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Abstract

This work deals with the relationship between induced abortion and mental health with a special focus on the area of political controversy. This article explores the historical background of the abortion and its legislative implications in Europe with special reference to Bosnia and Herzegovina. This work is based on etnographich, analitical and historical aproaches. It explains abortion in medical terms and analyzes the psychological effects of the abortion. This is a significant and challanging topic for those who find themselves facing the moral dilemma of whether or not to terminate a pregnancy. Problems of controversy are numerous. Is abortion a murder or not? Is fetus a person or not? When it becomes the one if ever till the birth? If abortion is not morally wrong, that doesn't mean that it's right to have an abortion. If abortion is morally wrong, that doesn't mean that it is always impermissible to have an abortion. The comon dilema is whether having an abortion is less wrong than the alternatives. These are some of the questions this paper deals with.
Epiphany: Vol. 5, No. 1, 2012
ISSN 1840-3719
Legal, Social and Psycho-Medical Effects of
Abortion
Bisera Mavrić
*
Abstract
This work deals with the relationship between induced abortion
and mental health with a special focus on the area of political
controversy. This article explores the historical background of the
abortion and its legislative implications in Europe with special
reference to Bosnia and Herzegovina. This work is based on
etnographich, analitical and historical aproaches. It explains
abortion in medical terms and analyzes the psychological effects of
the abortion. This is a significant and challanging topic for those
who find themselves facing the moral dilemma of whether or not to
terminate a pregnancy. Problems of controversy are numerous. Is
abortion a murder or not? Is fetus a person or not? When it
becomes the one if ever till the birth? If abortion is not morally
wrong, that doesn't mean that it's right to have an abortion. If
abortion is morally wrong, that doesn't mean that it is always
impermissible to have an abortion. The comon dilema is whether
having an abortion is less wrong than the alternatives. These are
some of the questions this paper deals with.
Keywords: Abortion, mental health, psychological effects, responsibility, controversy
*
Corresponding author: Bisera Mavrić, Faculty of Arts and Social Sciences, International
University of Sarajevo, Bosnia and Herzegovina, e-mail: bmavric@ius.edu.ba
B. Mavrić Legal, Social and Psycho-Medical Effects of Abortion
Epiphany: Journal of Transdisciplinary Studies, Vol. 5, No. 1, (2012) © Faculty of Arts and Social Sciences
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Introduction
The abortion debate deals with the rights and implications of deliberately
ending a pregnancy before natural childbirth. Different expert groups
have found opposite scientific evidence of a causal relationship between
abortion and poor mental health. Human life by itself poses different
meanings. It may mean a member of the biological human species -
having the human genetic code, or something different: a being that
possesses certain human characteristics in addition to the human genetic
code. What characterizes it is the ability to think, to imagine and to
communicate. This goes on and explains the being as a 'moral person', the
one that has rights and duties too. The time at which a fetus gets the right
to life is achieved from the moment of conception to the time the baby is
born. Every woman is a unique individual and has her own intrinsic
values and sense of morality. Despite suppress of remorse and attempts
of extenuation, abortions are accompanied with physical tension and
disorders that in some cases obtain a form of mental disease. Disorders
and frustrations make negative influence to relationships towards already
born children, partner or social environment. Consequences could be
even worse as cause searches somewhere else and not in abortion.
Some societies ban abortion almost completely while others
permit it in certain cases. There is no general agreement with regards to
the meaning of the word “morality.” For religious people morality is a set
of rules laid down by God. Some think of it as a set of socially imposed
rules with the function of reducing conflict in society. Others consider it a
set of principles about how we ought to live that applies to everyone
impartially, or which can be defended by appealing to the interests of
people in general. Abortion laws range from complete prohibition to
complete liberalization. Beside, unwillingness for announcing statistics
about abortion in public was always present. The biggest problems are
private ordinations which are hiding to make abortions so it is impossible
to find out statistics at any level when it comes to number of abortions
done. Even at state hospitals data are possible to discus because a great
number of abortions are made due to private connections without
B. Mavrić Legal, Social and Psycho-Medical Effects of Abortion
Epiphany: Journal of Transdisciplinary Studies, Vol. 5, No. 1, (2012) © Faculty of Arts and Social Sciences
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adequate evidence. Those statistics often alarm some parts of population
and draw a question of forcing forbiddance of abortion.
Historical Background
Abortion has always been an issue of controversy, debates and arguing.
Abortus provocatus or abortion is a forcible disruption of pregnancy and
sacrifice the fetus. Very often voluntary abortion, with approval or
demand of a pregnant woman, the right of a woman to dispose with her
body or both partner’s right to plan a family conflicts with fetus right to
live. Parents could invoke the right to respect for private and family life
or their right to found a family. Therefore, the consensus regarding the
matter has always been debatable.
