Module 4: Reproductive Health Flashcards
(287 cards)
1
Q
what percent of all pregnancies are unplanned
A
45%
2
Q
what country has the highest teen pregnancy and unplanned pregnancy rate of all developed countries
A
USA
3
Q
what percent of unplanned pregnancies occur to women in their 20s
A
55%
4
Q
why are most unplanned pregnancies in women in their 20s
A
- highly fertile
- increased rates of sexual activity
5
Q
how many teenagers become pregnant each year in the US today
A
700,000
6
Q
how many teenagers became pregnant each year in the US in the 2010s
A
1 million
7
Q
are most birth controls methods for men or women
A
women
8
Q
what is the difference between birth control and contraception
A
- birth control: aimed at not having a baby, includes abortion and plan B which are not contraception
- contraception: aimed at preventing fertilization (sperm + egg), a form of birth control
9
Q
define fertility
A
a person’s ability to reproduce
10
Q
when is the onset of fertility
A
- near puberty
- menarche for women and semenarche for men
11
Q
define semenarche
A
first ejaculation in males
12
Q
define menarche
A
first period in females
13
Q
define conception
A
the fertilization of an ovum by a sperm
14
Q
define contraception
A
the methods of preventing conception
15
Q
what conditions are necessary for conception
A
- a viable egg
- a viable sperm
- access to the egg by the sperm
16
Q
how long are eggs viable after ovulation
A
24 hours
17
Q
how long are sperm viable in the female body
A
5 days
18
Q
what does a pregnancy test measure
A
HCG hormone
19
Q
when can pregnancy tests detect HCG hormone
A
up to 2 weeks before a missed period
20
Q
what does it mean if a male has a positive pregnancy test
A
- they have HCG hormone in their body
- associated with certain types of testicular cancers
21
Q
can you get pregnant over a week after having sex
A
yes
22
Q
how long does it take for a fertilized egg to reach the uterus
A
1-2 days
23
Q
how long does it take for a fertilized egg to implant into the uterine wall
A
3-5 days
24
Q
when do you technically begin pregnancy
A
when the fertilized egg implants into the uterine wall
25
define theoretical efficacy
- the number of pregnancies that are likely to occur in the first year of use if the method is used consistently and correctly
- perfect use
26
define user efficacy
- the number of pregnancies that are likely to occur in the first year of use if the method is NOT always used consistently or correctly
- typical use, human use
27
how do theoretical efficacy and user efficacy usually compare
theoretical efficacy is usually 10% higher than user efficacy
28
list the types of contraception
- barrier
- hormonal
- behavioral
- emergency
- surgical
29
define barrier contraception
- blocks the egg and sperm form joining
- can be physical (condoms) or chemical (spermicides)
30
what are the 3 things that hormonal contraception does
- prevents ovulation
- thickens cervical mucus to inhibit sperm motility
- prevents a fertilized egg from implanting by thinning the endometrial lining
31
what are the 3 types of behavioral contraception
- withdrawal
- abstinence
- fertility awareness
32
define emergency contraception
prevent pregnancy after unsafe sex or failed birth control
33
define surgical contraception
prevent pregnancy permanently
34
what type of contraception are condoms
barrier
35
what are the 2 types of condoms
- male/external
- female/internal
36
describe a male/external condom
- thin sheath to cover an erect penis and catch semen before it enters the vagina
- can come with or without spermicide and lubrication
37
can a penis be flaccid to put on a male/external condom
no, must be erect
38
what materials can condoms be made out of
- latex
- polyurethane
- lambskin (animal intestines)
39
describe latex condoms
- thin
- cheap
- felxible
40
describe polyurethane condoms
- less elasticity than latex condoms
- slightly more likely to break because of less elasticity
41
which condoms protect against pregnancy
all
42
which condoms protect against STIs
- latex
- polyurethane
- NOT lambskin
43
why do lambskin condoms not protect against STIs
- larger pores than latex and polyurethane condoms
- can block larger particles like sperm but not smaller particles like bacteria or viruses
44
what is the most common spermicide in condoms
nonoxyl-9
45
how do spermicides work
- don't kill sperm
- paralyze the flagella of sperm so they can't move
46
which lubricants can and can't be used with condoms
- can: water or silicone based
- can't: oil based
47
why should you not used oil-based lubricants with condoms
they can break down the condom
48
what products can disintegrate the latex in a condom
- oil-based lubricants
- heat
49
list the steps to putting on a male/external condom
- check the expiration date
- make sure the packaging is intact; you should be able to feel an air bubble inside
