What is the difference between abortion and elective abortion

Two clinical review papers on the subject of miscarriage published in the BMJ since the turn of the century contained no allusion to potential distress and emotional upset. In this essay I have sought to convey the meaning of this change in language: the factors behind it and its subsequent significance. Until now, Richard Beard's letter to the Lancet has tended to be perceived as an isolated stimulus to the shift in medical language and as a spontaneous response to women's feelings.

However, evidence from medical journals and textbooks of the time reveals how Beard's letter and the change in medical language can be better understood in the context of certain historical developments that enabled and encouraged both the letter-writing and language shift.

From the late s onwards, the changes in Britain's legislation allowing women greater access to abortion services also enabled them to discuss these issues with doctors without fear of being criminalised. In turn, doctors could engage in conversations with women without concern that they were being deceived: specifically, they could be confident that women describing symptoms of spontaneous pregnancy loss were not concealing a deliberate and previously illegal termination.

By the s, developments in ultrasound technology enabled the content of a woman's uterus and any early pregnancy pathologies to be visualised in real time. Doctors were now able to apply their terminology diagnostically in the clinic. For the first time in the medical history of early pregnancy loss, following the legal and technological developments described above, diagnostic language could be immediately coupled to a clinically knowable reality.

For clinicians, this would have conferred greater significance upon the medical terminology and may have heightened consciousness of language in this context. Meanwhile, the need to define accurate and unambiguous terminology for describing diagnoses of fetal loss would have been given impetus by rapidly expanding medical knowledge of the fetus and the establishment of a new fetal-focused medical speciality.

Consistent with this, the communication that sought to define the terminology came from a senior figure at the forefront of this burgeoning speciality. The emotional experiences of women who miscarry were the most proximal stimulus to Richard Beard's writing and the justification that he refers to in his letter.

Most probably, given the temporality of other writing on this issue, these experiences were acknowledged after being channelled by women's associations and feminist commentators. The fact that the emotional experiences of women formed the basis for Beard's appeal to doctors suggests that these experiences, in theory at least, had some importance for clinicians, reflecting a growing value placed upon empathy and the patient's experience.

This may have aided the language shift among doctors, and brought some small improvement to the experiences of women who miscarried, but it did not necessarily betoken a more empathic or women-centred approach. The importance of ensuring appropriate standards of care is underscored by the estimation that one in five pregnancies will miscarry, and most of these women will seek medical attention. Competing interests : None. Provenance and peer review: Not commissioned; externally peer reviewed.

She was reinstated after a much-publicised campaign from local MPs, GPs and hundreds of protesters, and after it had become clear that she had been the victim of vested male professional interests. Although the David Alton's Abortion Amendment Bill ultimately failed, it shifted the focus in abortion debates toward the issue of the lower limit of fetal viability.

This legal defining of potential fetal viability in the context of abortion determined the terms of the Still-Birth Definition Act. Despite efforts to distinguish them, in , as in , miscarriage, its margins and its meanings were once more being defined by the law relating to abortion. National Center for Biotechnology Information , U. Medical Humanities. Med Humanit. Published online Feb Andrew Moscrop.

Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Keywords: History, Linguistics, Medical imaging.

Open in a separate window. Figure 1. Figure 2. Figure 3. In an article in the BMJ observed that: It is notoriously difficult to obtain reliable histories from patients suffering from septic abortion, and it is often suspected that criminal interference, which the patient will not acknowledge, has taken place.

The basis of perinatology By the s, thanks to legal and technical developments, early pregnancy loss could increasingly be diagnosed by doctors. Acknowledgments The author profusely thanks Eike Adams. References 1. Miscarriage or abortion? Lancet 2 —23 [ PubMed ] [ Google Scholar ]. Chalmers B. Terminology used in early pregnancy loss. Chamberlain G. Nomenclature: what is your name? BMJ ; [ Google Scholar ]. Lee E. Abortion law and politics today.

London: Macmillan, —94 [ Google Scholar ]. Off Centre: feminism and cultural studies. Oakley A. A history lesson: ultrasound in obstetrics. In: Oakley A, ed. Essays on women, medicine and health. The captured womb: history of the medical care of pregnant women.

Oxford: Blackwell, [ Google Scholar ]. Abortion, motherhood, and mental health: medicalizing reproduction in the United States and Great Britain.

