Septic shock After Medical Abortion – Rare but Deadly
Many women with unplanned pregnancy are opting for medical abortion, in the belief (1) that they can avoid a surgical procedure with all its anticipated pain, injury and complications, and (2) that medical abortion being non-invasive is therefore safer.
Medical abortion has a more friendly profile, it has improved convenience, better privacy and less adverse effects. This is true for those with optimal response. To align with surgical abortion, optimal outcome is the complete expulsion of pregnancy contents within twelve hours after initiating medical abortion. This occurs in practice but in a minority.
Besides the unpredictable response with medical abortion, there are gathering reports of woman succumbing to severe infection. Toxic shock syndrome after medical abortion is rare, but it has high fatality. Clostridium species are responsible for most of the infections, follow by other common uro-genital organisms like Klebsiella pneumonia, Klebsiella aerogenes and Group A strep. The sepsis develops about ten days after medical abortion, suggesting delay clearance of pregnancy products predisposes.
To those who are considering medical abortion, it is crucial to maintain vaginal hygiene, complete the prescribed antibiotics and be vigilant of early sepsis.
Abortion Mitigates Educational Under-achievements (in young women with unplanned pregnancy)
No one age group precludes unwanted pregnancy. For women below 21 years and have mis-timed pregnancies, many would opt to terminate them. The usual reasons are: disruption in their education (Torres & Forrest 1988), effect on career, inadequate finances and unstable relationships (Broen 2005).
In this millennium, young women are not prepared for motherhood. Finer found that this unpreparedness arises mainly from the interference to educational opportunities. The commercial value of education in each society differs according to the culture and economic development. In some communities, especially in East Asia, scholastic accomplishment makes or breaks a youngster’s career and future.
Earlier surveys in the late 1990s and early 2000s found indirect evidence of teenage abortion possibly benefiting subsequent life course outcomes. The common thread of teenage parenthood leading to educational under-achievement, poverty, welfare dependence, domestic violence and impaired relationships was repeatedly shown. Hofferth in 2001 reported teenage mothers completed two fewer years of schooling then mothers who first give birth after age thirty. Moore in 1993 wrote that lower ages at first birth were strongly associated with increasing risks of poverty for women at age twenty-seven. Adolescent mothers were more likely to become welfare dependent (Grindstaff 1988) and at increased risk for partner violence and relationship problems (Wiemann).
Does Abortion of Unwanted Teenage Pregnancies Reduce Adverse Life Course Outcomes?
In young women who had mis-timed pregnancies, those who seek abortion showed advantaged outcomes when compared with those who continued with the pregnancies. Zabin in 1989 found them more likely to complete high school and secured employment two years after.
The major reasons to abort unplanned pregnancies are to reduce the perceived adverse life course outcomes. In 2007, Fergusson studied abortion pattern among young women in Christchurch (New Zealand). He reported that those who seek abortion had relatively advantaged outcomes on educational achievement, income, avoidance of welfare dependence and partnership relationships. After analyzing the confounding factors, these differences were attributed to the advantaged social and educational standing of those who terminated the pregnancies. When due allowance was made for pre-pregnancy factors, only educational difference remained statistically significant.
Bailey in 2001 also highlighted that abortion may protect the educational opportunities in young women. Terminating the unplanned pregnancy mitigated the educational disadvantage associated with early pregnancy in adolescents. The statistics may illuminate certain benefits, but the abortion debate will rage on, dominated by the pro-life and pro-choice ideologies. Each camp stands on extreme views, neither willing to see or accept the counter argument.