Abortion for medical reasons. What to do? The biggest fear. Acceptance and humility

Medical abortion is an artificial interruption of pregnancy, which is carried out in a specialized institution qualified specialists. The choice of a method of artificial interrupt depends on the period of pregnancy and hold it with the written consent of the woman, pre-issuing relevant documentation. Medical abortion is made for various reasons. To interrupt pregnancy, a woman can at their own request for up to 12 weeks. According to social testimony, abortion is possible up to 22 weeks. For medical reasons such an interruption is possible on any time.

Indications

A woman is solved on the abortion of pregnancy for reasons that may adversely affect the birth and the further fate of the child and the mother (changing the personal life, the lack of the father of the future child, financial difficulties, the lack of living space). Conduct an abortion on your own request up to 12 weeks of pregnancy.

For medical testimony, abortion is carried out in two situations:

• diseases in which pregnancy and childbirth are able to significantly worsen the health of women and become a threat to life;
• heavy fetal developmental anomalies.

The abortion of pregnancy is carried out on the conclusion of a physician of the gynecologist, the head of this institution and specialists of the relevant profile (oncologist, therapist, surgeon). This interruption is carried out regardless of the term of pregnancy after a written statement from a woman, considered and signed by the Commission specifically created for this. In non-medical testimony, abortion occurs with the participation of a lawyer.

For social indicators, pregnancy is interrupted in the following situations:

• rape;
• disability or death of a husband during pregnancy;
• woman stay in prison;
• deprivation of parental rights.

The question of social testimony abortion solves a specially created commission, which gives conclusion with a complete execution of legal documentation.

An overview of the dates and methods for conducting an abortion is presented in the table.

Examination before abortion

Analyzes are passed immediately before carrying out the procedure. Depending on the results of the tests, the corresponding method will be selected, which will suit the woman in terms of its health.

Required list of analyzes:

• general blood analysis;
• blood chemistry;
• coagulogram;
• analysis on the Rh Factor and the Definition of the Blood Group;
• blood test for HIV, syphilis and hepatitis;
• general urine analysis;
• smear on flora;
• consultation therapist.

Interrupt methods:

• drug abortion;
• surgical abortion: vacuum aspiration of the fetal egg and scraping of the uterine cavity;
• interrupt pregnancy with drugs;
• small caesarean section.

Surgical method

Surgical method or instrumental is an interruption of pregnancy by scraping the uterus. This method is not safe for the further reproductiveness of the woman. However, the surgical method also has undoubted advantages. Initially, it guarantees almost 100% interruption with the complete removal of fruit eggs and the fruit shells. Surgical intervention is performed only in a specially equipped hospital.

For anesthesia, intravenous anesthesia is mainly used, for which the presence of anesthesiologist is required. After the introduction of anesthesia, an extension of the cervix mechanically produces. Then the gynecologist sulfates the uterus, removes the inner layer and the embryo with shells. Medical abortion in this case lasts 15-20 minutes. After the operation, the woman is still some time in the ward under the supervision of medical personnel. This procedure is included in the list of gratuitous services for medical insurance policy.

Vacuum aspiration

Vacuum aspiration, or mini abortion is an easy operation, performed in many medical clinics. Make mini abortion, in early terms, up to 6 weeks from the date of the last menstruation. The mini abortion practically does not have the consequences, but there are cases when the vacuum-aspiration method of interrupting pregnancy can be incomplete, then it is necessary to repeat the operation or make the scraping of the uterine cavity.

Before carrying out the procedure, a woman is introduced an anesthetic drug and an antispasmodic for self-disclosure of the cervix. The procedure is carried out using a tool that are injected into the cervix and with the help of electrical suction create inside the pressure. The doctor extremely carefully encourages the uterine cavity tool and pulls out the fruit egg in a special container. The time of the operation is a few minutes.

Medication method

Medical method is an interruption of pregnancy using tablets. Pharmacological interruption is carried out up to 6 weeks of pregnancy. The method is to apply drugs to suppress the secretion of hormones in the body and enhancing the contractile activity of the uterus. Medical method is optimal for women of women.

