A lyukas gumi miatt keletkezett terhesség megszakításában miért nem egyenjogú az erről hozható döntés?

És ráadásul pont egy olyan férfi pofázik arról, hogy a nő kapartassa ki a gyereket, vállalva az eü kockázatát a beavatkozásnak, aki egyébként az egyetlen -mellékhatásoktól teljesen mentes- férfi fogamzásgátló eszközt nem hajlandó használni, mert szerinte "fasisztoid" módszer.

Magyarul szerinted:

- a nő vállalja a fogamzásgátló tabletta vagy a spirál lehetséges egészségügyi kockázatait, vagy

- vállalja be, hogy megszakítással szexel, és ő lesz terhes

- és ha mégis terhes lesz, takarodjon el kikapartatni, mert őfelsége szerint a "méhtartalma" nem előrébb való, mint az a férfi, aki arra is képtelen, hogy normálisan védekezzen és ne sodorja ilyen helyzetbe azt, akit elvileg szeret

Ez minden, csak nem korrekt.

Ha gondolod, szívesen iderakom még a valódi megfelelőjét is, a női sterilizációt:

"Complications specifically associated with laparoscopic permanent contraception procedures are discussed here; general complications of laparoscopic surgery are discussed in detail separately. (See "Complications of laparoscopic surgery".)

Analysis of interval laparoscopic procedures in the United States Collaborative Review of Sterilization (CREST) cohort concluded that the overall rate of intraoperative and postoperative complications was 1.6 per 100 women [21]. When major surgeries that were not related to laparoscopic permanent contraception procedures were excluded, the rate was reduced to 0.9 per 100 women. There were no deaths and only one report of a life-threatening event among 9475 procedures.

Complications rates among the four most commonly referenced methods of laparoscopic tubal permanent contraception (silicone band, spring clip, bipolar or monopolar electrosurgery) ranged from 1.17 to 1.95 per 100 procedures in the CREST population. There was no statistically significant difference in complication rates between these techniques. Patient history of diabetes, general anesthesia, and previous abdominal or pelvic surgery were all found to be predictors of increased morbidity related to interval tubal permanent contraception [22]. There have not been any studies since CREST with a denominator large enough to rigorously compare complication rates between the more common modern methods of laparoscopic permanent contraception. A meta-analysis of 19 randomized trials demonstrated that the silicone band compared with the titanium clip had a higher rate of minor procedure-related injuries with no additional operation (4.6 versus 2.4 percent, odds ratio [OR] 1.95, 95% CI 1.36-2.78) and technical failures (3.3 versus 0.7 percent, OR 3.93, 95% CI 2.43-6.35) [23].

Another observational study, of 44,278 procedures in New York State between 2005 and 2013, reported the rate of iatrogenic complications (hemorrhage or hematoma complicating a procedure, and accidental puncture or laceration) to be 0.4 percent within 30 days following laparoscopic permanent contraception procedures. The rate of major medical complications (acute myocardial infarction, stroke, pulmonary embolism, perioperative shock, and respiratory complications) was reported to be 0.1 percent [22]. Both of these studies confirm that, overall, laparoscopic permanent contraception procedures are very safe.

While several studies have compared complications in complete versus partial salpingectomy for permanent contraception at time of cesarean section, no studies, to our knowledge, have evaluated differences in complications for complete salpingectomy versus the above mentioned interval techniques (ie, silicone band, spring clip, bipolar or monopolar electrosurgery). (See "Postpartum permanent contraception: Procedures", section on 'Complete salpingectomy'.)

Immediate complications — Immediate complications from surgical permanent contraception procedures may include bleeding, injury to other structures, or pain.

Bleeding — Bleeding may occur from the tube or mesosalpinx due to excessive traction during surgery or from trauma during placement of occlusive devices. In such cases, bleeding may be controlled with bipolar electrosurgery or with application of additional silicone bands or clips. Tubal transection may occur if a clip is placed too quickly; slow gradual pressure is advised to "milk away" any tubal edema present [3].

