Uterine injuries complicating hypertonic saline abortion

JJ Willems

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Author Summary
Two cases of uterine injury complicating midtrimester abortion induced by hypertonic saline are described, one with an extensive laceration of the cervix and the other with a rupture of the lower uterine segment extending into the vault of the vagina. The etiology, diagnosis and possible obstetric sequelae are discussed. With the increasing number of therapeutic abortions being performed in North America there is a concomitant increase in associated complications being reported in the literature. This report describes two of the more uncommon and potentially more important complications encountered when amnioinfusion is employed for the induction of midtrimester abortion. [Details of 19 year old and 15 year old patients at 16 and 18 weeks gestation respectively].


Willems J. Uterine injuries complicating hypertonic saline abortion. Can Med Assoc J. 1974 Dec 07;111(11):1223-1226.

(Editorial) Wilful exposure to unwanted pregnancy?

Carol A Cowell

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The WEUP syndrome (otherwise known as “Wilful Exposure to Unwanted Pregnancy”) has been well documented in a number of psychiatric publications. . .

. . . Abortion is not an emergency procedure and the lowering of the legal age of consent has had virtually no effect on the availability of the operation to the adolescent patient. . . .

. . . .does the “open approach” and provision of effective contraception mean to young people that you personally endorse premarital sexual experimentation and does this influence their behaviour? My answer is an unequivocal “No”; they make their own choice with or without your approval, and whether or not they are “outfitted” beforehand with effective contraception.

. . To the question “What was your main reason for having an abortion?” the following answers were given: “too young” (55%), “wanted to finish school” (15%), “wanted a child but couldn’t keep it” (12%), “pressure advice from parents (7%), “don’t want the kid (child)” (7%), other (4%). From our follow-up data regarding the girls’ assessment of what for them was the best solution (i.e. term delivery or abortion), 93.3% said that abortion was the best solution, with some 4.3% saying that it was not and 2.4% providing no answer. . .


Cowell CA. (Editorial) Wilful exposure to unwanted pregnancy?. Can Med Assoc J. 1974 Nov 16;111(10):1045, 1047.

The unwanted pregnancy

Sharon H Stone, Kenneth E Scott

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Authors’ Summary
A questionnaire was submitted to the mothers of 200 consecutively delivered infants; 15% of mothers were unmarried. The results showed a high prevalence of unwanted pregnancy, most accounted for by well educated, married women having their first or second baby, and despite access to contraceptive agents. Most of the married women and over 50% of the unmarried who had not wanted to become pregnant wanted the baby after its birth.


Stone SH, Scott KE. The unwanted pregnancy. Can Med Assoc J. 1974;111(10):1093-1097.

Applications for abortion at a community hospital

Marlene E Hunter

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Applications for therapeutic abortion over a 44-week period in a 647-bed community hospital are reviewed . . . . No contraceptive measures were being employed at the time of conception by 69.7%. Less than one sixth of the patients were applying because of severely adverse social, psychological or medical reasons. . . . it was often difficult to refrain from presuming that “she is in no position to raise a child” indicated inconvenience rather than incipient emotional disaster. . . . Women must be informed that abortion is not a minor procedure and that long term hazards to themselves, to future pregnancies and to future children are significantly high. . . . The concept of prevention rather than abortion should be emphasized. . . surely we can assist more women to achieve satisfactory methods of control.


Hunter ME. Applications for abortion at a community hospital. Can Med Assoc J. 1974 Nov 16;111(10):1088-1092.

(Correspondence) CMA policy on abortion

CMAJ

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
While the CMA has recommended the removal of the requirement for hospital therapeutic abortion committees from the Criminal Code, it has supported the retention of the balance of sections 251 and 252. The purpose of this stand is to retain the more serious implications of a violation of the Criminal Code as compared with a violation of provincial medical acts regarding the performance of abortions by non-qualified persons or by qualified physicians outside approved hospitals. This policy also reflects the association’s opinion that some provincial medical acts, and the means of enforcing them, are less than adequate.


CMAJ. (Correspondence) CMA policy on abortion. Can Med Assoc J. 1974 Nov 02;111(9):905.