Interruption of drugs

For a period of 14-22 weeks, the following means are used for abortion:

• prostaglandins;
• hypertensive solutions.

The use of prostaglandins leads to an increase in the tone of the uterus, which provokes the ripening of the cervix, detachment of the fetal egg and stimulates artificial childbirth. In the case of using hypertensive solutions, the fetus death occurs and generic activities are developing. In all these situations, dead fruit appears on the world.

Small caesarean section

The operation is carried out on the period of 13-22 weeks and only in cases where other methods are recognized in ineffective or unsafe. The procedure is shown in the event that a woman is solved on surgical sterilization after an abortion. The technique of performing the operation is similar to a conventional cesarean cross section. After completion of the procedure, antibacterial therapy is carried out. Lactation suppression means are used in late periods.

Complications after medical abortion

The most encountered complication is the delay of the fruit egg in the uterus. The main symptom of such a complication is the strong discharge with blood clots, which are not stopped for a long time. If the residues of the fetal egg is detected, it is necessary to urgently turn to a specialist and in stationary conditions to repeat the procedure.

Attention should be paid: if the medical abortion was performed not professionally and with the remnants of the fetal parts in the uterus, then this can lead to a deplorable results. The development of bacteria will immediately begin the development of bacteria, since the remains of the fetus are a favorable medium for their reproduction, which contributes to the development of various purulent diseases.

In the event of the following symptoms, it is necessary to refer to the gynecologist:

• heat;
• abundant discharge with blood clots;
• strong pain at the bottom of the abdomen;
• the appearance of unpleasant odor of the selection;
• dizziness, vomiting, faint.

To pay attention to after a medical abortion:

• After an abortion, it is desirable to consult a gynecologist about the use of contraceptive means.
• It is not desirable to use a bath or hot soul, but it is necessary to observe daily personal hygiene.
• Compliance with sexual rest, which is required to prevent and prevent infection in the uterus. The resumption of sexual relations is recommended no earlier than 14 days later.
• To regularly visit the toilet for the intestinal and bladder emptying: it has a beneficial effect on the contraction of the uterus.
• Control the body temperature daily, avoid hypothermia and exercise.
• Observe the correct power mode.
• Pay more attention.

For up to 28 weeks, counting from the date of the beginning of the last menstruation (distinguished early and late abortion - up to 12 or from 12 to 28 weeks, respectively). After 28 weeks, the interruption of pregnancy is called "premature childbirth". Abortion can be spontaneous (miscarriage) or artificial. It will be about the second. And we only touch on the topic of pregnancy abortion for medical testimony.

It is possible to interrupt pregnancy for medical testimony regardless of the term of pregnancy and strictly under a multidisciplinary hospital. By order of the Ministry of Health and Social Development of the Russian Federation of December 3, 2007 N 736 "On Approval of the List of Medical Indications for Artificial Abortion" a list of diseases was presented, in the presence of which pregnancy is desirable to interrupt.

There are four types of pregnancy interruption: drug abortion, which is done with the help of medical drugs for up to 6 weeks; Mini abortion (vacuum aspiration) for up to 5 weeks; surgical (operating abortion), conducted in the form of scraping of the uterine cavity; Artificial childbirth, which are held in the third trimester, pass through the mechanism of ordinary birth and ends with scanning.

What should be known to know a woman who is offered to interrupt pregnancy? First, according to the legislation of the Russian Federation (the document "On the protection of citizens' health of July 22, 1993, Article 36" Artificial Abortion of Pregnancy "):" Each woman has the right to independently decide on motherhood. " Secondly, such a verdict, as a pregnancy interruption, may be submitted after examining the patient in the hospital in terms of the hospital only by a consultation from the attendant physician, a profile specialist (therapist, surgeon, oncologist, etc.) and the head of the medical institution. That is, the female consultation doctor is not in the right to make such decisions or to inclination the woman to the abortion. Alas, a picture, when a healthy woman comes to putting in the LCD, and there it is stated: "You still don't take it out. Maybe break? ", Described by future mothers more and more. In case of such a situation, write a statement addressed to the chief physician consultation with a complaint about a particular physician.