Some surgeons report that in their practice there is less risk of transecting the tube and related bleeding complications during application of the clip compared with the silicone band [3]. A randomized trial using the titanium clip compared with the silicone band reported tubal or mesosalpingeal injury in 2 out of 904 (0.2 percent) of laparoscopic clip procedures, compared with 23 out of 880 (2.5 percent) of the silicone band procedures [24].

Injury to nearby structures — If salpingectomy is performed for permanent contraception, care should be taken to avoid excessive electrosurgery adjacent to the infundibulopelvic ligament. Identification of the infundibulopelvic ligament is crucial to avoid compromising ovarian blood flow, and if the vessels are divided inadvertently, significant bleeding can result. Venous structures in the mesosalpinx are another potential source of bleeding if the tube is grasped with excessive force or manipulated with a laparoscopic grasper that has teeth or sharp components, including the silicone band applicator.

Conversion to laparotomy — In the Collaborative Review of Sterilization (CREST) study, conversion from laparoscopy to laparotomy to complete the permanent contraception procedure due to complications specific to laparoscopic technique (such as injury to other structures at time of entry) occurred in only 14 out of 9475 procedures (0.15 percent). Nine laparotomies were performed for findings of incidental disease, 37 due to difficult visualization or mobilization of the fallopian tubes, four for equipment malfunction, three for unknown reasons, and 21 for patients in whom entry or pneumoperitoneum could not be obtained, for a total laparotomy rate of 0.09 percent [21]. The risk of conversion to laparotomy in current practice is likely to be even lower, given improvements in laparoscopic skill and technique since the CREST study was conducted.

Postoperative pain — Short-term postoperative pain is expected following laparoscopic gynecologic surgery due to the abdominal incisions and to diaphragmatic irritation from residual intraperitoneal carbon dioxide, as occurs after other laparoscopic surgeries. Most surgeons prescribe a limited number of oral narcotics to use for postoperative pain not controlled by the use of nonsteroidal anti-inflammatory drugs or acetaminophen during the first one to five days. For most patients, any severe pain is resolved by the third postoperative day [25].

The silicone band and clips appear to cause more postoperative pain than electrosurgery. This is likely because both these methods result in ischemic tubal tissue. Two studies included in a meta-analysis of randomized trials of methods for tubal occlusion compared postoperative pain (<24 hours) among patients undergoing laparoscopic permanent contraception via silicone band or electrosurgery. The combined analysis showed significantly more pain with silicone bands as compared with electrosurgery (OR 3.40, 95% CI 1.17-9.84) as well as higher postoperative analgesia use (OR 2.51, 95% CI 1.00-6.30). There was no difference in persistent pain at the follow-up visit [26]. Data are conflicting regarding whether the clip or silicone band is more painful [27,28].

In randomized trials, use of a bupivacaine at time of laparoscopic permanent contraception with silicone bands or titanium clips has been found to decrease postoperative pain scores compared with placebo [29,30]. Using a cannula placed through a lower port site, the surgeon can drip 5 mL of 0.5 percent bupivacaine along the tube from the uterus to the fimbria bilaterally prior to tubal occlusion.

Delayed complications

Ectopic pregnancy — Ectopic pregnancy is the most serious delayed complication, since unrecognized tubal rupture remains a significant contributor to maternal mortality in early pregnancy. Overall, ectopic pregnancies accounted for 32.9 percent of all pregnancies reported in CREST subjects, for an ectopic pregnancy rate of 7.3 per 1000 permanent contraception procedures [31].

Patients under age 30 years at time of permanent contraception had higher rates of ectopic pregnancy compared with older patients, except for those under 30 years sterilized by postpartum partial salpingectomy. The risk of ectopic pregnancy did not significantly vary with length of time since the permanent contraception procedure.

