• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

Card Range To Study

through

image

Play button

image

Play button

image

Progress

1/87

Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

87 Cards in this Set

  • Front
  • Back
Alcohol's effects on women
More potent effect on women then men:
-Alcohol dehydrogenase
Alcohol and Pregnancy
-All of major organs are formed in first trimester
-Fetal alcohol syndrome
-Number one cause of preventable mental retardation
Binge Drinking
4 drinks in a row for women
5 drinks in a row for men
Drinking and Driving
Driving Skills decreased after .05%
-women after 1-2 drinks
Physiological effects of Alcohol
Physiological effects:
-Central nervous system depressant
-Contributes to liver disease
Effects on:
Blood
immune system
Pancreas brain
Heart muscle stomach
Signs of Alcoholism
-Having 5 or more drinks a day
-Needing a drink to start the day
-Denial of the problem
-Sleep problems
-Changing brand
-Depression and paranoia
-Failure to recall what happened during a drinking episode
-Dramatic mood swings
-Doing things while drinking that are regretted afterwards
Definition of Auto immune disorders
-Disorders that occur when the body’s immune response is triggered against the self
-Anti-bodies attack bodily tissues
Types of Auto Immune disorders
1.Organ specific
2. Systemic
Disorders
1. Multiple Sclerosis
2. Lupus
3. Scleroderma
4. Thyroid disease
5. Rheumatoid Arthritis
6. Fibromyalgia
Multiple Sclerosis
MS is caused by damage to the myelin sheath, the protective covering that surrounds nerve cells. When this nerve covering is damaged, nerve impulses are slowed down or stopped.

-Central nervous system
-Myelin sheath
-Primarily affects women (60%)
-Young adulthood
Symptoms of Multiple Sclerosis
-Impaired vision
-Tremors
-Tingling
-Weakness or paralysis
-Spasticity
-Bladder problems
-Decreased perception of position
Types of Lupus
Discoid (face)
Lupus
Symptoms for Lupus
-Inflammation of heart lining
-Joint inflammation
-Blood disorders
-Oral ulcers
-Weight loss
-Fever
-Enlarged spleen or liver
-Aches and pains
Definintion of Auto Immune Disorders
There is a problem with the body's normal immune system response. Normally, the immune system helps protect the body from harmful substances. But in patients with an autoimmune disease, the immune system can't tell the difference between harmful substances and healthy ones. The result is an overactive immune response that attacks otherwise healthy cells and tissue. This leads to chronic (long-term) inflammation.

The underlying cause of autoimmune diseases is not fully known. Some researchers think autoimmune diseases occur after infection with an organism that looks like certain proteins in the body. The proteins are later mistaken for the organism and wrongly targeted for attack by the body's immune system.
Definition of Lupus
a person's immune system attacks various organs or cells of the body causing damage and dysfunction. Lupus is called a multisystem disease because it can affect many different tissues and organs in the body. Some patients with lupus have a very mild condition, which can be treated with simple medications, whereas others can have serious, life-threatening complications. Lupus is more common in women than men, and its peak incidence is after puberty-the reason for this is unknown.

-May cause death
-No classic progression of the disease
-Is managed rather then treated
Definition of Scleroderma
-Most serious of auto-immune disorders
-Very rare and life threatening
-Systemic sclerosis
-Deposition of scar tissue in skin and organs of body....
-Sclerodactyly refers to the localized thickening and tightness of the skin of the fingers or toes. This can give them a "shiny" and slightly puffy appearance. The tightness can cause severe limitation of motion of the fingers and toes.
Definition of Thyroid Disease
Thyroid disease occurs when the thyroid gland doesn't supply the proper amount of hormones needed by the body.
-Hashimoto’s disease
Symptoms of Thyroid Disease
-develops slowly
-feeling of fullness or tightness in your throat.
-trouble swallowing food or liquids.
-bump (called a goiter) in the front of your neck.
-tiredness, forgetfulness, depression, coarse dry skin, slow heartbeat, weight gain, constipation and intolerance to cold.
-Many people with this disease have no symptoms at all
Hypothyroidism versus Hyperthyroidism
If the thyroid is overactive, it releases too much thyroid hormone into the bloodstream, resulting in hyperthyroidism. ("Hyper" is from the Greek, meaning "over" or "above.") Hyperthyroidism causes the body to use up energy more quickly than it should, and chemical activity (like metabolism) in the cells speeds up.

