6.3 million pregnancies a year US
50% of pregnancies unintended
1/2 of unintended from women who don't use contraceptive
low SES account for more unintended pregnancies
unintended pregnancies how they end up
40% abortion
40% birth
10% fetal loss
induced abortion
20-24 yrs 33% of abortion
25-29 yrs 23% of abortion
30-34 yrs 15% of abortion
86% of abortions unmarried
>60% of abortions are less than 9 weeks
80% done under 12 weeks
7/100,000 births are fatal for mom
safer to have abortion early than to carry pregnancy 2/100,000 if early abortion
medical abortion 5-9 weeks
surgical 5-14 weeks
medical
advantages
performed w/o delay
no anesthesia
psychological easier
misoprostol, mifepristone, methotrexate rarely used (used for ectopics)
complications of medical abortion
bleeding 9-16 days
failure
infection (rare)
surgical procedure
manual <10>10 weeks
2nd trimester - laminaria (cervical dilators, wrapped in sea weed), need anesthesia
complications of surgical
infection, incomplete, perf, bleeding, clots, asherman,
2nd tri medical induction
option for patient desiring to hold or view fetus, give misoprostol or pitocin every 4-6 hours
30% chance of retained placenta - would need d&c
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