In the middle of first millennium before new era Hippocrates 460
371 BCE, the father of the medicine declared famous Hippocratic Oath
that represents the base of medical ethics. He talked about serious
problems that appear due to abortion. He said “I shall not give a mean for
abortion to a woman.” Plato also held that a human soul can exist in a
wholly independent and disembodied way or can be combined with any
sort of substance. Aristotelian doctrine of hylomorphism holds that
human soul is not an independent substance, but is logically related to the
human body, as any object is logically related to the raw material out of
which it is made. He writes about ways of making an abortion that were
present at the time. He distinguishes early abortion till 7 days and late on
after 7 days of pregnancy. He justifies early abortion till fetus does not
pose the soul yet (Gavrankapetanović 12). Similar opinions about
abortion could be found in the Greco-Roman world among scholars
Pliny, Dioscorides, Celsus and Galen (Gavrankapetanović, 9).
Early Christianity condemned abortion. St. Augustine allowed
that in early abortion “offspring” may die “before it lives”. A great
thirteen century philosopher saint Thomas Aquinas held that a fetus does
not have an intellectual or rational soul at conception but acquires one
forty days in the case of male fetus, later in the case of female. For many
centuries Catholic doctrine held that abortion in the early weeks of
pregnancy is not a murder because the soul is not yet present. But though
early abortion was not considered murder during this long period, it was
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certainly considered a grave sin; as the expression “anticipated homicide”
(Dworkin 40).
Traditional Jewish view about abortion has been more lenient
than Christian. Until its birth the fetus is not a nefesh. Accordingly
abortion is not a murder. However, it was permitted only in cases of
therapeutic abortion, where existed a grave threat to the life or health of
the mother. With very few exceptions the health of the fetus was not a
valid reason for abortion. Important reason of Jewish theology of
abortion in contemporary world in particular is related to their need to
expand birthrate.
Among Arab doctors who dealt with the abortion the most
important were Ibn Sina (Avicena), Ali Abas and Ibn al Khaleb.
Although Islam holds that the soul is given to a fetus forty days after
conception it allows abortion only in one case: when the life of a mother
is endangered. Traditionally, abortion was not deemed permissible by
Muslim scholars (Hedayat, 654). Shiite scholars considered it forbidden
after implantation of the fertilized ovum. Sunni scholars have held
various opinions, but all agreed that after 4 months gestation abortion
was not permitted. Recently, scholars have begun to consider the effect of
severe fetal deformities on the mother, the families and society. This has
led some scholars to reconsider the prohibition on abortion in limited
circumstances. For example, therapeutic abortion law was passed by the
Iranian Parliament in 2003 approving it before 16 weeks of gestation
under limited circumstances, including medical conditions related to fetal
and maternal health. Recent measures in Iran provide an opportunity for
the Muslim scholars in other countries to review their traditional stance
on abortion (Hedayat, 654).
Social and Legal Challenges
For some sholars very young babies don't really qualify as having earned
the right to life by possessing the right characteristics
(www.:/bbc.co.uk/ethics/abortion). Fortunately for young children, these
scholars concede that young babies do have the right to life as a result of
tradition and law. However, as stataed by Ramcharan:
The right to life is the most basic, the most fundamental, the most
primordial and supreme right which human beings are entitled to
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have and without which protection of all other human rights
becomes either meaningless or less effective. If there is no life there
is nothing left to human dignity?
The right to life is a norm guaranteed in international customary law as
well as in various international conventions. It has the character of jus
cogens. Accordingly the right to life may not be derogated except in
exceptional situations. No government may deny the existence of the
right to life and a higher duty and standard of protection of the right is
imposed upon governments. Beside the concept of responsibility and
concept of accountability should be taken into consideration (Ramcharan,
186). However, the right to life is not a guaranteed against the threats to
life, but against intentional deprivation of live. It must be prohibited and
punishable by law except for those cases in which such deprivation of life
is permitted. The most difficult problem is does the unborn child poses
his right to life. If it is the case, than abortus provocatus must in principle
be prohibited by the legislator and prosecuted by the authorities (Van
Dijk, and Van Hoof, 10).
Some societies ban abortion almost completely while others
permit it in certain cases. Such societies usually lay down a maximum
age after which the foetus must not be aborted, regardless of the
circumstances. At various times some of the following have been allowed
in some societies: abortion for the sake of the mother's health including
her mental health; abortion where a pregnancy is the result of a crime
such as crimes like rape, incest, or child abuse; abortion where the child
of the pregnancy would have an ' unacceptable quality of life' such as
cases where the child would have serious physical handicaps, serious
genetic problems, serious mental defects; abortion for social reasons,
including: poverty, mother unable to cope with a child (or another child),
mother being too young to cope with a child; and abortion as a matter of
government policy as a way of regulating population size, as a way of
regulating groups within a population, as a way of improving the
population (www.:/bbc.co.uk/ethics/abortion). Most opponents of
abortion agree that abortion for the sake of the mother's health can be
morally acceptable if there is a real risk of serious damage to the mother.
Abortion for social reasons is usually least acceptable to opponents.
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The most difficult problem nowadays is related to the question about the
beginning and the end of the physical life of the human person. The
question of abortion is variously treated in international documents and
conventions such as Universal declaration of human rights, Declaration
of the right of the child. International covenant on civil and political
rights, European convention on human rights, American convention on
human rights and African charter on human and people’s rights
(Ramcharan 317-318).