(Correspondence) CMA policy on abortion

Wendell W Watters

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
The recent special report “Abortion: a review of CMA policy and positions” by D. A. Geekie (Can Med Assoc J ill: 474, 1974) has left many members of the CMA and many other Canadians with a feeling of confusion and a deep sense of betrayal. If this idiosyncratic interpretation of the CMA policy on abortion does reflect the official views of the organization, many physicians will seriously question their association with and participation in the activities of that body. . . .. We categorically reject Mr. Geekie’s interpretation of the CMA position on abortion, and demand that the executive of the organization repudiate this document and reissue a statement that clearly puts forth a rational statement of policy on abortion.


Watters WW. (Correspondence) CMA policy on abortion. Can Med Assoc J. 1974 Nov 02;111(9):900-902.

(News) CFPC discusses changing world of the family physician

David Woods

Canadian Medical Association Journal, CMAJ
Canadian Medical Association Journal

Extract
Dr. Doran said that there are now 12 centres in Canada where genetic amniocentesis is performed, including his own group in Toronto which has done 195 in less than three years. The overall goal of the technique, he said, is to reduce genetic disease by therapeutic abortion (technically illegal under the present Criminal Code) and eventually by prevention.


Woods D. CFPC discusses changing world of the family physician. Can Med Assoc J. 1974 Oct 05;111(7):717-719.

Abortion and Conscience Clause: Current Status

Dennis J Horan

The Catholic Lawyer
The Catholic Lawyer

Abstract
The abortion controversy is currently in the coercive stage. The hard core proponents of legalized abortion are now busy opposing abortion legislation that keeps abortion in the criminal code, or that seeks to regulate abortion other than through the medical practice act. Their aim is the psychological satisfaction of making abortion not only legal, but morally acceptable to all but the cranky Catholics. Part of the plan includes opposition of conscience clauses. Obviously this latter stance smacks of a betrayal of their promise that their wish was only freedom now, and thus they are somewhat at a disadvantage before the courts, at least as far as the conscience clause is concerned.


Horan DJ. Abortion and Conscience Clause: Current Status. Catholic Lawyer. 1974;20(4):289-302.

Constitutional Law: Private Hospital May Refuse to Perform Abortion

Betty Berger

Saint Louis University Law Journal
Saint Louis University Law Journal

Extract
Conclusion

It is evident that the abortion question in relation to private hospitals is being fought on two grounds. One ground is state action. The other is freedom of religion and moral conviction. Decisions are beginning to indicate that public hospitals may have to perform abortions if they have the facilities. On the other hand, decisions such as Bellin, indicate that courts may not find sufficient state action when a private hospital is involved even if that hospital has received public funds. Even if they do, Bellin indicates that the right of conscience may protect the private hospital which is also sectarian and opposed to abortion on religious and moral grounds.’ Furthermore, the United States Congress has established a policy that receipt of funds from Hill-Burton or any other programs covered by the Health Services Extension Act of 1973 should not force a hospital to provide personnel and facilities for abortions. In addition, the first amendment protects the rights of individuals and groups to refuse to do what their religion prohibits. Abortions are generally a convenience and not a matter of life and death if not performed in the private hospital. In the balance of convenience versus first amendment freedoms, courts are unlikely to let convenience prevail. Private hospitals have sold neither their rights nor their private status..


Berger B. Constitutional Law: Private Hospital May Refuse to Perform Abortion. Saint Louis U Law J. 1974;18(3): 440-460.

(Correspondence) Inquiry into British law on abortion

PE Shea

Extract
Alan Massam’s article “Abortion Act gains outweigh drawbacks – British inquiry” (Can Med Assoc J 110: 1301, 1974) is a disturbing example of slanted journalism, aimed at further poisoning the minds of the bulk of doctors who sit on the fence in the abortion issue. . . .Mr. Massam, and apparently the inquiry, attempt to subtly convince us that abortion is a socially, morally, legally acceptable fact of life and we need only concern ourselves with its details. . . . Surely all our human rights are secondary to the right to life. This is the basic principle that the inquiry and Mr. Massam choose to ignore.


Shea P. (Correspondence) Inquiry into British law on abortion. Can Med Assoc J. 1974 Sep 7;111(5):388.