- push the condom to one corner and tear open the opposite corner
- check on the tip of your finger that the condom will roll in the right direction; the band of latex should be on the outside
- pinch the tip of the condom, place it on an erect penis, and roll the condom down the shaft of the penis
50
what is the theoretical efficacy of male/external condoms
97%
51
what is the user efficacy of male/external condoms
85%
52
which condoms have higher efficacy: male/external or female/internal
male/external have higher efficacy than female/internal
53
where can female/internal condoms be used
- vagina
- anus
54
describe female/internal condoms
- single use
- loose-fitting
- made of polyurethane
- one unit with two flexible rings at either end
55
do female/internal condoms prevent pregnancy, STIs, or both
- prevent pregnancy
- DO NOT prevent STIs
56
how are female/internal condoms inserted
- manually
- the upper ring is inserted into the vaginal canal and sits around the cervix
- the lower ring stays outside of the vagina and sits on top of the labia
57
when can female/internal condoms be inserted
8 hours before sex
58
how expensive are female condoms compared to male condoms
- female: $3 each
- male: $0.50 each
59
what is the only brand of female/internal condoms
F2C
60
how many sizes of female/internal condoms are there
1 size fits all
61
describe why the loose-fitting nature of female/internal condoms can be bad or uncomfortable
- the penis may not go into the condom
- the condom can move around and make noises
62
what is the theoretical efficacy of female/internal condoms
95%
63
what is the use efficacy of female/internal condoms
81%
64
list delivery methods of spermicides
- jellies
- creams
- foams
- suppositories
- film
65
describe how spermicides are used
- inserted into the vaginal canal
- will dissolve naturally in the vagina
- often used in conjunction with other methods
66
do you need to clean out spermicides after sex
- no
- the spermicide will be naturally absorbed by the vagina
67
what are good aspects of spermicides
- non-hormonal
- no prescription needed
- comes in a variety of types
68
which type of spermicides come in tubes
- jellies
- creams
69
which type of spermicide comes in aerosol cans
foams
70
which type of spermicide comes in a waxt capsule
suppositories
71
what are the bad aspects of spermicides
- must be applied manually (except suppositories which have applicators)
- can be messy
- do not protect against STIs
- not super effective at preventing pregnancy
72
what is the theoretical efficacy of spermicides
80%
73
what is the user efficacy of spermicides
70%
74
how should you test spermicides to make sure you don't have an irritation reaction
put a small amount on the inside of the wrist
75
will spermicides mess with the pH of the vagina
no, but that can cause irritation
76
what happens to your risk of STIs if you have a reaction to spermicides
irritation may make it easier to get STIs
77
when should you apply spermicides
- at least 10 minutes before sex (so it can be absorbed/dissolved)
- no longer than an hours before sex
78
when should you reapply spermicides
after each ejaculation
79
what type of barrier is a daphragm
- physical barrier
- also becomes a chemical barrier when used with spermicides
80
what was the first widely used birth control method for women
diaphragm
81
when was the diaphragm made
1930s
82
what did the diaphragm used to be called
womb veil
83
who had access to the diaphragm in the 1930s
only available by prescription for married women
84
describe the diaphragm
- soft and shallow cup
- made of thin latex rubber
85
where are diaphragms placed
- behind the pubic bone
- in front of the cervix to block access to the uterus
86
what must a diaphragm be used with
spermicidal cream or jelly
87
describe where spermicide should be placed when using a diaphragm
- inside the cup that will touch the cervix
- on the underside that touches the vaginal canal
88
how would you get a diaphragm
- prescription
- must be fitted by a physician
89
when do diaphragms need to be refitted
after a vaginal birth
90
what happens if a diaphragm isn't fitted perfectly
it may slip out of place
91
how much does a diaphragm cost
- $0 if have health insurance
- $400 without health insurance
92
how long do diaphragms last
4 years
93
what STIs can diaphragms reduce the risk of
- HPV
- HIV
- chlamydia
94
is the diaphragm considered a way to prevent STIs
no
95
how far in advance of sex can the diaphragm be inserted
8 hours before sex
96
what is the theoretical efficacy of the diaphragm
95%
97
what is the user efficacy of the diaphragm
84%
98
what is in combination birth control pills
- estrogen
- progestin
99
define progestin
synthetic progesterone found in hormonal birth control
100
define the O pill
non-prescription combination birth control pill
101
how much does the O pill cost
$15 a month
102
