Case Study 2: Selective Abortion and IVF

Case Study Assignments (45 points each, see rubric)

Greg and Abigail Grossman, an older couple who were patients of Mrs. Clemmons (a nurse in a clinic specializing in assisted reproduction) were finally successful in their third attempt at IVF. Mrs. Grossman’s pregnancy test was positive 2 weeks after the procedure, and her hormone levels were very high, indicating that more than one embryo was viable. Indeed, by the fourth month of pregnancy, five fetuses could be seen on ultrasound and all seemed to be developing normally. The clinic had followed the usual procedure of implanting more than one embryo in order to increase the chance that at least some would survive. Although implanting as many as five is uncommon, some people wanting to increase the probability of at least one successful pregnancy do transfer that many, especially if the woman is older and previous attempts have failed.

At this point, the clinic physician recommended that the Grossmans reduce the pregnancy to two fetuses to ensure their survival, to prevent the birth of premature infants needing costly neonatal nursery services for weeks after the birth, and to avoid potential harm (cardiac overload) to Mrs. Grossman. The procedure would be a selective abortion of three of the fetuses.

The Grossmans were horrified by this information and did not know what to do. They asked Mrs. Clemmons to help them make their decision. To be honest, she found it very hard to see couples faced with this type of choice. She shared their grief when they failed to become pregnant through sometimes several IVF procedures. Each IVF attempt was hard on the woman’s health, hard on the marriage relationship, and expensive. Many couples used their retirement savings or took huge loans to pay for the treatment and then had no idea how they would pay for the child’s college education. Once a woman became pregnant, it seemed a cruel twist to then recommend killing some of the fetuses so that others would have a better chance at healthy births—especially when it took such a great effort to have any fetuses in the first place! She found the potential for selective abortion one of the most undesirable aspects of IVF. Even though this possibility was explained to couples before beginning IVF, she had not observed one case in which a couple who made the decision to selectively abort did not experience serious emotional trauma and did not later question their decision. Two of the clinic’s couples had, in fact, lost their remaining fetuses a few weeks after selective abortions procedures. How could Mrs. Clemmons best help the Grossmans through this difficult decision?

1. If a couple could make a selective abortion choice based on sexual preference, what would prohibit some other couple from making a selective abortion choice based on genetic endowments such as blue eyes and blond hair, or mental intelligence?

2. What role should nurses have in discussing the limits of technological advances and the morality of their uses?

Nursing Geeks

Case Study: Abortion Laws

Case Study: Abortion Laws Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Case Study: Abortion Laws   Case Study: Abortion Laws Case Study: Abortion Laws Case Study: Abortion Laws Watch this clip from the popular TV show Last Week Tonight with John Oliver titled “Abortion Laws”. Abortion Laws: Last Week Tonight with John Oliver (HBO) (Links to an external site.)Links to an external site. Reply to this post with the answers to the questions below. 1. Inequality – What aspect(s) of inequality (class, race, gender, sexual orientation and/or age) were especially salient in shaping the issues surrounding abortion legislation as outlined in the video? How does the role of inequality in this video relate to the other social problems experienced by these social groups? Apply at least 1 key concept/theory from the relevant chapter on inequality in your response. 2. Institutions – What social institutions (the family, education, work/economy, healthcare and/or criminal justice) were especially salient in shaping the issues surrounding abortion legislation as outlined in the video? How does the role of institutions in this video relate to the other social problems associated with this institution? Apply at least 1 key concept/theory from the relevant chapter on social institutions in your response. 3. Theory – Which one of the three sociological frameworks (conflict, structural functionalism or symbolic interactionism) do you think is best to use for understanding the issues surrounding abortion legislation as outlined in the video? Why? Be specific and thorough in your response. You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. 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The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument. ADDITIONAL INSTRUCTIONS FOR THE CLASS Discussion Questions (DQ) Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses. 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Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition. Use of Direct Quotes I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source. LopesWrite Policy For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. 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Competing ethical claims in abortion

PIP: In cases of abortion, as in all cases of nursing care, the nurse has the ethical obligation to provide the best nursing care possible without judging the rightness or wrongness of the patient's action or behavior. Several staff nurses at a small community hospital in the United States personally believe that abortion is ethically wrong. This personal belief is reinforced for many by their religious belief system. Because of a rotation policy at this hospital, all nurses will be assigned to work in the abortion clinic, and this presents several problems. Initially, there is the ethical dilemma of an individual nurse's personal-religious value system, and the obligation to self to live according to it. This is in opposition to the ethical obligation to care for all patients. The nursing administration also faces an ethical problem related to enforcing this policy in the fairest way possible. Another problem for the nursing administration is a legal obligation to make sure that all patients receive adquate nursing care. The nurses at this 1 community hospital asked to meet with the nursing administratio for the purpose of discussing the issue of working in the abortion clinic. The meeting took place and though exploration of value systems and issues and through mutual willingness to compromise without being compromised, decisions to resolve the dilemma were reached. It was agreed that nurses would not be made to rotate into the abortion clinic against their religious beliefs and that nurses who did not have that ethical stance would work there.

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“Regardless, you are not the first woman”: an illustrative case study of contextual risk factors impacting sexual and reproductive health and rights in Nicaragua

BMC Women's Health volume  19 , Article number:  76 ( 2019 ) Cite this article

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Rape, unintended pregnancy, and abortion are among the most controversial and stigmatized topics facing sexual and reproductive health researchers, advocates, and the public today. Over the past three decades, public health practicioners and human rights advocates have made great strides to advance our understanding of sexual and reproductive rights and how they should be protected. The overall aim of the study was to understand young women’s personal experiences of unintended pregnancy in the context of Nicaragua’s repressive legal and sociocultural landscape. Ten in-depth interviews (IDIs) were conducted with women ages 16–23 in a city in North Central Nicaragua, from June to July 2014.

Case presentation

This case study focuses on the story of a 19-year-old Nicaraguan woman who was raped, became pregnant, and almost died from complications resulting from an unsafe abortion. Her case, detailed under the pseudonym Ana Maria, presents unique challenges related to the fulfillment of sexual and reproductive rights due to the restrictive social norms related to sexual health, ubiquitous violence against women (VAW) and the total ban on abortion in Nicaragua. The case also provides a useful lens through which to examine individual sexual and reproductive health (SRH) experiences, particularly those of rape, unintended pregnancy, and unsafe abortion; this in-depth analysis identifies the contextual risk factors that contributed to Ana Maria’s experience.

Conclusions

Far too many women experience their sexuality in the context of individual and structural violence. Ana Maria’s case provides several important lessons for the realization of sexual and reproductive health and rights in countries with restrictive legal policies and conservative cultural norms around sexuality. Ana Maria’s experience demonstrates that an individual’s health decisions are not made in isolation, free from the influence of social norms and national laws. We present an overview of the key risk and contextual factors that contributed to Ana Maria’s experience of violence, unintended pregnancy, and unsafe abortion.

Peer Review reports

Rape, unintended pregnancy, and abortion are among the most controversial and stigmatized topics facing sexual and reproductive health researchers, advocates, and the public today. Over the past three decades, however, the international community, States, and advocates have made great strides to advance our understanding of sexual and reproductive rights and how they can be protected at the national and international levels. The 1994 Cairo Declaration began this process by including sexual health under the umbrella of reproductive health and recognized the impact of violence on an individual’s sexual and reproductive health (SRH) decision-making. [ 1 ] One year later, the 1995 Beijing Platform for Action specifically addressed the issues of unintended pregnancy and abortion by emphasizing that improved family planning services should be the main method by which unintended pregnancies and unsafe abortions are prevented. [ 2 ]

A recent World Health Organization (WHO) report on the relationships between sexual health, human rights, and State’s laws sets the foundation for our contemporary understanding of these issues. The 2015 report describes sexual health as, “a state of physical, emotional, mental and social well-being in relation to sexuality.” [ 3 ] That state includes control over one’s fertility via access to health services such as abortion; it also includes the right to enjoy sexual experiences free from coercion, discrimination, and violence. [ 3 ] Whether experienced alone or in combination, rape, unintended pregnancy, and abortion are important SRH issues on which public health can and should intervene.

In the public health field, case studies provide a useful lens through which to examine individual women’s sexual and reproductive health experiences, particularly those of rape, unintended pregnancy, and unsafe abortion; an in-depth analysis of these personal experiences can identify contextual risk factors and missed opportunities for public health rights-based  intervention. This type of analysis is especially cogent when legal policies and social factors, such as gender inequality, may influence one’s SRH decision-making process. On an individual level, bearing witness to women’s stories through in-depth interviews helps document their lived experience; surveying these experiences within the context of laws related to SRH provides important evidence for the impact of such policies on women’s well-being.

We present the case of a 19-year-old Nicaraguan woman who was raped, became pregnant, and almost died from complications resulting from an unsafe abortion. Her complex experience of violence, unintended pregnancy, and unsafe abortion represent a series of contextual factors and missed opportunities for public health and human rights intervention. Ana Maria’s story, told through the use of a pseudonym, takes place in a city located in North Central Nicaragua – a country that presents unique challenges related to its citizens’ fulfillment of their sexual and reproductive health and rights.

Violence against women in Nicaragua

Along with 189 States, Nicaragua is a party to the United Nations (UN) Convention on the Elimination of All Forms of Discrimination against Women, which includes State obligations to protect and promote the health and well-being of Nicaraguan women. [ 4 ] As defined by human rights documents, the right to health includes access to health care services, as well as provisions for the underlying social determinants of health, such as personal experiences of structural violence. [ 5 ]

In the Nicaraguan context, political and sociocultural institutions support unequal power relations between genders. [ 6 ] Machismo is one such form of structural violence that perpetuates gender inequality and has been identified as a barrier to SRH promotion in Nicaragua. [ 7 , 8 ] The term ‘ machismo ’ is most commonly used to describe male behaviors that are sexist, hyper masculine, chauvinistic, or violent towards women. [ 9 ] These behaviors often legitimize the patriarchy, reinforce traditional gender roles, and are used to limit or control the actions of women, who are often perceived as inferior. [ 10 ]

The vast majority (89.7%) of Nicaraguan women have experienced some form of gender-based violence  during their lifetime, which poses a serious public health problem. The latest population-based Demographic and Health Survey showed that at least 50% of Nicaraguan women surveyed had experienced either verbal/psychological, physical, or sexual violenceduring their lifetime. An additional 29.3% of women reported having experienced both physical and sexual violence at least once, while another 10.4% reported having experienced all three types of violence. [ 11 ]

In 2012, Nicaragua joined a host of other Central and South American countries that have implemented laws to eliminate all forms of violence against women VAW, including rape and femicide. [ 12 ] Nicaragua’s federal law against VAW, Law 779, intends to eradicate such violence in both public and private spheres. [ 13 ] On paper, Law 779 guarantees women freedom from violence and discrimination, but it is unclear if the law is being adequately enforced; it has been reported that some women believe VAW has increased since the law’s implementation. [ 14 ]

Before Law 779, violent acts like rape, particularly of young women ages 15–24, were endemic in Nicaragua. Approximately two-thirds of rapes reported in Nicaragua between 1998 and 2008 were committed against girls under 17 years of age; most of these acts were committed by a known acquaintance. [ 15 ] Due to a lack of reporting and to culturally propagated stigma regarding rape, no reliable data suggest that Law 779 has been effective in reducing the incidence of rape in Nicaragua. For women who wish to terminate a pregnancy that resulted from rape, access to abortion services is vital, yet completely illegal. [ 16 ] In contrast, technical guidance from the WHO recommends that health systems include access to safe abortion services for women who experience unintended pregnancy or become pregnant as a result of rape. [ 17 ]

Family planning and unintended pregnancy in Nicaragua

Like violence, unintended pregnancies -- not only those that result from rape -- pose a widespread public health problem in Nicaragua. National data suggest that 65% of pregnancies among women ages 15–29 were unintended. [ 11 ] Oftentimes, unintended pregnancy results from a complex combination of social determinants of health including: low socioeconomic status (SES), low education level, lack of access to adequate reproductive health care, and restrictive reproductive rights laws. [ 18 , 19 , 20 ] Nicaraguan women of low SES with limited access to family planning services are at an increased risk of depression, violence, and unemployment due to an unintended pregnancy. [ 19 , 20 ]

The UN Committee on the Elimination of all forms of Discrimination Against Women (CEDAW) has expressed concern regarding the lack of comprehensive sexual education programs, as well as inadequate family planning services, and high rates of unintended pregnancy throughout Nicaragua. [ 21 ] Due to a lack of sexual education, Nicaraguan adolescents, if they use contraceptives like male condoms or oral contraceptive pills, often do so inconsistently or incorrectly. [ 22 ]

Deeply rooted cultural stigma surrounding unmarried women’s sexual behavior contributes to the harsh criticism of young women in Nicaragua that use a method of family planning or engage in sexual relationships outside of a committed union. [ 18 , 22 ] Also, young women who are not in a formal union may experience unplanned sex (consensual or nonconsensual) and are unlikely to be using contraception, which further increases the risk of unintended pregnancy. [ 22 ] These social and cultural factors, in conjunction with restrictive reproductive rights laws, may contribute to a high incidence of unintended pregnancy among young Nicaraguan women.

