The psycho-social aspect of the second trimester abortion with teenagers
Milica Berisavac, Rajka Argirovic, Radmila Sparic, Nebojsa Markovic, Ivan Pavlovic, Ivana Cmiljic (Serbia)
Institute for Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, Serbia
Introduction. There are numerous barriers for establishing communication with and education of teenagers in respect of protection from unwanted pregnancies and sexual behavior. Unwanted pregnancy at this age is often detected in the second trimester, due to sense of fear and embarrassment to confide with the mother, friend, or partner, as well as to the sense of possible condemnation and lack of understanding of the environment. The legal procedure stipulating the abortion in the second trimester is explicit. Both the psychological and physical immaturity, uncompleted education, often unstable and temporary relationship, can cause a significant alteration of teenagers’ mental health. A sexual relationship with drug users additionally complicates the psychological state of the patients.
Method. The retrospective study encompasses all the patients who were hospitalized during the years 2006 and 2007 due to second trimester abortion. We analyzed the age of the patients, the knowledge of methods of protection from unwanted pregnancy, gestational age in which the unwanted pregnancy was diagnosed, the psychological state of the patients and indications for the abortion.
Results. During the study period there were 173 second trimester abortions at the Institute for Gynecology and Obstetrics Clinical Center of Serbia, 18 of which with under-age patients (9.33%). Teenagers did not have any or of little knowledge on contraceptive methods. In the group to the age of sixteen a greater gestational age was diagnosed (18-20 weeks). In the age group from 16 to 18 the gestational age was 16-18 weeks. Three teenagers were mentally retarded, and one pregnancy happened at the institution. Reactio depresiva was indication for abortion in 15 cases. The abortive procedure was performed by application of hypertonic Na Cl, with abortive interval of 20-24 hours.
Discussion. In younger life age, advanced gestations were detected. The fear of condemnation by the family and the environment affected the late reference at younger teenagers. Even with older teenagers, there were no decisions to continue the pregnancy because they did not have the support of the family, partner nor had they the financial means or completed education. The absence of knowledge on protection methods from unwanted pregnancy imposes the necessity of comprehensive education of this population group, and inappropriate relationships in the family deprived of sincerity and understanding, bring the under-aged patient to the medical institution late in the pregnancy.