ob/gyn question on the subject of abortion

[bxb20420]

I work in a teaching hospital with 500+ beds we do not have a gyn floor. Our hospital does !st and 2nd trimester abortions. The medical staff and nursing adminstration that this is ok to do these procedures on

a AP floor with pregnant pts. The procedure that our hospital uses is to induce labor by placing lameria and then giving hemabate to the pt to induce contractions this a long and somtimes painful procedure that can take 1-3 days. I would like to know if this is a standard of practice or care at other hospitals. Or if other hospital expect a OB or L&D nurse to do these procedure?

[fiestynurse]

That is how it is done in my Community Hospital, also. The Antepartum unit is the safest place to do this. The baby has usually died in utero, and the procedure that we use is similar to yours, except we don't use hemabate anymore, we use another med. Unfortunately there is no other way to do this.

[HazeK]

we do terminations of pregancy for medical indications or inductions for fetal demise

from >15 weeks up in L&D.

This way we can have a private room, big enough for family to gather, The staffing is 1:1 on admission & at delivery, and we have an extensive Bereavement program for both categories of patients!

I can't even imagine our busy AP unit doing them....and still giving quality, individualized care!

[fiestynurse]

We do 1:1 care also and have an extensive bereavement process. I can't imagine doing it on a busy L&D unit. Oh well, what ever works!

[woopcrane]

I am going to ask you a few questions.

1) Are these elective or theraputic abortions?

2) Are you questioning the location in regards to the emotional distress of the person, having come to the hard decision of having the abortion, being placed on a unit with women who are hospitalized (usually due to pregnancy complications) who really want a baby?

3) Is your question referring to the ethics or the emotional distress of women who are hospitalized with pregnancy complications, who really want a baby, who KNOW that there is someone, perhaps next door, who has chosen to terminate a pregnancy? (Perhaps even at the same gestational age that the woman happens to be at presently?)

4) Are you questioning the practice in regards to the staff of the AP unit who, working in a place which philosophically supports the continuance of life, and grieve when a baby is lost, who suddenly have to deal with a person who chooses to terminate a pregnancy?

5) Or are you questioning the practice in regard to the best place to provide the best, safest, skilled care, both emotionally and physically, to the person having the abortion?

Most hospitals do this care within the L&D or AP areas.

I hope your hospital gets away from usuing hemabate - cytotec is much quicker and does not have the gastrointestical side effects

l trauma to either the person having the abortion to being placed on a

[kennedyj]

I have never seen hemabate used but I have worked in settings where cytotec is used to ripen the cervix to a few cm where the demised fetus can be expelled. I have seen it take up to 3 days. If you are referring why not do a d&c there is no indication unless there is bleeding or immediate maternal risk. A D&C has increased risk of infection and requires unnecessary medications and anesthesia.

J