The total ban on abortion in Nicaragua

Compounding the economic, social, and emotional burden of unintended pregnancy on women’s lives is the current prohibition of abortion in Nicaragua. In 2006, the National Assembly unanimously passed a law to criminalize abortion, which had been legal in Nicaragua since the late 1800s. [ 20 ] Researchers often refer to this law as the “total ban” on abortion. [ 20 , 23 ] The total ban prohibits the termination of a pregnancy in all cases, including incest, rape, fetal anomaly, and danger to the life of the woman. Laws that prohibit medical procedures are, by definition, barriers to access; equitable access to safe medical services is a critical element of the right to health. [ 3 , 5 ] The UN Committee on Civil and Political Rights (CCPR) has also recognized the discriminatory and harmful nature of criminalizing medical procedures that only women undergo. [ 24 ]

Nicaragua is one of the few countries in the world to completely ban abortion in all circumstances. In States where illegal, abortion does not stop. Instead, women are forced to obtain abortions from unskilled providers in conditions that are often unsafe and unhygienic. [ 25 ] Unsafe abortions are among the main preventable causes of maternal morbidity and mortality worldwide and can be avoided through decriminalization of such services. [ 26 ]

The Nicaraguan ban includes serious legal penalties for women who obtain illegal abortions, as well as for the medical professionals who perform them, which can have profound negative effects on women’s health. [ 20 , 23 ] Women who need or want an abortion face not only the health risks that accompany an unsafe procedure, but additional criminal penalties. The total ban on abortion violates the human rights of both health care providers and women nationwide, as well as the confidentiality inherent in the patient-provider relationship. [ 20 ] It also results in a ‘chilling effect’ where health care providers are unwilling to provide both abortion and postabortion care (PAC) services for fear of prosecution. [ 20 ]

In response to the negative impacts of the total ban on maternal morbidity and mortality in Nicaragua, as well as detrimental effects on women’s physical, mental, and emotional health, CEDAW has recommended that the Nicaraguan government review the total ban and remove the punitive measures imposed on women who have abortions. [ 21 ] While the Nicaraguan government may not view abortion as a human right per se, women should not face morbidity or mortality as a result of illegal or unsafe abortion. [ 27 ]

Criminalizing abortion also increases stigma around this issue and significantly reduces people’s willingness to speak openly about abortion and related SRH services. Qualitative research conducted in Nicaragua suggests that women who have had unsafe abortions rarely discuss their experiences openly due to the illegal and highly stigmatized nature of such procedures. [ 18 ] Therefore, the overall aim of the study was to better understand young women’s personal experiences of unintended pregnancy in the context of Nicaragua’s repressive legal and sociocultural landscape. Ten in-depth interviews (IDIs) were conducted with women ages 16–23 in a city in North Central Nicaragua from June to July 2014. This private method of data collection allowed for the detailed exploration of each young woman’s personal experience with an unintended pregnancy, including the decision-making process she went through regarding how to respond to the pregnancy. Given the personal nature of this experience – including the criminalization and stigmatization of women who obtain abortions – IDIs allowed the participants to share intimate details and information that would be inappropriate or dangerous to share in a group setting. One case, presented here, emerged as salient for understanding the intersections of violence, unintended pregnancy, and abortion – and the missed opportunities for rights-based public health intervention.

Emory University’s Institutional Review Board ruled the study exempt from review because it did not meet the definition of “research” with human subjects as set forth in Emory policies and procedures and federal rules. Nevertheless, procedural steps were taken to protect the rights of participants and ensure confidentiality throughout data collection, management, and analysis. The first author reviewed the informed consent form in Spanish with each participant and then acquired each participant’s signature and verbal informed consent before the IDIs were conducted. The investigators developed a semi-structured interview guide with open-ended questions and piloted the guide twice to improve the cultural appropriateness of the script (Additional file 1 ). The investigators also collaborated with local partners to design and implement the research according to local cultural and social norms. Due to the contentious topics discussed in this study, these collaborators prefer to not be mentioned by name. Interviews were conducted in Spanish in a private location and audio taped to protect the participants’ privacy. Recordings were transcribed verbatim and transcripts were coded and analyzed using MAXQDA11 software (VERBI GmbH, Berlin, Germany).

Initially, participants were recruited for interviews through purposive sampling of individuals who had disclosed a personal experience with unintended pregnancy during focus group discussions (FGDs) conducted in a larger parent study. At the end of each interview, participants were asked to refer other young women they knew who may have experienced an unintended pregnancy to participate in an interview. This form of respondent-driven sampling created a network of participants with a wide variety of experiences with unintended pregnancy. Of the ten interviewees, two had experienced unintended pregnancy as a result of rape, though both used the phrase “ sexo no consensual ” or “nonconsensual sex” in lieu of “ violación, ” the Spanish word for rape. One of these women shared her personal experience receiving an unsafe abortion to terminate an unintended pregnancy that had resulted from rape. Her story, shared under the use of the pseudonym Ana Maria, is presented here in order to:

Illustrate the harmful impact of restrictive abortion laws on the health and well-being of women – especially those who do not have access to abortion in the case of rape; and

Exemplify the nexus of contextual risk factors that impact women’s SRH decision-making, such as conservative social norms and restrictive legal policies.

Through thorough analysis, we examine the impact of these contextual factors that impacted Ana Maria’s experience.

When she was 19, Ana Maria was raped by her godfather, a close friend of her family.

In an in-depth interview, Ana Maria described enduring incessant verbal harassment from her godfather – her elder brother’s best friend – in the months before the assault. He constantly called and texted her cell phone in order to interrogate her about platonic relationships with other men in town and to convince her to spend time alone with him. Even though he was married with children and she repeatedly dismissed his advances, he continued to engage in this form of psychological violence with his goddaughter. Ana Maria described eventually “giving in” and meeting him – not knowing that this encounter would result in her forcible rape.

The disclosure of Ana Maria’s rape during her interview was spontaneous and unexpected. Ana Maria was unwilling to disclose explicit details of the sexual assault. Instead, she stated multiple times that the sexual contact was nonconsensual and she did not want to have sex with him. When asked if she told anyone about this experience, she said no because she did not want others to judge her for what had happened.

Approximately a month of scared silence after she was raped, Ana Maria noticed that her period had not come. Nervous, she bought a pregnancy test from a local pharmacy. To her dismay, the test was positive. In order to confirm the pregnancy, she traveled alone to the nearby health center in her town to obtain a blood test. Again, the test was positive. She had never been pregnant before and she was terrified. In the midst of her fear, she shared the results with her rapist, her godfather.

His response: get an abortion. He did not want to lose his wife and children if they found out about the pregnancy.

Other than their illegal nature, Ana Maria knew nothing about abortions – where to get one, how it was done, what it felt like. She asked her neighbors to explain it to her. They said “it was worse than having a baby and [experiencing] childbirth.”

Though Ana Maria did not want to get the abortion, her godfather continued to pressure her to get the procedure saying, “Regardless, you must get the abortion… you are not the first woman to have ever had one.” Similar to the emotional violence before he raped her, he called and texted Ana Maria every day telling her to, “do it as fast as you can.” He forbade her from telling anyone about the pregnancy and Ana Maria didn’t feel like she had anyone to confide in about the situation. She worried about people judging her for getting pregnant outside of a committed relationship – even though she was raped. Ana Maria described this difficult time:

“When he started to pressure me [to get the abortion], I felt alone. I did not have enough trust in anyone to tell them [what had happened] because… if I had had enough trust in someone, I know that they would not have let me do it. If I had been given advice, they would have said, ‘No, do not do it,’ but I did not have anyone and I felt so depressed. What made it worse, I couldn’t sleep; I could not sleep [because I was] thinking of everything he had told me. At night, I would remember how it all started and I do not know what he did to find that money, but he gave me the money to get the abortion.”

Her godfather gave her 3000 Córdobas (approximately USD112 at the time) and put her on a public bus, alone. He had arranged for her to receive the abortion from an older woman that practiced “natural medicine” in a nearby city. When Ana Maria arrived at the woman’s home, she was instructed to remove her pants and underwear and lie on a bed. Ana Maria did not receive any medication before the woman inserted a “device like the one used for a Papanicolau… and then another device like an iron rod” into her vagina.

After describing these devices, Ana Maria made a jerking motion back and forth with her arm to imitate the movement the woman used to perform the abortion.

Once it was over, the woman gave Ana Maria an injection of an unknown substance and told her that she would pass a few blood clots over the next few days. That night, however, Ana Maria’s condition worsened; she became feverish, felt disoriented, and began to pass dark, fetid clots of blood. She described the pain she experienced throughout the ordeal:

“I felt so much pain when they took her out of me. I felt pain when the blood was leaving my body and when I had the fever. I felt a terrible pain that only I suffered. I am [a] different [person] now because of those pains.”

Ana Maria was too afraid to tell her family about the assault or the abortion because she was uncertain how they would react. She was even more terrified of the potential legal repercussions that she could face for violating the total ban on abortion. Within a few days of the abortion, though, Ana Maria’s brother heard rumors of his sister’s situation from neighbors “in the street” and confronted her about what had happened. At first, Ana Maria denied that she had had an abortion, but her brother continued to ask for the truth. Though she was nervous, Ana Maria eventually told her brother everything that had happened – from her godfather’s incessant verbal harassment, to the rape, to the unsafe abortion she was forced to get.

Afraid for his sister’s life, Ana Maria’s brother contacted a local nurse who discreetly provides postabortion care (PAC) to women experiencing complications from unsafe abortion and other obstetric emergencies. This nurse is locally known to be one of the few health care providers who provide PAC despite many other providers’ fear of prosecution under the total ban. The nurse recommended that Ana Maria come to the hospital immediately.

Ana Maria spent almost two weeks as an inpatient at the only hospital in the region. She had become septic as a result of what she described as a “perforated uterus,” a common complication from unsafe abortion. [ 28 ] Upon her initial examination, the nurse was afraid that her uterus could not be repaired because the infection was so severe. Fortunately, the medical team administered an ultrasound, removed infected blood clots, and completed uterine surgery to repair the damage from the unsafe abortion. At the request of the gynecologist taking care of her, Ana Maria received the one-month contraceptive hormonal injection before being discharged. At the time of the interview, Ana Maria had not received the next month’s injection because she “didn’t have any use for a man.”

As a result of this experience, Ana Maria reported feelings of depression, isolation, and recurring dreams about a little girl, which she described in this way:

“After I was discharged, I always dreamt of a little girl and that she was mine, standing in my doorway and when I awoke, I couldn’t find her. I looked for her in my bed but she wasn’t there. And this has tormented me because, it’s true: I am the girl that committed this error, but the little girl was not at fault. He pressured me so strongly to get the abortion, so I did.”

Ana Maria had the same recurring dream every night for more than two weeks and she continued to feel depressed weeks after leaving the hospital. One of the sources of her depression was the isolation she felt because there was no one with whom she could share this experience.

According to Ana Maria, she longs to have other people to talk to about her experience – particularly those who may have had similar experiences. She also expressed a desire to pursue a law degree so that she can have a career in local government.

Discussion and conclusions

Ana Maria’s case provides insight into the contextual factors effecting her ability to realize her sexual and reproductive health and rights in Nicaragua where restrictive legal policies and conservative cultural norms around sexuality abound. These contextual risk factors include social norms related to sexual health, laws targeting VAW, and the criminalization of abortion.

Social norms related to sexual health

The fundamental relationship between structural inequality and sexual and reproductive rights has been duly noted; gender inequality, in particular, must be addressed in order to fulfill sexual rights for women. [ 29 ] As in many cases in Nicaragua, the fact that Ana Maria’s first sexual experience was nonconsensual and was initiated by an older male and trusted family friend highlights the uneven power relations between men and women in Nicaraguan culture, which propagate high instances of VAW and sexual assault. In a patriarchal society where machismo and gender inequality run rampant, women’s sexuality is further constrained by the stigmatization of sexual health and a culture of violence that limits women’s autonomy. The compound stigma surrounding sexual health in general, and rape in particular, negatively impacted Ana Maria’s knowledge and ability to access mental health and SRH services, including emergency contraception and post-rape care, which may have assisted her immediately following her assault. Before her brother intervened, Ana Maria’s fear of judgment and legal repercussions also prevented her from seeking PAC, which was necessary to save her life.

