ABORTION!

Abortion is the ending of pregnancy by the removal or forcing out from the womb of a foetus or embryo before it is able to survive on its own. An abortion can occur spontaneously, in which case it is often called a miscarriage. It can also be purposely caused in which case it is known as an induced abortion. The term abortion most commonly refers to the induced abortion of a human pregnancy. The similar procedure after the foetus may be able to survive on its own is medically known as a "late termination of pregnancy"
Abortion is a crazy painful experience, it can lead to depression, infertility and a whole lot of other issues..

Modern medicine uses medications or surgical methods for induced abortion. The two medications mifepristone and prostaglandin are as effective as a surgical method in the first trimester. While the use of medications may be effective in the second trimester,surgical methods appear to have a lower risk of side effects. Birth control, including the pill and intrauterine devices can be started immediately after an abortion. Abortion in the developed world has a long history of beingamong the safest procedures in medicine when allowed bylocal law.complicated abortions can cause either long term mental health or physical problems.Unsafe abortions result in approximately 47,000maternal deaths and 5 million hospital admissions per year globally.

An estimated 44 million abortions are performed globally each year, with slightly under half of those performed unsafely.This is quite a lot. Rates of abortions have changed little between 2003 and 2008,after having previously spent decades declining as access to education regarding family planning and birth control improved.As of 2008, 40% of the world's women had access to legal induced abortions "without restriction as to reason".There are; however, limits regarding how far along in pregnant they can be performed.

Induced abortion has a long history. They have been performed by various methods, including herbal medicines, the use of sharpened tools,physical trauma, and other traditional methods since ancient times.The laws surrounding abortion, how frequently they are performed, and their cultural and religious status vary a great deal around the world. In some contexts, abortion is legal based on specific conditions, such as incest, rape,problems with the fetus, socio-economic factors or the risk to a mother's health. In many parts of the world there is prominent public controversy over the moral,ethical, and legal issues of abortion. Those who are against abortion generally state that an embryo or foetus is a human with the right to lifea nd may compare abortion to murder.Those who support abortion rights emphasize a woman's right to decide matters concerning her own body as well as emphasising human rights generally. Where do you belong?

Induced
Approximately 205 million pregnancies occur each year worldwide. Over a third are unintended and about a fifth end in induced abortion.Most abortions result from unintended pregnancies.In africa1 to 2% of abortions are done due to genetic problems in the fetus.A pregnancy can be intentionally aborted in several ways. The manner selected often depends on the individual, the gestational age of the embryo or fetus, which increases in size as the pregnancy progresses.Specific procedures may also be selected due to legality, regional availability, and doctor or patient preference.

Reasons for procuring induced abortions are typically characterized as either therapeutic or elective. An abortion is medically referred to as a therapeutic abortion when it is performed to save the life of the pregnant woman; prevent harm to the woman's physical or mental health; terminate a pregnancy where indications are that the child will have a significantly increased chance of premature morbidity or mortality or be other wise disabled; or to selectively reduce the number of fetuses to lessen health risks associated with multiple pregnancy.An abortion is referred to as an elective or voluntary abortion when it is performed at the request of the woman for non-medical reasons (your boy friend says he does not want it)Confusion sometimes arises over the term "elective" because "elective surgery" generally refers to all scheduled surgery, whether medically necessary or not.

Spontaneous (Miscarriage)
Spontaneous abortion, also known as miscarriage, is the unintentional expulsion of an embryo or fetus before the 24thweek of gestation.A pregnancy that ends before 37 weeks of gestation resulting in alive-borninfant is known as a "premature birth" or a "preterm birth".When a fetus dies in utero after viability, or during delivery, it is usually termed "stillborn".Premature births and stillbirths are generally not considered to be miscarriages although usage of these terms can sometimes overlap.