However, if the diagnosis is confirmed (and is confirmed by several specialists), to preserve their lives and health, as well as the opportunity to give birth in the future, with the verdict of doctors have to agree. We want to want to wish for women through this test, do not close it in yourself, do not give up the help of loved ones or psychologists and believe that you can know the happiness of motherhood, let him somewhat later.

Girls, how to survive ??? Just discharged from the hospital, made PB for 20 weeks. I am 26 years old recently turned, children have not yet planned with her husband, but this surprise was very pleasant! And the name was invented, and the relocation was planned, and a change of work ... all for our crumb. All pregnancy proceeded easily, excellent analyzes, ultrasound for 12 week and screening on the same day - excellent. For about 15-16 weeks, the baby began to move and kick - there was no limit to happiness! And in 19 weeks, the ultrasound showed Hondrodnisy's child, the second ultrasound confirmed the diagnosis, went to the local guru - he did not simply confirmed the previous ultrasound, but also discovered the mass of other vices. It is unlikely that the girl would live more than a day ... (Tanatafinal dysplasia). Immediately held a concilium and put a pregnancy interruption on honey. Indications. I was even glad that no one became me to discharge to make this act, on the contrary, all doctors supported what exactly necessary to do. And the deadlines only allowed ...

I do not remember how I experienced another week before I entered the hospital. I know for sure that I did not eat anything, but the tears did not breathe ... The girl was hit by all his might. In the hospital fell not in the genus. the house, and in gynecology, drank three of some tablets, three more inserted in [Email Protected]# $% & after a day, and after 9-hour battle, I gave birth. At the time of birth, there was no one who did not have anyone, I barely managed to run into the dressing and lie down on the couch, screamed from pain and horror as cutting. The patients ran in the doorway, and I screamed to call medical or doctors - at least someone. Because my girl has already come out of me and moved between the legs. Nurses of the patient found on the neighboring department, they immediately have suffered, took me into operational. All this time I shouted so that they stop the heart of the child, since he was still moving between the legs. I never decided to take a look at him ... In the operating room, some unfamiliar doctor began to yell "what blessing? Crazy something, yell so? Think, one thing here?" Everyone has shifted! I don't know how to give birth - not pregnant! " I answer: "My child is moving! Make her injection so as not to suffer!" "What kind of child is there yet ??? this is not a child, but a fruit !!! Call things with your own names !!!" - It sounded a literal answer. Then I was introduced into anesthesia, they made cleaning and I woke up in the ward.

From that day, six days have passed, during which the pricks of antibiotics and oxytocin to reduce the uterus, drinking the pills from lactation, just discharged. In the hospital, I tried not to think about what happened, but now it broke through ... Tears do not stop, I remember all the time, as she moved. One thing to call Il because of frozen pregnancy or to take an abortion on an early term, and quite another - on your own initiative to practically kill my long-awaited child, who has already formed at such a term. How morally did you experience this situation? Is it really forgotten? I do not know how to meet with girlfriends who are now pregnant and with whom we discussed how our kids will be friends ... I really want children now, but it is not necessary to pregnant. The second time this is definitely not survived - immediately in Durku can be sent. I thought, go to church, ask for forgiveness, but it will not be honest, because I regret what happened, but I do not repent ... And the second time with a non-visual child I will do the same ... Probably to enter the baby for another four months and Prepare to prepare for the funeral of the living child - even worse ...

How to get rid of the feeling of guilt? How to forget her tech in the tummy? Very afraid of histology results - they will be ready in a week. I understand that at best, a born girl would be disabled (three different ultrasound devices and three different specialists could not be mistaken), but how can the heart calm down? I decided that we better would be dying with her in one day, what then we will suffer all my life ...

Perhaps, after all, in such a situation, no matter what you will regret ... Sorry for the long text, there are much more experiences in my head than it can be expressed in the text ... I really expect tips from those who had to go through this horror.

Yes, I forgot to clarify what I learned about pregnancy - I didn't drink, I didn't smoke for two years, my husband immediately threw. Tablets saw only those who doctors prescribed. Even the throat was treated with cranberry mors and did not drink a nose with pain, even though the doctor prescribed. Heredity we have a good. On the Internet they write that the main reason for such pathology is the mutation of the gene - I do not imagine what it is ...

