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Abortion: the antithesis of womanhood?

The debate regarding the practice and role of abortion has been an enduring and problematic area of discourse within the nursing literature, with a tendency towards a polarized and inevitably simplistic analysis of what, for many practitioners, women and families, remains a highly complex and morally fraught concept. This paper attempts to explore the concept of abortion from within a feminist epistemology, to present a review of the literature as regards women's reproductive health and responsibilities, and thereby to contribute to the process of better understanding the role of abortion within contemporary health care practice. In order to facilitate the study it has been necessary to explore the wide spectrum of historical, philosophical, legal, moral and political imperatives pertaining to the meaning of abortion as represented within contemporary society, not only in relation to women and their reproductive health, but to feminism, women's well-being and self-determinism per se.

Abortion, Legal↗

MD-1 is a critical part of the mechanism causing Th1-cytokine-triggered murine fetal loss syndrome.

PROBLEM: Fetal loss syndrome (abortion/resorption) occurring on or after gestation day (gd) 9.5 in CBA/JxDBA/2 matings is dependent upon presence of TNF-alpha + IFN-gamma, which act by increasing expression of fg12 prothrombinase at the feto-maternal interface. The magnitude by which the abortion rate can be boosted by an injection of these cytokines on gd 7.5 depends on endogenous rate of loss, and appears to depend on microbial flora. Is cytokine-triggered abortion dependent upon a third signaling pathway that senses 'danger'? METHODS: Female CBA/J were mated to DBA/2 males and, C57B1/6 and C57B1/6 TNFalphaR1-/-Mak were mated to C57B1/6 control or TNFalphaR1-/-Mak males. LPS from Escherichia coli and Salmonella enteritidis, or the combination of TNF-alpha + IFN-gamma, was injected to stimulate abortions. The effect of anti-MD-1, which interferes with expression of CD14 and, hence, with signaling by LPS via the CD14-tlr4 complex, on TNF-alpha + IFN-gamma was tested. The presence of MD-1 in the uterus was evaluated by in situ hybridization, and effect of lipopolysaccharide (LPS) on mice lacking TNF-alphaR1 was tested. RESULTS: Anti-MD-1 completely abrogated TNF-alpha + IFN-gamma-induced abortions. MD-1 was expressed on trophoblast and in deciduas on gd 8.5 but LPS could not abort mice that lacked the type 1 receptor for TNF-alpha. Pregnant CBA/J females had classical resorptions (abortions) countable on gd 13.5-14.5 in response to LPS from E. coli or S. enteritidis, but C57B1/6 strain mice resorbed only in response to the latter, and E. coli LPS appeared to induce 'occult' losses. 'Occult' loss did not require TNF-alphaR1. CONCLUSIONS: TNF-alpha + IFN-gamma could not induce murine abortions without co-presence of a 'danger' signal such as LPS acting via CD14 on toll receptors, and LPS could not act without co-signaling by TNF-alpha. Classical resorptions/abortions and 'occult' losses have a different mechanism in these models as reflected in type of endotoxin and requirement for TNF-alphaR1 signaling.

Abortion, Spontaneous↗

From what and why did genetics emerge as a medical specialism in the 1970s in the UK? A case-history of research, policy and services in the Manchester region of the NHS. National Health Service.

