacies and the like are exceedingly rare and if we discount late term abortion, we discount the extremely unlikely risks.

Share this post


Link to post
An elephant has a heartbeat. Doesn't prove it is human or a child.

I never understood why these people are so stuck on heartbeat. I mean, a fetus with Anencephaly have a heartbeat and too many pro-birth fans make it sound like they want it born. unsure.gif

 

I've been debating a lot lately about abortion on a couple of native newspages. biggrin.gif It's interesting how they use the same arguments as they do in American homepages. Sounds like they're echoing the same sources and don't think for themselves.

 

I've been grabbing some info and links from here. smile.gif

Share this post


Link to post
I've heard a fetus can perceive things as early as 19 weeks, though most sources say sometime early in the third trimester (I don't really have exact info, looking at fetal development stuff gives me panic attacks). And as far as I know no one is sure whether they're consciously perceiving anything at all.

 

Sentience of the fetus doesn't really matter in the abortion debate though - sentient or not, it's still using someone else's body to survive.

^

 

Yeah, sorry, my wording is kind of bad and confusing, particularly in the first part of my post. Sorry, Silverswift. ^^

 

~

 

Soulking -

 

Living directly off the nutrients of another person/being housed IN then is infinitely different from living off a machine or the aid of healthcare professionals or etc.

 

Have you considered the mental and psychological effects of pregnancy? How about the health effects of going through pregnancy (gestional diabetes, ppd, etc - I think that link is in the first post? If not, I have shared it here before, so I could probably find it again)?

Share this post


Link to post

 

Soulking -

 

Living directly off the nutrients of another person/being housed IN then is infinitely different from living off a machine or the aid of healthcare professionals or etc.

 

Have you considered the mental and psychological effects of pregnancy? How about the health effects of going through pregnancy (gestional diabetes, ppd, etc - I think that link is in the first post? If not, I have shared it here before, so I could probably find it again)?

Unless those the health effects happen most of the time it is not relevant, you could get killed by a vaccine but you still take the vaccine.

Mental problems tend to disappear after pregnancy, as they are caused by hormones.

A fetus does not tend to cause problems with sapping nutrients, as most people can eat enough for themselves and the fetus.

Share this post


Link to post

Soul King, there are many people who would be forced to discontinue medications that keep their pre-pregnancy health conditions (mental or otherwise) in check if they were to become pregnant - I am one of those people. I will not sacrifice my mental well-being for a -potential- child, that I cannot handle, nor want.

Share this post


Link to post
Soul King, there are many people who would be forced to discontinue medications that keep their pre-pregnancy health conditions (mental or otherwise) in check if they were to become pregnant - I am one of those people. I will not sacrifice my mental well-being for a -potential- child, that I cannot handle, nor want.

There are psychological medications proven to be safe when used in pregnancy.

Share this post


Link to post
There are psychological medications proven to be safe when used in pregnancy.

well yes, but you can't just take any medication...

Share this post


Link to post

@ SoulKing - For some people. Not every medication behaves the same in every person. For example, between even my sister and myself, my mood stabilizer works wonderfully, but my sister gets a potentially-fatal reaction to the same drug, as well as it making her -more- unstable. Her anti-anxiety med makes me more anxious. It took me YEARS to find a medication that worked halfway decently.

 

The same holds true even for painkillers - what a single ibuprofen can manage in one person, might take 4 or five for another person, and could be fatal to the person who has an allergy. Medication is -not- something you want to censorkip.gif around with while you're pregnant, especially when it can kill you - which more complex meds like anti-depressives and anti-anxiety meds run far higher risks.

 

I get the distinct impression that you've been blessed with never having a mental condition that requires medication, or you wouldn't be so dismissive.

Edited by Omega Entity

Share this post


Link to post
Since a fetus is not a human being by these definitions.

 

So someone in a coma or has Alzheimer or is a newborn or depends on life support should be killed, because by this definition itt is perfectly okay to kill them.

DO not dance around this or say this is not the same.

A fetus is human. Whether it has personhood depends upon whom you ask.

 

I don't think "should" is a proper term here, since people are giving situations in which abortion might be chosen, not saying that it should be chosen in all cases.

