ABORTION: DILATATION AND CURETTAGE (D&C)

Dilatation and curettage (D&C) involves dilating the cervix and then gently scraping the lining of the uterus with a metal instrument (the curette) to extract the fetal tissue, placenta, and

membranes. A D&C can be done until about fifteen weeks after the last menstrual period and, unlike the previously mentioned methods, requires the use of general anesthesia. A hysterotomy is an operation like a cesarean section which can be used throughout the second trimester. It also requires general anesthesia and is rarely used.

Although some people believe that eating certain foods, vigorous exercise, or other "do it yourself" techniques will lead to abortion, this is not true. Attempts at inducing abortion by

inserting objects such as a wire coathanger or knitting needle into the uterus are extremely dangerous and can lead to fatal infections or hemorrhage.

Modern abortion techniques are less risky to the mother than a full-term pregnancy: fewer than four deaths occur per 100,000 induced abortions compared to approximately twenty deaths per 100,000 pregnancies. In fact, among healthy women (those with no serious pre-existing medical problems) the risk of dying from a legal abortion in the United States is less than one per 100,000 procedures. There is no solid evidence that having a properly done abortion causes later infertility. Recent reports do indicate that having two or more induced abortions leads to a higher rate of miscarriages in subsequent pregnancies and may increase the rate of prematurity and

low-birth-weight infants.

The emotional benefits of abortion outweigh the psychological risks for most women. Serious problems requiring psychiatric referral occur in fewer than 3 women in every 100,000 who have had an abortion. Nevertheless, short-lived feelings of guilt, sadness, and loss are common in women who have had abortions; preabortion and postabortion counseling is often effective in helping women deal with these reactions.

One relatively neglected aspect of the abortion experience is the male's reaction. A 1984 survey by Shostak, McLouth, and Seng of the impact of abortion on men shows that many men try to approach the abortion decision in an abstract, intellectual way but later find themselves having to deal with feelings of hurt, guilt, or anger. Few abortion centers offer counseling services for men, perhaps reflecting the view of one abortion counselor who told us: "The imperial male attitude is just too hard to deal with in many cases. It's the woman who's pregnant, and it's her feelings I worry about. Let the men go find a psychiatrist on their own if they need to." While not all abortion counselors share this view, many point out that men don't seem interested in their services.

*71\342\2*

Men's Health Erectyle Dysfunction