when was the combination birth control pill first marketed and approved by the FDA
1960s
103
describe the cycle of taking combination birth control pills
- 3 weeks of active birth control pills, 1 week of placebo pills (no hormone)
- can be a longer cycle (3 months on, 1 week off)
- can skip the placebo pills if confirmed with physician
104
how often should you take a combination birth control pill
- every 24 hours
- always within the same hour
105
what conditions might combination birth control pills lessen the symptoms of
- PMS
- PMDD
- endometriosis
- PCOS
106
what health problems can combination birth control pills cause
- blood clots
- high blood pressure
107
describe why the combination birth control pill might cause blood clots
- estrogen increases the clotting factor in blood
- causes it to be more likely to get blood clots
- mostly a risk factor for people who smoke or are over 35
108
do combination birth control pills protect against STIs
no
109
what can lessen the effectiveness of combination birth control pills
- grapefruit juice
- st johns wart
- antibiotics used to treat TB
110
why does grapefruit juice impact the effectiveness of the combination birth control pill
so acidic that it can break down estrogen before its absorbed
111
what is the theoretical efficacy of combination birth control pills
99.7%
112
what is the user efficacy of combination birth control pills
92%
113
does taking any form of birth control decrease fertility
no, but some forms can delay fertility
114
what is another name for progestin only birth control pills
minipills
115
what should you do if you miss 1 day of birth control pills
take the missed dose as soon as you remember
116
what should you do if you miss more than 2 days of birth control pills
use a backup contraceptive method for 1 week
117
which type of birth control pill can be taken while breastfeeding
progestin only
118
how often do you take progestin only birth control pills
- 3 weeks on
- 1 week off
119
what are progestin only birth control pills not good at preventing and why
- breakthrough bleeding
- they don't contain estrogen which regulates the endometrial lining
120
is there a risk of blood clots with progestin only birth control pills
no because they don't contain estrogen
121
what is the theoretical efficacy of progestin only birth control pills
99%
122
what is the use efficacy of progestin only birth control pills
91%
123
what is the common brand name for the contraceptive skin patch
ortho-evra
124
how does the ortho-evra contraceptive skin patch deliver hormones
transdermal: through the skin to the bloodstream
125
how long is each ortho-evra contraceptive skin patch worn for
1 week
126
what should you do about the location of the ortho-evra skin patch every time you change it
switch locations to avoid irritation
127
how big is an ortho-evra contraceptive skin patch
2 inches by 2 inches
128
what hormones are in the ortho-evra contraceptive skin patch
- estrogen
- progestin
129
why has the FDA released several warnings for increased risk of blood clots when using the ortho-evra contraceptive skin patch
- each patch contains a weeks worth of estrogen
- having a higher dose of estrogen in the patch can increase the risk for blood clots
130
how many colors are there of the ortho-evra contraceptive skin patch
1 color- creamy-tan
131
what should you do if your ortho-evra contraceptive skin patch starts peeling before you're supposed to take it off
tape it down so it stays in contact with the skin
132
what is the maximum amount of time an ortho-evra contraceptive skin patch should be off the body at a time
3 hours
133
what is the theoretical efficacy of the ortho-evra contraceptive skin patch
99.7%
134
what is the user efficacy of the ortho-evra contraceptive skin patch
92%
135
what is the common brand name for the vaginal ring
nuvaring
136
how many sizes of the nuvaring are there
1 size fits all
137
describe the shape and texture of the nuvaring
- soft
- flexible
- solid ring
- 2 inches in diameter
138
what hormones are in the nuvaring
- estrogen
- progestin
139
describe the delivery of hormones with the nuvaring
transdermal: from vaginal wall to the bloodstream
140
how do hormones from the nuvaring get into the bloodstream
body heat causes the hormones imbedded in the material to leech out
141
how long is 1 nuvaring in the vagina
3 weeks
142
how do you insert the nuvaring
- manually
- insert into the vagina and push up as far as it will go
143
how does the nuvaring have a lower dose of estrogen that the ortho-evra contraceptive skin patch
the nuvaring is inserted into the vaginal canal which is very close to where the hormones need to be (ovaries)
144
describe how you would get a nuvaring
- initial doctors exam and prescription
- purchase a new one every month
145
what are the two ways you can skip the off week with the nuvaring
- take one out after 3 weeks and immediately insert a new one