 

Either way, people who are in a coma or on life support are taken off the machines and allowed to die, either by their own written request or the determination of the family, every day. Those with Alzheimer's, depending on the stage, are typically anywhere from mostly functional adults to those who need the care and supervision of a toddler; nowhere near the situation of a fetus. So while your Alzheimer's example is not quite the same until the disease has degenerated to the life-support level, once it gets there the above regarding disconnection applies.

Share this post


Link to post
Since a fetus is not a human being by these definitions.

 

So someone in a coma or has Alzheimer or is a newborn or depends on life support should be killed, because by this definition itt is perfectly okay to kill them.

DO not dance around this or say this is not the same.

A fetus is not a parasite. Nothing majorly bad will likely happen to you with proper nutrition.

By the way, ectopic pregnacies and the like are exceedingly rare and if we discount late term abortion, we discount the extremely unlikely risks.

???

 

A fetus or an embrio is not a person, but it is genetically a human being, from the species homo sapiens.

 

That said, I am pro choice. I can't stand these people that fight for life at all cost yet completely forget about the child once it is born. So the child must live, even if it is an unwanted child that'll be born in extreme poverty or in an abusive household. Sorry, but no, life should never be the ultimate end of all.

Share this post


Link to post
There are psychological medications proven to be safe when used in pregnancy.

It's not just psychological meds. I would have to stop taking testosterone if forced to go through with a pregnancy. As a trans person, being cut off from the meds that make living in this body more bearable would be devastating. And there's no alternative for hormones.

Share this post


Link to post
Soul King, there are many people who would be forced to discontinue medications that keep their pre-pregnancy health conditions (mental or otherwise) in check if they were to become pregnant - I am one of those people. I will not sacrifice my mental well-being for a -potential- child, that I cannot handle, nor want.

If it were a case of a pregnancy would force a person to quite taking some medication or other that was vital to keeping some potentially life threatening condition under control, I think that would fall under the category of it would jeaprodise theirlife.

 

THAT being said, I would suspect that those individuals are PROBABLY usually pretty careful about making sure that they use birth control to avoid the necessity of an abortion in the first place.

Share this post


Link to post

Birth control can fail. You can be 100% responsible, using a condom+pill/etc, do everything right and still get pregnant.

Share this post


Link to post
Unless those the health effects happen most of the time it is not relevant, you could get killed by a vaccine but you still take the vaccine.

Mental problems tend to disappear after pregnancy, as they are caused by hormones.

A fetus does not tend to cause problems with sapping nutrients, as most people can eat enough for themselves and the fetus.

Vaccines are meant to protect you (and others who can't get vaccines) from dangerous diseases. Pregnancy is... nothing like that. False comparison.

 

The whole reason I brought up things like post-partum depression and gestational diabetes (and pre-eclampsia and anemia and various infections) is because they are common.

 

Here are some other dangers:

 

Every minute, at least one person dies from complications related to pregnancy or childbirth – that means 529 000 persons a year.

For every person who dies in childbirth, around 20 more suffer injury, infection or disease – approximately 10 million women each year.

Some one million children are left motherless each year. These children are 10 times more likely to die within two years of their mothers’ death.

99% of all maternal deaths occur in developing countries.

Maternal mortality is higher in women living in rural areas and among poorer communities.

Young adolescents face a higher risk of complications and death as a result of pregnancy than older persons.

 

http://www.who.int/features/qa/12/en/

 

So because it'd be all a-okay (possibly) after nine months of hell, I should have to suffer from strong suicidal urges and mental breakdowns if I were to get pregnant because - what - you, who is not going through this hellish situation, think that's nothing serious? I get itchy and jumpy and uncomfortable just thinking about being pregnant. I'm hardly the only one.

 

Besides of which, there are other - preexisting - mental conditions that can worsen with pregnancy. And no, there aren't always other medical options for treating those during pregnancy. Not to mention the after effects of your mental health after pregnancy.

 

A fetus has no rights to exist within anyone's body, growing inside them, literally changing their bodies without permission.

Share this post


Link to post

You know after i open this can of worms to see what you all thought.I came up with a solution to all these problems.Men and women should keep their legs closed.That way no unborn child would be killed and if people want a child then they can try for one. but people think love is having something if someone truily loved you the way it should be they and you would wait till marriage anyway. So with that i end my case.

