When a woman was forced of something she did not wish for, what choices that she have? And what if that incident, results into a something more that a woman would carry for the rest of her life, wouldn’t she have the capability of choosing what she wanted? Rape is a crime of violence and humiliation of the victim expressed through sexual means. Rape is the perpetration of an act of sexual intercourse with a female against her will and without her consent, whether her will is overcome by force, fear of force, drugs, or intoxicants.It is also considered rape if the woman is incapable of exercising rational judgment because of mental deficiency or when she is below the age of consent (which varies among states from 14 to 18 years) (Van der Kolk, 2000). The crime of rape requires only slight penetration of the outer vulva; full erection and ejaculation are not necessary. Forced acts of fellatio and anal penetration, although they frequently accompany rape, are legally considered sodomy.
The woman who is raped also may be physically beaten, injured and worse, get pregnant.An intervention made to prevent this is Emergency Contraceptive Pills. The topic of Emergency Contraceptive Pills is a very delicate issue. It has been a long time debate. Some would interfere with the idea of giving Emergency Contraceptive Pill because of their religious beliefs.
“The notion of some healthcare providers that their refusal to provide a crucial, time-sensitive medication to prevent pregnancy is merely an expression of their personally-held religious beliefs and of little consequence to their patient is false.Healthcare providers have a professional obligation to their patients-an obligation that trumps their own personally-held beliefs and requires that they act in accordance with the beliefs of their patients. Creating obstacles for women to prevent pregnancy after a sexual assault is cruel and deplorable. ” -American Civil Liberties Union of Pennsylvania, July 26, 2006 But what really is an Emergency Contraceptive Pill and how does it work? According to Lefever-Kee 2004, the FDA announced in February 1997 that emergency contraception (EC) pills were “safe and effective” in the prevention of pregnancy after sexual intercourse.Furthermore, the FDA requested a pharmaceutical company to prepare an EC product with appropriate accompanying literature. The result was the Preven Emergency Contraception Kit, approved by the FDA in September 1998.
The kit is Medicaid reimbursable and costs about $20-less than 1 month’s supply of birth control pills. The kit requires a prescription and includes four tablets (each with 50g of ethinyl estradiol and 0. 25 mg of levonorgestrel), a pregnancy test, and literature. Two of the combination tablets should be taken as soon as possible within 72 hours of unprotected intercourse; the other two tablets should be taken 12 hours later.EC pills delay or prevent ovulation; interfere with tubal transport of the embryo, egg, or sperm; and /or change the hormones necessary for the preparation of the uterine lining.
They decrease the risk of pregnancy by 75% for each act of unprotected sexual intercourse; birth control pills have a much higher rate of effectiveness- almost 100%. The major side effect is nausea, irregular menstrual bleeding is another side effect. If a woman does not begin menstruation within a few days of the expected time, she should take a pregnancy test.Clients who are unable to take estrogen should not take the usual EC pill dosage. If pregnancy is already established or if implantation occurred since the unprotected sexual intercourse, the pregnancy is not disrupted.
EC pills do not result in an abortion and there are no reports of harm to the fetus. EC can be used when needed. EC is not as effective as taking oral contraceptives or using condoms as directed. Other forms of EC include progestin-only pills and copper IUD. It is initiated within 48 hours of unprotected intercourse.A number of regimens are available for emergency postcoital contraception.
The yuzpe regimen consists of the administration of two fixed-dose combination pills taken within 72 hours of unprotected intercourse (Wellbery, 2000). This is followed by two additional pills in 12 hours. This high dose of estrogen (200 mcg) will almost always cause nausea and vomiting. If a pill is vomited within 2 hours of administration, it should be repeated. Pretreatment with an ant emetic such as 50 mg meclizine (Bonine) is usually recommended to decrease the possibility of vomiting.A specially designed emergency contraceptive kit (Preven) is available for use (over the counter in some states) after unprotected sexual intercourse, particularly after a sexual assault has occurred.
These are often referred to as “morning-after pills. ” The kit consists of a urine pregnancy test to determine whether pregnancy has occurred and four pills that contain concentrations of estrogen/progestin (the first two taken within 72 hours of intercourse and the next two 12 hours later). The high level of estrogen interferes with the production of progesterone and therefore prohibits good implantation (Ho, 2000).A progestin-only method termed “Plan B” is also available.
With this plan, two pills containing high doses of levonorgestrel are taken (one pill immediately and one 12 hours later). This plan results in less nausea and may actually prevent more pregnancies than the estrogen based regimen (Grimes et al. , 2001). Overall, the rate of effectiveness for emergency post-coital methods of contraception is about 98%. The method should always be used cautiously because high levels of estrogen are associated with congenital anomalies if the pregnancy is not prevented.Mifepristone, discussed below as an abortifacient, may also be prescribed for emergency postcoital contraception.