Comprehensive sexual education is a primary way to challenge these social norms and widespread stigma surrounding sexuality and SRH services, such as contraception and PAC, at the population level. Such education might have mitigated Ana Maria’s experience of unintended pregnancy through the provision of advance knowledge of emergency contraception and medical options in the event of pregnancy. CEDAW has recognized this missed opportunity for public health intervention in Nicaragua, and recommends sexual education as a means of addressing stigma related to sexuality, decreasing unintended pregnancy, and increasing the acceptability and use of family planning services throughout the country. [ 21 ] Furthermore, the lack of adolescent-friendly sexual education and SRH services symbolizes a social reluctance to acknowledge the reality that young people have sex. [ 30 ] Such ignorance results in a lack of information on healthy relationships and human reproduction, as well as experiences of unintended pregnancy, early motherhood, and unsafe abortion. Exposure to this type of information may have improved Ana Maria’s ability to protect herself, mitigated the impact of Nicaragua’s pervasive misogyny on her decision making, and lessened the influence of her godfather’s coercion before her experiences of rape and unsafe abortion.

Individual and structural violence against women

Though we do not know explicit details of Ana Maria’s rape, the act of rape is inherently violent. The assault violated her right to enjoy sexual experiences free from coercion and violence. [ 3 ] To further constrain her sexual and reproductive rights, Ana Maria’s experience of rape resulted in an unintended pregnancy and an unsafe abortion that she was pressured into undergoing. Along with physical sequelae as a result of the procedure, she also expressed feelings of depression and isolation, which are common symptoms of post-traumatic stress disorder (PTSD). [ 31 ] These mental health consequences are forms of emotional violence that Ana Maria continued to experience long after the initial insult of physical violence. We can’t distinguish whether her mental health symptoms were a pre-existing condition or a result of the traumatic experience presented here. It is likely, however, that all parts of this experience impacted her mental and physical health. As reported elsewhere, perceived social criticism and a lack of social support are barriers to the fulfillment of sexual and reproductive health among young Nicaraguan women. [ 18 ] These contextual risk factors undoubtedly played a role in Ana Maria’s ability to navigate the circumstances surrounding her assault and its aftermath.

What legal recourse was feasibly available to Ana Maria for the crime of her sexual assault? To our knowledge, Ana Maria did not report the rape to authorities nor did her godfather ever face criminal charges for his actions. Yet Ana Maria’s own fear of prosecution for undergoing the unsafe abortion, as well as shame and fear of being stigmatized by others in her community, strongly influenced her decision not to report the rape -- even though Law 779 contains sanctions specific to those who commit rape.

In the event she had reported the crime, however, it is unclear if Law 779 would have provided justice. There are no data to suggest that Law 779 has led to an increase in the reporting or prosecution of rape at the national level. To the contrary, qualitative work in Nicaragua found a perceived increase in VAW following the passage of the law. [ 14 ] In Nicaragua, the inconsistent or ineffective enforcement of Law 779 is another factor worthy of consideration in cases like Ana Maria’s where individuals do not report such crimes. Documents like the UN Women Model Protocol have recently been released to improve the enforcement of laws like Law 779 in Latin American countries, presenting an opportunity for the effective operationalization of the law in Nicaragua. [ 32 ] If Law 779 is not adequately enforced, women like Ana Maria face the potential for re-victimization through the structural violence of impuity and continued exposure to VAW. To our knowledge, Ana Maria’s perpetrator faced no consequences for his perpetration of harassment, coercion and rape of Ana Maria. Moreover, in countries where abortion is criminalized, such as El Salvador, it is most often women who face criminal sanctions. [ 33 ] Indeed, it was Ana Maria herself who bore the physical and mental burden that resulted from her assault, unintended pregnancy, and unsafe abortion.

The criminalization of abortion

The criminalization of health services is a strategy that governments use to regulate people’s sexuality and sexual activity. [ 34 ] The criminalization of services such as abortion limits women’s ability to make autonomous decisions about their SRH. By definition, laws that restrict access to health services exclude people from receiving the information and services necessary to realize the highest level of SRH possible. [ 5 ] The criminalization of abortion puts the health and well-being of individuals and communities at risk. Beyond the individual level, complications from unsafe abortion often put unnecessary and immeasurable financial burdens on health systems that are already stretched [ 28 ].

Ana Maria did not have a choice when it came to her abortion; the man who raped her coerced her to undergo an unsafe and illegal procedure. The criminalization of abortion in Nicaragua put Ana Maria’s health at risk in two ways: first, it prevented her from obtaining a safe abortion and second, it limited her access to comprehensive sexual health information that could have helped her address her unintended pregnancy, through emergency contraception. After the unsafe abortion procedure, her access to PAC was likely constrained by her own fear of the possible legal repercussions of undergoing an abortion, and was compounded by her inability to trust that a health care provider would maintain patient confidentiality and provide adequate PAC.

In Nicaragua, the total ban on abortion directly contradicts strategic objectives outlined in the Beijing Declaration, which guarantees women’s rights to comprehensive SRH care, including family planning and PAC services. Though providing PAC is not considered illegal under the total ban, many Nicaraguan health care providers refuse to treat women who have had unsafe abortions, which results in a ‘chilling effect’; providers do not want to be accused of being complicit in providing abortions so they refuse to provide PAC services. The ‘chilling effect’ put Ana Maria at risk of morbidity or mortality as a result of the complications that resulted from her unsafe abortion.

Equally troubling is the use of criminal law against individuals like Ana Maria as well as health care professionals that provide PAC. By requiring health care providers to report to the police women who have had abortions, the total ban violates the privacy inherent in the patient-provider relationship. Health care providers are faced with a dual loyalty to both the State’s laws and the confidentiality of their patients, which makes it difficult for providers to fulfill their professional obligations. It also makes health care professionals complicit in a discriminatory practice, one where women face legal sanctions in ways that men do not. The criminalization of abortion in Nicaragua therefore resulted in the fear, stigma, discrimination, and negative health outcomes observed in Ana Maria’s case.

The contextual risk factors that contributed to Ana Maria’s experience of rape, unintended pregnancy, and unsafe abortion are as follows: sexual assault, impunity for violence, gender inequality, restrictive social norms around SRH, stigma resulting from unintended pregnancy and abortion, harmful health impacts from an unsafe abortion, and fear of prosecution due to the total ban. Her first sexual experience was forced and nonconsensual and preceded by months of harassment. Social norms made taboo any discussion of the harassment and sexual violence she experienced at the hands of her godfather; without social support, she was coerced into undergoing an unsafe abortion that resulted in serious mental and physical health sequelae. The illegal nature of abortion in Nicaragua placed Ana Maria at risk for social stigma as well as criminal prosecution. Her subsequent underutilization of family planning services at the time of the interview also placed Ana Maria at risk for an unintended pregnancy in the future; other long-term physical and mental health effects of her experience remain unknown.

The realization of one’s sexual and reproductive rights guarantees autonomous decision-making over one’s fertility and sexual experiences. However, Ana Maria’s story demonstrates that an individual’s SRH decisions are not made in isolation, free from the influence of social norms and national laws. Far too many women experience their sexuality in the context of individual and structural violence, such as VAW and gender inequality. This case highlights the contextual risk factors that contributed to Ana Maria’s experience of violence, unintended pregnancy, and unsafe abortion; we must continue to critically investigate these factors to ensure that experiences like Ana Maria’s do not become further normalized in Nicaragua. Due to restrictive social norms around SRH, Ana Maria grew up experiencing stigma and taboo associated with sex, sexuality, contraceptive use and abortion. She also lacked access to information regarding SRH, healthy relationships, and how to respond to VAW before she was assaulted. After her assault, she did not have access to post-rape care, emergency contraception, safe abortion services, or mental health services to help her process this trauma. Shame and fear of stigma also prevented Ana Maria from reaching out for social support from family, friends, or the health or legal system. From the legal perspective, inadequate enforcement of VAW laws and the criminalization of abortion further exacerbated the trauma Ana Maria experienced.

It would require active engagement from the Nicaraguan government to address the contextual risk factors identified herein to protect their citizens’ right to health and prevent future experiences like Ana Maria’s. These efforts are particularly relevant given recent political unrest throughout Nicaragua including anti-government protests demanding the president’s resignation. [ 35 ] Nicaraguans’ right to health is at risk not only due to the widespread violence, but also because health care workers are being dismissed and persecuted nationwide. [ 36 ] Sexual and reproductive health researchers, advocates, and the public will continue to monitor Nicaragua’s response to the immediate demands and needs of its citizens -- including the demand that Nicaraguan women like Ana Maria are able to fully exercise their sexual and reproductive rights in times of both conflict and peace.

Availability of data and materials

Deidentified data are available upon reasonable request.

Abbreviations

Committee on Civil and Political Rights

Committee on the Elimination of all forms of Discrimination Against Women

In-Depth Interviews

Postabortion Care

Post-Traumatic Stress Disorder

Socioeconomic Status

Sexual and Reproductive Health

United Nations

Violence Against Women

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Acknowledgements

The authors thank the research team and in-country collaborators from Proyecto Paz y Amistad, as well as the Emory University Global Field Experience (GFE) Fund and the Global Elimination of Maternal Mortality from Abortion (GEMMA) Fund for financially supporting this project. We are also grateful to Ellen Chiang for her editorial support.

This study was funded with support from the Emory University Global Field Experience (GFE) Fund and the Global Elimination of Maternal Mortality from Abortion (GEMMA) Fund. The funders did not play any direct role in the design of the study; the collection, analysis, and interpretation of data; or the writing of the manuscript.

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All authors contributed extensively to the work presented in this manuscript. SML, DPE, and RWR jointly designed the study. SML performed data collection and data analysis. SML and DPE wrote the manuscript with significant input from RWR. DPE and RWR also provided support and supervision throughout the study. All authors read and approved the final manuscript.

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Emory University’s Institutional Review Board found the study exempt from review because it did not meet the definition of “research” with human subjects as set forth in Emory policies and procedures and federal rules. The authors partnered with Proyecto Paz y Amistad, a local organization to design and implement this study. Proyecto Paz y Amistad deferred to the Emory University IRB’s determination. Nicaragua is notably absent from the US Department of Health and Human Services, International Compilation of Human Research Standards ( https://www.hhs.gov/ohrp/sites/default/files/2018-International-Compilation-of-Human-Research-Standards.pdf ). To our knowledge, there were no existing national level human subjects requirements or exemptions at the time of data collection.

Though the project was exempt from full review by Emory University’s Institutional Review Board, procedural steps were taken to protect the rights of participants and ensure confidentiality throughout data collection, management, and analysis. Verbal informed consent was acquired from all participants before the IDIs were conducted and each participant signed a waiver to participate.

Due to the sensitive nature of this work, individual partners at Proyeto Paz y Amistad have asked not be named publicly as authors on this work, although their partnership was instrumental in the implementation of this study.

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Luffy, S.M., Evans, D.P. & Rochat, R.W. “Regardless, you are not the first woman”: an illustrative case study of contextual risk factors impacting sexual and reproductive health and rights in Nicaragua. BMC Women's Health 19 , 76 (2019). https://doi.org/10.1186/s12905-019-0771-9

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nursing case study about abortion

Nursing Research Essay

Case Study: Abortion Laws

nursing case study about abortion

Case Study: Abortion Laws Case Study: Abortion Laws

Watch this clip from the popular TV show Last Week Tonight with John Oliver titled “Abortion Laws”.

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1. Inequality – What aspect(s) of inequality (class, race, gender, sexual orientation and/or age) were especially salient in shaping the issues surrounding abortion legislation as outlined in the video? How does the role of inequality in this video relate to the other social problems experienced by these social groups? Apply at least 1 key concept/theory from the relevant chapter on inequality in your response.

2. Institutions – What social institutions (the family, education, work/economy, healthcare and/or criminal justice) were especially salient in shaping the issues surrounding abortion legislation as outlined in the video? How does the role of institutions in this video relate to the other social problems associated with this institution? Apply at least 1 key concept/theory from the relevant chapter on social institutions in your response.

3. Theory – Which one of the three sociological frameworks (conflict, structural functionalism or symbolic interactionism) do you think is best to use for understanding the issues surrounding abortion legislation as outlined in the video? Why? Be specific and thorough in your response.

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Ethics: Nursing and Abortion

Ethics: Nursing and Abortion

To assist nurses in this task, the ethical issues surrounding abortion are enumerated and clarified. To better off explain research on this ethical topic I’m going to further explain my research on my findings on both points of view and balanced both sides so you can get a better understanding. For those of you whose doesn’t know what an abortion Is the proper meaning for It Is, ending a pregnancy before the fetus (unborn child) can live Independently outside the mother. If abortion happens spontaneously before 24 weeks of pregnancy, it is called a miscarriage.

