Second-Trimester Abortion: Perspectives After a Decade of Experience. Questo articolo non è disponibile.Second-Trimester Abortion: Perspectives After a Decade of Experience

Irvin M. Cushner, MD, MPH It is both remarkable and, at the same time, a sign of this era of rapid change that one can refer back to the "infancy" of a field which has existed for barely more than a decade. Yet, one now reads of the "maturing" of the family planning and abortion fields, both of which were incorporated into our society and integrated into our health care system within the past ten years. Indeed, in the very year that this book is being prepared, we note the tenth anniversaries of several significant events of 1970: 1) the enactment of Title X of the Public Health Service Act, establishing a Federal program in family planning; 2) the first issuance by a major health-related organization (the APHA) of a policy statement advocating repeal of all abortion laws; and 3) the enactment, by New York State, of an abortion law whose only restric­ tion was that it be performed by a licensed physician and the subse­ quent action, the first by any local health department (New York City), to assure both its implementation and its quality. They were, indeed, eventful days. These three events seemed to presage a then-unprecedented acceptance of fertility regulation as a right and as a needed service.

I Overview.- 1 Second-Trimester Abortion: A Global View.- 2 Second-Trimester Induced Abortion in the United States.- 3 The Availability of Second-Trimester Abortion Services in the United States.- II The Second Trimester of Pregnancy.- 4 Anatomy.- 5 Ultrasonic Evaluation.- 6 Physiology.- III Methods of Second-Trimester Abortion.- 7 Hypertonic Saline Instillation.- 8 Prostaglandin Procedures.- 9 Hyperosmolar Urea.- 10 Dilatation and Evacuation.- 11 Laminaria and Other Adjunctive Methods.- IV Evaluation.- 12 Morbidity and Mortality.- 13 Future Reproduction.- 14 The Role of Health Agencies.- 15 Recommended Procedures for Evaluation of Abortion Techniques.- V Related Issues.- 16 How Much is a Fetus Worth?.- 17 Social Issues.- 18 Psychological Impact on Patients and Staff.- 19 Emotional Issues for Professionals.- 20 Counseling Issues.- 21 Postabortal Contraception.- VI International Considerations: The Dutch Abortion Experience.- 22 Second-Trimester Abortion Services in the Netherlands.- 23 Aspirotomy.- 24 Complications of Aspirotomy.- VII Future Directions.- 25 The Future of Second-Trimester Abortion in the United States.- 26 The Future of Second-Trimester Abortion Throughout the World.- 27 Preventing the Need for Second-Trimester Abortion.- 28 Contragestational Agents.