Pengguguran kandungan: Perbedaan antara revisi

'''Pengguguran kandungan''' atau '''aborsi''' ({{lang-la|'''abortus'''}}) adalah berakhirnya [[kehamilan]] dengan dikeluarkannya [[janin]] (fetus) atau [[embrio]] sebelum memiliki kemampuan untuk [[viabilitas janin|bertahan hidup di luar rahim]], sehingga mengakibatkan kematiannya.<ref name="definition" group="note" /> Aborsi yang terjadi secara spontan disebut juga "[[keguguran]]". Aborsi yang dilakukan secara sengaja sering kali disebut "aborsi induksi" atau "abortus provokatus". Kata ''aborsi'' umumnya hanya digunakan dalam pengertian abortus provokatus. Prosedur serupa yang dilakukan setelah janin berpotensi untuk bertahan hidup di luar rahim juga dikenal dengan sebutan "[[aborsi tahap akhir]]".<ref>{{cite journal|last1=Grimes|first1=DA |last2=Stuart |first2=G |title=Abortion jabberwocky: the need for better terminology |journal=Contraception |year=2010 |volume=81 |issue=2 |pages=93–6 |pmid=20103443 |doi=10.1016/j.contraception.2009.09.005|issn = 0010-7824 }}</ref>

Dikatakan bahwa aborsi di negara-[[negara maju]], yang mengizinkannya merupakan salah satu prosedur medis yang paling aman dalam bidang kedokteran.<ref name="lancet-grimes">{{Cite journal |last1=Grimes |first1=DA |last2=Benson |first2=J |last3=Singh |first3=S |last4=Romero |first4=M |last5=Ganatra |first5=B |last6=Okonofua |first6=FE |last7=Shah |first7=IH |doi=10.1016/S0140-6736(06)69481-6 |title=Unsafe abortion: The preventable pandemic |journal=The Lancet |volume=368 |issue=9550 |pages=1908–1919 |year=2006 |pmid=17126724 |url=http://www.who.int/reproductivehealth/publications/general/lancet_4.pdf |format=PDF |access-date=2017-01-10 |archive-date=2011-06-29 |archive-url=https://web.archive.org/web/20110629040442/http://www.who.int/reproductivehealth/publications/general/lancet_4.pdf |dead-url=no }}</ref><ref name="Ray2014">{{cite journal |last1=Raymond |first1=EG |last2=Grossman |first2=D |last3=Weaver |first3=MA |last4=Toti |first4=S |last5=Winikoff |first5=B |title=Mortality of induced abortion, other outpatient surgical procedures and common activities in the United States |journal=Contraception |date=November 2014 |volume=90 |issue=5 |pages=476–479 |pmid=25152259 |doi=10.1016/j.contraception.2014.07.012}}</ref> Metode-metode modern memanfaatkan obat atau bedah dalam pelaksanaan aborsi.<ref name=1st_Methods>{{cite journal |last1=Kulier |first1=R |last2=Kapp |first2=N |last3=Gülmezoglu |first3=AM |last4=Hofmeyr |first4=GJ |last5=Cheng |first5=L |last6=Campana |first6=A |title=Medical methods for first trimester abortion. |journal=Cochrane Database of Systematic Reviews |date=9 November 2011 |issue=11 |pages=CD002855 |pmid=22071804 |doi=10.1002/14651858.CD002855.pub4}}</ref> Obat mifepriston dikombinasikan dengan [[prostaglandin]] kemungkinan sama aman dan efektifnya dengan bedah selama trimester pertama dan kedua kehamilan.<ref name=1st_Methods/><ref name=Kapp2013/> [[Pengaturan kelahiran]], seperti pil atau [[Intrauterine device (IUD)|alat intrauterin]], mungkin saja digunakan segera setelah aborsi.<ref name=Kapp2013>{{cite journal|last1=Kapp |first1=N |last2=Whyte |first2=P |last3=Tang |first3=J |last4=Jackson |first4=E |last5=Brahmi |first5=D |title=A review of evidence for safe abortion care |journal=Contraception |date=September 2013 |volume=88 |issue=3 |pages=350–63 |pmid=23261233 |doi=10.1016/j.contraception.2012.10.027}}</ref> Dilaporkan bahwa abortus provokatus, jika dilakukan secara aman dan legal, tidak meningkatkan risiko terkait masalah fisik ataupun [[kesehatan mental|mental]] pada jangka panjang.<ref name=BMJ2014/> Sebaliknya, aborsi yang tidak aman mengakibatkan 47.000 [[kematian maternal|kematian]] dan 5 juta kasus perawatan di rumah sakit setiap tahunnya.<ref name=BMJ2014>{{Cite journal |last1=Lohr |first1=PA |last2=Fjerstad |first2=M |last3=Desilva |first3=U |last4=Lyus |first4=R |title=Abortion |journal = BMJ | volume = 348 | page = f7553 | year = 2014 | doi = 10.1136/bmj.f7553}}</ref><ref name="OBGY09">{{Cite journal |last1=Shah |first1=I |last2=Ahman |first2=E |title=Unsafe abortion: global and regional incidence, trends, consequences, and challenges |journal=Journal of Obstetrics and Gynaecology Canada |volume=31 |issue=12 |pages=1149–58 |date=December 2009 |pmid=20085681 |url=http://www.sogc.org/jogc/abstracts/full/200912_WomensHealth_1.pdf |format=PDF |deadurl=yes |archiveurl=https://web.archive.org/web/20110716212405/http://www.sogc.org/jogc/abstracts/full/200912_WomensHealth_1.pdf |archivedate=16 July 2011 |df=dmy }}</ref> [[Organisasi Kesehatan Dunia]] merekomendasikan tersedianya aborsi yang aman dan legal bagi semua wanita.<ref name=WHOPolicy2012>{{cite book |author=World Health Organization |title=Safe abortion: technical and policy guidance for health systems |date=2012 |publisher=World Health Organization |location=Geneva |isbn=9789241548434 |page=8 |edition=2nd |url=http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf?ua=1 |format=PDF |access-date=2017-01-10 |archive-date=2015-01-16 |archive-url=https://web.archive.org/web/20150116223512/http://apps.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf?ua=1 |dead-url=no }}</ref>