An induced (or “therapeutic”) abortion is caused deliberately in order to end the pregnancy. Working in that environment is certainly a sensitive one, regardless of your personal opinions or not you must undergo certain training to properly fit the job and follow protocol. Not only working in that surrounding a main issue but the ethics of abortion already another ethical dilemma. There are many strong arguments about the Issue for those who are In favor and against it but sometimes there is not proper training assigned to resulting in personal feelings conflict with the pre and post procedure affecting the patient and their decision.

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Classes on the principles of nursing ethics give the nurse the tools to base ethical decisions upon. However, this knowledge is then shaped by the values, beliefs and experiences of the nurse. Recent investigation and studies have showed there has been conflicts arising wealth that environment. But In that particular circumstance there Is not a wrong or right, but there is do the ethical thing without harm. To first start my paper I’m going to briefly speak about the proper ethical way to deal with the whole abortion procedure including there responsibilities as a registered nurse sugarless of the circumstances and different environments.

Some of the different responsibly according to NASA, org are, the responsibility and obligation to provide competent and supportive nursing care (ANA, 2001, Provision #1 ; #3). * The responsibility to provide the patient with objective Information and to offer access to resources before, during and after a voluntary termination of pregnancy (ANA, 2001 , Provision #1 ; #2). * The responsibility to provide care without imposing personal beliefs on patients who choose to abort (ANA, 2001, Provision # 1 ; #2).

The obligation for educational preparation, and the responsibility to obtain such, to assist and meet the emotional, physical and psychological needs of patients who are considering or have had a voluntary termination of pregnancy (ANA, 2001 , Provision # * The right to refuse to participate in a voluntary termination of 2001, provision # 1). Pregnancy, except in an emergency situation, where the patient’s needs do not allow for substitution (ANA, 2001, Provision # 4 & #5). * The right not to be subjected to coercion, censure or discipline for reasons of such refusal (ANA, 2001 , Provision #4, 5, & #6). The right and responsibility to seek employment in areas where the care of patient choosing abortions will not be assigned. These are some of the responsibilities of being a Nurse within the termination field. Despite the protocols they must follow to prevent harm it’s not entitled to something may agree on. Remember nurses are being rotated on a day to day bases meaning they travel around the hospital working in different departments. Despite being pro- life or precipice they must follow the ethical guidelines not only to keep their Jobs and also inform the patient in every way as possible.

Nurses need to be clear about why they believe as they do, and they must arrive at a point of view in a rational and logical manner. To assist nurses in this task, the ethical issues surrounding abortion are enumerated and clarified. To do this, some of the philosophic and historic approaches to abortion and how a position can be logically argued are examined. According to nursing connect. Com, the nurses and social workers that were surveyed worked in a variety of settings including acute care facilities, ambulatory clinics and outpatient health centers. “We did find that about 40 percent are frustrated and 40 percent are fatigued.

One out of three feels powerless and the same even said they were physically ill. ” Many nurses believe that feeling conflicting in the decisions has took a toll on patients because attitudes Justify a lot in decision making. In an article I read prior to doing my research a Nurses by the name of Lurch quoted, “If one believes that they know the ethically correct course of action but are precluded from carrying that out, then patient care suffers in some way. Lurch believes that immunization and broader dialogue on the subject will help to limit moral distress and the negative impact it has on health care providers.

According to Lurch again, “Improving the ethical climate begins with administration and managerial leaders. First, I believe they have to recognize that nurses and other health care workers are facing tremendous ethical challenges in providing care and encountering stress related to these concerns. To me, this only impacts the quality of care that is delivered. ” I do believe with the proper tools, communication, as well as lots of raining they can create a better atmosphere and ethical comfortable environment they can focus less on the ethical problems their facing.

Every nurse who speaks up when feeling ethical or moral distress is one step closer to eliminating the issue entirely. Recent research according to the school of political and social science, they create assessment basically having little committee regarding the questions and concerns of the nurses and survey says it has increased positively. A lot of associations has been created in effort to reduce the ethical dilemma in the abortion procedure.

One to be specific is known as the New York State Nurses Association (NASA) Position Statement on Abortion was in response to the increasing legislative activity concerning abortion law, as well as requests from the professional nursing community with regard to their rights and responsibilities and the rights of their patients pertaining to the issue of abortion. NASA has, through the Council on abortion and reaffirms the position of the rights of women as patients and nurses. There’s many more ethical procedures a Nurse to follow according to the clinic or nursing guidelines.

The nurse should keep the patient informed of all aspects of the procedure, provide a supportive presence, perform standard physical monitoring during the operation and afterwards, provide contraceptive counseling, and act as a sounding board for discussion of interpersonal relationships and future plans. High quality nursing requires understanding the physical and psychosocial aspects of abortion reflecting the nurse’s recognition of the cultural, religious, and socioeconomic factors involved. This requires a nurse who is fully aware of her own feelings and can adapt or defer them to the patient’s needs.

In cases of suction or dilation abortions, these actions are particularly important, since the patient is in the hospital only a short time and can be easily ignored. In cases of saline infusion, the nurse should be fully aware of possible complications, including retained placenta, hemorrhage, infection, or uterine perforation. If the patient is readmitted for any of these complications, the nurse should continue to play the informative, supportive role. The nurse and social worker should also be aware of the possible psychological sequel of abortion and watch for mental health problems.

It is concluded that post abortion counseling is the best time for contraceptive counseling. Conscientious professional support along these guidelines should insure a positive experience for the abortion patient. Ethics committees involve individuals from diverse backgrounds who support health care institutions with three major functions: providing clinical ethics consultation, developing and/or revising policies pertaining to clinical ethics and hospital policy. To conclude my research paper I hope you came out with a clear balance on the ethical dilemma involved in nursing with it comes to abortion procedures.

Its takes a lot working in a field such of this when you’re pro- choice or pro-life but sometimes when you’re working in a certain settings there’s rules and guidelines that you must follow. But you should never feel obligated to something that’s you’re not for but in this situation your personal opinion should be kept to yourself that’s why in turn they created association, committees, and clubs set up with ethical consultants that helps with your concerns sometimes even with your thought of guilt. Hope you came out with my paper not only with an open mind but also a balancing side to both sides.

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Ethics: Nursing and Abortion. (2018, Feb 08). Retrieved from https://graduateway.com/ethics-nursing-and-abortion/

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Case Study:Abortion laws

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Abortion laws and their consequences in Sri Lanka Essay Assignment Paper Instructions – major essay

Your essay should be 3000 words, is worth 60% of the total marks for this subject.

Please ensure that you critically review the available evidence about the topic that you have chosen (i.e. Don’t just summarise the literature!).  I highly recommend you choose a particular setting to focus your essay.  The geographical scope should be commensurate with, and appropriate to, the issue you are writing about. For example, focusing on ‘Africa’ is inappropriate for an essay on HIV – you will drown in literature and be unable to critically discuss social or cultural factors across the very diverse continent.  Rather, choose a specific country.  For other issues where the literature is sparse, a region may be an appropriate setting.

Do try to write with a ‘gender lens’ – you do not need to strictly apply one of the gender analysis frameworks that we have discussed in class, but do discuss how gender roles and responsibilities impact upon the health issue that you are writing about, in the particular setting you have chosen.

INSTRUCTIONS:

The task is to critically review the available evidence – don’t just summarise the literature. For example, focusing on ‘Africa’ is inappropriate for an essay on HIV – you will drown in literature and be unable to critically discuss social or cultural factors across the very diverse continent. Rather, choose a specific country. For other issues where the literature is sparse, a region may be an appropriate setting.

o The paper has to be ‘critic’ the evidence enough. This means, what was ‘wrong’ or ‘missing’ or ‘contradicted’ about the evidence. At the same time, what was ‘insightful’, ‘valid’ or ‘true’ about the evidence?

State the findings from the literature in a clear way (stating only what is relevant to your topic). Say what was missing/wrong/incorrect/incomplete about the evidence. Say what was good about the evidence; did it have a high sample that represented all social classes? was it conducted independently from a group of both women and men fairly? o The paper has to cover strongly how gender roles and responsibilities impact upon the health issue. Look at the literature on cultural gender roles in India society.

o The paper has to present following an outstanding logical sequence.

o The paper has to demonstrate critical thinking/questioning/critique with regard to the material presented.

o The arguments in the paper have to be clearly and logically.

o The paper has to present alternative viewpoints

o The paper has to draw on material beyond what was uploaded in the attachments. ”

o The time frame of references has to be no more than 10 years, also to being of academic and reliable sources and citations correctly and consistently.

o The required FORMAT is the Harvard style

Format of written assessments

Assignments should be typed, using 11-point font and 1.5 spaced format and submitted as a Microsoft Word file or pdf.

Your arguments should be evidence based and all assertions should be appropriately referenced.

Referencing for written assessments

The Harvard referencing system should be used

Women and Global Health

Abortion laws and their consequences in Sri Lanka

Every year 22 million women undergo unsafe abortions worldwide- the vast majority of these occur in developing countries and they account for 13% of all maternal deaths in these regions (Ipas, 2014, Okonofua, 2006). Unsafe abortions are procedures performed “without the necessary skills or in an environment that does not conform to minimum medical standards, or both” (Grimes et al., 2006). These occur more commonly in countries where abortion is restricted by law and thus, can be considered as a largely preventable public health and human-rights issue (Ipas, 2014, Grimes et al., 2006). Sri Lanka presents a case-study with prohibitive legislation that is worth consideration; here, abortion is illegal except when a mother’s life is under threat (Kumar, 2013). By all accounts, Sri Lanka is a South Asian country to which others can aspire- enormous efforts have been made to improve health and education for all citizens (Arambepola and Rajapaksa, 2014, Gill and Stewart, 2011). Consequently, one might assume that gender equality is advancing in strides, irrespective of current abortion laws. Indeed it appears this assumption has been adopted by the Government, undermining any impetus for change. In this essay we will examine the current approaches to abortion laws in Sri Lanka, their validity within a national and international context and consequences of unsafe abortions for the health and well-being of Sri Lankan women. It will become apparent that despite superficial appearances, abortion laws- rather than being irrelevant to current progress in gender equality- are a symptom of a disconcerting double standard; where the rights of women are respected only within the limits of culture, religion and a predominantly patriarchal power structure. Ultimately, allowing women to have control over their own bodies “is a fundamental prerequisite to the achievement of sexual and reproductive health and rights” (Sri and Ravindran, 2015), and the Sri Lankan Government must recognise this critical issue if they are to continue to improve gender equality now and into the future.

Gender inequality in Sri Lanka

Gender inequality is comparatively more pronounced within Sri Lanka than in 71 other countries in the world, according to the gender inequality index; this score is based on reproductive health, empowerment (political participation and education) and labour market participation (Social Institutions & Gender Index, 2016). Whilst an improvement upon previous years- particularly in light of two decades of conflict and a tsunami disaster (Gill and Stewart, 2011)- this intermediary rank also indicates that substantial barriers to equality remain. Progress has largely been attributable to an improving economy, the provision of “free health for all” and universal education (Asian Development Bank, 2015, Gill and Stewart, 2011). Maternal mortality rates have declined significantly, health service utilisation- such as antenatal care- is enviably high and girls have higher enrolment and retention in secondary and higher education compared with boys (Asian Development Bank, 2015). Despite this, women are still perceived as natural reproducers and nurturers who must “obey and respect” their husbands (Jayatilleke et al., 2011). Controlling a wife’s behaviour is commonplace and acceptable (Bourke-Martignon, 2002) and for those women who transgress cultural norms, they are at significant risk of intimate partner violence (Jayatilleke et al., 2011). Indeed, lifetime prevalence of such violence is estimated at around 40% (Kuruppuarachchi and Wijeratne, 2005). Outside of the home, unemployment gaps between men and women have been narrowing, yet averages conceal the “unconscionably high” rates among younger or well-educated women relative to their male counterparts (Jayaweera et al., 2007). There are also horizontal and vertical gender divisions-  women are excluded from higher income positions and of those that are employed, this largely occurs in the informal sector with low-skill jobs or even unpaid family labour (Asian Development Bank, 2015, Gill and Stewart, 2011). Female representation in parliament has failed to exceed 6% (Asian Development Bank, 2015) and legally the elimination of gender-based discrimination in inheritance rights has not occurred (Social Institutions & Gender Index, 2016). Thus, despite the relatively satisfactory position of Sri Lanka compared to other South Asian countries, there are clearly lingering barriers to equality that permeate everyday life, let alone controversial issues such as abortion.

