The Abortion Dilemma
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Hysteroscopy with Dilation and Curretage (D & C)
501 19th Street, Trustees Tower FORT SANDERS WOMEN’S SPECIALISTS 1924 Pinnacle Point Way Suite 401, Knoxville Tn 37916 P# 865-331-1122 F# 865-331-1976 Suite 200, Knoxville Tn 37922 Dr. Curtis Elam, M.D., FACOG, AIMIS, Dr. David Owen, M.D., FACOG, Dr. Brooke Foulk, M.D., FACOG Dr. Dean Turner M.D., FACOG, ASCCP, Dr. F. Robert McKeown III, M.D., FACOG, AIMIS, Dr. Steven Pierce M.D., Dr. G. Walton Smith, M.D., FACOG, Dr. Susan Robertson, M.D., FACOG HYSTEROSCOPY WITH DILATION AND CURRETAGE (D & C) Please read and sign the following consent form when you feel that you completely understand the surgical procedure that is to be performed and after you have asked all of your questions. If you have any further questions or concerns, please contact our office prior to your procedure so that we may clarify any pertinent issues. Definition: HysterosCopy is an outpatient procedure that allows your doctor direct visualization of the inside of the uterine cavity (womb) by inserting a thin lighted telescope (hysteroscope) through the vagina (birth canal) and cervix, without making an abdominal incision. This procedure enables your doctor to examine the lining of the uterus, look for polyps, fibroids, scar tissue, blockages of the fallopian tubes, and abnormal partitions. In addition, this procedure allows your doctor to remove or surgically treat many of the abnormalities seen. Dilation and Curettage (D&C) allows your doctor to take a sample of the tissue that lines your uterus (endometrium) and/or to remove polyps, fibroid tumors, or hyperplasia. Suction D&C is used in cases of miscarriage. -
Do Nothing, Do Something, Aspirate: Management of Early Pregnancy
Disclosure Do Nothing, Do Something, • I train providers in Nexplanon insertion and removal Aspirate: • I do not receive any honoraria for this Management Of Early Pregnancy Loss Sarah Prager, MD, MAS Department of Obstetrics and Gynecology University of Washington Objectives Nomenclature By the end of this workshop participants will be able to: Early Pregnancy Loss/Failure (EPL/EPF) Spontaneous Abortion (SAb) 1. Understand diagnosis of early pregnancy loss (EPL) Miscarriage 2. Describe EPL management options in a clinic or the ED. 3. Describe the uterine evacuation procedure using These are all used interchangeably! the manual uterine aspirator (MUA). 4. Demonstrate the use of MUA for uterine Manual Uterine Aspiration/Aspirator (MUA) evacuation using papayas as simulation models. Manual Vacuum Aspiration/Aspirator (MVA) 5. Express an awareness of their own values related Uterine Evacuation to pregnancy and EPL management. Suction D&C/D&C/dilation and curettage Background Imperfect obstetrics: most don’t continue • Early Pregnancy Loss (EPL) is the most common complication of early pregnancy • 8–20% clinically recognized pregnancies • 13–26% all pregnancies • ~ 800,000 EPLs each year in the US • 80% of EPLs occur in 1st trimester • Many women with EPL first contact medical care through the emergency room Brown S, Miscarriage and its associations. Sem Repro Med. 1 Samantha Risk Factors for EPL • Age • 26 yo G2P1 presents to the • Prior SAb emergency room with vaginal • Smoking bleeding after a positive • Alcohol home pregnancy test. An • Caffeine (controversial) ultrasound shows a CRL of • Maternal BMI <18.5 or >25 7mm but no cardiac activity. • Celiac disease (untreated) • She wants to know why this • Cocaine happened. -
Dilation and Curettage (D&C) Consent Form
Dilation and Curettage (D&C) Consent Form Patient Name: ____________________________________________ Date of Birth: __________ Guardian Name (if applicable): ________________________________ Patient ID: ___________ Washington State law guarantees that you have both the right and the obligation to make decisions regarding your health care. Your physician can provide you with the necessary information and advice, but as a member of the health care team, you must participate in the decision making process. This form acknowledges your consent to treatment recommended by your physician. 