Mike Vidot


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    Vacuum aspiration before 7 weeks
    Mike Vidot, Clinica El Sur. Sevilla. Spain
    Until now pharmacological termination of pregnancy has been considered the method of
    choice in pregnancies below 7 weeks. In our experience surgical vacuum aspiration is also
    a safe and alternative method which can be used before 7 weeks, as long as a proper
    preoperative surgical assessment is performed. This technique has numerous advantages
    compared to the pharmacological method. It is as safe as the pharmacological method, but
    with more advantages for the patient. The procedure is immediate, less cost effective for
    both the clinic and the patient, reduces the psychological effects that an unwanted
    pregnancy can cause, gives the patient the opportunity for immediate contraception after
    termination of pregnancy and can be implemented in countries whereby anti-
    prostaglandins are not available.

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    Why abortion is performed in Spain until 26 weeks
    Mike Vidot, MD,  Clinica El Sur, Sevilla, Spain

    In Spain abortions can be performed based on a law of indications (Decree 9/1985; article
    417), which has not been modified in posterior reforms of the Penal Code of Conduct.
    This law states that abortion will not be pursued in Spain if it is practiced by a doctor or
    under his or her supervision when certain circumstances are given:
    - A pregnancy which results in a serious risk for the mothers’ physical and psychological
    health, diagnosed by a specialized physician, without gestational age limits.
    - Pregnancies resulting from rape can be performed up to 12 weeks.
    - Pregnancies up to 22 weeks when the foetus presents a high probability of having
    physical and psychological alterations certified by 2 different specialized physicians.
    These physicians under no circumstances should be the ones who perform the
    Hence, that’s why we think that in Spain we can consider that induced abortion is not
    voluntary, but a necessity derived from a situation.
    Also the WHO defines health as: a state of physical, psychological and social wellbeing,
    not the mere absence of diseases.
    Based on these 2 aspects (without gestational age limits where the mothers health is
    concerned and the definition of health by the WHO), in Spain, the private specialised
    clinics in abortion, interpret that if there is a criteria which estimates that a pregnancy is of
    high risk for the mothers health, this can be performed without a gestational age limit,
    understanding that an unwanted pregnancy alters the psychological and social welfare and
    that her health is at risk.
    On the other hand WHO in its Technical Resolution 461 defines abortion as ¨the
    interruption of pregnancy before its viability¨.
    The clinics of ACAI (Association of Accredited Clinics for Voluntary Interruption of
    Pregnancy) interpret that according to WHO, as soon as foetal viability is given, it is not an
    abortion and that the law could not be applied. Hence, based on the fact that foetal viability
    is considered from 25 to 26 weeks onwards, pregnancies with healthy foetuses up to 26 

    weeks can be interrupted if there is a psychiatric report certifying that there is a risk for the
    mothers mental health. Also, estimating that abortion is the best option in such cases
    pregnancies are interrupted beyond 26 weeks when a foetal malformation is not
    compatible with extra uterine survival or human dignity. In such cases a certificate of none
    viability signed by 2 different obstetricians is required. This legal interpretation of the law
    has not been questioned judicially until now.
    This has converted Spain in a destination for abortion, mostly from the European
    countries with Voluntary Interruption of Pregnancy laws which complicate the access of
    women who are more than 12 weeks pregnant or those countries which have restrictive
    laws regarding abortion above 22 weeks. 

    The Private Specialized Abortion Clinics have assumed also abortions which are not being
    performed in Spanish public hospitals. They only accept those with foetal pathology until
    22 weeks, pregnancies derived from rape or which puts in danger the mothers’ health.