Current approaches to abortion in Sri Lanka

The primary means by which the Sri Lankan Government impedes access to abortion services is through legal restriction, however this essentially amounts to sexual discrimination- given that these services are only required by women- and ultimately does little in the way of actually preventing terminations. Sri Lankan abortion laws are based on arachic colonial legislation from 1883 and state that abortion is legal only to save a woman’s life, and those who do not obey this law will be “punished with imprisonment” (Walatara, 1998, Government of the Democratic Socialist Republic of Sri Lanka). Simultaneously, the 1978 Constitution guarantees women fundamental rights as well as protecting against discrimination on the grounds of gender (Asian Development Bank, 2015). Sri Lanka has further ratified the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW), a document that considers access to safe abortion services as a necessity for gender equality (Gomez, 2004). Thus clearly current legislation is antithetical to sentiments in both the national constitution and international treaties, and infringes upon basic human rights. Nor is this transgression founded on inaction, but rather active opposition; recent attempts to amend the law in instances of rape, incest, and fetal abnormalities were unsuccessful (Kumar, 2013). Resolving this conflict, one is left to assume that the Ministry of Health places enormous significance on the imperative to save lives by criminalising abortion, above and beyond any ramifications on human rights or the law. Ironically however, this hard-line stance does little in the way of actually preventing terminations and instead, promotes unsafe practices and places women’s lives at risk. Clandestine services and abortive medications (although unregistered) are widely available and whilst there are no national level statistics, it is estimated that over 500 abortions occur per day (Ban et al., 2002). Therefore Sri Lankan women are not only facing unlawful discrimination- despite national sentiment supporting gender equality- the Government is also compromising their health and wellbeing through the consequences of inevitable unsafe practices.

Remaining defiant on the issue of legalisation, the Sri Lankan Government instead favours primary prevention and tertiary management of the consequences of unsafe abortions (Family Health Bureau, 2009); however even these services are implemented through a gender lens that emphasises traditional roles and responsibilities for women. Primary prevention is the provision of health services to minimise the risk of unwanted pregnancies. This largely encompasses family planning programs- accepted into national policy in the 1960s (Asian Development Bank, 2015)- as well as sexual and reproductive health education. These programs are well-established and expansive, increasing contraceptive use to 70% and causing a decline in the national fertility rate to 2.3 (Asian Development Bank, 2015). National averages such as these however, overlook district variations as well as the inconsistent impact on vulnerable and marginalised women. Barriers to contraceptive use include inaccessibility, privacy concerns, social barriers and financial costs, and for some women abortion becomes the predominant method of family planning (Perera et al., 2004). It is also worth noting that contraceptives are largely targeted to married women, whom historically have constituted the majority of individuals seeking terminations (Abeyasinghe et al., 2009). Even so, this underestimates changing societal norms within Sri Lanka; premarital sex appears to be increasing along with urbanisation, internal and external migration, increased marital age and a shift from arranged marriages towards “love marriages” (Jordal et al., 2013). Persisting cultural barriers- see above- and a lack of sexual education for adolescents has led to notably poor contraceptive use among unmarried couples (Kumar, 2012). This highlights how the current system is failing women- failing to afford them with equal sexual and reproductive health services in the first place and then failing to give them control over choices to manage the ensuing consequences. The reason why this occurs is likely the same mechanism as for discrepancies in the employment and political sectors. Were the Sri Lankan Government truly committed to gender equality and simultaneously opposed to abortion, one would anticipate efficient and effective primary preventative services for all women, not the deficiencies described here. Thus abortion laws are merely a symptom of an ongoing disease of discrimination.

Tertiary management of unsafe abortions, involving the “integration and institutionalization” of post-abortion care into the Sri Lankan health care system, also fails to adequately meet the needs of women (Okonofua, 2006). For the most part, tertiary management has been achieved through “free health for all,” rather than specific directives. Indeed, the most recent Reproductive Health Policy of 1998 and the National Strategic Plan on Maternal and Newborn Health (2012-2016), both failed to include provisions for post-abortion care (Kumar, 2012). This passive stance endangers the health and well-being of women, particularly given the ongoing rate with which abortions occur. This is compounded by fear and stigma. In one small study, many women delayed seeking help from a Government hospital following an abortion because they were concerned about legal ramifications, as well as discrimination from health care providers (Thalagala, 2010). These women claimed that they had few opportunities to ask questions regarding their health upon admission and more than 10% experienced verbal abuse from staff (Thalagala, 2010)- women who have had abortions are often subject to “social ridicule, reprimand and exclusion from both family and society” (Jordal et al., 2013). This is particularly true for unmarried women, who are seen to be violating sexual norms and proper behaviour, with a woman’s virginity closely linked to the dignity of a family (Jordal et al., 2013). Thus clearly a more direct approach to managing the consequences of unsafe abortion is required, and one that adequately addresses privacy and legal concerns. The situation described above reflects not only a failure to manage medical consequences of terminations, but a disregard for the wide-reaching ramifications of abortion laws; it appears that “free health for all” has a caveat- so long as women conform to rules and regulations placed upon their behaviour (Gill and Stewart, 2011).

Consequences of abortion laws and unsafe practices

Liberalisation of abortion laws within other South Asian countries has largely been driven by a desire to reduce maternal mortality (Shakya et al., 2004, Klugman and Budlender, 2000)- whilst this impetus is absent from Sri Lanka, by no means are preventable deaths due to unsafe abortions “acceptable”. Maternal mortality rates have received international commendation, steadily declining since the 1950s to reach 35 deaths per 100,000 live births (Kumar, 2013). It is estimated that more than 98% of births are attended by skilled personnel or take place in hospitals (Kumar, 2012). Therefore maternal mortality is not a “campaign-turner” for abortion reform, but the impact of these laws on health and wellbeing cannot be overlooked (Kumar, 2012). Whilst reliable statistics on abortion morbidity and mortality are unavailable- women accessing care often do not disclose their medical history- it has been estimated that 7-16% of hospital admissions for women are related to the complications of these procedures (Kumar, 2013). Given the widespread success of health care reform in Sri Lanka, other preventable causes of maternal mortality have generally declined such that the proportion of deaths attributable to unsafe abortions has steadily increased (Kumar, 2013). For example, in 2008 it is estimated that mortality from unsafe abortions was equivalent to those caused by postpartum haemorrhage (Family Health Bureau, 2011), the predominant cause of maternal deaths in most developing countries (Kumar, 2013). More important however, is the fact this morbidity and mortality is preventable. Continuing to deny women access to safe abortions is a denial of women’s rights- women are dying “because societies have yet to make the decision that their lives are worth saving” (Fathalla, 2006). Sri Lanka has shown some commitment to gender equality, however it appears this is only superficial, with little concern for the lives of individuals who fail to meet expectations according to traditional social and cultural norms.

Illegal abortion- and false pretences of gender equality- not only endanger the psychological and physical well-being of women, but also broaden the social inequality gap. This has significant consequences for both individual women and for the ongoing socioeconomic development of Sri Lanka. Terminations continue to occur illegally within an unregulated market, where access to safe services are dictated by the ability to pay a “substantial fee” (Arambepola and Rajapaksa, 2014). A decision to undergo an unsafe procedure is based on economic instability (Arambepola and Rajapaksa, 2014) and thus women of low socio-economic status (SES) will more often than not, find safe abortion services to be too expensive (Okonofua, 2006). Moreover, poverty is one of the most common reasons for seeking out an abortion within Sri Lanka in the first place (Perera et al., 2004). Thus poorer women are more likely to require an abortion but less capable of accessing quality services; this places them at increased risk of physical complications as well as social stigmatisation. The alternative choice, to continue the pregnancy in unfavourable conditions, has its own ramifications. Lacking the ability to control the timing of motherhood, these women often sacrifice educational or economic independence, perpetuated by the predominant role of Sri Lankan women in childrearing (Siegel and Siegel, 2013). In this way, the cycle of illegal abortions and poverty becomes self-perpetuating and women of lower SES have fewer opportunities to control her own health, well-being and future direction in life. Given these laws apply only to women, clearly this also further entrenches gender inequality in Sri Lanka and highlights a double standard for a Government committed to improving the health of all of it’s citizens (Arambepola and Rajapaksa, 2014).

Proponents of anti-abortion laws state the necessity to protect the sanctity of human life, however within Sri Lanka these decisions are dictated by a patriarchal power structure that appears to be more concerned with controlling women (Jordal et al., 2013). Potential amendments to the law were recently put forward in Parliament, however it was thought this would “affect the fundamentals of social and cultural life” and result in an increase in promiscuity among women (Kumar, 2012). Clearly this sentiment reflects underlying intentions- to control thought and behaviour. Furthermore, if the sanctity of human life really were central to this law, it is expected that the Government  would “bend over backwards” to provide support to women who are “ required to bear- too often alone- the awesome physical, emotional, and financial costs of pregnancy, childbirth, and childrearing” (Siegel and Siegel, 2013). In reality however, vulnerable women must face compelled motherhood with veritable indifference from the Government (Siegel and Siegel, 2013). Single mothers represent the extreme- despite not being allowed to undergo an abortion, should they continue with the pregnancy they receive no state support, face social stigma and are often forced to work in low paid positions or even migrate (Jordal et al., 2013). Thus abortion laws in Sri Lanka reflect a perception of what is “natural” and appropriate for a woman within society. Indeed as was seen above, this law is not only failing to protect human life- since abortions continue to occur- it is actually placing lives in extreme danger.  As described by Gill and Stewart (2011), Sri Lanka and other similar South Asian countries must “develop a critical consciousness of their common patriarchal cultural ideology, which exacerbates gender inequities” and only by doing this will progress truly be made for women’s rights.

Overall, recent socioeconomic development within Sri Lanka stands to disguise the ongoing inequality faced by women and that is reflected in current abortion laws. There is a double standard whereby the Government legally, politically and publically has committed itself to protecting the rights of women, whilst simultaneously undermining them and perpetuating discriminatory behaviour. Moreover, a failure to provide adequate services to prevent and manage the consequences of this approach underscores a general disregard for the health and wellbeing of women, particularly those who do not conform to societal norms. Clearly legislation surrounding abortion has less to do with safeguarding and cherishing life, and more to do with power and control over women. In reality what is required for this controversial issue, is the same dispassionate and scientific approach as other public health concerns (Grimes et al., 2006). Whilst this is unlikely to occur in the foreseeable future given current active opposition, it is imperative that the Sri Lankan Government make steps to recognise this issue in order to move towards true- rather than superficial- gender equality. Admittedly legalisation on abortion is not the complete picture either, and a shift in societal and cultural norms is also required to provide free access to sexual and reproductive services, but certainly this will act as a precedent for such change (Grimes et al., 2006). The facts are that abortions occur regardless of legislation and access to safe services improves health and equality for women (Grimes et al., 2006)- it’s hard to argue with that.

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Assessment criteria – Major Essays (60% of total mark)

Criteria Marks allocated Logical organisation and presentation of ideas(Does the material presented follow a logical sequence?  Are you able to build a convincing argument or clearly and logically make your point?  Does the paper follow written conventions ie. have an introduction and conclusion?)

10% Inclusion of required material(Does the paper include material that addresses the question outlined in the subject guide?  i.e. have you written the paper you were asked to write?)

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Complications of Unsafe Abortion: A Case Study and the Need for Abortion Law Reform in Nigeria

Original Articles

Complications of unsafe abortion account for 30–40% of maternal deaths in Nigeria. This paper reports a case of unsafe abortion by dilatation and curettage, carried out by a medical practitioner in a private clinic on a 20-year-old single girl in Lagos, Nigeria. The girl was 16 weeks pregnant. She suffered complications consisting of perforation of the vaginal wall through the utero-vesical space into the abdominal cavity with gangrenous loops of small intestine herniating through it. Information was obtained from her case notes and the operating theatre register. She had a resection and anastomosis of the small intestine and had to remain in hospital, where she made a full recovery, for two weeks. Unsafe abortion is fraught with many complications, including pelvic sepsis, septicaemia, haemorrhage, renal failure, uterine perforation and other genital tract injuries, and gastro-intestinal tract injuries. Where expert, emergency treatment for these is not available, women die. Unsafe abortion procedures, untrained abortion service providers, restrictive laws and high morbidity and mortality from abortion tend to occur together. We advocate for a review of the existing restrictive laws in Nigeria in order to reduce the high morbidity and mortality from unsafe abortion.

Les complications consécutives à un avortement à risque représentent 30–40% des décès maternels au Nigéria. Cet article décrit un avortement par dilatation et curetage mené par un praticien médical dans une clinique privée sur une célibataire de 20 ans à Lagos, Nigéria. La patiente était enceinte de 16 semaines. Elle souffrait d'une perforation de la paroi vaginale par l'espace utéro-vésical dans la cavité abdominale, des anses gangrenées de l'intestin grêle formant des hernies. Les informations ont été obtenues à partir de son dossier et du registre de la salle d'opération. Elle a subi une résection et une anastomose de l'intestin grêle et a dû être hospitalisée pendant deux semaines avant de se rétablir complètement. L'avortement non médicalisé comporte beaucoup de complications: infection pelvienne, septicémie, hémorragie, insuffisance rénale, perforation utérine et autres lésions de l'appareil génital, et lésions de l'appareil gastro-intestinal. Quand un traitement spécialisé d'urgence n'est pas disponible, les femmes meurent. Les procédures à risque, les praticiens non formés et les lois restrictives tendent à coı̈ncider avec des taux élevés de morbidité et de moralitédues à l'avortement. Nous plaidons pour une révision des lois restrictives en vigueur au Nigéria afin de ré duire les taux élevé de morbidité et de mortalité dues aux avortements à risque.

