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.
References in periodicals archive ?
5] Other trends, such as the growing demand for sex selective abortion, are likely to increase the incidence of unsafe abortion and adversely change the gender dynamics even further.
Sex selective abortion laws are an international law issue, affecting the United Nations global population efforts.
For the past two decades, some countries in Asia have also had to face the issue of sex determination followed by a selective abortion, most often of female fetuses.
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.
Because we don't know if it is sex selective abortion or not, so it is better to keep ourselves away from it.
The imbalance, first noticed centuries ago, is a natural phenomenon not due to selective abortion of girls in some areas.
Despite laws enacted to stop selective abortion or even tests to determine the sex of the foetus, societies in which sons continue to be valued more than daughters continue to practise gender-based abortion.
In India, everyday 7000 girl children are being missed so the reason behind is really when we see violence related to women and sex selective abortion and female infanticide, foeticide, there are various reasons, so from womb to tomb, there are many reasons for a child, a girl, a woman to be abused physically, mentally, socially and we can say at all levels," he said.
These missing women are victims either of sex selection during pregnancy through prenatal sex detection and selective abortion, or of infanticide or child neglect following birth," the report notes.
But this isn't a story from India or China where sex selective abortion (aka female infanticide) is carried out.
According to Jha, selective abortion of girls in India has grown in the past two decades and accounts for most of the large and growing imbalance in the ratio of girls to boys up to six years of age.