It has not been to this thread for a long time in order to try to delete from the memory (my story I wrote earlier) and forget all the survived hell. But yesterday I read about the barbarism of the medical personnel .... and was just shocked. I'm madly lucky, which you can't tell you about you, I am very sympathetic ..... that the whole tragedy still had to face horror in which you were immersed in the hospital. Bold, we are a woman's people strong ... Forget at all, it will not be possible that this is a fact, but that the terrible pain loss will leave and there will be a bright future and healthy kids ahead. You are still young, collect all the strength ... These tests are already passing. As a gynecologist told me, zipper 2 times in one tree does not shoot ..... although in life it happens differently, but at our most exactly it is so !!!

A little about yourself: 6 months have passed since my tragedy ... when it happened, I lost faith in everything ... and even in God, as it does not sound. Now I still plan to visit the church, and ask for all forgiveness. The tragedy for health did not pass without a trading, all the same, this jump hormone plus stress .... The cycle like recovered, hormonal pills did not drink. There were problems with breasts, no milk left for a long time. 5 months after all, a new problem was released in the form of an outdoor hemorrhoid, before that he never had it. The doctor explained that these are all the consequences of interruption and Natuchi during her. I had to operate it, now everything is bad ... And I now have a fight against this problem. Therefore, girls are cute, after interruption, you do not need to float tears infinitely, you need to start thinking about yourself about your health so that there were forces to fight on. Take yourself immediately with your recovery. And tears, regrets, insult, bitterness .... they are very underminated from the inside .... It happened, I didn't cry without it without it and go further. Towards a bright future. All health, beautiful and healthy pups in the future.

Not always the pregnancy flows joyfully and cloudless, as I would like, often there are cases when it needs to be interrupted on a large period. It should be noted that no one will not be on the "desirable" in the later timing of the abortion. According to the existing legislation, pregnancy for a period of more than twelve weeks can be interrupted only on existing medical or social indications.

Abortion of pregnancy for a period of over 20 weeks is accompanied by an extremely high risk for the health and life of the mother. On the other hand, an abortion on such timing can be equal to the murder, since the fetus by this time is viable. In such situations, a woman should have very weighty arguments to decide on such a step.

Indications for abortion in late dates.
The basis for making a decision on the interruption of pregnancy in late terms, medical and social reasons can be. The first group of testimony include a serious deterioration in the general health of the mother against the background of complications of diabetes mellitus, the available blood diseases, hearts and blood vessels, the central nervous system, of different types of tumors that require immediate therapy. In addition, the indication of the late abortion is considered to identify from the fetus of chromosomal anomalies, malformations that interfere with its further normal development or provoke its death, as well as the risk of genetic diseases. It must be said that some infectious diseases can lead to the interruption of pregnancy. In these situations, the abortion is the only salvation of mom and child from future suffering.

To obtain a documentary permission to conduct a surgical operation to terminate the intrauterine development of the fetus at the later time of pregnant, it is recommended to refer to the obstetrician-gynecologist at the place of observation, which will be issued after the survey and analyzes, as well as after the exclusion of any contraindications to its conduct. According to the results of the tests, the overall health of women and the degree of abnormal development of the fetus are evaluated.

It happens that the woman in virtue of physiology did not immediately determine that pregnant, or was mistaken when calculating the period of pregnancy (sometimes it happens that menstruation continues in pregnant women after fertilization), or did not immediately told this news to his lover or relatively, Therefore, the interruption decision is accepted at the later date. It is for such cases that there is a second group of indications for an abortion - social. This group of reasons should also be attributed to extremely unpleasant situations, when a husband or father of the future kid dies in a pregnant woman, when this pregnancy is a consequence of rape, or when the future mother is in the "places not so distant". The deprivation or restriction of parental rights, as well as the disability of the first and second group, can also serve as a serious basis for the artificial interruption of pregnancy at the later date. In each particular case, the Special Commission of Doctors at the place of observation of pregnant.