An underactive thyroid produces too little thyroid hormone, resulting in hypothyroidism. ("Hypo" means "under" or "below.") When the amount of hormone released into the bloodstream is below normal, the body uses up energy more slowly, and chemical activity (metabolism) in the cells slows down.
Symptoms of Graves Disease
-more common in women
-Sudden acute onset
-Irritability
-Insomnia
-Increased sweating
-Increase bowel movements
-Good appetite but lose weight
Definition of Graves Disease
Graves' disease is the most common form of hyperthyroidism, occurring when your immune system mistakenly attacks your thyroid gland and causes it to overproduce the hormone thyroxine. This higher thyroxine level can greatly increase your body's metabolic rate, which may affect you in numerous ways, from your moods to your physical appearance.
Definition of Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs.

-Group of inflammatory diseases
-Crippling
-Small bones of hand and feet most affected
-Chronic condition
Symptoms of Rheumatoid Arthritis
-Widespread musculoskeletal pain
Classic symptoms;
-Pain in the chest, lower back and radiating down the leg
-Tender points on the body (11 of 18 tender points)
-Fatigue
-Generalized pain
-Disordered sleep
-Anxiety
-Can mimic other diseases
-Difficulty concentrating bowel
irregularities
Smoking
-Most widely used drug in USA
-1/5 deaths are related to cigarette smoking
-All smokers are more likely
to die sooner
-Dose related
-Women who smoke heavily are 2 X’s more likely to develop lung cancer then men

Plays a role in the development of the following cancers:
-Ovarian
-Cervical
-Oral
-Larynx, esophageal
pancreatic

-Heart disease
-Smoking plus using birth control pills increases risk for heart attack and stroke
-Smoking lowers HDL’s

Males that smoke
-Reduced sperm count
-More defective sperm
-More dead sperm
Lung Cancer
-75-80% found in smokers
-Number one cancer killer of women
Emphysema
-Effects air sacs
-No elasticity
-weakened and collapsed air sacs with excessive mucus
Chemicals in Tobacco
4000 chemicals:
-47 carcinogens
-Nicotine
-Tar
-carbon monoxide
Secondhand Smoke
Also called:
Mainstream
Side-stream

-Higher levels of carcinogens then smoke drawn in by smoker
Smoking and Pegnancy
-Narrows blood vessels in placenta

Increases risk of
-Miscarriage
-Bleeding
-Premature birth
-Still birth
-Low birth weight
-Increase in SID’s
-Increase in birth defects
-Increase in allergies
Permanence of Smoking Damages
-Must stop before onset of irreversible damage
-After 1 year of non-smoking risk for heart attack decreases
-After 10 years it is like that of a person that has never smoked
-Lung cancer risk goes down after 10-15 years of non-smoking
Facts about Alcohol
-Alcohol kills more people below the age of 21 than cocaine, marijuana and heroin combine
-Each year more than 100,000 students between the age of 18-24 report having been too intoxicated to know if they consented to having sex

the standard drink:
-12 oz. beer
-5 oz. wine
-1.25 oz. of hard liquor
Definition of Cancer
-A “malignant neoplasm”
-Characterized by uncontrolled growth that often invades surrounding tissues
-Classified by the part of the body it originates in and the type of cell
-Distinguished by the nature site and clinical course of the lesion
-All cancers are NOT the dame
Most Common Types of Cancer
-Carcinomas
-Sarcomas
-Lymphomas
-Leukemia
Causes of Cancer
-Still uncertainty about exact causes