Entre el 30 y el 40 por ciento de las muertes maternas en Nigeria se deben a complicaciones de abortos practicados en condiciones de riesgo. Este artı́culo describe el caso de una joven soltera de 20 años con 16 semanas de embarazo a quién un médico en una clı́nica privada en Lagos, Nigeria le hizo un aborto por dilatación y curetaje. Ella sufrió como complicaciones la perforación de la pared vaginal atravesando el espacio útero-vesical hasta la cavidad abdominal con lazos del intestino delgado gangrenosos enclavados en ella. Se obtuvo la información de su ficha médica y del registro del quirófano. Le hicieron una resección y anastomosis del intestino delgado, y ella tuvo que permanecer hospitalizada por dos semanas, recuperándose completamente. El aborto practicado en condiciones de riesgo conlleva muchas complicaciones, incluı́das la sepsis pélvica, septicemia, hemorragia, paro renal, perforación del útero y otros daños al aparato genital, y daños al aparato gastrointestinal. Donde no existan tratamientos de urgencia especializados para estas condiciones, las mujeres mueren. Suelen conjugarse las intervenciones malhechas, los proveedores no calificados, las leyes restrictivas y la alta morbi-mortalidad a causa del aborto. Estamos a favor de una revisión de las leyes restrictivas en Nigeria para reducir la alta morbi-mortalidad del aborto inseguro.

As many as 53 million pregnancies are estimated to be terminated by induced abortion each year worldwide Citation [1] , while in Nigeria an estimated 610,000 abortions are performed yearly Citation [2] . A significant number of these abortions are thought to be performed by physicians in Nigeria and are generally assumed to be relatively safe Citation [2] Citation [3] . However, unsafe abortions remain a major reproductive health concern in Nigeria and indeed in most other parts of the developing world Citation [2] . They are also a major contributor to maternal mortality, accounting for as many as 30–40% of maternal deaths in Nigeria and one in eight maternal deaths in the West African sub-region as a whole Citation [3] Citation [4] Citation [5] . Abortion is legal only when done to save the life of a woman in Nigeria, which is restrictive by law. In fact, many abortions are performed by unskilled abortion care providers, as the following case reported shows.

Case report

A 20-year-old, single girl with no children was admitted to the accident and emergency department of Lagos University Teaching Hospital in January 2000 with a nine-hour history of protrusion of a mass from the vagina. The information reported here was obtained from her case notes and the operating theatre register.

Earlier that day she had had an attempted termination of a 16-week pregnancy by dilatation and curettage (D&C) at a private hospital. However, she became restless with the injection of an anaesthetic drug (ketamine), and an attempt at the passage of instruments into the vagina for the procedure led to a suspected uterine perforation. The procedure was subsequently abandoned and the patient was referred to our Gynaecological Emergency Centre. The patient, however, went home instead because of the fear of coming to a public institution.

At home, while eating, she developed a cough and with each coughing episode she noticed an increasing protrusion of a mass from her vagina. She was brought to the Gynaecological Emergency Centre with associated abdominal pain and mild bleeding from the vagina as well. She said she had had an induced abortion (at six weeks of pregnancy) the previous year without complications.

On examination, she was found to be mildly dehydrated and pale but with a normal pulse rate of 84 beats/min and blood pressure of 120/70 mmHg. Her abdomen was not distended, the Fundal height was 16-week size and the bowel sounds were absent. There were loops of gangrenous small intestine protruding from her vagina ( Figure 1 ). A diagnosis of uterine perforation with herniation of the small intestine was made. She was resuscitated with intravenous fluids and antibiotics, and had an emergency exploratory laparotomy.

Published online:

Fig. 1 Loops of gangrenous small intestine protruding from the vagina, 20-year-old girl, Lagos University Teaching Hospital, Nigeria.

nursing case study about abortion

At surgery, a perforation through the utero-vesical space was found with herniation of the small intestine through it. The uterus was still intact and no injury was seen. The gangrenous small bowel was reduced, i.e. returned to the abdominal cavity through the perforation, and a resection and anastomosis (excision and rejoining) was performed. The perforation in the utero-vesical space was repaired. While awaiting proper second trimester induction, the patient expelled the products of conception spontaneously three days post-operatively and an evacuation by manual vacuum aspiration was done. She was maintained on appropriate antibiotics, made a satisfactory recovery and was discharged two weeks post-admission. She was also given contraceptive counselling and referred to the Departmental Family Planning Clinic for services.

Unsafe abortion is fraught with many complications, including pelvic sepsis, septicaemia, haemorrhage, renal failure, uterine perforation and other genital tract injuries, gastro-intestinal tract injuries. Where emergency expert treatment for these is not available, death will result Citation [6] Citation [7] . This case of induced abortion with bowel injury highlights the persisting problems of unsafe abortions in Nigeria. Bowel injury is a serious and life-threatening complication in a case such as this Citation [6] , though occurring in this girl in an unusual presentation. Complications such as this occur when abortion is badly performed, particularly by untrained personnel and in unhygienic conditions Citation [7] . While a significant and increasing number of abortions are being performed by physicians, usually in private clinics and hospitals Citation [2] Citation [8] Citation [9] , these abortions must be done in secretive conditions and training for the doctors involved is often less than optimal or non-existent. This happens when the law is so restrictive, as is the case in Nigeria. This situation is exemplified by this case report, in which the provider attempted a second trimester termination using D & C, failed to take the patient directly to the referral centre or at least arrange for her immediate transfer, and then the patient was too frightened to come to a public hospital on referral.

The issue of abortion remains a delicate one in our country, presenting a complex moral and ethical dilemma. In all societies, however, no matter what the legal, moral or cultural status of abortion is, there are women who will seek to terminate an unwanted pregnancy Citation [10] . While correct and consistent use of highly effective contraception will prevent most unwanted pregnancies and greatly reduce the need for abortion, it cannot eliminate this need Citation [11] Citation [12] , nor have most Nigerian women and men yet achieved this level of contraceptive use Citation [13] .

It is for reasons such as these and in order to prevent the serious morbidity reported here, which is so costly for women's health and for the health service itself, that many have advocated the need for reform of the current abortion law and policy, to ensure that safe abortion services are made available to all women in need, as well as training for abortion service providers Citation [11] Citation [14] . Unsafe abortion procedures, untrained abortion service providers, restrictive laws and high morbidity and mortality from abortion tend to occur together Citation [14] . It is therefore necessary to advocate for a review of the existing restrictive laws in Nigeria in order to reduce the high morbidity and mortality from unsafe abortion.

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Case Study on Abortion

Free case study on abortion:.

Almost all students who study at High school, College and University will face the problem of writing a case study on abortion , because this topic is very important nowadays and attracts much attention of the public. Being a complicated topic, it requires only reliable data and minimum of imagined facts and narration, that is why students often apply for professional writing help in the Internet and read free samples of case studies on abortion there to raise their chances of writing a good case study paper.Abortion is a procedure aimed to stop pregnancy. The general attitude towards abortion is extremely different and categorical.

Many people, including doctors support abortion or at least some of its kinds but every scholar agrees that the procedure should be done as early as possible, because abortion at later terms is a big threat to the life of a woman. The majority of conservative thinking people, various religious organizations are completely against of abortion claiming it is an inhumane action. Many countries treat abortion as a crime and the woman with the doctor who has practised the operation can be imprisoned. On the other hand, abortion is the only way out when pregnancy is a threat to a woman’s life and then the procedure is legal.As you see abortion is quite a controversial topic and you are free to research it in your own way.

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You may concentrate your attention at the types of this procedure with the description how it is done and prepare a general case study analysis on abortion ethics. Next, abortion is really a dangerous and serious procedure, so you way dwell on the research of this side of the topic and write a case study on threatened abortion or a case study on incomplete abortion. Many women risk their lives and want to get rid of the pregnancy on the late terms, so present a research on the terms when the procedure is more or less safe in the case study on missed abortion.In order to complete a successful case study one should read much about the topic. Read encyclopedias, articles on medicine by reliable scholars who illustrate the procedure and the condition of a woman (physical and psychological impact of abortion on the woman’s body and soul).

It will be useful to take advantage of free examples of case studies on spontaneous abortion available in the web, so pay attention to these samples and understand to the way and the style of writing, type of the content and structure of the paper. In the end think over about effective methods to cope with the problem of abortion or how to make it safer for the woman’s body.

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Abortion Nursing Care and Patient’s Rights

Introduction, patient’s rights, abortion nursing care.

Abortion has always been a controversial issue, dividing both the caregivers and the general public into two distinctive categories: pro-life and pro-choice. The U.S. has many abortion laws and limitations; furthermore, the procedure is widely frowned-upon in American society. Women who decide to undergo the procedure want it to remain confidential and to receive quality care from medical practitioners without being judged. In contrast, some caregivers may experience an ethical dilemma whenever required to assist with abortions, which can cause inner conflict between their individual views and nursing duties, thus affecting the treatment quality.

Legal rights of the patients with regards to abortion correspond to the basic ethical principles, such as the rights to be informed, to maintain personal privacy, to receive high-quality health care, and to make free choices about abortion: “It is obvious that a pregnant woman has rights, including an unconditional right to control what happens to her body” (Chervenak, McCullough and Brent, 2011, p. 315.e2). The right to information rests on the principle that a woman is entitled to receive full information about the procedure and her health (Chervenak et al.), as well as to have access to information regarding qualifications and license of the medical practitioner (Pregnancy Resource Center, 2016, para. 1).

Due to the sensitive nature of the issue, it is also important to protect the woman’s privacy rights and ensure the confidentiality of all disclosed information and the procedure itself. Finally, each woman has the right to be treated properly by the medical practitioners, receive high-quality care, and be transported to emergency care institutions should there be any complications during the procedure (Pregnancy Resource Center, 2016, para. 1).

However, women undergoing abortions are not the only ones experiencing ethical dilemmas regarding the procedure. Fant (2012) explores the ethical implications and concerns experienced by nurses who assist with abortions and care about females who undergo the procedure. These ethical concerns are “shaped by the values, beliefs, and experiences of the nurse” (Fant, 2012, para. 3) and affect the provision of care by the nurse in one way or the other.

One of the fundamental dilemmas that Fant addresses is pro-life versus pro-choice, a conflict particularly relevant in abortion and euthanasia practices. A nurse who is pro-life will either deny participating in abortion cases altogether or, if forced to take part, could experience difficulties with being empathic and caring. Fant (2012) also discusses other dilemmas, such as control versus free will: for instance, if abortion could have grave consequences on the patient’s health, but the patient wants to proceed, it is unclear whether or not the nurse should have a say on the case (para. 7). Disclosure of health conditions is another ethical issue (Fant, 2012, para. 8).

However, as this problem generally arises out of the family’s desire to keep some information secret from the patient, it has fewer applications to the confidential and private cases of abortion.

Overall, abortion is a complicated issue, in which moral views and values of different parties often collide. This could cause many problems both for the patients and for the nurses, which is why it is important to respect the will of both sides and to develop an effective controlling procedure that would ensure fulfillment of the patient’s rights, as well as the possibility for nurses to choose whether or not to take part in abortion cases, depending on their stand in the pro-life versus pro-choice conflict.

Chervenak, F. A., McCullough, L. B., & Brent, R. L. (2011). The professional responsibility model of obstetrical ethics: avoiding the perils of clashing rights . American Journal of Obstetrics , 205(4), 315.e1–315.e5. 

Fant, C. (2012). Major ethical dilemmas in nursing . Nurse Together . 

Pregnancy Resource Center (2016). Legal rights for women seeking abortion . Pregnancy Resource Center . 

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StudyCorgi. (2022, March 14). Abortion Nursing Care and Patient’s Rights. Retrieved from https://studycorgi.com/abortion-nursing-care-and-patients-rights/

StudyCorgi. (2022, March 14). Abortion Nursing Care and Patient’s Rights. https://studycorgi.com/abortion-nursing-care-and-patients-rights/

"Abortion Nursing Care and Patient’s Rights." StudyCorgi , 14 Mar. 2022, studycorgi.com/abortion-nursing-care-and-patients-rights/.

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People are social creatures, and it’s only natural of us to request help from experts.. That’s why we ask doctors, electricians, or plumbers to help us! They’re all specialists. Who writes essays for you better than you do? Right, people who write numerous essays every day. We are experts in academic writing, aimed at satisfying all your needs related to education.