Beside the Declaration of the right of the child only American
convention of human rights poses the clausal from the moment of
conception. It could easily lead to conclusion that in USA problems of
abortion should be minimized due to the law. On the contrary USA is the
country with the most controversial point of views regarding abortion.
Though American law insists on a sharp formal separation between
Church and State, and though the Supreme Court has forbade even
nondenominational prayer in public schools, The United States is
nevertheless among the most religious of all Western countries and, in
the tone of some of its most powerful religious groups, by far the most
fundamentalist (Quoted in Dworkin 6). Conflict is also dramatically
immanent in Latin-American countries that are almost homogeny
Catholic. Church holds a human life is made by conceive so abortion
represents a murder. Church influence is high and most of the countries
imposed proviso - Article 4 of American Declaration. Anyhow principle
nature of this proviso enables some of the countries in that region to
allow abortion at particular cases.
In Bosnia and Herzegovina interruption of the pregnancy is legal
and in accordance with Law about terms of abortion. Law that
pronounces „it is a human right to decide about children born.“ This law
implies that the basis and limitations considering abortion till 10 weeks of
pregnancy could be done by request. After 10 weeks of pregnancy there
is the risk to life and health of the women, risk to physical and mental
health of the child that should be born, rape or other sexual crime. After
20 weeks of pregnancy there is an option to save life or health of the
women.
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Ministry of Justice Bosnia and Herzegovina specifies the following
conditions: abortion must be done in the hospital or other certificated
facility for medical care; if women is under age, approval of the parents
or tutor is requested; After 10 weeks of pregnancy, special permeation of
the commission is requested (contained of gynecologist/obstetrician,
general practice doctor or specialist of intern medicine and social worker
or psychologist; and woman can turn to comitia of second instance if
commission of first instance refuse her demand (9).
Although they are legal, abortions can hardly be done in areas
where Croat citizens are in majority. It has been reported that those same
practitioners that refused to make abortions at public hospitals made
those at private clinics with very high prices. In areas where Bosnians are
majority although it is legal some doctors are refusing to make abortions.
Pre-war number of legal abortions was smaller than number of registered
pregnancies, which leaded to conclusion that interruption of the
pregnancy, was the most frequent method of planning a family.
Other European countries demand a waiting period for the
procedure, pre-abortion counseling, parental approval for minors, and in
the others there are no mandatory requirements. Abortion laws range
from complete prohibition to complete liberalization. The accessibility
and availability of abortion are a reflection of abortion law and the
accessibility and availability of abortion services. In Europe abortions are
generally well accessible in terms of abortion laws. There are differences
in accessibility to abortion services between the countries, and in some
countries, also between different areas of the country. Abortions are
generally performed in authorized facilities by gynecologists or general
practitioners.
Today abortion is still illegal concept in Ireland except to save a
woman’s life and this ban is written into its constitution. Due to it 6000
of Irish women travel each year to Britain for the operation, high
percentage of them in late-term because of the lack of support and advice
at home. Therefore, anti abortionists called this type of migration
“abortion-tourism”. It could be only stopped by reform. Over last
decade’s situation has been changed. Abortion services in great part of
Europe are relatively easily accessible in terms of the law, availability of
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facilities and health insurance coverage of the procedure in the
Netherlands, France and Slovenia. Abortion service is less accessible in
United Kingdom, Hungary and Turkey, as a result of limited accessibility
to abortion services or a relatively high abortion fee. In some Eastern
European countries there has been a tendency in the last decade to limit
the availability and access to abortion (Pinter 62).
The worldwide trend toward liberalization of abortion laws has
continued with changes in Canada, Czechoslovakia, Greece, Hungary,
Romania, the Soviet Union and Vietnam. Forty percent of the world's
population lives in countries where induced abortion is permitted on
request and twenty five percent lives where it is allowed only if the
woman's life is in danger. In recent years, abortion rates have been
increasing in Czechoslovakia, England and Wales, New Zealand and
Sweden and declining in China, France, Iceland, Italy, Japan and the
Netherlands (Barclay 215).
Psycho-Medical Effects
Pre-existing factors in a woman's life, such as emotional
attachment to the pregnancy, lack of social support, pre-existing
psychiatric illness, and conservative views on abortion increase the
likelihood of experiencing negative feelings after an abortion. Some
scientists used the term "post-abortion syndrome" to refer to negative
psychological effects which they attribute to abortion. However, "post-
abortion syndrome" is not recognized by any serious medical or
psychological organization.
Since many post-aborted women use repression as a coping
mechanism, there may be a long period of denial before a woman seeks
psychiatric care. These repressed feelings may cause psychosomatic
illnesses and psychiatric or behavioral in other areas of her life. As a
result, some counselors report that unacknowledged post-abortion
distress is the causative factor in many of their female patients, even
though their patients have come to them seeking therapy for seemingly
unrelated problems (www://afterabortion.com).