Edited by Laryal

Share this post


Link to post

And a little more about pregnancy and childbirth, including changes to physiology and common complications. This as all based around the mother's health and not the child's, simply because my speciality is adult nursing. So perhaps this might help demonstrate several things for those who are saying that problematic births are rare, mental health disorders are easily treated, and the like.

 

Anatomy and Physiology Post-Partum

Physiological and Psychological changes after birth.

 

Puerperium/Postpartum – period of up to six weeks after delivery where uterus and other structures of reproductive system return to pre-pregnant state.[1,2]

 

Physiological

 

Headaches are common for the first week after birth, likely due to tension. [1, 2]

 

Sleep is disturbed, but this tends to be as a result of caring for the baby. [1, 2]

 

Pregancny-induced hypertensions. [1]

 

Pain as a consequence of the birthing process. Afterpain are common as a result of the continued contraction of uterine muscle as it returns to pre-pregnant state, esp. in subsequent births. [1]

 

Hormones. Many changes in hormone balance and endocrine system through pregnancy. With expulsion of placenta hormone levels drop rapidly – the drop in oestrogen allows prolactin to act on alveoli of breast to begin milk production. Endocrine system as a whole returns to normal within six weeks postpartum. [1,2]

 

Sight problems not uncommon in pregnancy due to corneal oedema, as well as changes in taste and smell. Changes often return to normal after delivery. [1,2]

 

CVS; during pregnancy the CVS system must meet the increased demands of both woman and fetus; the altered hormone levels also impact on this. Cardiac output rises by 40% due to increase in stroke volume and heart rate. Increase in blood vessels to deliver blood to placenta. Vasodilation occurs due to presence of progesterone resulting in a drop in BP. Plasma volume increases 50% and RBC by 18%. Post-partum the circulatory system diminishes to pre-pregancy state, aided by diuresis (increased urine output) first 48hrs post delivery. Normally takes 6 – 8 weeks for CVS to return to normal. Mobility needs to be encouraged to minimise risk of thrombosis due to high number of clotting factors in blood. [1,2]

 

MSK; relaxin and progesterone act on cartiledge and connective tissue, allowing more movement in many joints – useful in the pelvis as it gives larger diameter for passage of the fetus. Abdomen muscles also become greatly stretched. Backache through pregnancy is common due to change of posture, increased weight, change of centre of gravity and other factomrs, and can persist post-pregnancy. Physiotherapy exercises postpartum can help manage this. MSK system can take up to three months to revert to a pre-pregnancy state; pelvic floor and abdo muscles may regain their tone more readily if mother takes regular postnatal exercises.[1]

 

During pregnancy rearrangement of the digestive tract occurs as the fetus develops, which can cause discomfort. The increase in circulating hormones can also cause food cravings, increase in appetite, and constipation, and a gain of weight to store nutrients is also common. With the decrease of progesterone the digestive system quickly returns to normal function; immediate weight loss of up to 5kg and within six months a return to pre-pregnancy weight is normal, although there is an average retention of about 1kg/pregnancy. Constipation is not uncommon during the postpartum period. [1,2,3]

 

Urination habits change due to the pressure of uterus on the bladder and hormonal influences; postpartum urinary output increase for ~7days as excess circulatory fluid and waste products from the involution of the uterus are expelled, but fluid balance can take up to three weeks to be restored. Bladder function can be slow to return to normal, and factors such as length of labour and pelvic floor damage make a difference. Renal system takes about six weeks to return to normal, but the morphological changes can take up to 16wks and in 10% of women anatomical changes may remain. UTIs develop in 2% - 4% of women postpartum. [1,2] Stress incontinence (involuntary incontinence on exertion) and urge incontinence are common postpartum, and can last past 1yr. [3]

 

Uterus returns to normal size and tone, from 1kg in weight to 60g, through process of autolysis (muscle breaks down) and ischaemia (reduction of blood flow to uterine lining). Lochia (materials discharged from uterus) can continue up to a month after birth; lochia rubra (red in colour, 3 – 4 days), lochia serosa (brown, 5 – 9 days) and lochia alba (yellow-white, 10 – 28 days), with colours corresponding to material being discharged (e.g. blood, amniotic fluid, cervical mucus, general debris). [1,3]

 

Menstruation and Ovulation. Postpartum period is period of relative infertility; resumption of menstruation and ovulation varies, although greater tendency for exclusively-breastfeeding women to experience longer period of anovulation and amenorrhea. Menstruation usually begins 4 – 6 weeks post-birth for non-lactating women; first cycle may not be ‘normal’ but second cycle is usually normal.