It should be noted that, despite the presence of a significant social or medical testimony to carry out the late abortion, in the presence of inflammatory diseases of the female sexual sphere in acute form, inflammatory processes in acute form and infectious diseases in acute form, such surgical intervention is not permissible.

Examination before the abortion.
Before the pregnancy interruption operation is assigned to carry out ultrasound of the fetus and uterus, the blood group and the rhesv factor are determined, the blood test is made on HIV, syphilis, hepatitis, hemostasiogram, biochemical blood test, the urine, strokes from the urethra, cervical canal and vagina are investigated, antibodies are determined To hepatitis C, X-ray study of the organs of the chest, and is also inspected by the therapist and other specialists if necessary.

In the case of social or medical reasons for the abortion of pregnancy, a woman is issued a certified conclusion with the presentation of a complete clinical diagnosis with signatures of specialists and the seal of the institution. In the case of diagnosing a woman in a woman of mental and venereal nature, the documents are transferred to the obstetric and gynecological institution. In the absence of medical contraindications, a woman is given a direction to a medical and prophylactic institution, where the term of pregnancy, survey results, the conclusion of the commission (diagnosis) and social indications are indicated.

Since the late abortion is associated with a multitude of risks, this operation is carried out using painkillers in a hospital and only specialists who have special training. At the end of the operational intervention, an ultrasound is carried out to accurately evaluate the result (check whether all parts of the fetus and placenta are removed).

Methods of interrupting pregnancy at the later date.
Taking into account the term of pregnancy, the doctor selects the appropriate method of abortion. The smallest number of complications gives an interruption of pregnancy for a period of no more than 21-22 weeks, and in general the abortion is possible up to 27 weeks.

The expansion of the cervix and the extraction of the fetus is carried out in the period of 12-20 weeks of pregnancy. A vacuum aspirator is introduced into the uterus, through which the fetus and the fruit shell is extracted in parts. With this technique, the risk of injury to the wall of the uterus, the consequence of which is the strongest bleeding, often ending with death.

Another method of interrupting pregnancy for a period of 20-28 weeks is the vaginal administration of fluids (one of the methods of artificial bodies). Expanding the cervix, by means of special tools made of a fruit bubble, a small amount of fruit waters is sued, after which the same volume of highly concentrated solutions of salts and glucose is introduced into the uterus. As a result, the fruit is dying, and a day after a day, a woman begins, and the dead fruit is brazed with the body (a kind of miscarriage). On average, such an abortion occurs within thirty hours.

In rare cases, laminaria sticks injected into the cervical canal to call. If in this case the bouts do not begin, special substances-stimulators of generic activity (prostaglandins, oxytocin, sozasolitics) are introduced.

It is very rare, but in the presence of medical contraindications with a simultaneous medical or social indication for the late abortion, a small caesarean cross section is carried out. During such an operation, surgeons open the front abdominal wall and the front wall of the uterus, then the fruit is extracted from the uterus and the surrounding fabrics, and the wall of the uterus is subject to scraping. As a result of the use of such a technique, the fruit may be alive, but it does not apply any resuscitation actions, and it dies.

Complications after late abortion.

• Not a complete purification of the uterine cavity from fragments and parts of the fetus with the addition of infection.
• Placental polyp.
• Hematometer.
• Cervical breaks.
• Perforation of the uterus.
• Diseases of purulent-inflammatory flow.

The removal procedure from work on medical testimony at the legislative level is not fixed. But the employer is obliged to remove the employee if it becomes aware of contraindications on health. We will help to figure out how to make a removal from work on medical reasons or dismiss an employee for medical conclusion.

Read in our article:

How to make a removal from work on medical testimony

The employer must remove the employee from the fulfillment of official duties as soon as it will be aware of the presence of contraindications on health. The consent of the employee at the same time no one asks - this follows from the para. 5 h. 1 Art. 76, para. 12 h. 2 tbsp. 212 TK RF.

It should be noted that the removal procedure from work at the normative level is not resolved. The employer has the ability to independently fasten the procedure at the local level.

As soon as a disease is revealed, which is incompatible with the fulfillment of duties - a person can be removed from work without warning.

