Maternal Indications For Abortion

Sticky Issue

Abortion is a sticky moral problem for many people, but less so when it comes to the concept of therapeutic abortions that must be performed to save the mother's life. Still, it's not easy to weigh the absolute necessity for such abortions. That's because it's pretty hard to know for sure that performing an abortion is going to save a woman's life or that not performing the abortion will cause irreparable harm to the woman in question. These issues are subjective and at a certain point, the doctor must take the plunge and make a decision based on some pretty fuzzy information, including the fact that pregnancy can cause adverse ill health or complications in a woman who has certain preexisting medical conditions.

Soul Searching

Yet another difficult moral question regards terminating a pregnancy due to fetal anomalies. Technological advances in prenatal diagnostic testing means that a diagnosis of fetal anomalies has much greater accuracy than in the past. However, certain anomalies are still quite unpredictable and may vary a great deal in severity. A couple faced with the decision of whether to terminate a fetus due to some abnormality will still need to do much soul-searching, especially if the pregnancy has occurred after a struggle with infertility, as is so common today.

A great number of pregnancy complications today are due to the vast increase in multi-fetal pregnancies which in turn are due to modern assisted reproductive technology (ART). It used to be that twins occurred once in every 90 pregnancies. Today that number is once in 45 pregnancies, a significant rise. The rate of higher-order multiple pregnancies has risen fourfold within the past two decades.

Very Successful

Pregnancies containing multiple fetuses are vulnerable to complications such as increased rates for fetal morbidity and mortality. These issues often come on the tails of premature delivery or intrauterine growth restriction (IUGR), common occurrences in multi-fetal pregnancies. Physicians have therefore introduced selective reduction as a technology to improve the outcome of such pregnancies. But to some, "selective reduction" is just a fancy term for elective abortion. Even so, it's hard to argue with the figures showing that these procedures have been very successful in cutting down on premature deliveries and have improved the rates for morbidity and mortality.

Most health care providers refuse to countenance the idea that an abortion can be therapeutic. They prefer to believe that any termination of pregnancy is elective, or a decision made by the patient on a voluntary basis. But there are real factors that are taken into account by physicians that help them to determine whether the termination of a pregnancy is medically indicated.

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