The most common cause of spontaneous abortion(miscarriage) during the first trimester is chromosomal abnormalities of the embryo or fetus,accounting for at least 50% of sampled early pregnancy losses.Other causes include vascular disease(such aslupus),diabetes, other hormonal problems, infection, and abnormalities of the uterus.Advancing maternal age and a patient history of previous spontaneous abortions are the two leading factors associated with a greater risk of spontaneous abortion.A spontaneous abortion can also be caused by accidental trauma; intentional trauma or stress to cause miscarriage is considered induced abortion or feticide.

Medical Abortion
The most common early first-trimester medical abortion regimens use mifepristone in combination with a prostaglandin analog (misoprostolorgemeprost) up to 9 weeks gestational age,methotrexatein combination with a prostaglandin analog up to 7 weeks gestation, or a prostaglandin analog alone.Mifepristone–misoprostol combination regimens work faster and are more effective at later gestational ages than methotrexate–misoprostol combination regimens, and combination regimens are more effective than misoprostol alone.This regime is effective in the second trimester.

In very early abortions, up to 7 weeks gestation, medical abortion using a mifepristone–misoprostol combination regimen is considered to be more effective than surgical abortion (vacuum aspiration), especially when clinical practice does not include detailed inspection of aspirated tissue.Early medical abortion regimens using mifepristone, followed 24–48 hours later by buccal or vaginal misoprostol are 98% effective up to 9 weeks gestational age.If medical abortion fails, surgical abortion must be used to complete the procedure

Surgical
Up to 15 weeks' gestation,suction-aspiration or vacuum aspiration are the most common surgical methods of induced abortion.Manual vacuum aspiration(MVA) consists of removing the fetus or embryo,placenta, and membranes by suction using a manual syringe, while electric vacuum aspiration(EVA) uses an electric pump. These techniques differ in the mechanism used to apply suction, in how early in pregnancy they can be used, and in whether cervical dilation is necessary.‎

MVA, also known as "mini-suction" and "menstrual extraction", can be used in very early pregnancy, and does not require cervical dilation.Dilation and curettage(D&C), the second most common method of surgical abortion, is a standard gynecological procedure performed for a variety of reasons, including examination of the uterine lining for possible malignancy, investigation of abnormal bleeding, and abortion.Curettage refers to cleaning the walls of the uterus with acurette. This is recommended and also calledsharp curettage,only when MVA is unavailable.

From the 15th week of gestation until approximately the 26th, other techniques must be used.Premature labor and delivery can be induced with prostaglandin; this can be coupled with injecting the amniotic fluidwith hypertonic solutions containingsalineorurea. After the 16th week of gestation, abortions can also be induced byintact dilation and extraction(IDX) (also called intrauterine cranial decompression), which requires surgical decompression of the fetus's head before evacuation. IDX is sometimes called "partial-birth abortion," which has beenfederally bannedabroad.

In the third trimester of pregnancy, abortion may be performed by IDX as described above, induction of labor, or by hysterotomy.Hysterotomy abortionis a procedure similar to acaesarean sectionand is performed undergeneral anesthesia. It requires a smaller incision than a caesarean section and is used during later stages of pregnancy.

First-trimester procedures can generally be performed using local anaesthesia, while second-trimester methods may require deep sedation ‎or general anaesthesia.

Abortion is sometimes attempted by causing trauma to the abdomen. The degree of force, if severe, can cause serious internal injuries without necessarily succeeding in inducing miscarriage‎

Reported methods of unsafe,self-induced abortion ‎include misuse ofmisoprostol, and insertion of non-surgical implements such as knitting needles and clothes hangers into the uterus. These methods are rarely seen in developed countries where surgical abortion is legal and available.