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While psychological reactions to abortion fall into many categories, some
women experience all or some of they symptoms of post-traumatic stress
disorder (PTSD). The lowest incidence rate of PTSD reported following
abortion is 1.5%, which would translate to over 600,000 cases of abortion
induced by it. Approximately half had many, but not all, symptoms of
PTSD, and 20 to 40 percent showed moderate to high levels of stress and
avoidance behavior relative to their abortion experiences (Adler, 1979).
PTSD is a psychological dysfunction which results from a traumatic
experience which overwhelms a person’s normal defense mechanisms
resulting in intense fear, feelings of helplessness or being trapped, or loss
of control. The risk that an experience will be traumatic is increased
when the traumatizing event is perceived as including threats of physical
injury, sexual violation, or the witnessing of or participation in a violent
death. PTSD results when the traumatic event causes the hyperarousal of
“flight or fight” defense mechanisms. This hyperarousal causes these
defense mechanisms to become disorganized, disconnected from present
circumstances, and take on a life of their own resulting in abnormal
behavior and personality disorders (Adler, 1979). As an example of this
disconnection of mental functions, some victims may experience intense
emotion but without clear memory of the event; others may remember
every detail but without emotion; still others may reexperience both the
event and the emotions in intrusive and overwhelming flashback
experiences (Adler, 1979).
Women may experience abortion as a traumatic event for several
reasons. Some of them are forced into an unwanted abortions by
husbands, boyfriends, parents, or others. If the woman has repeatedly
been a victim of domineering abuse, such an unwanted abortion may be
perceived as the ultimate violation in a life characterized by abuse. Other
women, no matter how compelling the reasons they have for seeking an
abortion, may still perceive the termination of their pregnancy as the
violent killing of their own child (www://afterabortion.com). The fear,
anxiety, pain, and guilt associated with the procedure are mixed. Still
other women, report that the pain of abortion, inflicted upon them by a
stranger invading their body, feels identical to rape. Researchers have
found that women with a history of sexual assault may experience greater
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distress during and after an abortion exactly because of these associations
between the two experiences. When the stressor leading to PTSD is
abortion, some clinicians refer to this as Post-Abortion Syndrome (PAS).
The major symptoms of PTSD are generally classified under three
categories: hyperarousal, intrusion, and constriction.
Hyperarousal is a characteristic of inappropriately and
chronically aroused “fight or flight” defense mechanisms. The person is
seemingly on permanent alert for threats of danger. Symptoms of
hyperarousal include: exaggerated startle responses, anxiety attacks,
irritability, outbursts of anger or rage, aggressive behavior, difficulty
concentrating, hypervigilence, difficulty falling asleep or staying asleep,
or physiological reactions upon exposure to situations that symbolize or
resemble an aspect of the traumatic experience (Adler, 1979).
Intrusion is the reexperience of the traumatic event at unwanted
and unexpected times. Symptoms of intrusion in PAS cases include:
recurrent and intrusive thoughts about the abortion or aborted child,
flashbacks in which the woman momentarily reexperiences an aspect of
the abortion experience, nightmares about the abortion or child, or
anniversary reactions of intense grief or depression on the due date of the
aborted pregnancy or the anniversary date of the abortion
(www://afterabortion.com).
Constriction is the numbing of emotional resources, or the
development of behavioral patterns, so as to avoid stimuli associated with
the trauma. It is avoidance behavior; an attempt to deny and avoid
negative feelings or people, places, or things which aggravate the
negative feelings associated with the trauma (Adler, 1979). In post-
abortion trauma cases, constriction may include: an inability to recall the
abortion experience or important parts of it; efforts to avoid activities or
situations which may arouse recollections of the abortion; withdrawal
from relationships, especially estrangement from those involved in the
abortion decision; avoidance of children; efforts to avoid or deny
thoughts or feelings about the abortion; restricted range of loving or
tender feelings; a sense of a foreshortened future (e.g., does not expect a
career, marriage, or children, or a long life diminished interest in
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previously enjoyed activities; drug or alcohol abuse; suicidal thoughts or
acts; and other self-destructive tendencies (www://afterabortion.com).
Barnard’s study (www://afterabortion.com) identified a 19% rate
of PTSD among women who had abortions three to five years previously.
But in reality the actual rate is probably higher. Clinical experience has
demonstrated that the women least likely to cooperate in post-abortion
research are those for whom the abortion caused the most psychological
distress. Research has confirmed this insight, demonstrating that the
women who refuse followup evaluation most closely match the
demographic characteristics of the women who suffer the most post-
abortion distress (Adler, 1979). The extraordinary high rate of refusal to
participate in post-abortion studies may interpreted as evidence of
constriction or avoidance behavior (not wanting to think about the
abortion) which is a major symptom of PTSD.
For many women, the onset or accurate identification of PTSD
symptoms may be delayed for several years. Until a PTSD sufferer has
received counseling and achieved adequate recovery, PTSD may result in
a psychological disability which would prevent an injured abortion
patient from bringing action within the normal statutory period. This
disability may, therefore, provide grounds for an extended statutory
period (Adler, 1979). Thirty to fifty percent of aborted women report
experiencing sexual dysfunctions, of both short and long duration,
beginning immediately after their abortions. These problems may include
one or more of the following: loss of pleasure from intercourse, increased
pain, an aversion to sex and/or males in general, or the development of a
promiscuous life-style.