 

Dyspareunia, or pain during intercourse, is common in the first eight weeks and can persist up to 18months after birth, sometimes coupled with a disinterest in sex. [3]

 

Psychological

 

PTSD is defined as extreme psychological stress following a traumatic or threatening experienced. This can be due to unfulfilled expectations of the birthing process, intense pain caused, use of technological interventions or insensitive/undignified care. PTSD is often associated with feelings of pain, humiliation, mutilation and helplessness. Traumatic birth has been likened to sexual assault. Commonly assosciated with individuals with a history of psychiatric disorders. Tx is psychotherapy and 50% recover within 6 months. [1]

 

Puerperal psychosis is very uncommon, characterised by thought disorders, severe depression and may result in suicide/infanticide. Occurrence is ~0.2% and onset is normally 1 – 4wks after birth. A sudden onset after an interval of well-being since birth is characteristic, and thos with previous puerperal psychosis have risk of developing it a second time. May be characterised by schizophrenic and affective symptoms, frank psychosis, cognitive impairment and grossly disorganised behaviour. Hospitalisation is usually necessary and preferable to admit mother and child together in a specialist unit. Tx is psychotherapy and pharmacological methods. [3]

 

Fatigue is best defined as a decrease in response after prolonged activity, a protective mechanism where body slows or stops to allow regeneration. High rates of fatigue are expected especially in the immediate postpartum period, and some studies suggest that by the end of the postpartum period around half of women still feel fatigued. [3]

 

Alcohol and pregnancy

In Utero Effects of Alcohol

 

As well as crossing the blood-brain barrier, alcohol can also cross the placental barrier and cause Fetal Alcohol Syndrome (FAS). This can be mild to severe, characterised by:

- Retarded growth which begins before birth and continues after,

- Facial abnormalities including:

o rounded foreheard,

o skin flaps over edge of eyes,

o thin upper lip,

o flatted philtrum,

o upturned nose,

- Central Nervous System impairments including:

o Motor abnormalities

o General learning disabilities/delays

o Motor abnormalities

o Tremors

o Hyperactivity

- Heart defects

- Skeletal abnormalities

 

How much alcohol is required to produce FAS varies and again it may depend on other factors as well, but it is recognised that it is rare in those who drink in moderation during pregnancy.

 

References

1. Wylie, L. (2005) Essential Anatomy and Physiology in Maternity Care 2nd Edn. London; Churchill Livingstone Elsevier.

2. Blackburn, S. T. (2007) Maternal, Fetal and Neonatal Physiology: A Clinical Perspective 3rd Edn. Missouri; Saunders Elsevier.

3. Bick, D, MacArthur, C. & Winter, H. (2009) Postnatal Care: Evidence and Guidelines for Management 2nd Edn. London; Churchill Livingstone Elsevier.

 

 

Obstetric Emergencies

 

A&E Admissions – e.g. RTC

 

Trauma in pregnancy is estimated at around 7% of all pregnancies. Fetal outcome is largely related to maternal outcome, so for any effective care of an in utero fetus aggressive management and care of the mother is required. As pregnancy does result in physiological changes for the mother it can be difficult to interpret vital signs and physical/physiological assessments, so it is important to utilise specialist professionals in these cases. There is also the consideration that a fetus can sustain serious injury with the mother displaying only minor injury. Oxygen therapy is considered crucial as maternal oxygen reserve is generally low to begin with due to the fetus. [4]

 

It should also be kept in mind that medical conditions can be detrimentally affected by pregnancy, and new conditions can be brought about by pregnancy. Commonly aggravated conditions include; heart disease, hypertension, diabetes, respiratory disorders, renal disorders, epilepsy, thyroid disorders. Admissions with an exacerbation or possible exacerbation of this conditions may affect the health of the fetus as well as the mother and should be managed swiftly. [3]

 

Preeclampsia is a serious hypertensive disorder of pregnancy which accounts for 15% of maternal death in the UK per year. The triad of symptoms are normally peripheral oedema, proteinurea and gradual hypertension, though headaches, nausea, weight gain and visual disturbances have also been repeated as common signs. Preeclampsia is a serious condition that can impair liver and renal function of the mother, affect the growth and development of the fetus, and can lead to life-threatening seizures (known as a state of eclampsia). Although this normally resolves with delivery this can affect a woman post-partum. [3,4]

 

The assessment of a child in any situation is, as per adults, based around the ABCDE approach, although the PAT tool can also be used to help support this assessment [1,2,3]. However as children are anatomically different they require special consideration [1,4]. There are some conditions unique to children (such as febrile convulsions) while traumatic admissions require remembering the unique characteristics of paediatric anatomy (smaller body mass means more force per unit area in trauma MoI, incompletely calcified skeleton allows for organ injury without fractures, more susceptible to hypothermia, to name a few) [4]. For this reason a paediatric admission to A&E requires the paediatric trauma/emergency teams to be alerted so that they can provide the specialist knowledge and care for a child. There is also the consideration of safeguarding; children with more than one admission to A&E in the last year, or any potential signs of safeguarding concerns, must be flagged immediately to the safeguarding team [3,4].

 

Childbearing Emergencies

 

Childbirth is a natural process that normally requires minimal intervention from medical staff [3,4].

 

In traumatic injuries the stability of the mother should be considered before taking a decision on emergency childbirth or Ceserean. If the mother has sustained serious injury and blood loss she may not be able to survive such a procedure. The gestational age should also be considered – the further past 24 weeks, the greater the chance of the child surviving, although admission to NICU would be likely. Thus the health of both mother and child have to be considered and weighed up before a decision is made. [4]

 

Observations of C-sections in practice; a fellow nurse explained that emergency C-sections were normally split into three categories, each one relating the seriousness of the situation and the urgency at which the baby should be delivered. Two C-sections were for labours that failed to progress, however there was no immediate risk of harm to mother or child; one C-section was for twins, the other a single child. The third C-Section was a ‘Category B’ emergency, where there had been identified a potential risk to the life of the child and thus C-Section had to be performed within 40min of the emergency being declared. All four children were delivered safely. In the case of one C-section the mother’s bladder was ‘nicked’ by the blade during the procedure, which was discovered by fresh blood found in the patient’s catheter at the end of the procedure, and so the patient was re-opened to have the wound sealed. All three mothers recovered well with no further complications.

 

Obstetric Haemorrhage

 

Any bleeding in third trimester should be considered an emergency that requires immediate specialist evaluation and care [3,4]. The potentially life-threatening causes of vaginal bleeding in the third trimester are:

- Abruptio placenta; premature separation of the placenta from the uterus wall, normally from hypertension or trauma. As the fetus is cut off from the blood supply then it is likely to die, while the continued haemorrhage can threaten the life of the mother. [3,4]

- Placenta praevia; the placenta is implanted low and thus can occlude the cervical canal as it grows. Although blood supply to the fetus is not immediately threatened, a rupture can cause severe haemorrhaging and threaten life of mother and fetus. [3,4]

- Uterine rupture; rupturing of the uterus. Severity of condition depends on severity of rupture. [3,4]

 

In all three cases the obstetrics team must be notified and the mother stabilised (use of fluid resuscitation and oxygen therapy as appropriate), and prepared for delivery [4]. Hysterectomies can be the outcome of these emergencies should the bleeding not be resolved [4].

 

References

1. Dieckmann, R, Brownstein, D. & Gausche-Hill, M. (Eds) (2000) Pediatric Education for Prehospital Professionals Jones & Bartlett; Sudbury.

2. Thim, T, Karup, N.H.V, Grove, E.L, Rohde, C.V. & Løfgren, B (2012) “Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach” International Journal of General Medicine 2012:5, pp. 117-121

3. Caroline, N, Fellows, R. & Woolcock, M. (2007) Nancy Caroline’s Emergency Care In The Streets (6th Edn) London; Jones and Bartlett.

4. Markovchick, V.J. & Pons, P.T. (2006) Emergency Medicine Secrets (4th Edn) London; Elsevier.

Edited by Kestra15

Share this post


Link to post

  • Recently Browsing   0 members

    No registered users viewing this page.