Safety

The health risks of abortion depend on whether the procedure is performed safely or unsafely.illegal abortions are those performed by unskilled individuals, with hazardous equipment, or in unsanitary facilities. ‎Legal abortions performed in the developed world ‎are among the safest procedures in medicine. In Nigeria, there are a lot of poorly done abortions due to our stand as a society..we frown at the idea of abortion hereby forcing these women to go to the wrong places and the wrong people to carry out these operation. This leads to complications and most times loss of life.‎

Vacuum aspirationin the first trimester is the safest method of surgical abortion, and can be performed in a ‎primary care office,abortion clinic, or hospital. Complications are rare and can include uterine perforation,pelvic infection, and retained products of conception requiring a second procedure to evacuate. Preventive antibiotics (such as doxycycline ‎or metronidazole) are typically given before elective abortion, as they are believed to substantially reduce the risk of post operative uterine infection. Complications after second-trimester abortion are similar to those after first-trimester abortion, and depend somewhat on the method chosen.

There is little difference in terms of safety and efficacy between medical abortion using a combined regimen of mifepristone and misoprostol and surgical abortion (vacuum aspiration) in early first trimester abortions up to 9 weeks gestation. ‎Medical abortion using the prostaglandin analog misoprostol alone is less effective and more painful than medical abortion using a combined regimen of mifepristone and misoprostol or surgical abortion.

Some purported risks of abortion are promoted primarily by anti-abortion groups, but lack scientific support. ‎For example, the question of a link between induced abortion and breast cancer ‎has been investigated extensively. Major medical and scientific bodies (including the World Health Organization, the US National Cancer Institute, the American Cancer Society, the Royal College of Obstetricians and Gynaecologists ‎and the American Congress of Obstetricians and Gynecologists) have concluded that abortion does not cause breast cancer, although such a link continues to be promoted by anti-abortion groups.

Similarly, evidence indicates that induced abortion does not cause mental-health problems. The American Psychological Association ‎has concluded that a single abortion is not a threat to women's mental health, and that women are no more likely to have mental-health problems after a first-trimester abortion than after carrying an unwanted pregnancy to term. Abortions performed after the first trimester because of fetal abnormalities are not thought to cause mental-health problems. Some proposed negative psychological effects of abortion have been referred to by anti-abortion advocates as a separate condition called "post-abortion syndrome", which is not recognized by any medical or psychological organization.

Unsafe abortion
Women seeking to terminate their pregnancies sometimes resort to unsafe methods, particularly when access to legal abortion is restricted. They may attempt to self-abortor rely on another person who does not have proper medical training or access to proper facilities. This has a tendency to lead to severe complications, such as incomplete abortion,sepsis, hemorrhage, and damage to internal organs.

Unsafe abortions are a major cause of injury and death among women worldwide. Although data are imprecise, it is estimated that approximately 20 million unsafe abortions are performed annually, with 97% taking place in developing countries. ‎Unsafe abortions are believed to result in millions of injuries. Estimates of deaths vary according to methodology, and have ranged from 37,000 to 70,000 in the past decade; deaths from unsafe abortion account for around 13% of all maternal deaths.To reduce the number of unsafe abortions, public health organizations have generally advocated emphasizing the legalization of abortion, training of medical personnel, and ensuring access to reproductive-health services.

The legality of abortion is one of the main determinants of its safety. Countries with restrictive abortion laws have significantly higher rates of unsafe abortion (and similar overall abortion rates) compared to those where abortion is legal and available. ‎For example, the 1996 legalization of abortion in South Africa had an immediate positive impact on the frequency of abortion-related complications, with abortion-related deaths dropping by more than 90%. In addition, a lack of access to effective contraception contributes to unsafe abortion. It has been estimated that the incidence of unsafe abortion could be reduced by up to 75% (from 20 million to 5 million annually) if modern family planning and maternal health services were readily available globally.

‎ In Nigeria here, abortion is killing uncountable numbers of teenagers and adults alike, mostly due to its illegality, WON'T IT BE RIGHT TO LEGALISE IT IN NIGERIA? pls drop your opinion here, our ladies are dieing in thousands monthly from abortions done by quacks

Please let us know your opinion.

HYMEN

Hi peeps, it's been a while I posted on this blog, any body miss me? I miss blogging anyway. I actually felt as a doctor it's easier for me to blog while on leave than at work, alas! Am wrong, blogging while working is easier for me, maybe that's due to what my blog is about(things I see personally) or due to increase in my adrenaline level while working, whichever way, I totally miss my blog.