External:
-Chemicals
-Radiation
-Viruses
-Ultra-violet rays

Internal:
-Hormones
-Immune conditions
-Inherited mutations
Lifestyle Factors of Cancer
-Cigarette smoking
-Diet
-Age
-Viruses
-Alcohol consumption
Definition of Carcinogens
-Substances that cause the growth of cancer
-Introduced into body
-Some become activated in body and bind to genetic code
-Altered DNA may be responsible for growth of cancer cells
Cancers that most effect women
-Breast
-Lung
-Colorectal
-Endometrial
-Ovarian
-Cervical
-skin
Breast Cancer
-Being a woman
-Can occur at any age but more common the older one gets
-Women who have first degree relative with breast cancer
-Women who have never had children
-Women who had their firs child after the age of 30

Breast self exam=7 days after your period begins
Symptoms of Breast Cancer
-Lump or thickening in the breast
-Dimpling
-Skin irritation
-Distortion
-Retraction
-Scaliness
-Nipple discharge
Cervical Cancer
-Most will be caught early and cured (PAP smear)
-1/3 will result in death
-More common in women past childbearing age not having regular check-ups

Who is at risk:
-Any woman that has been sexually active
-Multiple sex partners
-Women whose sex partners have had multiple partners
-Women with HIV
-Women with genital warts
-Women who smoke
Ovarian Cancer
-“Silent Cancer”
-No signs or symptoms until it’s in later stages
-1/55 women
-Symptoms are subtle, persistent and increase over time
Symptoms of Ovarian Cancer
-Bloating, abdominal swelling, feeling of fullness
-Urinary tract problems
-Indigestion, constipation, diarrhea
-Pelvic pain, cramps, menstrual disorders
-Fatigue, backaches, appetite loss
Who is at risk of Ovarian Cancer?
-Increases with age
-Women who have never had children
-Family history of ovarian cancer
-Women who have had breast cancer
-Possibility of increasing risk
-Multiple exposures to fertility drugs
-Ashkenazi Jewish heritage
-Genital contact with talc or asbestos that may be in talc douches or condoms

Decreasing the risk:
-Pregnancy
-Oral contraceptives
-Tubal ligation
Endometrial Cancer
Cancer of the inside lining of the uterus
Who is at risk of Endometrial Cancer?
-Women over age 50
-Estrogen replacement
-Tamoxifen therapy
-Early onset of menstrual cycle
-Late menopause
-History of infertility
-Never having had children
-Obesity
-Diabetes
-High blood pressure
Who is at risk of Prostate Cancer?
Age:
-70% in men over 65
Race:
-60% in black men
Nationality:
-Most common in North America and northwestern Europe
-Family history
-First degree relative
Diet:
-High fat diet
-Physical activity/overweight and obesity
-Physical activity reduces risk
Who is at risk of Lung Cancer?
-Can be almost totally prevented
-People who smoke
-Exposure to certain chemicals (arsenic)
-Exposure to radon, asbestos
Skin Cancer
-Most easily treated and cured
-Melanoma is deadly if not treated early: number is increasing in number
Who is at risk of Skin Cancer?
-People with fair complexions
-People with a close family member that had melanoma
-People who have severe sunburns before the age of 18
Signs of Skin Cancer
-A for asymmetry: A mole that, when divided in half, doesn't look the same on both sides.
-B for border: A mole with edges that are blurry or jagged.
-C for color: Changes in the color of a mole, including darkening, spread of color, loss of color, or the appearance of multiple colors such as blue, red, white, pink, purple or gray.
-D for diameter: A mole larger than 1/4 inch in diameter.
-E for elevation: A mole that is raised above the skin and has an uneven surface.
Colon Cancer
-Treatable if caught early

