There are many ethical aspects which derive from the application of reproduction control in women's health. Women's health can be enhanced if women are given the opportunity to make their own reproduction choices about sex, contraception, abortion and application of reproductive technologies.

1. 10. Ethical Issue
On Reproductive:
Dr. Ayub Abdulkadir (Dr. Alto)
Medical Ethics

2. WHAT IS ABORTION:
• ……. The word abortion comes from the Latin
abortio, which means to abort, miscarry, deliver
prematurely. The Latin word abortus means
"miscarriage, premature, untimely birth".
• In medicine abortion means ending a pregnancy
prematurely.
• An abortion is when the pregnancy is ended so that
it does not result in the birth of a child.
• Sometimes this is called 'termination of
pregnancy'.

3. ABORTION IN INDIAN LAW:
• Abortion in India is legal only up to twenty weeks of
pregnancy under specific conditions and situations
which are broadly defined as:
If a woman is married, her own written consent is
sufficient. Her husband’s consent is not required
If a woman is unmarried and over 18, she can provide
her own written consent.
If a woman is unmarried and under 18, she must
provide written consent from her guardian.
If a woman is mentally unstable, she must provide
written consent from her guardian.

4. Abortion as per the Indian MTP Act The
Medical Termination of Pregnancy (MTP) Act:
• Clearly mentions the conditions under which only a
pregnancy can be ended.
1. A pregnancy may be terminated by a
registered medical practitioner.
2. A pregnancy occurring as a result of
rape.
3. Failure of contraceptive device used
by a couple.

5. ABORTION IN USA LAW:
• In consultation with their physician, women have a
constitutionally protected right to have an abortion
in the early stages of pregnancy.
• Abortion has been legal in the USA since 1973, but
may be restricted by any of the 56 states to varying
degrees.
• Approximately 3700 abortions are conducted daily
in the United States.

6. • An adult woman has an unrestricted access to
abortion through the end of the first trimester.
• First-trimester abortions are clearly unrestricted.
Women do not need the approval or consent of
anyone else to obtain a first-trimester abortion.
• In the second trimester the decision is still between
a woman and her physician, but the ease of access
to a second trimester abortion is less clear.
• States may place regulations on free access to a
second trimester abortion.
• Third-trimester abortions are not freely available,
because the fetus is potentially viable.
• Third-trimester abortions are clearly restricted.
• consent by the father for an abortion is not
required; the fetus is considered as a part of the
woman’s body.

8. REASONS FOR GIVEN ABORTION:
• Concern for/ responsibility to other individuals.
• Not wanting their lives changed by the birth of a
baby.
• Yong or unmarried.
• Unplanned or unwanted.
• Relationship problem.
• Mother health risk.
• Pregnancy is the result of crime.
• Unacceptable quality of life.

9. • Procedure Abortions must be performed by a doctor
with one of the following qualifications:
• A registered medical practitioner who has performed at
least 25 medically assisted terminations of pregnancy.
• A surgeon who has six months’ experience in obstetrics
and gynaecology.
• A person who has a diploma or degree in obstetrics and
gynaecology.
• A doctor who was registered before the 1971 Medical
Termination of Pregnancy Act and who has three years’
experience in obstetrics and gynaecology.
• A doctor who registered after 1971 and has been
practising in obstetrics and gynaecology for at least a
year.

10. Abortion Health Risks and
Side:
A. Pain and/or cramping.
B. Nausea.
C. Vomiting.
D. Diarrhea.
E. Reaction to anesthetic.
F. Death.

11. • Short-Term Problems
Post- Abortion:
1. Infection.
2. Heavy Bleeding.
3. Retained Tissue.
4. Puncture of the
uterus.
5. Sterility.
• Long-Term Problems
Post-Abortion:
1. Future Fertility.
2. Psychological and
Emotional.
3. The Abortion-Breast
Cancer Connection.

12. THE ARGUMENTS FOR AND
AGAINST ABORTION:
• PRO-LIFE ARGUMENT: This is defined as the
responsibility or obligation of the government to
preserve all human life regardless of intent, viability
or quality of life concerns.
• PRO-CHOICE ARGUMENT: This is the belief that
women have the rights to choose to abort the baby.

13. WOMEN RIGHTS:
1. A women has a right to make decision that
involve her body.
2. If the pregnancy was the result of hard cases like
rape, incest etc.
3. Major issues for abortion-right to life, right to
liberty, right to security.
4. Involve risk to life.
5. Child will be disabled and low quality of life.

14. CHILD RIGHTS:
1. The fetus is a human being with fundamental
right to life.
2. Every child is wanted child.
3. The unborn child has the right not to be killed.

15. Conclusion:
• Abortion is ethical and also unethical.
• Abortion is not legal nor illegal.
• It is not a relief as most of them feel so.
•But it is still a debatable
issue.