Few days ago I did a small presentation on # HYMEN and virginity on twitter, it was a lovely conversation between me and my followers, I encourage all to pls follow me on Twitter @dr90ng,we can iron out lot of things.

Where am from we lay a lot of emphasy on virginity and retaining your hymen as a lady, may be keep it till your wedding night! What a mythical thought!!.

I once scanned a lady one time who claimed to be a virgin, she was brought to my office by her mom,15yr old I think, with body built like a 25yr old. The history as given,points to  pregnancy. On putting my probe, she's about 16wks gone, she was so surprised that I thought am scanning the wrong womb, maybe the womb I was scanning belong to her mom!.

As a good samarithan, I told the mom to excuse us so I can have a word with the daughter. Mothers! Amazing species they are. She did and I spoke with this little gem, she told me her teenage boy friend sometimes rubs his penis on her vagina, but they never had penetrative sex, and so she was sure she's a virgin, she even told me I can examine her with her mom, what a poor fellow, I felt bad  for her.

Well, enough of my chinua achebe-ing, what am I driving at? Is the hymen a real indicator of virginity? Can a virgin get pregnant with an intact hymen?

The hymen is a piece of skin covering the vaginal opening, it starts forming from the 4th month while a woman is still in her mothers womb, it partially surrounds the vaginal opening but not covering it completely such that there is a hole that remains open at all time, offcourse the hymen differs in women.
The skin of the hymen gets thicker with maturity, such that it's lighter in children and with rigorous activities like dancing, cycling, strenuous exercises it can be broken.

I am of the opinion that the hymen is not a real indicator of virginity (my opinion), I see a lot of rape cases, where doctors will be asked to confirm if the act actually occur,most of these cases are seen few days after the evil act, hence limiting the authenticity of our examinations. Most times, the hymen is never intact, this doesn't make it a rape, the lady or little girl as the case may be could have ruptured the hymen from other causes, which cannot be proven medically, at least in my country.

It will be surprising that most people don't even know where the hymen is, even the owner of this gem might not. Doctors are not left out of these ignorance. Few to most physicians don't know.

It must be said that a woman can actually get pregnant despite an intact hymen, note that intact hymen in this case is not synonymous with virginity. From the case scenario I gave above, if you have intact gem and romance the penis close to the vaginal canal without active penetration, there is a high probability that the male ejaculate can find its way into the vagina canal, resulting in pregnancy if the timing is right. I have seen cases like this.

The hymen can actually be a gift and a curse in some circumstances, e. g case of imperforate hymen. In these case there's no opening in the hymen at all, this might go unnoticed for a while till the young lady start menstruating, there will not be outward flow of the blood which can lead to other medical conditions.

As long as am not encouraging anything as per virginity or no virginity, there a few tips on stretching the hymen naturally
1.Place one lubricated fingers against the hymen gently. Work on trying to get at least the pinky finger inside. You can attempt to work up to two fingers, but remember to be gentle.
Vigorous exercise can help to stretch or even pre-break the hymen. Sports like Horseback riding, motorcycle riding and dancing are infamous for rupturing the hymen. If your partner suspects you are not a virgin, explain these facts to them.
Tampon use can help to stretch or break the hymen. Start using the smallest type and work up to the larger sizes. A small amount of sterile lubricant can ease the tampon into place. Never force a tampon into the vagina.
The first time you have intercourse, make sure your partner moistens their finger with lubricant and gently manipulates the hymen first.

There are surgeries being done to replace broken hymen, so who says u can only be a virgin once! There are claims that some drugs can actually create or repair the hymen, I have not seen any of those drugs, but the fact am writing from Nigeria can be a factor, so hit me up if you have seen any of such, or if you have any contribution towards this topic, we can all learn one or two things.

So, Mr I can only marry a virgin, good luck to you, your golden virgin just left dr90210's office!. You don't have to know (in John legends voice)