The history of genetics has concentrated on eugenics in the first half of the 20th century and molecular genetics in the second. There is yet little historical analysis of the emergence of genetics as a medical specialism, even for the USA. This paper explores the creation of a regional genetic service in Manchester, UK. It surveys the ways in which hereditary diseases were managed and investigated in the first two decades of the NHS (1948-68), and the marginality of geneticists in this period. It suggests that the emergence of consultant geneticists as conspicuous service specialists depended heavily on their ability to create and control laboratory and counselling services for antenatal diagnosis, especially of Down's syndrome, from the late 1960s. These services, for syndromes that were not strongly hereditary, helped extend the meaning of 'genetic' in medicine from 'hereditary' to 'related to chromosomes and genes'. The services received government support because of popular demand for diagnoses (following the Abortion Act of 1967), because 'preventive services' were seen as cost effective, and because geneticists could argue that inadequate counselling might give rise to legal difficulties. By linking laboratory services and counselling, geneticists offered an integrated service, in line with other consultant-led services (e.g. for kidneys) which linked research, laboratory services, clinical work, and education/public health functions. We suggest such services fitted the hospital-dominated political economy of medicine which underlay the NHS re-organisation of 1974; and that the salience of the new genetics owed much to this combination of high-science and public concern. Geneticists were then able to integrate molecular genetics into key regional centres, so shaping the initial phases of the 'molecular' revolution. We maintain that this local study offers useful wider insights, not only into the development of a key specialism, but also into the changing dynamics of research and policy in the NHS.

Genetics, Medical↗

Felix A. Theilhaber--pioneer sexologist.

Felix A. Theilhaber, a physician, was born in Germany in 1884 and died in Israel in 1956. He was a pioneer sexologist, demographer, and sportsman and an early Zionist. Theilhaber was an original thinker and a prolific writer. He fought courageously against the pervasive reactionary and antisocial attitudes in the Germany of his time and campaigned actively, in his public addresses, books, pamphlets, and papers, for sexual reform, especially for liberalization of abortion and legalization of contraception. He founded the Society for Sexual Reform (Gesex) in 1913 and was cofounder and sexologic adviser of one of the first birth control and sex advisory clinics in Berlin (1930), operating under the patronage of the Gesex. In 1925, he founded the Coalition for Reform of the (Germany) Criminal Law, and in 1928, the periodical Sexual Hygiene. Among 20 books authored by Theilhaber are The Decline of the German Jews (1911), Das Sterile Berlin (1913), and Goethe, Sexus and Eros (1929). After his emigration to Israel in 1935, he continued his writings and later founded a Health Insurance Company in Tel Aviv, acting as its medical director. He has left a great legacy for sexology.

Abortion, Legal↗

[A case-control study on risk factors of hypospadias].

OBJECTIVE: Hypospadias is one of the most commonly seen urogenital congenital malformations in males and to identify its etiological factors. METHODS: A hospital-based case-control study was conducted, with 107 hypospadias cases. Two matched controls per case were randomly selected. Both cases and controls were face to face interviewed with a uniformed questionnaire. Conditional logistic regression model was used for univariable and multivariate analysis on SAS 6.12 to estimate odds ratios (OR) and 95 per cent confidence internals (95% CI). RESULTS: Data from multiple conditional logistic regression analysis showed that hypospadias was positively associated with maternal history of spontaneous abortion (OR = 3.87, 95% CI: 1.60 - 9.39), with threatened abortion in the first or second trimester (OR = 3.57, 95% CI: 1.31 - 9.64), with common cold accompanied fever in the first trimester (OR = 7.63, 95% CI: 2.50 - 23.24), with maternal drug (antibiotic, analgesiscs) exposure during the second trimester (OR = 16.46, 95% CI: 3.46 - 78.21), with paternal exposure to pesticides occupationally (OR = 3.70,95% CI: 1.49 - 9.16), with neonatal low birth weight (OR = 12.62, 95% CI: 2.97 - 53.67), but was negatively associated with maternal diet supplemented with protein in the first trimester (OR = 0.33, 95% CI: 0.15 - 0.74). CONCLUSIONS: The risk factors of hypospadias seemed to include maternal history of spontaneous abortion, threatened abortion in the first or second trimester, maternal common cold accompanied fever in the first trimester, maternal drug exposure during the second trimester, paternal occupational exposure to pesticides, neonatal low birth weight. However, maternal diet supplemented with protein probably acted as the protective factor for neonatal hypospadias in the first trimester.

Adolescent↗