DEAR DOC

Jamaica Gleaner - - WELL OUTLOOK -

QDear doc, I am a wor­ried young fe­male. I be­came preg­nant at 13 and had a bounc­ing baby girl. I am now 20 and preg­nant again. I was on the pill so I re­ally didn’t ex­pect that. I am 13 weeks preg­nant. Is it too late for an abor­tion to be done? I am in school and I can­not af­ford a next baby. Please help me ASAP.

Your ques­tion is a very con­tro­ver­sial one to which there is no sim­ple straight­for­ward an­swer. Un­for­tu­nately many women find them­selves in a sim­i­lar sit­u­a­tion as you have.

To an­swer your ques­tion sim­ply, the an­swer is no, it is not too late for an abor­tion; but please al­low me to also give you some very im­por­tant in­for­ma­tion re­gard­ing this.

Firstly and most im­por­tantly, abor­tion in Ja­maica is il­le­gal! Any per­son who at­tempts to bring about a mis­car­riage, or per­forms a task to ob­tain one, is sub­ject to life im­pris­on­ment, with or without hard labour.

How­ever, the law will al­low for an abor­tion to be per­formed to save the life of the preg­nant woman.

Grounds on which an abor­tion is per­mit­ted in­cludes:

To save the life of the woman To pre­serve the phys­i­cal health of the woman

To pre­serve the men­tal health of the woman

The law does not make al­lowances for abor­tions in the case of Rape or in­cest, Fe­tal im­pair­ment or for eco­nomic or so­cial rea­sons.

Due to these facts, physi­cians in Ja­maica are usu­ally hes­i­tant to per­form

AIan abor­tion, as the law af­fords them no real pro­tec­tion, and many of them fear the pos­si­bil­ity of prose­cu­tion.

The other im­por­tant bit of in­for­ma­tion, is how it would be per­formed, and this largely de­pends on how far along you are in the preg­nancy. For coun­tries where abor­tion is le­gal, for most of them it is al­lowed up to “vi­a­bil­ity” or 24 weeks.

There are two ba­sic ways abor­tions are per­formed:

A ‘med­i­cal abor­tion’ which is when you take medicine to end the preg­nancy.

The other is called a ‘sur­gi­cal abor­tion’ or ‘Di­la­tion and evac­u­a­tion (D&E)’, which is when a health­care provider does a pro­ce­dure to re­move the preg­nancy.

A med­i­cal abor­tion is most ef­fec­tive for preg­nan­cies that are less than 10 weeks. If the preg­nancy is later (be­yond 14 weeks), you may be given medicines that in­duce la­bor to cause an abor­tion. This type of abor­tion would be per­formed in a hos­pi­tal and is usu­ally called “la­bor in­duc­tion.” This later pro­ce­dure how­ever is not as com­mon as a sur­gi­cal abor­tion for that ges­ta­tional age.

A sur­gi­cal abor­tion is done in a clinic or hos­pi­tal to end a preg­nancy. It can be done for early as well as later preg­nan­cies. The pro­ce­dure

IIIis done by re­mov­ing the preg­nancy tis­sue through the cervix, by as­pi­rat­ing the am­ni­otic fluid and re­mov­ing the fe­tus with for­ceps through the cervix and vagi­nal canal. Usu­ally dis­ar­tic­u­la­tion (or dis­mem­ber­ment) oc­curs as the physi­cian de­liv­ers the fe­tal part grasped in the in­stru­ment and pulls it through the cervix. A fi­nal suc­tion curet­tage is of­ten per­formed to en­sure that the uterus is com­pletely evac­u­ated.

At your ges­ta­tional age, the lat­ter op­tion is most of­ten done.

I do sug­gest you seek sup­port and dis­cuss al­ter­nate op­tions with your health care provider along with a trusted rel­a­tive or friend. Dear Doc, I was 38 years old on Oc­to­ber 23. I would like to know if I can still have a cir­cum­ci­sion done at my age. I

Qwould like to know the price range to do a surgery and where I can do it. Thank you.

That is a very un­usual con­sid­er­a­tion/re­quest at your age but yes it can still be done.

Male cir­cum­ci­sion, which is the sur­gi­cal re­moval of the fore­skin, has been dated back to the pre­his­toric ages.

The pro­ce­dure is of­ten per­formed as a part of ei­ther a re­li­gious, or cul­tural prac­tice; re­gard­less of the rea­son, cir­cum­ci­sions are most of­ten per­formed dur­ing the neona­tal or pre­pu­ber­tal ages (baby to in­fant ages).

In the event that Male Adult Cir­cum­ci­sion (MAC) is per­formed, it is usu­ally done for a va­ri­ety of med­i­cal rea­sons, in­clud­ing var­i­ous pe­nile patholo­gies, and dis­ease pre­ven­tion – mainly sex­u­ally

Atrans­mit­ted in­fec­tions (STI’s). It is also per­formed for rea­sons such as sex­ual dys­func­tion as well as for a per­sonal pref­er­ence. De­pend­ing on the rea­son for the cir­cum­ci­sion, a par­tic­u­lar sur­gi­cal tech­nique and method of aneas­t­he­sia will be de­cided on. The method cho­sen will also de­pend on the sur­geon and the tech­nique with which he/she is most com­fort­able per­form­ing. All of these con­sid­er­a­tions will af­fect the cost of the pro­ce­dure, as well as health in­sur­ance cov­er­age.

The pro­ce­dure is usu­ally done by a sur­geon, par­tic­u­larly a Urol­o­gist.

The best way to get an idea of the cost and to learn more about male adult cir­cum­ci­sion will be to visit one of those spe­cial­ists, and to dis­cuss your op­tions.

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