Who is at risk:
-Anyone
-Family history
-Polyps
-Inflammatory bowel disease
-Diets high in fat low in fiber
Lumpectomy VS mastectomy
-Lumpectomy is surgery in which only the tumor and some surrounding tissue is removed.
-Mastectomy is surgery to remove a breast.
Key Terms of Cancer
-Insitu
-Invasive
-Staging
TNM:
-“T”:tumor size and level of invasion: ranges fro 1-4
-“N”:represents node involved: ranges from 1-4
-“M”:presence or absence of distant metastases: x, 0 or 1
Facts about Cardiovascular Disease
-2001:39% of all deaths
-In terms of total death since 1984, CVD has claimed the lives of more women then men
-25% of men and 38% of women will die within one year after having a heart attack
30% of non-Hispanic white men and 24 % of non-Hispanic white women have CVD
Parts of the Cardiovascular System
-Heart, arteries, arterioles, capillaries, and veins
-Two upper chambers: atria
-Two lower chambers: ventricles
-Coronary arteries
Types of CVD
-Atherosclerosis
-Coronary heart disease
-Angina
-Arrhythmia
-Congestive heart failure
-Congenital heart disease
-Stroke
Risks of Cardiovascular Disease
Can be controlled:
-Avoid tobacco
-Cut back on saturated fat and cholesterol
-Monitor your cholesterol levels
-Maintain a healthy weight
-Exercise regularly
-Control diabetes
-Control blood pressure
-Manage stress

Can not control:
-Heredity
-Age
-Gender
-Race
Women and heart disease
-Estrogen
Symptoms in women:
-Delays in diagnosing
-Complexity of interpreting chest pain in women
-Less aggressive treatment
Gender bias in research:
-It’s a “male problem”
Diagnosis and Treatment of CVD
-ECG
-Angiogram
-Angioplasty
-Bypass surgery
-Cardiac rehab
High Blood Pressure and Stroke
-The “silent killer”
-Normal BP
*120/80
-African Americans have an increase risk
Symptoms of a Stroke
-Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
-Sudden confusion, trouble speaking or understanding
-Sudden trouble seeing in one or both eyes
-Sudden trouble walking, dizziness, loss of balance or coordination
-Sudden, severe headache with no known cause
Type I Diabetes
-also know juvenile onset
-10% of all diabetics
-Insulin dependent
-Pancreas stops producing insulin or makes too little
Type II Diabetes
-Also known as adult onset
-90% of all diabetics
Risk factor of Type II Diabetes
-Overweight
-Heredity
Type II Diabetes and Pregnancy
Gestational:
-3-5 % of all pregnancies
-Return to normal levels after pregnancy
-Remain highly susceptible years later
Symptoms of Diabetes
-Frequent urination
-Excessive thirst
-Dramatic weight loss
-Irritability
-Weakness and fatigue
-Recurring and hard to heal skin , gum
-Bladder infections
-Drowsiness
-Blurred vision
-Itching
-Tingling or numbness in feet or hands
Facts about Abortion
-Abortion is safe, legal and common
-The way to reduce the number of abortions is to reduce the number of unintended pregnancies.
-The issues surrounding abortion are varied and vast.
-The high rate of unintended pregnancy in the US explains the high rate of abortion. Each year more than 6 million women become pregnant (1 of every 10 women of reproductive age [15-44]); almost ½ are unintended.
-Almost ½ (43%) of American women have had at least one abortion; if current rates continue, estimated that more than 1/3 (35%) of women of reproductive age in US will have had an abortion by age 45.
-In addition to those women, millions more of both sexes have helped them: partners, parents, friends, health care workers.

