2: Unplanned pregnancy and psychosocial problems

Question 1

How many abortions are carried out in the UK every year?

Answer 1

200,000

Question 2

Failure of what is a common reason for abortion?

Answer 2

Failure of contraception

Question 3

Apart from failure of contraception, what are some other reasons women choose to have an abortion?

Answer 3

Pregnancy as a result of abuse

Lack of knowledge about implications of pregnancy, family planning

Question 4

If you become pregnant, what are your three options?

Answer 4

1. Continue with the pregnancy and keep the baby

2. Continue with the pregnancy and put the baby up for adoption

3. End the pregnancy via termination

Question 5

The rates of abortion are highest in which age group?

Answer 5

20 - 24

Question 6

Having an abortion is (safer / more dangerous) than carrying a baby to term.

Answer 6

safer

Question 7

Abortion rates are strongly associated with which social factor?

Answer 7

Deprivation

Question 8

Which legal act was written to regulate abortions?

Answer 8

Abortion Act (1967)

Question 9

Under the Abortion Act, who has to approve an abortion before it occurs?

Answer 9

Two registered medical practioners

Question 10

Under the Abortion Act, where do abortions have to take place?

Answer 10

NHS hospitals or NHS-approved centres

Question 11

Under the Abortion Act 1967, which forms need to be filled out

a) by two medical practitioners for a planned abortion
b) by one medical practitioner for an emergency abortion?

Answer 11

a) Certificate A

b) Certificate B

Question 12

In general, when is abortion acceptable?

Answer 12

When risks (physical / mental) of carrying baby to term are greater than the benefits for mother or existing children

When baby would be born with severe physical or mental abnormalities

Question 13

After which week in gestation can an abortion NOT be performed?

Answer 13

Week 24

Question 14

When is an emergency abortion acceptable?

Answer 14

When abortion is necessary to save the life of, or prevent serious physical / mental harm to, the pregnant women

Question 15

Can abortions be performed for under 16s?

Answer 15

Yes - if they are assessed to be competent

Question 16

As a doctor, which term is used to describe opting out of any procedures related to abortion?

Answer 16

Conscientious objection

Question 17

If you conscientiously object to carrying out procedures related to abortion or giving advice to patients, what must you do?

Answer 17

Hand patient over to a qualified medical practitioner who can look after them instead

Question 18

Treatment in the event of an ____ may not be denied on the grounds of conscientious objection.

Answer 18

emergency

Question 19

How long after being referred will patients expect to be seen in a termination of pregnancy clinic?

Answer 19

2 weeks

Question 20

What happens at the first appointment in the TOP clinic?

Answer 20

Discussion of abortion and certainty to proceed

Ultrasound abdomen to make sure pregnancy is uterine i.e not ectopic

Full medical history

Discussion of abortion methods

Question 21

While an abortion is being arranged, patients may be screened for which diseases?

Answer 21

STIs

Question 22

Which drugs may patients be given in the time between their initial consultation and termination of pregnancy?

Answer 22

Contraception

Prophylactic antibiotics

Question 23

In terms of gestational age, when is the cutoff for abortion?

Answer 23

24 weeks

Question 24

The legal cutoff for abortion is 24 weeks.

What does this mean practically?

Answer 24

Abortion needs to be carried out by 23 weeks 6 days

Question 25

The **legal cutoff** for abortion is **24 weeks.** What is the exception to this law?

Answer 25

**Foetal abnormalities** If present, abortion is legal at any gestational age

Question 26

The **legal cutoff for abortion is 24 weeks.** When is the **NHS Tayside cutoff**?

Answer 26

**19 weeks (medical abortion)** **12 weeks (surgical abortion)**

Question 27

Which drugs are used in **medical termination of pregnancy**?

Answer 27

**1. Mifepristone** - anti-progesterone which causes the endometrium to become unviable for pregnancy **2.** Then **misoprostol** 1-2 days later - prostaglandin which causes uterine contractions, expelling the pregnancy

Question 28

**Misoprostol** is given every ___ hours until abortion occurs.

Answer 28

**three hours**

Question 29

If a **medical abortion** fails, what may have to be carried out?

Answer 29

**Surgical abortion**

Question 30

**Surgical abortion** may be carried out up to which point in gestation?

Answer 30

**12 weeks** Or in an **emergency** e.g following failed medical abortion

Question 31

What are two methods of **surgical abortion**?

Answer 31

**Vacuum aspiration** **Dilatation and evacuation**

Question 32

How may the cervix be **primed** for surgical abortion?

Answer 32

**Misoprostol** Prostaglandin analogue, encourages uterine contractions \> expellation of products

Question 33

What form of contraception may be fitted during surgical abortion?

Answer 33

**Long-acting reversible contraception** e.g intrauterine implant, system (hormones) or device (copper)

Question 34

What **complications** can be caused by both **medical** and **surgical abortion?**

Answer 34

**Pain** **Haemorrhage** **Infection** **Incomplete abortion** **Uterine rupture**

Question 35

What is a **rare complication** of medical and surgical abortion which is a medical emergency?

Answer 35

**Uterine rupture**

Question 36

What **test** are women given post-abortion?

Answer 36

**Urine pregnancy test**

Question 37

Which **drug** are women given post-abortion?

Answer 37

**Anti-D injections** **To prevent Rhesus disease in subsequent pregnancies** (if mum is Rhesus-negative and foetus was Rhesus-positive)

Question 38

**Women MUST be encouraged to use ___ post-abortion.**

Answer 38

**Contraception**

Question 39

What are **psychosexual problems**?

Answer 39

**Disturbance of sexual functioning** Which may be caused by non-organic problems (psychological, emotional)

Question 40

What are the **most common psychosexual problems** for **men?**

Answer 40

**Loss of libido** **Premature ejaculation** **Performance anxiety**

Question 41

What are the **most common psychosexual problems** for **women**?

Answer 41

**Anorgasmia** **Vaginismus** **Loss of libido**