Approximately 60 percent of women who experience post-
abortion sequelae report suicidal ideation, with 28 percent actually
attempting suicide, of which half attempted suicide two or more times.
Researchers in Finland have identified a strong statistical association
between abortion and suicide in a records based study. The identified 73
suicides associated within one year to a pregnancy ending either naturally
or by induced abortion. The mean annual suicide rate for all women was
11.3 per 100,000 (www://afterabortion.com). Suicide rate associated with
birth was significantly lower (5.9). Rates for pregnancy loss were
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significantly higher. For miscarriage the rate was 18.1 per 100,000 and
for abortion 34.7 per 100,000 (Speckhard, 1987). The suicide rate within
one year after an abortion was three times higher than for all women,
seven times higher than for women carrying to term, and nearly twice as
high as for women who suffered a miscarriage. Suicide attempts appear
to be especially prevalent among post-abortion teenagers (Speckhard,
1987). Post-abortion stress is also linked with increased cigarette
smoking. Women who abort are twice as likely to become heavy smokers
and suffer the corresponding health risks (Harlap, 1975). Post-abortion
women are also more likely to continue smoking during subsequent
wanted pregnancies with increased risk of neonatal death or congenital
anomalies (Obel, 1979). Over twenty studies have linked abortion to
increased rates of drug and alcohol use. Abortion is significantly linked
with a two fold increased risk of alcohol abuse among women (M. Plant,
1985). Abortion followed by alcohol abuse is linked to violent behavior,
divorce or separation, auto accidents, and job loss. In addition to the
psycho-social costs of such abuse, drug abuse is linked with increased
exposure to HIV/AIDS infections, congenital malformations, and
assaultive behavior.
For most couples, an abortion causes unforeseen problems in their
relationship. Post-abortion couples are more likely to divorce or separate.
Many post-abortion women develop a greater difficulty forming lasting
bonds with a male partner (www://afterabortion.com). This may be due
to abortion related reactions such as lowered self-esteem, greater distrust
of males, sexual dysfunction, substance abuse, and increased levels of
depression, anxiety, and volatile ange. Women who have more than one
abortion (representing about 45% of all abortions) are more likely to
require public assistance, in part because they are also more likely to
become single parent (www://afterabortion.com).
Women who have one abortion are at increased risk of having
additional abortions in the future. Women with a prior abortion
experience are four times more likely to abort a current pregnancy than
those with no prior abortion history (Joyce, 1978).
This increased risk is associated with the prior abortion due to lowered
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self esteem, a conscious or unconscious desire for a replacement
pregnancy, and increased sexual activity post-abortion. Subsequent
abortions may occur because of conflicted desires to become pregnant
and have a child and continued pressures to abort, such as abandonment
by the new male partner.
Aspects of self-punishment through repeated abortions are also
reported (Leach, 1979). Approximately 45% of all abortions are now
repeat abortions. The risk of falling into a repeat abortion pattern should
be discussed with a patient considering her first abortion. Furthermore,
since women who have more than one abortion are at a significantly
increased risk of suffering physical and psychological sequelae, these
heightened risks should be thoroughly discussed with women seeking
abortions.
A study of the medical records of 56,741 California medicaid
patients revealed that women who had abortions were 160 percent more
likely than delivering women to be hospitalized for psychiatric treatment
in the first 90 days following abortion or delivery
(www://afterabortion.com). Rates of psychiatric treatment remained
significantly higher for at least four years. In a study of post-abortion
patients only 8 weeks after their abortion, researchers found that 44%
complained of nervous disorders, 36% had experienced sleep
disturbances, 31% had regrets about their decision, and 11% had been
prescribed psychotropic medicine by their family doctor (Ashton, 1980).
A 5 year retrospective study in two Canadian provinces found
significantly greater use of medical and psychiatric services among
aborted women. Most significant was the finding that 25% of aborted
women made visits to psychiatrists as compared to 3% of the control
group (Badgley, 1977). Women who have had abortions are significantly
more likely than others to subsequently require admission to a psychiatric
hospital. At especially high risk are teenagers, separated or divorced
women, and women with a history of more than one abortion
(www://afterabortion.com).
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Conclusion
Throughout the history, people have fundamentally disagreed about the
moral status of the human embryo. In early times this was because people
knew very little about what actually went on in the womb - and so had
very little idea what an embryo was. Later, the problem was that a
pregnancy could not be recognised until it was well established and the
embryo made its presence felt by causing unmistakeable symptoms in the
mother or by starting to move in the womb. At this stage of pregnancy, it
was natural to think of the embryo as a being that was able to do things,
and they assumed that this was also true of the very earliest (and
unknown) stages of pregnancy.
This article attempted to gave answer to questions on what is
abortion and what are the possible medical consequences, psychological
effects, amount of diversity and impossibility of consensus in the world
towards this problem. Feminist’s central claim on abortion is the right of
a woman to control their own bodies. What about the woman as a whole?
She is the one that is dealing with the horror decision, and at the end if
she decide on abortion she is the one who will bear consequences.