-Abortion is becoming less common among white, affluent women and more common among poor women and women of color.
-History shows us that abortion won’t go away if it’s made illegal.
History of Abortion
-18th Century (1700s): abortion accepted and widely used: mostly home remedies; permitted until quickening; dangerous due to no sterilization of medical instruments; no real discussion of abortion being bad;
-19th Century (1800s): abortion outlawed and illegal for approximately 100 years
-Why?
> Laws against poison and to control quackery; most of the potions sold used coded language (i.e. douches for ‘feminine hygiene’).
>Abortion after quickening was a crime not because of loss of fetus but because mother often died.
>Most concerned that abortion was a way to cover the sin of fornication.
>Concerned about declining birthrate: 1800 average woman bore 7 children; 100 years later, reduced by ½;
>What was birth control like in Colonial America?
-Abstinence or drugs that didn’t work. Abortion was most common way to prevent having a baby.
Self-induced abortions
-Desperation, feared multiple pregnancies because of possibility of death, health problems, more children than they could care for; women reluctant to have sex with husbands labeled as frigid;
-Attempts to cause a miscarriage, then seek medical attention
-use of sharp instruments such as hangers; fall downstairs; swallow lye, bleach, turpentine; hitting abdomen; hot baths
-Terrible results either way: death, mutilation, long-term illness, sterility
What is Indiana’s abortion law?
-1st trimester (14 weeks after LMP): may be performed in clinics; always by a doctor
-2nd trimester: must be done in a hospital or ambulatory outpatient surgical center; few in IN will do; referred out of state;
-After viability of fetus, only allowed in cases of permanent impairment of the life or physical health of the mother; 2nd Dr. must be present
-3rd trimester: only in hospital with premature infant care; 2nd doctor present; almost never done in Indiana
-Written parental consent from one parent or legal guardian for women under age 18; judicial bypass available if a teen cannot talk with parents or chooses not to, appears before a judge. Judge considers: is she mature enough to decide on her own; if not, judge will decide if abortion is in her best interests.
-Past viability, must be done with least harm to mother and fetus (induce labor);
-18 hour waiting period; ruled not unreasonable;
-State mandated script; must be delivered in person (PP raised prices $50 to cover costs associated with complying with the law; in clinic (surgical): $400; pill abortion (medical): $500; prices as of 4/09)
Why do Women have Abortions?
-93% cite more than one reason; median # of reasons cited: 4 (Data from 2004 study)
-74% concern for or responsibility to others; will dramatically change life: e
education, work, other children
-73% cite financial reasons (usually together with other reasons)
-relationship problems or fear of single parenthood; completed childbearing; not ready for another child; not mature enough; husband or partner wants the abortion; fetal problems; women’s health; parents want the abortion; rape; incest.
-6 of 10 women say they consult others, mostly husband or partner, in making decision to abort;
-Women who have abortions and women who have children are not two distinct groups but rather the same women at different points in their lives. 6 of 10 who have an abortion are already a parent.
Reasons for late abortions (after 16 weeks since last LMP) {average # of reasons given, 2.2}
-71% didn’t realize she was pregnant;
-48% difficulty making arrangements
-33% afraid to tell parents or partner;
-24% needed time to make decision;
-8% hoped relationship would change;
-8% pressured not to have abortion;
-6% something changed during pregnancy;
-6% didn’t know timing was important;
-5% didn’t know she could get an abortion;
-2% fetal abnormality diagnosed late;