- leave the nuvaring in for 4 weeks
146
what happens when you leave a nuvaring in for 4 weeks
- will still be good at preventing pregnancy
- lower hormone levels may cause breakthrough bleeding
147
how should you store your nuvaring
- in refrigerator
- so hormones don't leech out of the ring when it isn't inserted into the vagina
148
how long can you leave a nuvaring out of the body at a time
3 hours
149
can a penis feel the nuvaring
no
150
what is the theoretical efficacy of the nuvaring
99.7%
151
what is the user efficacy of the nuvaring
92%
152
what is the common brand name for contraceptive injecitons
depo-provera
153
where can depo-provera shots be injected
- arm muscles
- gluteal muscles
154
how long does it take depo-provera to start working after the first shot
24 hours
155
how long is each depo-provera shot good for
3 months
156
how many depo-provera shots do you need in a year
4
157
what hormone is in the depo-provera shot and why
- progestin only
- a 3 month dose of estrogen would be dangerous
158
describe what happens to a woman's period when she first gets the depo-provera shot and after a year
- can cause irregular bleeding at first because of the lack of estrogen
- most women experience amenorrhea within a year
159
how long does the depo-provera shot delay fertility
1 year
160
why does it take 1 year after receiving depo-provera shots for fertility to return to normal
- progestin is fat soluble so some will be stored in the fat
- over time, the fat will slowly dissolve which will microdose you with progestin during the year after your last depo-provera shot
- after a year, all the progestin in the fat should be gone
161
what is the only method of birth control that is associated with weight gain
depo-provera shots
162
what condition can depo-provera shots cause
osteopenia (pre-osteoporosis)
163
what is the highest dose progestin birth control option available
depo-provera shots
164
why do depo-provera shots cause osteopenia
- increased progestin levels lower the ratio of progestin-estrogen in the body
- you need a higher ratio of estrogen to maintain bone density
165
how long should depo-provera shots be used for
no longer than 2-4 years
166
what is the theoretical efficacy of depo-provera contraceptive shots
99.7%
167
what is the use efficacy of depo-provera contraceptive shots
97%
168
what is the common name brand for the contraceptive implant
nexplanon
169
what was the name of the old contraceptive implant
implanon
170
how can you see the nexplanon implant if you can't feel it
x-ray
171
how long is a nexplanon implant
length of a matchstick
172
where is the nexplanon inserted
- into the skin on the inner side of the upper arm
- in the fat layer; above muscle and under skin
173
what hormone is in the nexplanon
progestin only
174
how long can you keep a nexplanon in
3 years
175
define LARCs
- long acting reversible contraceptives
- contraceptive implants and IUDs
176
what is the number 1 complaint people have with the nexplanon
irregular and breakthrough bleeding
177
describe how the nexplanon is inserted
- inserted by clinician
- device inserts the nexplanon through a needle about the diameter of a grain of rice
178
define estrodiol
- medication with synthetic estrogen
- treats breakthrough bleeding, especially for those using the nexplanon
179
how much does a nexplanon cost with and without health insurance
- without: $1000
- with: $0 (thanks to ACA)
180
what is the theoretical and user efficacy of the nexplanon
99.5%
181
describe IUDs
- intrauterine devices
- small, plastic, flexible device with nylon string attached that is placed in the uterus through the cervix
- also called IUC (intrauterine contraceptive)
182
what is the theoretical and user efficacy of IUDs
99.7%
183
what hormones are in the paragard IUD
none
184
how long does the paragard IUD last
10-12 years
185
what does the paragard IUD help with
- only pregnancy prevention
- does not regulate the menstrual cycle, inhibit ovulation, or protect against STIs
186
how does the paragard IUD prevent pregnancy
- the body and arms of the IUD are wrapped in copper microfilament which kills the sperm
- the shape of the IUD may act as a physical barrier
187
what hormones are in the mirena, skyla, kyleena, and liletta IUD
progestin only
188
what was the first IUD approved in the US
mirena IUD
189
how long is the mirena IUD good for
5 years
190
who can get the mirena IUD and why
- only women who have had a pregnancy before
- the mirena is large so it may be uncomfortable for women who do not have a slightly stretched out uterus
191
how long is the skyla IUD good for
3 years
192
how does the skyla IUD compare to the mirena IUD
skyla is slightly smaller than the mirena
193
how long is the kyleena IUD good for
5 years
194
how long is the liletta IUD good for
3-6 years
195
what is the smallest IUD
liletta
196