Abortion releases men from responsibility, sexual responsibility but also
from child rising responsibility. Moral convictions of many people or at
least substantial minority is that abortion could be morally justified for a
variety of serious reasons. It is justified not only to save the life of the
mother and in case of rape or incest but also in cases in which fetal
abnormality has been diagnosed. Anyhow moral dilemma remains.
Who is to be empowered to decide is a women’s life more
valuable or the one of the unborn child. It is not a State, nor the parents,
nor the society. Therefore, this paper indicated that through history
abortion was always controversial. Scientists were contemplating,
writing, women were suffering, children never catch sight of sunlight.
Even if fetus is not a human being jet and does not have its rights,
abortion could be seen as los of the future. The loss of a child during
pregnancy can hearth a woman soul. With it comes the loss of hopes and
the promise of future generations. Each year, over 1.2 million abortions
are performed only in the United States. Of that number, untold numbers
of women grieve the loss of their unborn children.
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Today, the future is changing. Scientists are modifying plants,
animals and their own moods. People are trading their kidneys, their
blood and everything else what is possible to be sold. In such
“contemporary” world value of a single baby should be greater than ever.
B. Mavrić Legal, Social and Psycho-Medical Effects of Abortion
Epiphany: Journal of Transdisciplinary Studies, Vol. 5, No. 1, (2012) © Faculty of Arts and Social Sciences
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References
Barclay, Linda Rights, intrinsic values and the politics of abortion”.
Utilitas, Vol. 11 Issue 2, (1999): 215. Academic Search Premier.
EBSCO host. Accessed 25 Apr. 2011
<http://search.ebscohost.com/
B. Howe, et al., “Repeat Abortion, Blaming the Victims,” Am. J. of
Public Health, 69 (12):1242-1246, (1979).
Catherine Barnard, The Long-Term Psychological Effects of Abortion,
Portsmouth, N.H.: Institute for Pregnancy Loss, (1990).
<http://afterabortion.com/
Copelon, Rhonda; Zampas, Christina; Brusie, Elizabeth; deVore,
Jacqueline. Human Rights Begin at Birth: International Law and
the Claim of Fetal Rights” Reproductive Health Matters, Vol. 13
Issue 26 (2005), 120-129. Academic Search Premier. EBSCO
host. Accessed 25 Apr. 2010 <http://search.ebscohost.com/
C. Berger, et al.,“Repeat Abortion: Is it a Problem?” Family Planning
Perspectives 16 (2):70-75 . EBSCO host. Accessed 21 Apr.
2011<http://search.ebscohost.com/
Dimitrijević, Vojin, and Milan Paunović. Ljudska prava. Beograd:
Beogradski centar za ljudska prava, 1997.
Doerr, Edd. “ABORTION: Right or Wrong?” USA Today Magazine, Vol.
117 Issue 2524 (1989): 51-53. Academic Search Premier.
EBSCO host. Accessed 21 Apr. 2011
<http://search.ebscohost.com/
Dworkin, Ronald. Life’s dominion: An argument about abortion,
euthanasia, and individual freedom. New York: Vintage Books,
1994
Gavrankapetanović, Munir. Problem abortusa (pobačaja). Sarajevo:
Islamic Relief, 1994.
Gibson, Susanne. “The Problem of Abortion: Essentially Contested
Concepts and Moral Autonomy”. Bioethics 18 Issue 3, (2004):
221-233. Academic Search Premier. EBSCO host. Accessed 29
Apr. 2007 <http://search.ebscohost.com/
Glover, Jonathan. Causing Death and Saving Lives: The moral problems
of abortion infanticide, suicide, euthanasia, capital punishment,
war, and other life or death choices. London: Penguin Group,
1990.
Greenberg, Blu. “Abortion: A Challenge to Halakhah”. Judaism, Vol. 25
Issue 2 (1976):201. Academic Search Premier. EBSCO host.
Accessed 25 Apr. 2009 <http://search.ebscohost.com/
B. Mavrić Legal, Social and Psycho-Medical Effects of Abortion
Epiphany: Journal of Transdisciplinary Studies, Vol. 5, No. 1, (2012) © Faculty of Arts and Social Sciences
[136]
Harlap, “Characteristics of Pregnant Women Reporting Previous Induced
Abortions,” Bulletin World Health Organization, 52:149 (1975);
N. Meirik, “Outcome of First Delivery After 2nd Trimester Two Stage
Induced Abortion: A Controlled Cohort Study,” Acta Obsetricia
et Gynecologica Scandinavia 63(1):45-50(1984);
<http://afterabortion.com/
Hedayat, K. M.; Shooshtarizadeh, P.; Raza, “Therapeutic abortion in
Islam: Contemporary views of Muslim Shiite scholars and effect
of recent Iranian legislation” M.. Journal of Medical Ethics , Vol.
32 Issue 11 (2006): 652-657. Academic Search Premier. EBSCO
host. Accessed 25 Apr. 2007 <http://search.ebscohost.com/
Henshaw, Stanley “Induced Abortion: A World Review, 1990”. K..