Other reasons:
-Lack of financial and/or emotional support from male partner; absence of partner due to death or estrangement
-Psychological denial of pregnancy, as may occur in cases of rape or incest
Lack of pregnancy symptoms such as presumed continuation of period
-Women who do not menstruate regularly due to illness, medication or athletic activity
-Those who believe they can’t be pregnant because they’re breastfeeding or under medical care
-Those who think lack of period indicates menopause
Reasons why adolescents delay abortion until after 1st trimester
-Adolescents are more likely than older women to obtain abortions later
-Among women under age 15, ¼ are performed at 13 or more weeks
-Reasons: fear of parents’ reaction; denial of pregnancy; irregular periods; parental consent laws; believe common myths; kept rape or abuse a secret; not familiar with health care system
Pregnancy
-measured in time passed since LMP (last menstrual period)
-Pregnancy test: based on elevated levels of a hormone produced by placenta about 10 days following fertilization
-IUHC lab test will show positive results as early as one week after implantation of fertilized embryo (4-5 days before missed period; approximately 10 days after unprotected intercourse)
-Walk-in for urine test, $15/w. health fee; results in person or by phone within one hour
Abortion
-expulsion of fetus from uterus before mature enough to live on its own
-How safe is abortion? The risk of abortion complications is minimal when the procedure is performed by a trained professional in a hygienic setting: Fewer than 1% of all U.S. abortion patients experience a major complication. The risk of death associated with abortion in the United States is less than 0.6 per 100,000 procedures, which is less than one-tenth as large as the risk associated with childbirth.
-Required in Indiana: 2 visits
1.State mandated script read to patient in person
2.Minimum of 18 hours later: administrative procedures including reading, video and one-on-one verbal;
-Choice of procedure is made; lack of coercion is determined;
Surgical (suction curettage) abortion
-1st trimester (as early as 6 weeks and up to 13.6 weeks LMP)
-Meds are provided to make patient comfortable; do not self-medicate
-Pelvic exam is performed by doctor
-Vagina is cleansed with an antiseptic
-Cervix is numbed by local anesthetic injected into or near the cervix and gradually stretched
-Plastic tube (pencil width), attached to suction machine, is inserted through cervix into uterus
-Contents of uterus drawn out by suction; takes 5-10 minutes; pressure and cramping
-Time in clinic can be 4-6 hours total: lab work, intake and recovery
-Following procedure, woman may experience spotting;
-Follow up exam required 3 weeks later
-Locally cost is $400.
-Most abortions (81%) performed by this procedure.
Reasons for Surgical Abortion
-Less likely to have incomplete abortion
-Procedure over in less time as compared to medical abortion procedure
-Patient not alone during procedure
-Patient doesn’t have to see blood and tissue of conception
Medical Abortion – Mifeprex(mifepristone)
-Drug approved by FDA: 9/28/00 after approximately 10 years of testing in US
-What is MIFEPREX? An ANTI-PROGESTIN drug which blocks a hormone needed to continue pregnancy; breaks down uterine lining causing uterus to let go of fetal tissue;
-What else is used? A second drug, MISOPROSTOL, causes uterine contractions, cramping, softens cervix and expels the embryo.
-Where do you get Mifeprex? Only from Doctor’s office or medical clinic; not dispensed through pharmacies;
-Who can give Mifeprex? A doctor or someone s/he supervises. Some states have restrictions on who may dispense;
-When can it be used? Only during first EIGHT weeks, or less, after the first day of woman’s LMP. This means only during the first THREE to FOUR WEEKS after a missed period.
-How do you take Mifeprex? Woman takes first dose (one pill) at the clinic under doctor’s supervision;
-Second drug is taken 24-48 hours later; PP allows woman to take pills in privacy of her home; 4 pills are actually sucked on, 2 on each side of mouth, for about 30 minutes, not swallowed; phone consultation available if patient has questions or an emergency; abortion usually occurs within 4-24 hrs but could take longer.
-Return to provider in two weeks for follow up exam; if abortion is not complete, patient must have surgical abortion; effective methods of contraception are discussed.
-What are the side effects? Similar to a miscarriage: cramping, bleeding, sometimes heavy, including clots; may cause diarrhea, nausea.
-How effective is Mifeprex? Studies say it is effective 92-96% of time, but higher with use of second drug.
-How much does it cost? Locally it’s $500.
-Medical abortions represented 9.9% of all procedures, although proportions of medical abortions varied widely by state.
Reasons for choosing medical abortion
-Feels more natural
-Feels a sense of control over procedure
-No surgery or anesthesia
-Procedure completed early in pregnancy
-Privacy
-High patient satisfaction rates - 96% who have used Mifeprex would recommend method to others
Negatives associated with medical abortion
-Waiting for abortion to happen; takes longer than surgical procedure
-Uncertainty if procedure was complete
-In some cases, more cramping as compared to surgical procedure
Post-Abortion Effects
-For most women, decision to terminate is complex and difficult; feelings of relief;
-In repeated studies, since the early 1980s, leading experts have concluded that abortion does not pose a hazard to a woman’s mental health. “Post abortion Syndrome” does not exist according to the American Psychological Association
-Factors causing problems for some women: strongly held personal values, ambivalence toward abortion, excessive pressure from others, decision made late in pregnancy, lack of family or partner support, termination of an originally desired conception.