On the other hand, there are catholic health care providers who prioritize the health care of their patient rather than their own religious beliefs. A person who is already forced to something that she did not want is already traumatizing and for that to result into something that she has to carry forever is beyond the pale. It is not her obligation to carry a life that is made out of mistake in the first place, for it will result into a lot of psychological disturbances both to the mother and the child who is are born from rape.According to Burgess and Holmstrem, two physicians who studied 109 women that attended the Boston City Hospital in 1974 complaining of rape, they collected their data at the time of initial presentation at the hospital and again 3 months later. They documented the "rape trauma syndrome".
They found two phases of adjustment following rape or attempted rape. They call these the acute phase and the long term reorganization phase, both of which are stress reactions to a life threatening situation. The physical and psychological trauma that rape victims suffer is severe.Related medical problems can include acute injury, sexually transmitted diseases, pregnancy, and lingering medical complaints.
A cross-sectional study of medical patients found that women who had been raped rated themselves as significantly less healthy, visited a physician twice as often, and incurred medical costs more than twice as high as women who had not experienced any criminal victimization (American Medical Association, 1999). The level of violence experienced during the assault was found to be a powerful predictor of the future use of medical services.Many victims of rape experience fear, helplessness, shock and disbelief, guilt, humiliation, and embarrassment especially when resulted into pregnancy. They also may avoid the place or circumstances of the rape; give up previously pleasurable activities; and experience depression, sexual dysfunction, insomnia, and impaired memory. (American Medical Association, 1999). Emotional reactions include fear, humiliation, anger, guilt/shame and feelings of degradation and powerlessness.
Mood swings and enhanced emotional liability may occur.Increased irritability with, and suspiciousness of other people may also be present. The issue of trust may be important in the counselling process. Given that the victim's trust in people has been betrayed by the rapist, it may make it more difficult for her to trust others.
The counsellor needs to indicate that she can empathize with the victim's feelings, that she can listen and acknowledge the intense emotions the victim has, and encourage rather than suppress discussions of these. The victim may displace her anger onto the counsellor, police, hospital or family.She may be dominated by feelings of helplessness and powerlessness. She needs to be encouraged to make decisions for herself in order to learn to feel some control over her life again. Crisis counselling which is an issue orientated is an effective management procedure, and the counselling needs of the victim include ventilation and clarification of issues.
Only 15% of victims at the hospital continue in counselling after 6 interviews. The situation is a crisis, most victims are psychologically healthy people, and the treatment of choice is crisis intervention so this is appropriate.In my own personal view, women who are raped should be treated specifically with regards to her health and her life. Women in the society have always been treated unfairly with regards to a lot of things because of people’s opinion with regards to their beliefs. I believe that one has the right to live in his or her fullest potential. If people believe that carrying the life out rape is right, well how can it be right when it is wrong in the first place? Decisions about life are tough especially when a life of an innocent is involved.
A rape victim would most likely have low self esteem and feeling of unworthiness.She would feel that even if she did not want the baby she should take care of it because she also feels guilty about the rape incident. She would have thoughts of “why did I went out with him? ” or “why did I walked alone the street late that night? ” Therefore, given a chance to choose, sometimes she would opt to continue the pregnancy even if she doesn’t have to. Raising a child is not easy for a woman, what more for a rape victim who would bring up the child alone? Although there are institutions that help these kinds of victims, it is not a guarantee that it would give them a good life.It cannot remove the social stigma that will be attached to the woman and the child as time goes on.
What would the child’s life be like when he/she starts going to school? And what kind of job will the mother have? Can she support both of them? How would her colleagues treat her? The prescription of emergency contraceptive drugs has been a long time debate. In an article written by Julie Petrella, Director, Duvall Reproductive Rights Project of the ACLU of PA, a rape victim in Lebanon County whose ER doctor refused to prescribe her emergency contraception (a higher dose of regular birth control pills) because of his religious beliefs.The victim was eventually able to obtain a prescription from her gynecologist, only to find that the local pharmacy was out of the medication. She had to travel from eastern Lebanon County to Reading to get the prescription filled.
Having an emergency contraceptive drug alarms the religious believers because if a drug like this existed, some may take advantage of it and use as an abortive drug. Health care providers should be sensitive enough to know the decision of the victim before judging and / or acting in accordance to his/her own beliefs. Culture plays a big part with regards to ethical decisions that involves life and death.But life as if we know it, no matter how hard it gets, every woman has the right to live freely into this world just like everybody else. No matter what she choose, whether to take emergency contraceptives or not, if her own entire life is at stake, the right and just decision for her health should be prioritized. However, in an article written by Kara A.
Crawford there are Catholic Health Care Providers who offers compassion and truth in cases of rape and sexual assault. In this article, it defended the main purpose of giving emergency contraceptive, stating that it is not prohibited in the natural law nor it is by the church.The true predicament here is that Emergency Contraceptive drugs are often misunderstood. The moralists would look at it as another “abortive” drug that uses a different name.
The fact is, it is just combination of high dose estrogens that would interfere fertilization to take place. It often takes 1 year or more for survivors of rape to regain previous levels of functioning. In some cases, survivors of rape have long-term consequences such as posttraumatic stress disorder. If a woman and a child born out of rape would suffer these consequences because of others opinion, what kind of life would they have?