1 MY PROCEDURE I hereby give my consent for Dr. or/and his/her associates to perform a Dilation and Curettage upon me. I understand the procedure is to be performed at the First Hill Surgery Center. This has been recommended to me by my physician in order to diagnose or treat dysfunctional uterine bleeding, menorrhagia (heavy menstrual bleeding) increased endometrial thickness, uterine polyps, and/or miscarriage. I understand that the procedure or treatment can be described as follows: The cervix is mechanically dilated and the lining of the uterus is either scraped or suctioned to remove tissue for possible biopsy. This procedure is routinely done in an outpatient surgery center and typically takes 15-20 minutes to complete. General anesthesia or sedation may be required for this procedure and will be administered by a qualified anesthesiologist. Your anesthesiologist will be available to discuss this further with you on the day of your procedure. 2 MY BENEFITS Some potential benefits of this procedure include: Removing tissue from the uterus may temporarily relieve abnormal bleeding lining; removing tissue for biopsy of the uterine lining; resolution of failed pregnancy. -
Model for Teaching Cervical Dilation and Uterine Curettage
Model for Teaching Cervical Dilation and Uterine Curettage Linda J. Gromko, MD, and Sam C. Eggertsen, MD Seattle, W a s h in g to n t least 15 percent of clinically recognizable pregnan METHODS A cies terminate in fetal loss, with the majority occur ring in the first trimester.1 Cervical dilation and uterine The fabric model was developed under the guidance of curettage (D&C) is frequently important in the manage physicians at the University of Washington Department ment of early pregnancy loss to control bleeding and re of Family Medicine and is commercially available.* The duce the risk of infection. D&Cs are also done for thera model, designed to approximate a 10-week last-menstrual- peutic first trimester abortions in family practice settings. period-sized uterus, is supported by elastic “ligaments” Resident experience may vary greatly, and some may feel on a wooden frame (Figure 1). A standard Graves spec inadequately trained in this procedure. The initial use of ulum can be inserted into the “vagina,” permitting vi gynecologic instruments (ie, tenaculum, sound, dilators, sualization of a cloth cervix. After placement of a tena curette) can feel awkward to the learner, and extensive culum onto the cervix, a paracervical block can be verbal tutoring may be discomfiting to the awake patient. demonstrated and the uterus sounded. Progressive dilation Training on a model can reduce these problems. After with Pratt or Denniston dilators follows: a drawstring al gaining basic skills on a model, the resident can focus on lows for the cervix to retain each successive degree of di gaining additional skills and refining technique during pa lation. -
Dilation and Curettage (D&C)
Fact Sheet From ReproductiveFacts.org The Patient Education Website of the American Society for Reproductive Medicine Dilation and Curettage (D&C) This fact sheet was developed in collaboration with The Society of Reproductive Surgeons “Dilation and curettage” (D&C) is a short surgical as intestines, bladder, or blood vessels, are injured. If procedure that removes tissue from your uterus (womb). any of these organs are injured, they must be repaired You may need this procedure if you have unexplained with surgery. However, if no other organs have been or abnormal bleeding, or if you have delivered a baby injured, long-term complications from a perforation are and placental tissue remains in your womb. D&C also is extremely rare and the uterus heals on its own. performed to remove pregnancy tissue remaining from can occur after a D&C. If you are not a miscarriage or an abortion. Infections pregnant at the time of your D&C, this complication How is the procedure done? is extremely rare. However, 10% of women who were D&C can be done in a doctor’s office or in the hospital. pregnant before their D&C can get an infection, usually You may be given medications to relax you or to put you within 1 week of the procedure. It may be related to a to sleep for a short time. Your doctor will slowly widen sexually transmitted infection or due to normal bacteria the opening to your uterus (cervix). Opening your cervix that pass from the vagina into the uterus during or can cause cramping. -
Interactions Between the Pro-Choice and Pro-Life Social Movements Outside the Abortion Clinic Sophie Deixel Vassar College
