Title: | Supporting Maternal Autonomy in Medical Abortion Pathways |
Contributor(s): | Turner, Joseph V (author) ; Chaku, Jyoti D (author) |
Publication Date: | 2024-12-13 |
DOI: | 10.1007/978-3-031-64292-0_18 |
Handle Link: | https://hdl.handle.net/1959.11/64412 |
Related DOI: | 10.1007/978-3-031-64292-0 |
Abstract: | | From the woman's perspective, the clinical safety of medical abortion using a recommended regimen is well-established. There is, however, considerable debate about options for women who change their mind wishing to discontinue a medical abortion and continue their pregnancy instead. Mifepristone antagonization with progesterone, known colloquially as "abortion reversal", has been proposed by some and opposed by others in political, clinical, and scientific arenas. Current literature and clinical guidelines recommend against providing active measures for women who change their mind after commencing medical abortion, citing pharmacological implausibility of the progesterone-after-mifepristone approach, and lack of quality evidence from well-designed clinical trials in this area. For women in such a situation who choose to then try and keep their pregnancy, adherence to the four pillars of medicine, namely autonomy, justice, beneficence and non-maleficence, favours treatment of these women with progesterone. This chapter critically analyses key areas relevant to the intervention of mifepristone antagonism by progesterone, including demand, pharmacological basis, clinical evidence, safety for the woman, patient autonomy, and clinician duty of care. Other important issues requiring consideration include: evidence for untreated pregnancy continuation rates after mifepristone, success rates relating to gestational age, and the actual number of women discontinuing medication abortion and seeking to keep their pregnancy.
Publication Type: | Book Chapter |
Source of Publication: | Integrated Science for Sustainable Development Goal 3, v.24, p. 461-479 |
Publisher: | Springer |
Place of Publication: | Cham, Switzerland |
ISBN: | 9783031642913 9783031810510 9783031642920 |
Fields of Research (FoR) 2020: | 321503 Reproduction 500104 Human rights and justice issues (excl. law) 321502 Obstetrics and gynaecology |
Socio-Economic Objective (SEO) 2020: | 200509 Women's and maternal health 200105 Treatment of human diseases and conditions 200204 Health inequalities |
HERDC Category Description: | B1 Chapter in a Scholarly Book |
Publisher/associated links: | https://www.springer.com/series/16554 |
Series Name: | Integrated Science |
Series Number : | 24 |
Editor: | Editor(s): Rezaei, N. |
Appears in Collections: | Book Chapter School of Rural Medicine
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