You just hire a professional to get a paper written, like you normally do in other situations. Our team of writers know everything about writing your paper and can cope with assignments of any complexity and academic level. Well-researched and expertly-written papers are what we do for our customers, and we always do our work professionally so that you could kick back and enjoy your life to the fullest.

The undeniable benefits of our custom paper-writing service

Apart from a paper written in accordance with the highest standards, we provide a wide range of contributory advantages to make your life easier. Let’s take a closer look at them.

Round-the-Clock Support. Our paper-writing service works day and night to help you with all current issues. Our friendly support team is available whenever you need them, even if it’s the middle of the night. They will gladly guide you and answer all your questions on how to order customized papers or consult you about the matters at hand. Feel free to share your questions or concerns with them and get comprehensible answers.

High-Class Quality. ‘Will you write a paper for me that meets all requirements?’ This question is frequently asked by many students, and we always answer in the affirmative. Our main goal is to deliver a perfectly written paper the meets the highest possible writing standards. We don’t rest unless you are satisfied with our work. If you hire a paper writer online, we guarantee you that you get 100% original and plagiarism-free assignments of high quality.

Complete Anonymity. We value your privacy and use modern encryption systems to protect you online. We don’t collect any personal or payment details and provide all our customers with 100% anonymity. ‘Can you write a paper for me and let me stay anonymous?’ Of course, we can! We are here to help you, not to cause problems.

Fast Delivery. We completely understand how strict deadlines may be when it comes to writing your paper. Even if your paper is due tomorrow morning, you can always rely on us. Our writers meet all set deadlines unequivocally. This rule is ironclad! The offered range is wide and starts from 6 hours to 2 weeks. Which one to choose is totally up to you. On our part, we guarantee that our writers will deliver your order on time.

Free Revisions. Our mission is to hone your paper to perfection. That’s why we offer you free revisions to make everything ideal and according to your needs. Feel free to ask for revisions if there is something you would like to be changed. That’s how our paper writing service works.

Money-Back Guarantee. You can get up to a 100% refund if you are dissatisfied with our work. Nevertheless, we are completely sure of our writers’ professionalism and credibility that offer you hard-core loyalty to our guarantees.

Comprehensible Explanations. ‘Can someone write my paper for me and provide clarifications?’ This question arises from time to time. Naturally, we want you to be totally prepared for the upcoming battle with your professor. If you need to fill the gaps in your knowledge, you can always ask for clarifications related to your paper. Moreover, when you order ‘write my paper for me’ service, you can always turn to our support agents for assistance. They will be glad to provide you with the necessary information and comprehensible explanations.

Fast and Customer-Focused Solutions. ‘Is it possible to do my paper for me so that I don’t worry about it at all?’ It certainly is! We offer all-encompassing solutions to all your academic problems by defining issues, determining their causes, selecting proper alternatives, and ultimately solving them. You are free to do your favorite activities while we are taking care of ongoing matters. You can always rely on us when it comes to essay-writing online and taking an individual approach to every case.

Who will write my paper when I order it?

Another crucial advantage of our service is our writers. You may have asked yourself, ‘I’d like to pay someone to write a paper for me, but who exactly will that person be?’ Once you order a paper, our managers will choose the best writer based on your requirements. You’ll get a writer who is a true expert in the relevant subject, and a perfect fit is certain to be found due to our thorough procedure of selecting.

Every applicant passes a complex procedure of tests to become one of our permanent writers. First of all, they should provide their credentials.  We need to make sure that any prospective writers we hire have the proper experience.. The next step resides in passing a series of tests related to grammar, in addition to subject and/or discipline. Every paper-writer must pass them to prove their competency and their selected field of expertise.

One more step includes writing a sample to prove the ability to research and write consistently. Moreover, we always set our heart on hiring only devoted writers. When you ask us to write your essay or other academic works, you can be sure that they always do their best to provide you with well-structured and properly-written papers of high quality.

The final chord is related to special aspects of academic paper-writing. It means that every writer is prepared to cite properly, use different styles, and so on, so you don’t have to be worried about formatting at all.

‘So, can they write an ideal paper for me?’ We answer in the affirmative because we select only the best writers for our customers. Approximately 11% of all applicants can pass the whole set of tests and are ready to help you. All writers are fully compensated for their work and are highly motivated to provide you with the best results.

We are online 24/7 so that you could monitor the process of paper-writing and contact us whenever necessary. Don’t forget that your satisfaction is our priority. Our writers fully focus on your order when it comes to the ‘write my paper’ procedure. Our managers will immediately send all the information to your writer if any corrections are required.

It’s time to write my paper! What should I do?

‘I am ready to pay to have a paper written! Where do I start?’ Our team hears these words every day. We really believe that every student should be happy. That’s why we offer you to look at the simple steps to make the process even more convenient.

Every paper we can write for you is expertly-researched, well-structured, and consistent. Take a look at some types of papers we can help you with:

Questions like ‘I would like you to write a paper for me without destroying my reputation. Can you promise to do so?’ or ‘Can you write my paper for me cheap and fast?’ often arise, and we take pride that these options are included in the list. Your safety and anonymity are parts of our common priority, which is to make you fully satisfied with all offered services.

Moreover, our pricing policy is flexible and allows you to select the options that totally suit your needs at affordable prices. You will be pleased with the results and the amount of money spent on your order. Our managers and writers will do the rest according to the highest standards.

Don’t hesitate and hire a writer to work on your paper now!

We believe that students know what is best for them, and if you suppose that it is time to ‘write my paper right now,’ we will help you handle it. ‘Will you do my paper without any hesitation?’ Of course, we will. Our service has all the necessary prerequisites to complete assignments regardless of their difficulty, academic level, or the number of pages. We choose a writer who has vast experience and a breadth of knowledge related to your topic.

Our ‘write my paper for me’ service offers a wide range of extra features to make the ordering process even more pleasant and convenient. Unlike lots of other services, we provide formatting, bibliography, amendments, and a title page for free.

‘When you write my paper for me? Can I monitor the process?’ Naturally, you can. We understand that you may want to ensure that everything is going well. Furthermore, there may be situations when some corrections are needed. We believe that a tool like this can come in handy. The assigned writer will strictly follow your and your professor’s requirements to make sure that your paper is perfect.

‘Is it possible to write my essay from scratch?’ We don’t do just proofreading or editing. Our goal is to fully carry your burden of writing. When this or similar questions appear, we always assure our customers that our writers can do whatever they need. Apart from writing from scratch or editing and proofreading, our experts can effortlessly cope with problem-solving of all kinds;even sophisticated software assignments!

Our ‘write my paper for me’ service is good for everyone who wants to delegate paper-writing to professionals and save precious time that can be spent differently and in a more practical way. We want you to be happy by offering the great opportunity to forget about endless and boring assignments once and forever. You won’t miss anything if your papers become the concern of our professional writers.

Don’t waste your precious time browsing other services. We provide you with everything you need while you are enjoying yourself by doing things you really enjoy. ‘Write my paper then! Do my paper for me right now!’ If you are ready to exclaim these words with delight, we welcome you to our haven, a place where students spend their time serenely and never worry about papers! It’s your turn to have fun, whereas our mission is to provide you with the best papers delivered on time!

Questions our customers ask

Can someone write my paper for me.

Yes, we can. We have writers ready to cope with papers of any complexity. Just contact our specialists and let us help you.

Who can I pay to write a paper for me?

We will help you select a writer according to your needs. As soon as you hire our specialist, you’ll see a significant improvement in your grades.

Can I pay someone to write a paper for me?

Yes, you can. We have lots of professionals to choose from. We employ only well-qualified experts with vast experience in academic paper writing.

What website will write a paper for me?

WritePaperFor.me is the website you need. We offer a wide range of services to cover all your needs. Just place an order and provide instructions, and we will write a perfect paper for you.

Is it safe to use your paper writing service?

Our service is completely safe and anonymous. We don’t keep your personal and payment details and use the latest encryption systems to protect you.

What are you waiting for?

You are a couple of clicks away from tranquility at an affordable price!

- Will you write my paper for me? - Yes, we will.

What we offer:, let’s write a paper for you in no time, follow these 4 simple steps and solve you problem at once.

Provide details such as your topic, the number of pages, and extra requirements, and we’ll do a paper for you in no time!

Log in to your personal account to know the current status of your paper(s). You can also turn to our support team for the same purpose. Enjoy your life while we're working on your order.

As soon as we write the paper(s) for you, check it for correctness, and if everything is good to go, just download it and enjoy the results.

Our customers’ feedback

Still hesitant just look: others have already used our services and were pleased with the results.

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You’ll write my paper for me, won’t you? We certainly will!

So tired of writing papers that you’re starting to think of your professor’s demise? Relax, we’re only joking! However, even a joke is woven with the thread of truth, and the truth is that endless assignments are constantly nagging at you and keeping you up all night long.

‘Writing my papers is unbearable!’ you may think But you’re not alone… What if we told you that we know a magical place where professionals can write your essays so perfectly that even professors’ most sophisticated requirements will be met? You’ve probably already guessed that we’re talking about WritePaperFor.me — the most delightful, facilitating, and destressing custom paper-writing service!

We are not going to be shy about our wish to see you as our steady customer. As a result, we aren’t twiddling our thumbs but permanently improving our services; we carefully select writers who always bone up on their subjects and disciplines, and we won’t rest unless you’ve gotten your ideal paper(s). All your wishes become our unshakable rules!

Why would I ask you to write paper for me?

Despite the obvious and even natural resistance to the idea of paper writing in principle that may occur with any student, you may also ask yourself, ‘Why would I need you to help me write my paper?’ The answer to this question lies in the spectrum of your routine actions. It’s not surprising that studying becomes part of our lives, but sometimes we’ve just got too much going on!

When you write an essay or academic paper, you just do one of the numerous things you face daily or weekly. This part of your life consumes lots of energy and time, so how can you possibly get around to doing other things like having fun, working, playing sports, helping relatives, and spending time with friends?

People are social creatures, and it’s only natural of us to request help from experts.. That’s why we ask doctors, electricians, or plumbers to help us! They’re all specialists. Who writes essays for you better than you do? Right, people who write numerous essays every day. We are experts in academic writing, aimed at satisfying all your needs related to education.

You just hire a professional to get a paper written, like you normally do in other situations. Our team of writers know everything about writing your paper and can cope with assignments of any complexity and academic level. Well-researched and expertly-written papers are what we do for our customers, and we always do our work professionally so that you could kick back and enjoy your life to the fullest.

The undeniable benefits of our custom paper-writing service

Apart from a paper written in accordance with the highest standards, we provide a wide range of contributory advantages to make your life easier. Let’s take a closer look at them.

Round-the-Clock Support. Our paper-writing service works day and night to help you with all current issues. Our friendly support team is available whenever you need them, even if it’s the middle of the night. They will gladly guide you and answer all your questions on how to order customized papers or consult you about the matters at hand. Feel free to share your questions or concerns with them and get comprehensible answers.

High-Class Quality. ‘Will you write a paper for me that meets all requirements?’ This question is frequently asked by many students, and we always answer in the affirmative. Our main goal is to deliver a perfectly written paper the meets the highest possible writing standards. We don’t rest unless you are satisfied with our work. If you hire a paper writer online, we guarantee you that you get 100% original and plagiarism-free assignments of high quality.

Complete Anonymity. We value your privacy and use modern encryption systems to protect you online. We don’t collect any personal or payment details and provide all our customers with 100% anonymity. ‘Can you write a paper for me and let me stay anonymous?’ Of course, we can! We are here to help you, not to cause problems.

Fast Delivery. We completely understand how strict deadlines may be when it comes to writing your paper. Even if your paper is due tomorrow morning, you can always rely on us. Our writers meet all set deadlines unequivocally. This rule is ironclad! The offered range is wide and starts from 6 hours to 2 weeks. Which one to choose is totally up to you. On our part, we guarantee that our writers will deliver your order on time.

Free Revisions. Our mission is to hone your paper to perfection. That’s why we offer you free revisions to make everything ideal and according to your needs. Feel free to ask for revisions if there is something you would like to be changed. That’s how our paper writing service works.

Money-Back Guarantee. You can get up to a 100% refund if you are dissatisfied with our work. Nevertheless, we are completely sure of our writers’ professionalism and credibility that offer you hard-core loyalty to our guarantees.

Comprehensible Explanations. ‘Can someone write my paper for me and provide clarifications?’ This question arises from time to time. Naturally, we want you to be totally prepared for the upcoming battle with your professor. If you need to fill the gaps in your knowledge, you can always ask for clarifications related to your paper. Moreover, when you order ‘write my paper for me’ service, you can always turn to our support agents for assistance. They will be glad to provide you with the necessary information and comprehensible explanations.