Layne L. Motherhood lost: a feminist account of pregnancy loss in America. New York: Routledge, 9—40 [ Google Scholar ]. A women's health model for pregnancy loss: a call for a new standard of care.

Rest as needed. DO NOT do any vigorous activity for a few days. Light housework is fine. Avoid sexual intercourse for 2 to 3 weeks. A normal menstrual period should occur in about 4 to 6 weeks. You can get pregnant before your next period. Be sure to make arrangements to prevent pregnancy, particularly during the first month after the abortion.

Medical and surgical abortions are safe and effective. They rarely have serious complications. It is rare for a medical abortion to affect a woman's fertility or her ability to bear children in the future. American College of Obstetricians and Gynecologists. Practice bulletin no. Obstet Gynecol. PMID: pubmed. Women's health. Kumar and Clark's Clinical Medicine. Philadelphia, PA: Elsevier Limited; chap Rivlin K, Westhoff C. Family planning. Comprehensive Gynecology. Philadelphia, PA: Elsevier; chap Editorial team.

You can consider talking with your partner, a family member, trusted friend, counselor, obstetrician—gynecologist ob-gyn , or another health care professional. There also are local and national resources that you can reach out to. See the Resources section below. In the United States, more than 8 in 10 abortions occur in the first trimester.

Abortion during the first trimester is a safe procedure. Procedural abortion in the first trimester typically is done with vacuum aspiration. Abortion with vacuum aspiration usually is offered up to 13 weeks of pregnancy.

To start, a speculum is placed in the vagina to hold it open. A numbing medication may be given to help block sensation in the cervix. The cervix may need to be dilated opened for the procedure. The cervix can be opened with medication or dilators rods. Most first-trimester procedures require dilation before the procedure starts. Most procedures also will include dilation during the procedure.

A thin, plastic tube is inserted through the cervix and into the uterus. The tube is then attached to a suction or vacuum pump, which removes the pregnancy. Your health care professional should take steps to ensure you are comfortable during the procedure. Pain medication may be recommended but is not always necessary. Antibiotics may be given to help prevent infection. You will go home the day of your procedure if there are no complications.

You can expect to have soreness or cramping for a few days afterward. You may be offered a prescription for pain medication or you can take over-the-counter pain medication. Bleeding and spotting may last for up to 2 weeks. This is normal. A medication abortion requires two steps. First, you take a medication called mifepristone. This medication helps stop a pregnancy from growing. About 1 to 2 days after the mifepristone you take a medication called misoprostol.

Misoprostol causes cramping and bleeding. This causes the uterus to empty. Your health care professional should explain how to take these medications. Depending on where you live, you may be able to request abortion medication from your health care professional during a telehealth visit. This is a visit done by phone or video chat. For some, a medication abortion may cause vaginal bleeding that is much heavier than a menstrual period.

The bleeding may be like a miscarriage. There may be severe cramping. There also may be nausea, vomiting, fever, and chills. Your health care professional should explain what to expect in terms of pain, bleeding, and passing the pregnancy. Also, you should have a follow-up plan with your health care professional to be sure that the abortion is complete. Follow-up may be an in-person appointment or a phone call. A second-trimester abortion is one that takes place after 13 weeks of pregnancy.

It can be done with a procedure or with medication. Abortion with medication is often called induction abortion. Most women who have a second-trimester abortion have a procedural abortion. You may need to start the process of dilating opening the cervix before the procedure starts.

There are different ways to dilate the cervix before a procedure, including using medication or dilators rods. Sometimes, this may require you to visit your health care professional the day before your procedure.

On the day of the procedure, dilators are removed if they were placed. The cervix may be dilated more if needed. A suction device and instruments are used to remove the pregnancy.

Suction may then be used to remove any remaining tissue. No incision is needed. You may receive some type of anesthesia.

Pain medication may be recommended. Medication abortion usually is done in a hospital or clinic where you can be monitored throughout the procedure. Medical abortion in the second trimester usually takes 12 to 24 hours to be completed.

The medications used may be placed in the vagina, taken by mouth, injected into the uterus, or given through an intravenous IV line. These medications cause the uterus to contract and pass tissue. Medication to relieve pain usually is given.