See also:

The following procedure has developed in law enforcement practice:

Step 1. Documentation. Stewartes Alevtina came to the medical examination. The doctor revealed noise in her heart. These data must be appropriately decorated - they will be the basis for removing the alentine from work.

Step 2. Order. The diagnosis was transferred to the airline management. From records it is clear that Alevtina can not work. In an arbitrary form, an order is made on removal from work on medical testimony.

In the order, be sure to specify:

• reasons due to which remove the employee;
• the period during which it will not work;
• payment for this period, if there is - because by law, the suspended employee will no longer receive a salary;
• links to medical documents that will confirm the rightness of your actions.

Step 3. Acquaintance. Alevtine was summoned to the personnel department, showed the order and offered to sign next to the string "acquainted." Here are two options. The first - Alevtina peacefully will sign everything, the second - refuses and will insist that he is healthy, the doctor was wrong, "you do not have the right." Then it will be necessary to make a special act - also in an arbitrary form, call two witnesses from among employees and at them to read the order aloud to the alertine. As soon as you did it - your hands are clean, you entered the law.

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Step 4. Fixing in the card. This is our ultimate recommendation: Be sure to make data on securing your employee's personal card to the "Additional Information" section. This will help you in the future correctly calculate the experience and vacation period for a suspended worker.

Step 5. Fixing in the operating time accounting table. There is a special code for this, or the letter, or digital - that is, you write in the table or NB, or 35.

What are the timing of the removal from work? Suppose the doctor claims that the problems of the health of health are temporary and everything can be fixed for up to 4 months. The Labor Code of the Russian Federation states that in this case the former so far that the flight attendant should be offered a temporary translation to any work that is compatible with its health condition. But if there is no such work (or Alevtina refused to refuse) - you have to remove it from work for all that time, which, on medical conclusion, is needed for recovery.

Order on removal from medical reading: sample

Removal from work due to ill-treatment

As we mentioned above, when removing from work on medical discovery, the salary is not paid. And this is a weighty reason so that the person "forgot" about his medical examination and did not tell anyone about it.

If the employee did not pass a periodic medical examination - what to do? In this case, on the table of the head of the enterprise most often there is a report from the direct supervisor, or a call from the doctor is coming from a doctor, or a certificate comes from the polyclinic, where inspection is carried out ... in many ways the truth appears.

See also:

Remember: as soon as information about the non-examination of the medical examination came out, you must immediately remove the employee from work. For this, an order is published on removal from work in connection with the non-examination of the medical examination - only the term there will be defined not a specific date, but an event, that is, the passage of compulsory medical examination by the employee.

And as long as the employee does not bring you a certificate from a doctor about the medical examination, not to allow him to work - your holy duty.

Order on removal from work for disrupting the medical examination: sample

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Dismissal of medical testimony: step-by-step procedure

Now let's go back to Alevtine and consider the sad scenario - after 4 months, her health problems did not disappear anywhere, or the doctor initially put this diagnosis, from which it is clear that she is no longer a stewardess. In this case, the company has two options:

• translate alerticle to another work, which is compatible with its health condition - of course, with the consent of the alentine itself;
• in case of refusal or the absence of suitable free vacancies - dismiss alerticle in accordance with paragraph 8 of part 1 of article 77 of the Labor Code of the Russian Federation.

Step 1. The employer offers a new post employee. It is important that this work suggests under all the limitations specified by the doctor in medical conjunction. If consent is received - make a translation.

Step 2. If the consent worker did not give - the time comes for the next step: it must write a statement, which refuses to offer. By the way, if you do not have a position for him - it also needs to confirm the relevant documents.

Step 3. Place the dismissal ordinary order - only the basis in this case

indicate paragraph 8 of Part 1 of Article 77 of the Labor Code of the Russian Federation. In order, as a basis, specify the medical conclusion and the employee failure from the proposed vacancies (or a document confirming the absence of vacancies).

Step 4. Open the labor book and make a record, referring to paragraph 8 of part 1 of article 77 of the Labor Code of the Russian Federation. Signature, print - everything is ready.

Step 5. Fill out the employee's personal card and acquaint your employee with it.

Step 6. On the day of dismissal, make a final calculation, issue a labor book and all the necessary references.