Vassar College Digital Window @ Vassar Senior Capstone Projects 2018 Whose body, whose choice: interactions between the pro-choice and pro-life social movements outside the abortion clinic Sophie Deixel Vassar College Follow this and additional works at: https://digitalwindow.vassar.edu/senior_capstone Recommended Citation Deixel, Sophie, "Whose body, whose choice: interactions between the pro-choice and pro-life social movements outside the abortion clinic" (2018). Senior Capstone Projects. 786. https://digitalwindow.vassar.edu/senior_capstone/786 This Open Access is brought to you for free and open access by Digital Window @ Vassar. It has been accepted for inclusion in Senior Capstone Projects by an authorized administrator of Digital Window @ Vassar. For more information, please contact [email protected]. Vassar College Whose Body, Whose Choice: Interactions Between the Pro-Choice and Pro-Life Social Movements Outside the Abortion Clinic A Thesis submitted in partial satisfaction of the requirements for the degree Bachelor of Arts in Sociology By Sophie Deixel Thesis Advisors: Professor Bill Hoynes Professor Erendira Rueda May 2018 Deixel Whose Body Whose Choice: Interactions Between the Pro-Choice and Pro-Life Social Movements Outside the Abortion Clinic This project explores abortion discourse in the United States, looking specifically at the site of the abortion clinic as a space of interaction between the pro-choice and pro-life social movements. In order to access this space, I completed four months of participant observation in the fall of 2017 as a clinic escort at the Planned Parenthood clinic in Poughkeepsie, New York. I thus was able to witness (and participate in) firsthand the interactions between the clinic escorts and the anti-abortion protestors who picketed outside of the clinic each week. -
The Political and Moral Battle Over Late-Term Abortion
CROSSING THE LINE: THE POLITICAL AND MORAL BATTLE OVER LATE-TERM ABORTION Rigel C. Oliverit "This is an emotional,distorted debate. We are using the lives ofa few women to create divisions across this country... -Senator Patty Murray' I. INTRODUCTION The 25 years following the Supreme Court's landmark decision in Roe v. Wade2 have seen a tremendous amount of social and political activism on both sides of the abortion controversy. Far from settling the issue of a woman's constitutional right to an abortion, the Roe decision galvanized pro-life and pro- choice groups and precipitated many small "battles" in what many on both sides view to be a "war" between fetal protection and women's access to reproductive choice. These battles have occurred at the judicial, grassroots, and political levels, with each side gaining and losing ground. Pro-life activists staged a nation-wide campaign of clinic protests, which led to Congress's 1994 enactment of the Federal Access to Clinic Entrances law creating specific civil and criminal penalties for violence outside of abortion clinics.3 State legislatures imposed limitations on the right to abortion, including mandatory waiting periods and requirements for parental or spousal notification. Many of these limitations were then challenged before the Supreme Court, which struck down or upheld them according to the "undue burden" standard of review articulated in PlannedParenthood of Southeastern Pennsylvania v. Casey.4 Recent developments have shifted the focus of conflict from clinic entrances and state regulation of abortion access to the abortion procedures themselves. The most controversial procedures include RU-486--the "abortion drug"-and a particular late term surgical procedure called intact dilation and extraction ("D&X")-more popularly known as "partial-birth abortion." The controversy surrounding the D&X procedure escalated dramatically in June of 1995, when both houses of Congress first introduced legislation to ban the procedure. -
CRS Report for Congress Received Through the CRS Web