Family Planning Perspectives, Vol. 22 Issue 2 (1990): 76-89,
Academic Search Premier. EBSCO host. Accessed 25 Apr. 2011
<http://search.ebscohost.com/
Korcz, K.A.. “Two Moral Strategies Regarding Abortion”. Journal of
Social Philosophy, Vol. 33 Issue 4 (2002): 581-605. Academic
Search Premier. EBSCO host. Accessed 20 Apr. 2011
<http://search.ebscohost.com/
Moranjak, Nirman, B, ed. Izazovi feminizma. Sarajevo: Forum Bosnae,
2004.
P. Van Dijk and Van Hoof G. Theory and Practice of the European
Convention on Human Rights. Deventer: Kluwer Law and
Taxation Publishers, 1990.
Pinter, B; Aubeny, E; Bartfai, G; Loeber, O; Ozalp, S; Webb, A.
Accessibility and availability of abortion in six European
countries”. European Journal of Contraception & Reproductive
Health Care, Vol. 10 Issue 1 (2005): 51-58. Academic Search
Premier. EBSCO host. Accessed 25 Apr. 2010
<http://search.ebscohost.com/
Ramcharan, B, ed. The right to Life in International Law. Dordrecht:
Kluwer Academic Publisher Group, 1985.
Robbins, Stanley. Patologijske osnove bolesti. Zagreb: Školska knjiga,
1987.
S. Henshaw, “The Characteristics and Prior Contraceptive Use of U.S.
Abortion Patients,” Family Planning Perspectives, 20(4):158-
168 (1988)
Shepard, et al., “Contraceptive Practice and Repeat Induced Abortion: An
Epidemiological Investigation,” J. Biosocial Science, 11:289-
302 (1979);
B. Mavrić Legal, Social and Psycho-Medical Effects of Abortion
Epiphany: Journal of Transdisciplinary Studies, Vol. 5, No. 1, (2012) © Faculty of Arts and Social Sciences
[137]
E. Freeman, et al., “Emotional Distress Patterns Among Women Having
First or Repeat Abortions,” Obstetrics and Gynecology,
55(5):630-636 (1980); (1984). Accessed 10 Aug.2012
<http://afterabortion.com/
Leach, “The Repeat Abortion Patient,” Family Planning Perspectives,
9(1):37-39 (1977); S.
Fischer, “Reflection on Repeated Abortions: The meanings and
motivations,” Journal of Social Work Practice 2(2):70-87
(1986); <http://afterabortion.com/
Levin, et al., “Association of Induced Abortion with Subsequent
Pregnancy Loss,” JAMA, 243:2495-2499, June 27, 1980.
M. Bracken, “First and Repeated Abortions: A Study of Decision-Making
and Delay,” J. Biosocial Science, 7:473-491 (1975);
<http://afterabortion.com/<http:/bbc.co.uk/ethics/abortion/
ResearchGate has not been able to resolve any citations for this publication.
Article
We compared prior pregnancy histories of two groups of multigravidas—240 women having a pregnancy loss up to 28 weeks' gestation and 1,072 women having a term delivery. Women who had had two or more prior induced abortions had a twofold to threefold increase in risk of first-trimester spontaneous abortion, loss between 14 to 19 and 20 to 27 weeks. The increased risk was present for women who had legal induced abortions since 1973. It was not explained by smoking status, history of prior spontaneous loss, prior abortion method, or degree of cervical dilatation. No increase in risk of pregnancy loss was detected among women with a single prior induced abortion. We conclude that multiple induced abortions do increase the risk of subsequent pregnancy losses up to 28 weeks' gestation. (JAMA 243:2495-2499, 1980)
Article
This paper is an attempt to answer three questions concerning women who have repeated abortions -Why do they do it?, What is being aborted?, and why do they need to repeat it? By exploring developmental factors in relation to clinical cases, ideas are formulated about the type of women who might be using abortion to act out problems of separation-individuation. I speculate that for some women abortion may act as a rite de passage from one self-image to another or from dependency toward independence. The act of abortion may be an unconscious way to touch or repair infantile developmental failure and to find a 'good enough' resolution.
Article
The relationship between abortion experience and contraceptive practice is examined among women having a first or repeat induced abortion at the same clinic(n=443 in each group). A previous abortion was the single most important predictor of past contraceptive practices and of contraception at the conception of the pregnancy being terminated. A previous abortion was associated with greater use of all methods of contraception among women not on welfare (P < 0·001). During the 18–month study the proportion of patients who had had previous abortions rose from 13·3% to 21·1%, and those undergoing repeat abortions appeared increasingly likely to be on welfare. Contraceptive practies did not change over time except for women on welfare having repeat abortions who became less likely to have used contraception at the time of conception (p < 0·05). While the experience of abortion is generally associated with improved contraceptive practice, many women in this population, particularly those on welfare, appear to remain exposed to unprotected coitus and subsequent repeat abortion.