what might the liletta IUD help with
menstrual migraines (association only)
197
when are IUDs effective
immediately upon insertion
198
describe the process of inserting an IUD
- patient lays on the table like they are getting a pelvic exam
- a speculum is placed into the vaginal canal
- the cervix will be dilated using a medication called cytotec
- the clinician will measure the depth of the cervix
- the clinician will insert the IUD into the uterus and trim the strings
- the clinician will confirm the placement using a vaginal ultrasound
199
what does the medication cytotec do
dilates and softens the cervix
200
how long might it take for cramping and bleeding to subside after an IUD insertion
48-72 hours
201
describe the IUD string that hangs outside of the cervix
- nylon microfilament string
- used for removal of the IUD
202
what is the cost of an IUD with and without health insurance
- with: $0
- without: $1000s
203
why is the IUD nylon string one strand and not braided
braided nylon string can harbor bacteria and cause uterine infections
204
describe what may happen if you get pregnant with an IUD
- it is likely to be ectopic
- if it is not ectopic, it will likely spontaneously terminate
- small possibility that the pregnancy will be carried to term
205
what is the second leading method of contraception for women of all ages
surgical contraception
206
what is the leading method of contraception for married women and women over the age of 35
surgical contraception
207
what is the efficacy of surgical contraception (assuming it was done correctly)
100%
208
what are the two types of female sterilization
- tubal ligation
- hysterectomy
209
describe tubal ligation
- laparoscopic procedure
- tying off fallopian tubes
210
describe hysterectomy
- can be a laparoscopic procedure
- removal of uterus, uterus and fallopian tubes, or all internal reproductive organs
211
how long does a hysterectomy typically take
15-20 minutes
212
define partial hysterectomy
removal of uterus only
213
define total hysterectomy
removal of uterus and fallopina tubes
214
define radical hysterectomy
removal of all internal female reproductive organs
215
what type of hysterectomy is performed as a method of contraception
partial hysterectomy (removal of uterus only)
216
when would a radical hysterectomy be performed
to treat cancer
217
what happens when you remove the ovaries in a radical hysterectomy
- no estrogen is being produced anymore
- causes menopause overnight
218
what is the one type of male sterilization
vasectomy
219
describe vasectomy
tying off the vas deferens
220
describe the process of a vasectomy
- local anesthetic used
- takes 5 minutes
- done in office
- semen analysis performed after
221
which is considered less invasive: female or male sterilization
male sterilization
222
can men still ejaculate with a vasectomy
yes but it will not contain sperm
223
how does emergency contraception work
- gives an extremely large does or progestin
- inhibits ovulation, fertilization, and implantation of an egg
224
will taking emergency contraception harm an existing pregnancy
no, it is progestin only which will not harm a baby
225
what is the efficacy of emergency contraception if taken within 24 hours
95%
226
what is the efficacy of emergency contraception is taken within 72 hours
88%
227
what are brand names for emergency contraception
- plan B one-step
- next choice
228
how much does non-prescription emergency contraception cost
$40
229
what emergency contraception is available by prescription only
ella
230
how much does ella emergency contraception cost (with health insurance)
$0
231
how long is ella emergency contraception good for
5 days
232
what is the efficacy of ella emergency contraception within 5 days
95%
233
can you take an emergency contraceptive pill if you are taking another hormonal bith control
yes
234
does emergency contraception lose efficacy the more times you take it
no
235
what is the number 1 side effect of emergency contraception
nausea
236
how long must you keep down emergency contraception for it to work
2 hours
237
when should you get your period after taking emergency contraception
the next day or up to 2 weeks
238
when should you take a pregnancy test if you have not gotten your period after taking emergency contraception
after 2 weeks
239
list behavioral methods of contraception
- withdrawal
- abstinence and "outercourse"
- fertility awareness methods
240
what is the scientific term for withdrawal
coitus interruptus
241
what is the theoretical efficacy of withdrawal
80%
242
what is the user efficacy of withdrawal
70%
243
what percent of college students report using withdrawal as their method of birth control
25%
244
what is the only method that is 100% effective against pregnancy
abstinence
245
does abstinence protect from STIs
yes
246
does outercourse protect from STIs
no, you can still get STIs through nonpenatrative sex