Sekitar 56 juta aborsi terjadi setiap tahunnya di seluruh dunia,<ref>{{cite journal|last1=Sedgh|first1=Gilda|last2=Bearak|first2=Jonathan|last3=Singh|first3=Susheela|last4=Bankole|first4=Akinrinola|last5=Popinchalk|first5=Anna|last6=Ganatra|first6=Bela|last7=Rossier|first7=Clémentine|last8=Gerdts|first8=Caitlin|last9=Tunçalp|first9=Özge|last10=Johnson|first10=Brooke Ronald|last11=Johnston|first11=Heidi Bart|last12=Alkema|first12=Leontine|title=Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends|journal=The Lancet|date=May 2016|doi=10.1016/S0140-6736(16)30380-4}}</ref> dengan hampir setengahnya dilakukan secara tidak aman.<ref name="Sedgh 2012">{{Cite journal |last1=Sedgh |first1=G. |last2=Singh |first2=S. |last3=Shah |first3=I. H. |last4=Åhman |first4=E. |last5=Henshaw |first5=S. K. |last6=Bankole |first6=A. |doi=10.1016/S0140-6736(11)61786-8 |title=Induced abortion: Incidence and trends worldwide from 1995 to 2008 |journal=The Lancet |volume=379 |issue=9816 |pages=625–632 |year=2012 |pmid=22264435 |url=http://www.guttmacher.org/pubs/journals/Sedgh-Lancet-2012-01.pdf |format=PDF |quote=Because few of the abortion estimates were based on studies of random samples of women, and because we did not use a model-based approach to estimate abortion incidence, it was not possible to compute confidence intervals based on standard errors around the estimates. Drawing on the information available on the accuracy and precision of abortion estimates that were used to develop the subregional, regional, and worldwide rates, we computed intervals of certainty around these rates (webappendix). We computed wider intervals for unsafe abortion rates than for safe abortion rates. The basis for these intervals included published and unpublished assessments of abortion reporting in countries with liberal laws, recently published studies of national unsafe abortion, and high and low estimates of the numbers of unsafe abortion developed by WHO. |access-date=2017-01-10 |archive-date=2012-02-06 |archive-url=https://web.archive.org/web/20120206043854/http://www.guttmacher.org/pubs/journals/Sedgh-Lancet-2012-01.pdf |dead-url=no }}</ref> Angka atau tingkat aborsi hanya berubah sedikit antara tahun 2003 dan 2008,<ref name="Sedgh 2012" /> setelah sebelumnya mengalami penurunan selama setidaknya dua dasawarsa karena meningkatnya akses atas pengendalian kelahiran dan [[keluarga berencana]].<ref name="worldtrends2007">{{Cite journal |vauthors=Sedgh G, Henshaw SK, Singh S, Bankole A, Drescher J |title=Legal abortion worldwide: incidence and recent trends |journal=Int Fam Plan Perspect |volume=33 |issue=3 |pages=106–116 |date=September 2007 |pmid=17938093 |doi=10.1363/ifpp.33.106.07 |url=http://www.guttmacher.org/pubs/journals/3310607.html |access-date=2017-01-10 |archive-date=2009-08-19 |archive-url=https://web.archive.org/web/20090819122933/http://www.guttmacher.org/pubs/journals/3310607.html |dead-url=no }}</ref> Pada tahun 2008, 40% wanita di seluruh dunia memiliki akses untuk melakukan aborsi secara legal tanpa batasan tertentu sebagai alasan.<ref name=IJGO10/> Setiap negara yang mengizinkan aborsi memiliki batasan berbeda mengenai seberapa terlambat aborsi kehamilan diperbolehkan.<ref name=IJGO10>{{Cite journal|vauthors=Culwell KR, Vekemans M, de Silva U, Hurwitz M |title=Critical gaps in universal access to reproductive health: Contraception and prevention of unsafe abortion |journal=International Journal of Gynecology & Obstetrics |volume=110 |pages=S13–16 |date=July 2010 |pmid=20451196 |doi=10.1016/j.ijgo.2010.04.003}}</ref>

Sejak zaman kuno, aborsi telah dilakukan dengan menggunakan obat-obatan herbal, benda-benda tajam, dengan [[cedera|paksaan]], atau juga [[ramuan tradisional|metode-metode tradisional]] lainnya.<ref name="Management of Abortion, Chp 1">{{cite book|chapter=1. Abortion and medicine: A sociopolitical history|isbn=978-1-4443-1293-5|publisher=[[John Wiley & Sons, Ltd.]]|year=2009|location=[[Oxford, United Kingdom]]|title=Management of Unintended and Abnormal Pregnancy|edition=1st|editors=M Paul, ES Lichtenberg, L Borgatta, DA Grimes, PG Stubblefield, MD Creinin|first=Carole|last=Joffe|url=http://media.wiley.com/product_data/excerpt/62/14051769/1405176962.pdf|format=PDF|archiveurl=https://www.webcitation.org/62bppK1Iw?url=http://media.wiley.com/product_data/excerpt/62/14051769/1405176962.pdf|archivedate=2011-10-21|deadurl=no|access-date=2017-11-28}}</ref> Terdapat perbedaan [[hukum aborsi]] dan [[agama dan aborsi|pandangan agama]] ataupun budaya di seluruh dunia. Di beberapa wilayah hukum, aborsi dilegalkan dalam kasus tertentu seperti pemerkosaan, [[kelainan bawaan|masalah pada janin]], [[status sosial ekonomi|kemiskinan]], risiko pada kesehatan sang ibu, ataupun [[inses]].<ref name="Dev98-07">{{Cite journal |last1=Boland |first1=R. |last2=Katzive |first2=L. |doi=10.1363/ifpp.34.110.08 |title=Developments in Laws on Induced Abortion: 1998–2007 |journal=International Family Planning Perspectives |volume=34 |issue=3 |pages=110–120 |year=2008 |pmid=18957353 |url=http://www.guttmacher.org/pubs/journals/3411008.html |access-date=2017-01-10 |archive-date=2011-10-07 |archive-url=https://web.archive.org/web/20111007221828/http://www.guttmacher.org/pubs/journals/3411008.html |dead-url=no }}</ref> Di berbagai daerah di dunia terjadi banyak [[perdebatan aborsi|perdebatan]] terkait isu moral, etika, dan hukum dalam hal aborsi.<ref>{{cite book|last1=Nixon|first1=edited by Frederick Adolf Paola, Robert Walker, Lois LaCivita|title=Medical ethics and humanities|date=2010|publisher=Jones and Bartlett Publishers|location=Sudbury, Mass.|isbn=9780763760632|page=249|url=https://books.google.ca/books?id=9pM2pw-2wl4C&pg=PA249|access-date=2017-01-10|archive-date=2023-08-10|archive-url=https://web.archive.org/web/20230810101023/https://books.google.ca/books?id=9pM2pw-2wl4C&pg=PA249|dead-url=no}}</ref><ref>{{cite book|last1=Johnstone|first1=Megan-Jane|title=Bioethics a nursing perspective|date=2009|publisher=Churchill Livingstone/Elsevier|location=Sydney, N.S.W.|isbn=9780729578738|page=228|edition=5th|url=https://books.google.ca/books?id=EG-Yg1xDYakC&pg=PA228|quote=Although abortion has been legal in many countries for several decades now, its moral permissibilities continues to be the subject of heated public debate.|access-date=2017-01-10|archive-date=2023-08-10|archive-url=https://web.archive.org/web/20230810100944/https://books.google.ca/books?id=EG-Yg1xDYakC&pg=PA228|dead-url=no}}</ref> Mereka yang [[gerakan antiaborsi|menentang aborsi]] umumnya bersikukuh bahwa embrio ataupun janin adalah seorang pribadi manusia dengan [[hak untuk hidup]] dan mereka menyamakan aborsi dengan suatu [[pembunuhan]].<ref>{{Cite news |author=Pastor Mark Driscoll |title=What do 55 million people have in common? |publisher=Fox News |date=18 October 2013 |accessdate=2 July 2014 |url=http://www.foxnews.com/opinion/2013/10/18/what-do-55-million-people-have-in-common/ |archive-date=2014-08-31 |archive-url=https://web.archive.org/web/20140831022138/http://www.foxnews.com/opinion/2013/10/18/what-do-55-million-people-have-in-common/ |dead-url=no }}</ref><ref>{{Cite news |first=Dale |last=Hansen |title=Abortion: Murder, or Medical Procedure? |publisher=Huffington Post |date=18 March 2014 |accessdate=2 July 2014 |url=http://www.huffingtonpost.com/dale-hansen/abortion-murder-or-medica_b_4986637.html |archive-date=2014-07-14 |archive-url=https://web.archive.org/web/20140714230359/http://www.huffingtonpost.com/dale-hansen/abortion-murder-or-medica_b_4986637.html |dead-url=no }}</ref> Sedangkan mereka yang mendukung legalitas aborsi umumnya berpandangan bahwa seorang wanita memiliki hak untuk mengambil keputusan atas tubuhnya sendiri.<ref>{{cite book|last1=Sifris|first1=Ronli Noa|title=Reproductive Freedom, Torture and International Human Rights Challenging the Masculinisation of Torture.|date=2013|publisher=Taylor and Francis|location=Hoboken|isbn=9781135115227|page=3|url=https://books.google.com/books?id=9pVWAgAAQBAJ&pg=PA3}}</ref>

* Pengeluaran hasil konsepsi sebelum janin dapat hidup di luar kandungan (berat kurang dari 500 gram atau kurang dari 20 minggu).<ref>{{cite book|last=Astari|first=Rika|last2=Triana|first2=Winda|date=2018|url=http://eprints.uad.ac.id/19039/1/Kamus%20Kesehatan_11Nop18.pdf|title=Kamus Kesehatan Indonesia-Arab|place=[[Sleman]], [[Yogyakarta]]|publisher=Trussmedia Grafika|isbn=978-602-5747-22-9|edition=|pages=3|language=|coauthors=|access-date=2022-02-02|archive-date=2022-05-28|archive-url=https://web.archive.org/web/20220528040907/http://eprints.uad.ac.id/19039/1/Kamus%20Kesehatan_11Nop18.pdf|dead-url=no}}</ref> Dari segi [[medikolegal]] maka istilah abortus, keguguran, dan kelahiran prematur mempunyai arti yang sama dan menunjukkan pengeluaran janin sebelum usia kehamilan yang cukup.

'''[[Abortus provokatus]]''' merupakan jenis abortus yang sengaja dibuat/dilakukan, yaitu dengan cara menghentikan kehamilan sebelum janin dapat hidup di luar tubuh ibu.<ref>{{Cite book|last=Ristica|first=Octa Dwienda|last2=Juliarti|first2=Widya|date=2015|url=https://www.google.co.id/books/edition/Prinsip_Etika_dan_Moralitas_dalam_Pelaya/4WvkCAAAQBAJ?hl=en&gbpv=1&dq=Abortus+provocatus+merupakan+jenis+abortus+yang+sengaja+dibuat/dilakukan,&pg=PA100&printsec=frontcover|title=Prinsip Etika dan Moralitas dalam Pelayanan Kebidanan|publisher=Deepublish|isbn=9786022806745|pages=100|url-status=live|access-date=2022-02-02|archive-date=2023-08-10|archive-url=https://web.archive.org/web/20230810100949/https://www.google.co.id/books/edition/Prinsip_Etika_dan_Moralitas_dalam_Pelaya/4WvkCAAAQBAJ?hl=en&gbpv=1&dq=Abortus+provocatus+merupakan+jenis+abortus+yang+sengaja+dibuat/dilakukan,&pg=PA100&printsec=frontcover|dead-url=no}}</ref> Pada umumnya bayi dianggap belum dapat hidup di luar [[kandungan]] apabila usia kehamilan belum mencapai 28 minggu, atau [[berat badan]] bayi kurang dari 1000 gram, walaupun terdapat beberapa kasus bayi dengan berat dibawah 1000 gram dapat terus hidup. Pengelompokan Abortus provokatus secara lebih spesifik:

* Hukum yang memperbolehkan abortus atas indikasi sosio-medik, seperti di Eslandia, Swedia, Inggris, ScandinaviaSkandinavia, dan India.

* "[T]he standard medical definition of abortion [is] termination of a pregnancy when the fetus is not viable". {{cite book|editor1-last=Gabbe|editor1-first=Steven G.|editor1-link=Steven Gabbe|editor2-last=Niebyl|editor2-first=Jennifer R.|editor3-last=Simpson|editor3-first=Joe Leigh|year=2007|title=Obstetrics: Normal and Problem Pregnancies|url=https://archive.org/details/obstetricsnormal0000unse_z6w5|edition=5|publisher=[[Churchill Livingstone]]|chapter=51. Legal and Ethical Issues in Obstetric Practice|isbn=978-0-443-06930-7|last1=Annas|first1=George J.|authorlink1=George Annas|last2=Elias|first2=Sherman}}

* "Abortion is the spontaneous or induced termination of pregnancy before fetal viability. Because popular use of the word abortion implies a deliberate pregnancy termination, some prefer the word miscarriage to refer to spontaneous fetal loss before viability&nbsp;... The National Center for Health Statistics, the Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO) define abortion as pregnancy termination prior to 20 weeks' gestation or a fetus born weighing less than 500 g. Despite this, definitions vary widely according to state laws." {{cite book|editor1-last=Schorge|editor1-first=John O.|editor2-first=Joseph I.|editor2-last=Schaffer|editor3-first=Lisa M.|editor3-last=Halvorson|editor4-first=Barbara L.|editor4-last=Hoffman|editor5-first=Karen D.|editor5-last=Bradshaw|editor6-first=F. Gary|editor6-last=Cunningham|year=2008|title=Williams Gynecology|url=https://archive.org/details/williamsgynecolo0000unse_u2n9|edition=1|publisher=McGraw-Hill Medical|isbn=978-0-07-147257-9|chapter=6. First-Trimester Abortion}}

* "1. a. The expulsion or removal from the womb of a developing embryo or fetus, spec. (Med.) in the period before it is capable of independent survival, occurring as a result either of natural causes (more fully spontaneous abortion) or of a deliberate act (more fully induced abortion); the early or premature termination of pregnancy with loss of the fetus; an instance of this." {{cite book |title=[[Oxford English Dictionary]] |chapter=abortion, n. |chapterurl=http://www.oed.com/viewdictionaryentry/Entry/503 |edition=Third |date=September 2009 |orig-year=online version September 2011 |publisher=[[Oxford University Press]] |access-date=2017-01-10 |archive-date=2023-08-10 |archive-url=https://web.archive.org/web/20230810100955/https://www.oed.com/dictionary/abortion_n |dead-url=no }}

* "a medical operation to end a pregnancy so that the baby is not born alive". ''[[Longman Dictionary of Contemporary English]]'', [http://www.ldoceonline.com/dictionary/abortion online edition] {{Webarchive|url=https://web.archive.org/web/20131029224903/http://www.ldoceonline.com/dictionary/abortion |date=2013-10-29 }}.

* "The deliberate termination of a pregnancy, usually before the embryo or fetus is capable of independent life." {{cite book |title=The American Heritage New Dictionary of Cultural Literacy |edition=3rd |publisher=[[Houghton Mifflin Company]] |year=2005 |url=http://dictionary.reference.com/browse/abortion |access-date=2017-01-10 |archive-date=2013-10-29 |archive-url=https://web.archive.org/web/20131029210140/http://dictionary.reference.com/browse/abortion |dead-url=no }}

[[Kategori:Kehamilan dan kelahiranKelahiran]]