Article
Associations between previous induced abortion and demographic and health factors in pregnancy were measured in 9 874 women who gave birth and who had been interviewed during pregnancy. Previous abortion was most rare among women having their first baby and increased with increasing birth order up to the fourth, thereafter decreasing. It was positively correlated with maternal age and negatively with age at marriage. There was no effect of years of schooling, when other variables were taken into account, but there were significant differences between ethnic groups, abortion being commonest among Jewish women from North African countries and more prevalent in those from western and Asian countries than in the second-generation Israel-born or in Arab women.Women who reported abortions were less likely to be strict as regards religious observance and less likely to have had a previous stillbirth or child death, other variables being equal. They were more likely to be smokers or former smokers and to be delivered of their babies in certain obstetric units. They more often reported vomiting, bleeding, and medication in early pregnancy. On the other hand, there was no significant association with diabetes, anaemia, blood groups, or season of birth.The findings show that women reporting previous induced abortions differ significantly from other pregnant women in a wide range of demographic and health characteristics. Such women may also be biased for complications of pregnancy and outcome, particularly if selected from a clinic population. Observations that indicate a deleterious effect of induced abortions on subsequent pregnancy outcomes must therefore be interpreted with considerable caution.
Article
In a sample of 345 women aborting at a New York clinic, women having a repeat abortion had delayed significantly less in seeking abortion than had women aborting for the first time. Those having a repeat abortion were more likely to anticipate, suspect and acknowledge pregnancy, and to have located the abortion clinic more rapidly, once the decision to have an abortion was made. Psychological reactions to the decision did not differ between women having first and repeat abortions. The complex interactions of many of the factors involved in the decision-making process were examined by path analysis. Variables entering the path analysis explained 36·0 and 52·4% of the variance in delay for first and repeat abortions, respectively. The analyses suggest that women having repeat abortions come from at least three groups: (1) those whose contraceptive method failed because of technical failure; (2) those experiencing contraceptor failure due to social and personal interactions with the method not conducive to optimal contraceptive practice, and (3) those women who are not practising contraception and for whom repeated unwanted pregnancies may be a response to neurotic needs.
Article
Hispanic women are 60 percent more likely than non-Hispanics to have an unintended pregnancy that they terminate by abortion, but they are less likely than nonwhites to do so. Women who profess no religion have a higher abortion rate than do women who report some religious affiliation; among the latter, Catholics are about as likely to obtain an abortion as are all women nationally, while Protestants and Jews are less likely to do so. One in six abortion patients in 1987 described themselves as born-again or Evangelical Christians; such women are half as likely as other American women to obtain abortions. Unmarried cohabiting women are nine times as likely as married women living with their husbands to have an abortion, and separated women are also at high risk. Other characteristics associated with an above-average likelihood of abortion are current school enrollment, current employment, low income, Medicaid coverage, intention to have no more children and residence in a metropolitan county. Half of all abortion patients in 1987 were practicing contraception during the month in which they conceived, and a substantial proportion of those who were not doing so had stopped using a method only a few months before becoming pregnant. The majority of abortion patients who had stopped using a method prior to becoming pregnant said they had most recently used the pill. Nonuse of a method of birth control among abortion patients is greatest for those who are young, poor, black, Hispanic or less educated.
Article
In a historical cohort study the outcome of the first birth after a legal 2nd trimester two-stage abortion induced with saline or prostaglandin F2 alpha was evaluated for 142 nulliparous and 65 parous women. The birth-outcome was compared with that for 180 parity-matched control women and for all women in Sweden 1975. No statistically significant differences were disclosed with regard to means of infants' birthweight and length of gestation, or to occurrence of low birthweight (LBW) infants and preterm deliveries. The nulliparous women with a previously induced abortion tended, however, to have more LBW-infants than did the other nulliparae . More LBW-infants were born to the 29 nulliparae with a previous abortion induced with prostaglandin than to the 113 nulliparae having abortions induced with saline (p = 0.11); otherwise no noteworthy differences were found in the birth-outcome for the 39 women with a previous abortion induced by prostaglandin, compared with the 168 having abortions induced by saline.
Article
As the number of Canadian women who have had induced abortions increases with each succeeding year, the number at risk--and the actual incidence--of repeat abortion also increases. Some researchers have argued that women who have more than one induced abortion are less well adjusted, others that they are less willing to use contraceptives, perhaps because of anxiety about sexuality. Still others have suggested that repeat abortion is unrelated to the psychology or attitudes of individual women, but rather is an inevitable result of imperfect contraceptives, imperfect contraceptive practice and the availability of legal abortion for the termination of unwanted pregnancies. A group of 580 women seeking abortions were interviewed at the Montreal General Hospital and given a number of psychological tests. About one in five of these women were having repeat abortions. The women having repeat abortions were older, less likely to be married and more tolerant of legal abortion than were women having their first abortions. They also had intercourse more frequently than the first-abortion patients. Women obtaining a repeat abortion were slightly more likely to have been using contraceptives at the time they became pregnant, but they did not differ from first-abortion patients in the types of methods that they used. On no other social or demographic characteristics, measures of psychological adjustment or attitudes about sexuality were there any important differences between the groups. A more complex statistical analysis reveals that the two most important factors differentiating first-abortion and repeat-abortion patients are age and coital frequency--both of which are variables that reflect added exposure to the risk of unintended pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS)