Abortion, Selective

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Abortion, Selective

 

Definition

Selective abortion, also known as selective reduction, refers to choosing to abort a fetus, typically in a multi-fetal pregnancy, to decrease the health risks to the mother in carrying and giving birth to more than one or two babies, and also to decrease the risk of complications to the remaining fetus(es). The term selective abortion also refers to choosing to abort a fetus for reasons such as the woman is carrying a fetus which likely will be born with some birth defect or impairment, or because the sex of the fetus is not preferred by the individual.

Purpose

A woman may decide to abort for health reasons, for example, she is at higher risk for complications during pregnancy because of a disorder or disease such as diabetes. A 2004 case reported on an embryo embedded in a cesarean section scar. Although rare, it can be life threatening to the mother. In this care, selective abortion was successful at saving the mother and the remaining embryos.
However, selective reduction is recommended often in cases of multi-fetal pregnancy, or the presence of more than one fetus, typically, at least three or more fetuses. In the general population, multi-fetal pregnancy happens in only about 1-2% of pregnant women. But multi-fetal pregnancies occur far more often in women using fertility drugs.

Precautions

Because women or couples who use fertility drugs have made an extra effort to become pregnant, it is possible that the individuals may be unwilling or uncomfortable with the decision to abort a fetus in cases of multi-fetal pregnancy. Individuals engaging in fertility treatment should be made aware of the risk of multi-fetal pregnancy and consider the prospect of recommended reduction before undergoing fertility treatment.

Description

Selective reduction is usually performed between nine and 12 weeks of pregnancy and is most successful when performed in early pregnancy. It is a simple procedure and can be performed on an outpatient basis. A needle is inserted into the woman's stomach or vagina and potassium chloride is injected into the fetus.

Preparation

Individuals who have chosen selective reduction to safeguard the remaining fetuses should be counseled prior to the procedure. Individuals should receive information regarding the risks of a multi-fetal pregnancy to both the fetuses and the mother compared with the risks after the reduction.
Individuals seeking an abortion for any reason should consider the ethical implications whether it be because the fetus is not the preferred sex or because the fetus would be born with a severe birth defect.

Aftercare

Counseling should continue after the abortion because it is a traumatic event. Individuals may feel guilty about choosing one fetus over another. Mental health professionals should be consulted throughout the process.

Key terms

Multi-fetal pregnancy — A pregnancy of two or more fetuses.
Selective reduction — Typically referred to in cases of multi-fetal pregnancy, when one or more fetuses are aborted to preserve the viability of the remaining fetuses and decrease health risks to the mother.

Risks

About 75% of women who undergo selective reduction will go into premature labor. About 4-5% of women undergoing selective reduction also miscarry one or more of the remaining fetuses. The risks associated with multi-fetal pregnancy are considered higher.

Normal results

In cases where a multi-fetal pregnancy of three or more fetuses is reduced to two fetuses, the remaining twin fetuses typically develop as they would if they had been conceived as twins.

Resources

Periodicals

"Multiple Pregnancy Associated With Infertility Therapy." American Society for Reproductive Medicine, A Practice Committee Report (November 2000): 1-8.
"Selective Reduction Eleiminates an Emryo Embedded in a Cesarean Scar." WomenÆs Health Weekly (April 8, 2004): 117.

Organizations

The Alan Guttmacher Institute. 120 Wall Street, New York, NY 10005. (212) 248-1111. http://www.agi-usa.org.
The American Society for Reproductive Medicine. 1209 Montgomery Highway, Birmingham, AL 35216-2809. (205) 978-5000. http://www.asrm.org.
Gale Encyclopedia of Medicine. Copyright 2008 The Gale Group, Inc. All rights reserved.
References in periodicals archive ?
Although India outlawed the selective abortion of female foetuses in 1994, the practice remains commonplace in the country, where parents tend to see boys as future breadwinners, whereas girls are seen as costly liabilities.
The consequence of a lack of contextual clarity is that bans on sex-selective abortions have been "misappropriated by advocates for sex selective abortion bans in the United States" (65).
In Pennsylvania, proposed legislation that would outlaw the selective abortion of children with Down syndrome has met with support from the bishop of state capital Harrisburg, while a similar measure in Utah never got a vote before the legislative session ended.
(16.) Zhu WX, Lu L and Hesketh T, China's excess males, sex selective abortion, and one child policy: analysis of data from 2005 national intercensus survey, BMJ, 2009, 338:b1211, doi: 10.1136/bmj.b1211.
The increasing practice of sex selective abortion also tends to place the women for undergoing unsafe abortion done by unqualified service providers because women opting for sex-selective abortions may not get legal abortion services.
Sex selective abortion laws are an international law issue, affecting the United Nations global population efforts.
ThePreconception and Prenatal Diagnostic Techniques(PCPNDT)Act was passed in 1994 with the aim of making selective abortion illegal, but it has been poorly enforced.
This paper will focus around the theories that support and oppose the idea of sex selective abortion. It will further discuss the sources reviewed and add a synthesis or response towards the practice of sex-selective abortion in India.
Because we don't know if it is sex selective abortion or not, so it is better to keep ourselves away from it." (Respondent, 7 years' practice)
The imbalance, first noticed centuries ago, is a natural phenomenon not due to selective abortion of girls in some areas.