16. CONTRACEPTION

18. • Contraception stems from two words—contra, or
against, and conception, meaning the union of the
male sperm and the female ovum.
• Therefore, contraception is any action taken to
prevent pregnancy from occurring.
• Abstinence from sexual intercourse and non-coital
sex are also means of avoiding pregnancy.

19. TYPES
• Hormonal Methods – includes control pills, Depo
Provera injections and Norplant.
• Barrier Methods – includes condom, diaphragm,
and cervical cap.
• Spermicides – it contains nonoxynyl.
• Intrauterine Devices – also known as IUD.
• Tubal Sterilization.
• Vasectomy.
• Emergency Contraception.

20. • UK has one of the highest teenage pregnancy rates
in Europe
• Teenage pregnancy has an association with infant
mortality, poor access to education, poverty, poor
maternal emotional health.
• Women currently have access to wide range of
contraception choices
• Effective contraception reduces the number of
unsafe abortions and to plan the size of their family
and space their pregnancy.

21. Clinical assessment of women
seeking contraception:
• Detailed menstrual & sexual history:
• In menstrual history:
• The pattern & duration of bleeding.
• Desire for regular cycle.
• Cervical screening.
• Abnormal vaginal bleeding prior to IUC or HC.
• Sexual history:
• Women under age 25 years.
• Have new sexual partner.
• High risk for STI.

22. • Past history
• Contraceptive history.
• Gynae & Obs.
• Breastfeeding & plan for future pregnancy.
• Any medical condition.
• Family & drug history.
• Detailed discussion regarding contraception its
efficacy, risks, benefits and attitude of her partner.
• Influence of lifestyle, social, cultural or religious
factors on contraception.

23. Clinical examination:
• Blood pressure measurement.
• Weight and calculation of body mass index (BMI).
• Routine screening for STIs is not required unless
women are symptomatic.
• Symptomatic women and high risk women should
be offered screening.

24. • It is important to bear in mind that the Catholic
Church has, as a tradition, condemned
contraception.
• In addition, several states still have laws that
prohibit selling contraceptives to minors.
• However, many people do not consider
contraception and sterilization to be moral issues.

25. • Contraception is a form of abortion.
• Some birth control techniques can operate by
preventing the implantation and development of a
fertilised egg.
• Those opposed to such methods say that this
amounts to an abortion, and that if abortion is
wrong then those forms of contraception must also
be wrong.
• The forms of contraception included in this
objection are:
• Some birth control pills; most modern birth control
pills _ the "morning-after" pill.

27. OTHER RELIGIOUS GROUPS:
• All major denominations in America support the
morality of contraception as a personal and family
decision—one that helps to ensure responsible
parenthood and healthy families.
• Episcopal Church approved contraception for
purposes of family planning.
• United Methodist Church says that “each couple
has the right and the duty prayerfully and
responsibly to control conception according to their
circumstances.”

28. • Evangelical Lutheran Church of America supports
the use of safe, effective birth control methods and
believes that they encourage “responsible
procreation.”
• Church of Jesus Christ of Latter-day Saints supports
all methods of contraception except surgical
sterilization.
• **Other Christian denominations that support
contraception include the United Church of Christ,
Unitarian Universalists, Mennonite Church USA,
and Church of the Brethren.

29. STERILIZATION

30. • Is the process of medically altering reproductive
organs so as to terminate the ability to produce
offspring.
• It may be the result of surgical intervention such as a
vasectomy (surgical removal or tying of the vas
deferens to prevent the passage of sperm) in the male
or a tubal ligation (tying the fallopian tubes) in the
female.
• While sterilization is usually considered an elective or
voluntary procedure, it can also be therapeutic,
incidental, or an involuntary action.

31. • Sterilization can be incidental if the procedure is
performed for another purpose, such as in the case
of a hysterectomy for uterine carcinoma.
• It can also be a side effect of treatments such as
chemotherapy.

32. • Voluntary Sterilization: Voluntary or elective
sterilization of competent persons presents few
legal problems— although there are religions that
oppose sterilization.
• Therapeutic sterilization is sought if the mother’s
health is in danger.
• Genetic reasons.
• Sign a special consent thirty days prior to having
the procedure.

33. • Eugenic (involuntary) sterilization, considered to
be unethical by most people, is the sterilization of
certain categories of persons, such as those who
are insane, cognitively impaired, or epileptic, in
order to assure that they won’t pass on the
defective gene to their children.
• Some states still authorize the involuntary
sterilization of wards of the state who are
genetically impaired.
• The procedure must be proven to the courts to be
in the best interests of the mentally disabled
person.
• Recent research demonstrates that most forms of
cognitive impairment are not hereditary.