95-1101 SPR Updated November 17, 1997 CRS Report for Congress Received through the CRS Web Abortion Procedures Irene E. Stith-Coleman Specialist in Life Sciences Science Policy Research Division Summary The Partial-Birth Abortion Ban Act of 1997, H.R. 1122 was vetoed by President Clinton on October 10, 1997. This legislation would have made it a federal crime, punishable by fine and/or incarceration, for a physician to perform a partial birth abortion unless it was necessary to save the life of a mother whose life is endangered by a physical disorder, illness, or injury. The bill permitted a defendant to seek a hearing before the State Medical Board on whether the physician’s conduct was necessary to save the life of the mother. H.R.1122 defined a partial birth abortion as “an abortion in which the person performing the abortion partially vaginally delivers a living fetus before killing the fetus and completing the delivery.” In his veto message to Congress, the President indicated that he vetoed H.R. 1122 for “exactly the same reasons” he vetoed similar legislation, H.R.1833, in April 1996. With that 1996 veto, the President asserted that if Congress presented him with a bill amended to add an exception for partial birth abortions for “serious health consequences,” to the mother, he would sign it. Congress did not attempt to override the veto of H.R.1122 before it adjourned, but do intend to try to override it in the second session. The partial-birth abortion legislation has stimulated a great deal of controversy. -
Unintended Pregnancy and Induced Abortion in the Philippines
Unintended Pregnancy And Induced Abortion In the Philippines CAUSES AND CONSEQUENCES Unintended Pregnancy And Induced Abortion In the Philippines: Causes and Consequences Susheela Singh Fatima Juarez Josefina Cabigon Haley Ball Rubina Hussain Jennifer Nadeau Acknowledgments Unintended Pregnancy and Induced Abortion in the Philippines; Alfredo Tadiar (retired), College of Law and Philippines: Causes and Consequences was written by College of Medicine, University of the Philippines; and Susheela Singh, Haley Ball, Rubina Hussain and Jennifer Cecille Tomas, College of Medicine, University of the Nadeau, all of the Guttmacher Institute; Fatima Juarez, Philippines. Centre for Demographic, Urban and Environmental The contributions of a stakeholders’ forum were essential Studies, El Colegio de México, and independent consult- to determining the scope and direction of the report. The ant; and Josefina Cabigon, University of the Philippines following participants offered their input and advice: Population Institute. The report was edited by Susan Merlita Awit, Women’s Health Care Foundation; Hope London, independent consultant. Kathleen Randall, of the Basiao-Abella, WomenLead Foundation; Ellen Bautista, Guttmacher Institute, supervised production of the report. EngenderHealth; Kalayaan Pulido Constantino, PLCPD; The authors thank the following current and former Jonathan A. Flavier, Cooperative Movement for Guttmacher Institute staff members for providing assis- Encouraging NSV (CMEN); Gladys Malayang, Health and tance at various stages of the report’s preparation: Development Institute; Alexandrina Marcelo, Reproductive Akinrinola Bankole, Erin Carbone, Melanie Croce-Galis, Rights Resource Group (3RG); Junice Melgar, Linangan ng Patricia Donovan, Dore Hollander, Sandhya Ramashwar Kababaihan (Likhaan); Sharon Anne B. Pangilinan, and Jennifer Swedish. The authors also acknowledge the Institute for Social Science and Action; Glenn Paraso, contributions of the following colleagues at the University Philippine Rural Reconstruction Movement; Corazon M. -
The Effects of the Global Gag Rule on Democratic Participation and Political Advocacy in Peru, 31 Brook
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Brooklyn Law School: BrooklynWorks Brooklyn Journal of International Law Volume 31 | Issue 3 Article 8 2006 The olitP ics of Gagging: The ffecE ts of the Global Gag Rule on Democratic Participation and Political Advocacy in Peru Rachael E. Seevers Follow this and additional works at: https://brooklynworks.brooklaw.edu/bjil Recommended Citation Rachael E. Seevers, The Politics of Gagging: The Effects of the Global Gag Rule on Democratic Participation and Political Advocacy in Peru, 31 Brook. J. Int'l L. (2006). Available at: https://brooklynworks.brooklaw.edu/bjil/vol31/iss3/8 This Note is brought to you for free and open access by the Law Journals at BrooklynWorks. It has been accepted for inclusion in Brooklyn Journal of International Law by an authorized editor of BrooklynWorks. THE POLITICS OF GAGGING: THE EFFECTS OF THE GLOBAL GAG RULE ON DEMOCRATIC PARTICIPATION