247
what are the 3 fertility awareness methods
- cervical mucus method
- body temperature method
- calendar method
248
describe the cervical mucus method of fertility awareness
- examining cervical secretions
- secretions are thinner near ovulation
- use the string method: pull apart fingers with cervical mucus on them, if a string can form then you are near ovulation
249
describe the body temperature method of fertility awareness
- checking basal body temperature
- body temperature is warmed near ovulation (1/10 - 1 degree warmer)
- not super reliable
250
describe the calendar method of fertility awareness
- tracking menstrual cycle
- good if you have a regular cycle
251
how do people generally use fertility awareness methods
use more than 1 at a time
252
what is the efficacy of fertility awareness if using 2+ methods
80%
253
what percent of people who have abortions have at least 1 kid already
30-40%
254
list reasons why women choose abortions
- pregnancy would reduce woman's ability work, finish school, or care for others
- cannot afford a(nother) baby
- relationship issues or not wanting to be a single mother
- completed childbearing
- not ready for a(nother) child
- did not want people to know she was pregnant or had sex
255
what is the cutoff time for when a woman can have an abortion in the US
no abortions are allowed after 16 weeks (exceptions for rape/incest)
256
what determines the method of abortion someone may choose
- how far along they are in the pregnancy
- comfort with different methods
257
what percentage of abortions are done by woman in their 20s
60%
258
what percent of woman will have had an abortion by age 45
25%
259
what percent of abortions take place within the first 12 weeks of pregnancy
88%
260
which is associated with more complications: wisdom teeth removal or abortion
wisdom teeth removal
261
describe surgical abortions
abortion using surgical instruments
262
how long do surgical abortions typically take
5 minutes
263
what are the types of surgical aboritons
- suction curettage
- dilation and evacuation (D&E)
- dilation and curettage (D&C)
264
what is a curet
- medical instrument
- has a looped end
265
describe suction curettage
- surgical abortion
- removal of pregnancy from the side walls of the uterus using a curet
- suction removes all pregnancy contents from the uterus
266
when would a suction curettage be performed
0-12 weeks of pregnancy
267
how big is the pregnancy at 12 weeks of gestation
3-3.5 inches
268
describe dilation and evacuation (D&E)
- surgical abortion
- vacuum aspiration
- dilate cervix using medication and remove all pregnancy contents
269
when would a dilation and evacuation (D&E) be performed
12-16 weeks of pregnancy
270
how big is the pregnancy at 16 weeks of gestation
4-4.5 inches
271
when would a dilation and curettage (D&C) be performed
- 16-20 weeks of pregnancy
- usually done to remove contents after a miscarriage
272
what is the term for fetal death from 0-20 weeks
miscarraige
273
what is the term for fetal death from 20-40 weeks
stillbirth
274
how much do surgical abortions cost
$400-600
275
when are abortions covered by insurance
- when the mother's life is in danger, when it is a medical emergency
- elective abortions are not covered by insurance
276
describe medication abortions
abortion by use of medications that block progesterone
277
what medications are used for a medication abortion
- mifepristone (mifeprex) and misoprostol
- collectively called RU-486
278
when are medication abortions performed and why
- only performed before 12 weeks
- after 12 weeks, the pregnancy would be too large for a woman to pass without cervix dilation
279
which medication is taken first in a medication abortion
mifepristone
280
what does mifepristone do
- blocks progesterone
- stops blood flow to the pregnancy
281
which medication is taken second in a medication abortion
misoprostol
282
how long do you wait after taking mifepristone to take misoprostol in a medication abortion
24 hours
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what does misoprostol do
starts uterine contractions to dislodge tissue
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where does a medication abortion take place
- take medications in office
- pass tissue at home
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how long can it take to pass tissue after a medication abortion
24-48 hours
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how long after taking a medication abortion do you need to follow up with a physician and why
- follow up 1 week later
- do ensure no tissue is retained
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describe the heart beat ban in texas
- no abortions are allowed after 6 weeks (when a heartbeat can be detected)
- there were no exceptions at first but there are now exceptions for the health of mom, rape, and incest