Fast and Customer-Focused Solutions. ‘Is it possible to do my paper for me so that I don’t worry about it at all?’ It certainly is! We offer all-encompassing solutions to all your academic problems by defining issues, determining their causes, selecting proper alternatives, and ultimately solving them. You are free to do your favorite activities while we are taking care of ongoing matters. You can always rely on us when it comes to essay-writing online and taking an individual approach to every case.

Who will write my paper when I order it?

Another crucial advantage of our service is our writers. You may have asked yourself, ‘I’d like to pay someone to write a paper for me, but who exactly will that person be?’ Once you order a paper, our managers will choose the best writer based on your requirements. You’ll get a writer who is a true expert in the relevant subject, and a perfect fit is certain to be found due to our thorough procedure of selecting.

Every applicant passes a complex procedure of tests to become one of our permanent writers. First of all, they should provide their credentials.  We need to make sure that any prospective writers we hire have the proper experience.. The next step resides in passing a series of tests related to grammar, in addition to subject and/or discipline. Every paper-writer must pass them to prove their competency and their selected field of expertise.

One more step includes writing a sample to prove the ability to research and write consistently. Moreover, we always set our heart on hiring only devoted writers. When you ask us to write your essay or other academic works, you can be sure that they always do their best to provide you with well-structured and properly-written papers of high quality.

The final chord is related to special aspects of academic paper-writing. It means that every writer is prepared to cite properly, use different styles, and so on, so you don’t have to be worried about formatting at all.

‘So, can they write an ideal paper for me?’ We answer in the affirmative because we select only the best writers for our customers. Approximately 11% of all applicants can pass the whole set of tests and are ready to help you. All writers are fully compensated for their work and are highly motivated to provide you with the best results.

We are online 24/7 so that you could monitor the process of paper-writing and contact us whenever necessary. Don’t forget that your satisfaction is our priority. Our writers fully focus on your order when it comes to the ‘write my paper’ procedure. Our managers will immediately send all the information to your writer if any corrections are required.

It’s time to write my paper! What should I do?

‘I am ready to pay to have a paper written! Where do I start?’ Our team hears these words every day. We really believe that every student should be happy. That’s why we offer you to look at the simple steps to make the process even more convenient.

Every paper we can write for you is expertly-researched, well-structured, and consistent. Take a look at some types of papers we can help you with:

Questions like ‘I would like you to write a paper for me without destroying my reputation. Can you promise to do so?’ or ‘Can you write my paper for me cheap and fast?’ often arise, and we take pride that these options are included in the list. Your safety and anonymity are parts of our common priority, which is to make you fully satisfied with all offered services.

Moreover, our pricing policy is flexible and allows you to select the options that totally suit your needs at affordable prices. You will be pleased with the results and the amount of money spent on your order. Our managers and writers will do the rest according to the highest standards.

Don’t hesitate and hire a writer to work on your paper now!

We believe that students know what is best for them, and if you suppose that it is time to ‘write my paper right now,’ we will help you handle it. ‘Will you do my paper without any hesitation?’ Of course, we will. Our service has all the necessary prerequisites to complete assignments regardless of their difficulty, academic level, or the number of pages. We choose a writer who has vast experience and a breadth of knowledge related to your topic.

Our ‘write my paper for me’ service offers a wide range of extra features to make the ordering process even more pleasant and convenient. Unlike lots of other services, we provide formatting, bibliography, amendments, and a title page for free.

‘When you write my paper for me? Can I monitor the process?’ Naturally, you can. We understand that you may want to ensure that everything is going well. Furthermore, there may be situations when some corrections are needed. We believe that a tool like this can come in handy. The assigned writer will strictly follow your and your professor’s requirements to make sure that your paper is perfect.

‘Is it possible to write my essay from scratch?’ We don’t do just proofreading or editing. Our goal is to fully carry your burden of writing. When this or similar questions appear, we always assure our customers that our writers can do whatever they need. Apart from writing from scratch or editing and proofreading, our experts can effortlessly cope with problem-solving of all kinds;even sophisticated software assignments!

Our ‘write my paper for me’ service is good for everyone who wants to delegate paper-writing to professionals and save precious time that can be spent differently and in a more practical way. We want you to be happy by offering the great opportunity to forget about endless and boring assignments once and forever. You won’t miss anything if your papers become the concern of our professional writers.

Don’t waste your precious time browsing other services. We provide you with everything you need while you are enjoying yourself by doing things you really enjoy. ‘Write my paper then! Do my paper for me right now!’ If you are ready to exclaim these words with delight, we welcome you to our haven, a place where students spend their time serenely and never worry about papers! It’s your turn to have fun, whereas our mission is to provide you with the best papers delivered on time!

Questions our customers ask

Can someone write my paper for me.

Yes, we can. We have writers ready to cope with papers of any complexity. Just contact our specialists and let us help you.

Who can I pay to write a paper for me?

We will help you select a writer according to your needs. As soon as you hire our specialist, you’ll see a significant improvement in your grades.

Can I pay someone to write a paper for me?

Yes, you can. We have lots of professionals to choose from. We employ only well-qualified experts with vast experience in academic paper writing.

What website will write a paper for me?

WritePaperFor.me is the website you need. We offer a wide range of services to cover all your needs. Just place an order and provide instructions, and we will write a perfect paper for you.

Is it safe to use your paper writing service?

Our service is completely safe and anonymous. We don’t keep your personal and payment details and use the latest encryption systems to protect you.

What are you waiting for?

You are a couple of clicks away from tranquility at an affordable price!

IMAGES

  1. Nursing care for abortion

    nursing case study about abortion

  2. Nursing Crib Com NURSING CARE PLAN Spontaneous Abortion

    nursing case study about abortion

  3. Midwifery Obstetrical Nursing: Abortion

    nursing case study about abortion

  4. Terminating an Unplanned Pregnancy

    nursing case study about abortion

  5. Contrary To Media Reports, New Abortion Pill Study Finds It Endangers Women & Reversal Works

    nursing case study about abortion

  6. Nursing Care Plan Abortion

    nursing case study about abortion

VIDEO

  1. Abortion services resume at Planned Parenthood Health Centers

  2. New state regulations for abortion clinics

  3. Eight-month pregnant woman loses child due to hospital's carelessness in Jammu

  4. Making Abortion Unthinkable (Session One)

  5. How to write case study? Nursing case study tips #nursingstudent #nursing

  6. Topic : Abortion

COMMENTS

  1. Abortion and nursing: a legal update

    Abortion and nursing: a legal update Author J Horsley PMID: 1465543 Abstract PIP: Almost 2 decades after the Supreme Court's landmark decision in Roe v. Wade, nurses' refusal to assist in abortions is still in question. There are about 1.6 million abortions a year.

  2. 10.10 nursing abortion.docx

    Case Study 3: The Pregnant Teenager with a Genetic Problem Case Study 3: The Pregnant Teenager with a Genetic Problem Melinda did have a right to know this information. However, since Melinda is a minor, it is not unusual for the medical practitioner involved with her diagnosis to tell her mother first regarding Melinda's NF2 gene and the 50% likelihood that she might transmit the disease to ...

  3. Abortion Nursing Care Planning and Management

    Nursing Management Definition Abortion is a medical term for the disruption of a pregnancy before the fetus reaches its viable age of more than 20 to 24 weeks of gestation or weighs at least 500g. Pathophysiology

  4. Case Study 2: Selective Abortion and IVF » Nursing Experts

    The procedure would be a selective abortion of three of the fetuses. The Grossmans were horrified by this information and did not know what to do. They asked Mrs. Clemmons to help them make their decision. To be honest, she found it very hard to see couples faced with this type of choice.

  5. Case Study: Abortion Laws

    Case Study: Abortion Laws Click here to ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Case Study: Abortion Laws Case Study: Abortion Laws Case Study: Abortion Laws Case Study: Abortion Laws Watch this clip from the popular TV show Last Week Tonight with John Oliver titled "Abortion Laws". Abortion Laws: Last Week Tonight…

  6. Nursing Ethics Case Study Analysis (1).docx

    Case Study 4-2 Solution 1. The ethical competencies that will be exercised for this encounter would be the mental and physical distress that Ms. Mason would need to go through and unsafe abortions too are detrimental to health of women.

  7. Competing ethical claims in abortion

    Several staff nurses at a small community hospital in the United States personally believe that abortion is ethically wrong. This personal belief is reinforced for many by their religious belief system. Because of a rotation policy at this hospital, all nurses will be assigned to work in the abortion clinic, and this presents several problems.

  8. "Regardless, you are not the first woman": an illustrative case study

    The case also provides a useful lens through which to examine individual sexual and reproductive health (SRH) experiences, particularly those of rape, unintended pregnancy, and unsafe abortion; this in-depth analysis identifies the contextual risk factors that contributed to Ana Maria's experience. Conclusions

  9. Case Study: Abortion Laws » Nursing Research Essay

    Case Study: Abortion Laws Case Study: Abortion Laws. Watch this clip from the popular TV show Last Week Tonight with John Oliver titled "Abortion Laws". Abortion Laws: Last Week Tonight with John Oliver (HBO) (Links to an external site.)Links to an external site. Reply to this post with the answers to the questions below. 1.

  10. Abortion Case Study Examples That Really Inspire

    The case study is of a minor young girl who does not want her parents to know that she has become pregnant. She is considering an abortion and has already decided that whatever be her medical condition, she would provide consent on her own without any consultation with her parents.

  11. CASE STUDY Abortion

    Diagnosis - Abortion Ward - Gynae ward Present Complaints: Patient having complaint of Pain in abdomen, Discomfort, per vaginal bleeding. Present Medical History: Patient admitted in hospital with complaints of per vaginal bleeding and pain in abdomen. History of excessive bleeding per vagina, passage of poc's.

  12. Ethics: Nursing and Abortion Essay Example

    High quality nursing requires understanding the physical and psychosocial aspects of abortion reflecting the nurse's recognition of the cultural, religious, and socioeconomic factors involved. This requires a nurse who is fully aware of her own feelings and can adapt or defer them to the patient's needs.

  13. Case Study:Abortion laws

    Case Study:Abortion laws Case Study:Abortion laws. ORDER NOW FOR AN ORIGINAL PAPER ASSIGNMENT: Case Study:Abortion laws. Case Study:Abortion laws. Abortion laws and their consequences in Sri Lanka Essay Assignment Paper Instructions - major essay. Your essay should be 3000 words, is worth 60% of the total marks for this subject.

  14. Case Study:Abortion laws

    Case Study:Abortion laws - Our doctorate-prepared nursing assignment writers at Nursing Paper Acers are ready to deliver. ... Case Study:Abortion laws. Abortion laws and their consequences in Sri Lanka Essay Assignment Paper Instructions - major essay. Your essay should be 3000 words, is worth 60% of the total marks for this subject. ...

  15. Complications of Unsafe Abortion: A Case Study and the Need for

    Abstract. Complications of unsafe abortion account for 30-40% of maternal deaths in Nigeria. This paper reports a case of unsafe abortion by dilatation and curettage, carried out by a medical practitioner in a private clinic on a 20-year-old single girl in Lagos, Nigeria.

  16. Case Study on Abortion

    On the other hand, abortion is the only way out when pregnancy is a threat to a woman's life and then the procedure is legal.As you see abortion is quite a controversial topic and you are free to research it in your own way. We Will Write a Custom Case Study Specifically For You For Only $13.90/page! order now

  17. PDF Nursing Care Plan For Abortion Pdf George Castledine (Download Only)

    is Nursing Care Plan For Abortion Pdf below. Study Guide for Maternal Child Nursing Care - E-Book - Shannon E. Perry 2017-09-01 Master content and apply knowledge from Maternal Child Nursing Care, 6th Edition with this corresponding Study Guide. In addition to reviewing content from the text, it encourages you to think critically and use the ...

  18. Pregnancy Case Study Examples That Really Inspire

    In the worst case scenario, if the severe conditions are detected earlier through ultrasound, abortion is recommended. Folate, also called folic acid is a B group vitamin that can prevent most neural tube defects. The recommended dose for the women who are planning to become expectant is 0.5 mg every day for a ... Read more Pregnancy Genetics

  19. Abortion Nursing Care and Patient's Rights

    Patient's Rights. Legal rights of the patients with regards to abortion correspond to the basic ethical principles, such as the rights to be informed, to maintain personal privacy, to receive high-quality health care, and to make free choices about abortion: "It is obvious that a pregnant woman has rights, including an unconditional right ...

  20. Vet Nursing Case Study Examples

    After getting 'my' initial draft in hand, you can go for unlimited revisions for free, in case you are not satisfied with any content of the draft. We will be constantly there by your side and will provide you with every kind of assistance with our best essay writing service. 1343. Finished Papers.

  21. Case Study Against Abortion

    Case Study Against Abortion 100%Success rate NursingManagementBusiness and EconomicsCommunications and Media+96 $4.90 Only a Ph.D. professional can handle such a comprehensive project as a dissertation. The best experts are ready to do your dissertation from