If the child survived the crash

there are no Simple answers in this topic. Each year, approximately 500 children after the 12 are in Switzerland. Week of pregnancy an abortion. These are the 5 percent of all abortions. From the 17. Week of pregnancy can show a child after an abortion signs of life, his heart beats, it breathes for a short time, from the 22./23. Week it can survive with intensive medical care. The members of the National ethics Commission in human medicine (NEK) yesterday released a 50-page long opinion on the subject of late abortions, because many of the medical, legal and ethical questions.

"These crashes are a reality. You happen to be in the world, whether we like it or not," says Tanja Krones, the head Physician of clinical ethics at Zurich University hospital, a member of the NEK, and co-author of the opinion, "that's why I think it is very important that we talk about it. It doesn't help anyone, if we make this topic taboo."

in Addition, wish for the NEK, that the practice in Switzerland is standardised and the offer is better distributed. Not all clinics perform in this country of late abortions, it is mainly the large centres. The strain on personnel is high.

Up to 12. Week of pregnancy, the decision for an abortion in Switzerland at the woman. From the 13. Week, a doctor must see a medical or social-medical emergency, in order to allow the abortion. The further the pregnancy progressed, the more serious must be the reasons for a crash. The number of late abortions has not increased in the last few years. In the year 2017, there were 103 crashes after 17. Week of pregnancy and 41 abortions after the 23rd. Week. Each year, 25 children survive about this intervention. The child survived, the medical staff must be taken care of, like every other premature babies.

Only a portion of the truth

"it often means that the prenatal diagnosis is the main reason for these Figures", says Krones. The blood tests to diagnose chromosomal disorders such as trisomy 18 or 21, you can get today already in the first three months. To the diagnosis, but often further investigation, which delayed a possible crash. Severe organic damage to be seen in an ultrasound until around 20. Week. Developmental disorders of the brain, for example, if large parts are missing, are often diagnosed only after several appointments with different specialists definitely. Abortion is then only between 22. 24. Week possible.

Nevertheless, you should point out to women before they make prenatal testing, what the consequences could have a potentially positive result. Who can think of no late-term abortions, must ask, what is the point of the Tests. Abortions due to Chromosomal defects can often be found between the 13. and 18. Week of pregnancy.

A pregnancy must not necessarily only happiness of the marriage. Photo: Imago/Westend61

The prenatal diagnosis, however, is only part of the truth, says Krones. Some women develop in the course of the pregnancy, for example severe mental illness. "These women are sometimes in the highest degree suicidal, even if you wanted the child originally." Because there is little study data, whether or not psychotropic drugs cause harm to the unborn child, to treat these diseases very difficult to. One in ten women suffer after the birth, post-partum Depression, about what you speak also little. "All this does not fit into the salvation picture of the happy mother," says Krones.

Not only mental diseases, rape can be a reason for late abortions. Sometimes the women, what happened to displace, so strong that you notice a pregnancy until the fourth or fifth month. The idea to have a child by the rapist, can trigger an existential psychological crises.

Significant

Some people react in horror to these facts and reject abortion for ethical or religious reasons in principle. explain "We respect these positions, however, in the current debate, we have to face other pressing issues," says Krones. No one wishes late crashes. "But the life-creating difficult situations with which we must somehow deal with it." To condemn the Concerned, morally, won't help anyone.

Legally, the unborn child of the woman is not equal. Until the Moment of birth, it gets the same right to mental and physical integrity. Once it is in the world, the plight of the woman, but like the Doctors, the child with the best medical can provide. However, the fact that children can survive, especially late abortions, would have to clear up the Affected more clearly, writes the National ethics Commission.

"Nobody is helped, if we make the subject taboo or morally condemn."Tanja Krones, the head Physician of clinical ethics at the University hospital of Zurich

"If a woman is not mentally or physically able for pregnancy to continue, she Krones, the right to a comprehensive advice," says. The Physicians should also mention the so-called palliative birth in the conversation more frequently as a possibility. A child is disabled, so difficult, that it lives after birth, is only a few minutes, hours, or days, should the medical staff of the woman the opportunity to give birth to your child, and to care for it then palliative in his short life time. That is, to give the child the necessary care, to not let it suffer, but also no unnecessary medications.

"are Often the parents of the important moments that you can spend with your child," says Krones. But even here, there are no patent recipes. For some women and couples this is the best way, others wished to have a crash in which you noticed as little as possible. Why women have an abortion late, will not be recognized in Switzerland in detail. The most common indication is for the "severe emotional distress of the woman".

touchy subject

At difficult it was for all Concerned, if the child is not actually healthy, the woman is able to make it out. "The technical staff discusses the possibility of Adoption." Could force it but no one. Women, which denied the abortion, partly abroad. The UK, France or the Netherlands have more liberal rules than Switzerland. Around 50 Swiss pairs are looking a year in foreign aid. "This shows that we can't prevent the crashes, the importance of a carefully guided professional process is, rather," says Tanja Krones.

The NRC requires, in its opinion, also increased discussions about the methods used by Doctors in the late-term abortions. In Switzerland, the drug way is with 75 percent of the most common. The drugs that trigger labor, the women give birth to their child. In other countries, surgical methods are more common. After stretching of the cervix the woman should be given a General anesthesia, and the Doctors the child will pick up with the tongs on the world.

"A birth is for the child, painful, and not always the best solution."Tanja Krones, the head Physician of clinical ethics at the University hospital of Zurich

"A hidden Christian morality plays in the discussion on the choice of Method often," says Krones. This morality encourages the taboo, to talk about the late-term abortions, and at the same time swinging an implicit attitude is, if abort, then it would have to be as difficult and painful. "That doesn't help anyone."

A particularly sensitive issue is the Termination. Doctors have the option, to the unborn child with a potassium injection to the death trigger. The child then comes lifeless to the world. "That sounds terrible", says Krones. It is for the child would die after birth anyway, depending on but the more peaceful variant. "A birth is for the child, painful, and not always the best solution."

Nevertheless, it is also very important to take care of the medical staff in these matters of consideration. No doctor should have to perform a Termination, which actually goes against the doctors ' understanding of to keep the people alive. Some clinics reject the practice in principle. "At the same time, Doctors also have a duty to help the woman when she is in an acute emergency situation," says Krones. So, for example, bleed to death or kill, if the pregnancy would continue.

(editing Tamedia)

Created: 28.02.2019, 21:59 PM