A fierce debate is ongoing regarding legalizing abortion, with all concerned stating their views for and against it.
Whether it is legal, moral or not is for different religious, political and social outfits to debate and decide. But one thing is certain. It is a potentially hazardous procedure and no abortion is absolutely safe.
By definition, abortion is the expulsion of the fetus before it is viable. It may be spontaneous or induced. Induced abortions are more hazardous, more so if done by unskilled hands. If a woman decides to abort her pregnancy, she should know the likely health hazards she is exposing herself to. There are immediate and late complications and problems of physical as well as mental health afterwards.
The first physical risk of abortion is excess bleeding which can be life threatening for the patient. The balance of hormones in the body tries to keep the pregnancy ongoing and the fetus healthy. But when the pregnancy is interrupted due to abortion, this hormonal balance is disturbed. This can result in heavy bleeding, at present and also in later pregnancies.
Rupture of the uterus and amniotic fluid embolism are other potentially fatal complications which can occur after abortion.
When a woman gets abortion done, the other risk she is exposed to is infection of the pelvis. Acute infection can become generalized leading to sepsis and septic shock. Chronic pelvic infection can result in persistent lower abdominal pain with or without vaginal discharge. The resultant infection can affect the fallopian tubes, blocking them, resulting in secondary sterility. Now when such a woman wants a baby again, she finds it difficult to conceive. Blocked tubes are a potential cause for ectopic pregnancy later on, i.e. pregnancy at a site other than the uterus. This is a life threatening condition needing urgent intervention.
In subsequent pregnancy, there is greater risk of abnormal placenta and complications of labor if a woman induces abortion during a pregnancy.
Infection from the uterus can also ascend to the urinary bladder leading to chronic cystitis causing frequency of urination and painful urination.
Due to induced abortion, one can have trauma to the lower part of the uterus. This can result in miscarriages during later pregnancies. This occurs because the opening of the lower part of the uterus (cervical os), becomes incompetent to hold the growing baby. If the pregnancy continues, there is a high risk of premature delivery. Induced abortion can damage the lower part of the urinary bladder because of its close proximity to the uterus in women. This results in urinary incontinence, i.e. passing urine involuntarily.
Statistics show a much higher risk of breast cancer in women who have aborted.
Mental health of women is also adversely affected by abortion. Acute psychosis is known to be precipitated by abortion in women who are prone to it. Many women suffer from depression and recurrent nightmares after undergoing abortion. In those who are unable to conceive after an abortion, there is no end to the grief and guilt they experience. In case of some physical or mental problem in the child born subsequently after an aborted pregnancy, women always carry the burden of guilt for the abortion done before.
The hazards of abortion increase with duration of pregnancy. Risk is minimum in first 8 to 10 weeks of pregnancy, but increases after that.
Abortion should not become a substitute for contraceptive methods. It is important that a woman should be aware of the hazards, before attempting abortion. Before aborting a pregnancy, she should weigh the health hazards against continuing the pregnancy and then make a decision.
Pande is a specialist Internal medicine-Ruhengeri Hospital