AND POLITICAL ADVOCACY IN PERU I. INTRODUCTION he United States is one of the world’s largest donor countries to Tglobal family planning activities.1 The majority of its international grants to foreign providers come under the auspices of United States Aid for International Development (USAID) grants, making the United States an important player in global family planning.2 The 2001 reinstatement of the historically controversial “Mexico City Policy” attaches wide ranging aid conditionalities to the receipt of USAID funding, and effec- tively enables the United States to dictate the domestic and international family planning policies of recipient countries.3 Many of these funding restrictions relate to the provision of abortion services and counseling.4 In addition, some of the policy’s provisions are aimed at curtailing politi- cal advocacy for liberalized abortion regulation by foreign recipient non- governmental organizations (NGOs).5 The restrictions of the U.S. -
Miscarriage and the Dignity of the Human Body
Hope for Healing: Miscarriage and the Dignity of the Human Body Andrew J. Sodergren, M.S. Abstract This paper examines the issue of miscarriage from the perspective of the mother-child couplet. A discussion of the psychology of motherhood and miscarriage highlights the negative impact miscarriage has on the mother. Mothers must be helped to mourn the irreplaceable child lost in miscarriage. A review of Catholic teaching on the human body and dignity of the unborn emphasizes the respect owed to pre-natal human life and the bodies of embryos and fetuses who have died. Finally, it is argued that holding a funeral/burial is the best possible way to assist the mother’s grieving and to respect the deceased child. Current practices and attitudes fail to recognize either of these norms. Hope for Healing: Miscarriage and the Dignity of the Human Body Catholic bioethicists today are continually confronted with a number of pressing issues raised by the culture of death and new medical technologies: stem cell research, cloning, frozen embryos, reproductive technologies, euthanasia, and the like. While it is necessary that scholars and Church officials devote their energies to responding to these many new challenges, a regrettable consequence of this is that less controverted, more mundane issues are sometimes overlooked. When this happens, people are left without sound ethical guidance and support for dealing with situations in their lives. This is precisely the case with miscarriage, a very common and morally delicate event that has received little attention. Central to the issue of miscarriage is the care due to the two people most affected by it: the mother and her unborn child. -
Abortion at Or Over 20 Weeks' Gestation
Abortion At or Over 20 Weeks’ Gestation: Frequently Asked Questions Matthew B. Barry, Coordinator Section Research Manager April 30, 2018 Congressional Research Service 7-5700 www.crs.gov R45161 Abortion At or Over 20 Weeks’ Gestation: Frequently Asked Questions Summary Legislation at the federal and state levels seeking to limit or ban abortions in midpregnancy has focused attention on the procedure and the relatively small number of women who choose to undergo such an abortion. According to the Guttmacher Institute, about 926,200 abortions were performed in 2014; 1.3% of abortions were performed at or over 21 weeks’ gestation in 2013. A 2018 National Academies of Sciences, Engineering, and Medicine study found that most women who have abortions are unmarried (86%), are poor or low-income (75%), are under age 30 (72%), and are women of color (61%). Stages of Pregnancy and Abortion Procedures A typical, full-term pregnancy spans 40 weeks, separated into trimesters: first trimester (week 1 through week 13), second trimester (week 14 through week 27), and third trimester (week 28 through birth). Abortion in the second trimester can be performed either by using a surgical procedure or by using drugs to induce labor. According to the Centers for Disease Control and Prevention (CDC), in 2014 a surgical method was used for 98.8% of U.S. abortions at 14-15 weeks’ gestation, 98.4% at 16-17 weeks, 96.6% at 18-20 weeks, and 90.2% at 21 weeks or later. Proposed Legislation Related to Abortion Legislation in the 115th Congress, the Pain-Capable Unborn Child Protection Act (H.R.