-There is conflicting evidence that reports the negative side effects, both physical and emotional, experienced by women who have abortions including depression, guilt, anger, insomnia, increased use of alcohol and drugs. It has been reported that some of these effects do not show up for years or even decades following the abortion.
-Exhaustive reviews by panels convened by US and British gov. concluded no association between abortion and breast cancer or other cancers.
Trends in Abortion
-Mandatory waiting periods required in 24 states, usually 24 hours;
-State mandated counseling: In most states, woman can receive counseling by phone or internet; 7 states, including IN, require to be provided in person.
-Parental involvement laws: As of November 2006, 35 states require some parental involvement for a minor to obtain an abortion (could be notification and/or consent); three states require consent from both parents.
-Mandated Ultrasounds: 5 states require providers to perform an ultrasound on at least some women (not defined) and offer the option of seeing the image. Most extreme example, 2008 law in Oklahoma; enjoined pending legal action.
-Funding issues: no federal Medicaid funding of abortion except in rare circumstances; about 1/3 of private health ins. does not cover abortions. Current health care reform debate may impact private insurance coverage for abortion…yet to be determined.
-Rise of abortion rate among low-income women (below 200% of federal poverty line); account for more than ½ of all abortions though comprising only 15% of population in the U.S. Why? Lack of access to information, education, quality health care, contraceptive methods and services.
>Clinical research continues to improve the safety of various procedures & opens up new possibilities for future
>Fewer doctors willing to perform abortion; safety issues; older
doctors (retired or died) may have a personal history with abortion when it was still either illegal or difficult to obtain; do not want to return to those days when abortion was unsafe
>Training – only 12% of medical schools teach 1st trimester abortion as a routine part of gynecology or other residency programs; the likelihood that a Dr. will provide abortions is highly associated with training received;
>Integrate abortion care into settings where it has not been traditionally available and increasing number of providers because of medical abortion availability.
>Future of US Supreme Court? What will the court look like under Obama administration? No change expected, although not known for sure.
>Attitudes of general public: over 200 years have remained stable-permissive about early abortion, more opposed to later procedures; (poll from 2000: 51% legal under some circumstances; 28% legal under all circumstances; 19% always illegal)
How to decrease need for Abortion
-Decrease risky behavior
-Promote effective contraceptives
-Improve effectiveness by which all methods are used – through education
-Guarantee young people access to comprehensive sexuality education that teach both benefits of delaying intercourse and importance of using contraception
-Improve accessibility to contraceptive services; public funding for contraceptive services has declined or stagnated; (due to higher costs of some new methods, ½ of family planning clinics unable to offer certain methods)
-Better Insurance coverage for all women so they can freely choose best method – not all private insurance covers all methods; more importantly, 2/10 women of reproductive age and 4/10 low income women of reproductive age have no insurance
1973 – Supreme Court Decisions on Abortion
-Court ruled that a woman’s right to choose, in consultation with a doctor, is constitutionally protected but not absolute (i.e. after viability- restrictions)
-Roe v. Wade – landmark decision which overturned a Texas law; based on 14th amendment’s “Right to Privacy”
-Doe v. Bolton – overturned a Georgia law which had numerous provisions restricting access to abortion;
-Decisions: affirmed a women’s right to choose;
-Greatly restricted ways in which government could interfere with that choice;
-Struck down laws in most states; brought all states in line with federal law; no state regulations allowed during lst trimester;
Specifics of ruling by Supreme Court on Abortion
Pregnancy divided into 3 trimesters:
-1st trimester (12 weeks/3 months): state may not interfere with decision to terminate except to require it performed by a doctor;
-2nd trimester (4-6 months): state may regulate conditions (where, standards of care); may not limit reasons for abortion;
-3rd trimester (7-9 months): state may regulate or forbid except to save life of mother;
-Court declined to address whether human life begins at conception, birth or somewhere in between.
1980s & 1990s Legislation on Abortion
-1989: Webster Supreme Court decision opens the door to state regulations of abortion such as parental consent and waiting periods.
-1992: Casey Supreme Court decision upheld right to abortion but significantly weakened legal protections to women and doctors; introduced concept of “undue burden” on the woman. This led to laws being passed to test this standard. (i.e. Mississippi has one of the strictest parental consent laws; requires consent of both parents of a minor; is this an undue burden on women?)
-These restrictions tend to have a greater effect on women who are at highest risk of unintended pregnancy, namely poor and young women.
Legislation on Abortion;1990s and beyond
-1992: ban on abortion pill testing lifted
-1994: increases in anti-abortion violence lead to the Freedom of Access to Clinic Entrances Act (FACE): prohibits force, threats or physical obstruction to any person entering or leaving an abortion clinic.
-2000: Mifepristone (abortion pill) approved by the FDA.