In the original CREST study, bipolar electrosurgery resulted in the highest probability of ectopic pregnancy (17.1 per 1000 procedures at 10 years after permanent contraception), and postpartum partial salpingectomy resulted in the lowest (1.5 per 1000 procedures at 10 years after permanent contraception) [31]. The rate of ectopic pregnancy is likely much lower using modern techniques, since reanalysis of the CREST data suggests that applying bipolar electrosurgery to three adjacent sites on the tube dramatically decreases the cumulative pregnancy rate to 3.2 per 1000 procedures [5]. (See 'Efficacy' below.)

Incorporating more modern methods, an analysis of 44,829 patients undergoing tubal permanent contraception procedures in Western Australia from 1990 to 2010 identified 89 patients with subsequent ectopic pregnancy for a cumulative probability of 1.7 per 1000 procedures at five years, 2.4 per 1000 by 10 years, and 3 per 1000 by 15 years after surgery [32]. Differences in probability varied by age (highest for younger patients) and by method, though they disclose that 40 of the 89 patients with ectopic pregnancy had a laparoscopic permanent contraception procedure by an unspecified method of destruction or occlusion. Bipolar electrosurgery by laparoscopy had a reported risk of ectopic pregnancy of 8.4 per 1000 procedures at 5 and 10 years after surgery. Following laparoscopic occlusion with the titanium clip, the probability of ectopic pregnancy was only 1.7 per 1000 procedures at five years and 2.0 per 1000 at 10 years after permanent contraception. Laparoscopic or open salpingectomy and hysteroscopic permanent contraception procedures were not commonly performed, but not associated with subsequent ectopic pregnancy in this analysis.

Ectopic pregnancy is covered in detail separately. (See "Ectopic pregnancy: Clinical manifestations and diagnosis" and "Ectopic pregnancy: Methotrexate therapy".)

Device migration — For permanent contraception procedures using a clip, delayed migration or expulsion via the urethra, bladder, vagina, or rectum have been reported, but are uncommon events. Based upon available data, it appears that such events are not associated with failed tubal occlusion or other significant morbidity, as the tubal segment remains obstructed from the previous clip placement [3,33]. Silicone bands are often seen to be peritonealized and still attached to the mesosalpinx or even found elsewhere in the pelvis at the time of subsequent surgery, with no reports of failure or adverse outcomes related to migration."

Nyilván nincs teljesen korrekt megoldás. Azt kellene végre felfogni, hogy biológiailag a nő és a férfi különbözik, és csak a nő tud terhes lenni.

Innentől kedve nem lehet olyan megoldást találni, ami mindkét fél számára teljesen igazságos.

Azonban az teljeen alapvető dolog, hogy a saját testéről mindenki maga dönt, nem vethető alá egy egészségügyi kockázatokkal járó beavatkozásnak (legyen bármennyire is kicsi a kockázat!!), ha ő nem egyezik bele.

A férfit sem lehet vazektómiára kényszeríteni, a nőt sm lehet abortuszra kényszeríteni.

A "jogi abortusz" a férfi számára pedig nyilvánvalóan azért nem működik, mert így is számos olyan eset van, mikor a KÍVÁNT terhesség létrejött után apuci meggondolja magát. Fordított eset (anyuka akarta, aztán mégis elmegy kikapartatni ezzel szemben marha ritka).

Szóval ilyen esetben mi védené azokat a nőket, akiknek szex előtt a pasi azt mondja, hogy szeretne gyereket, aztán szex után már érdekes módon mégse?

Egyetlen dolog működhet, ha gyermekvállalás előtt foglalják írásba, hogy akarnak-e gyereket és ha nem, akkor ki mit szándékozik tenni egy nem kívánt terhesség esetén.

De ugye kicsit kevéssé megvalósítható, hogy az első randin mindenki az ügyvédhez szaladgáljon...

#84, miután - egyelőre - a nőnél van a punci, és az ő kezében van a "fegyver", hogy megtartja-e a magzatot vagy sem, így a férfi lesz kénytelen olyan megoldást keresni, hogy a nő ne eshessen teherbe az ő (azaz a férfi) akarata ellenére.

Van több megoldás.

Ha egyik se tetszik, mert a fent vázolt egyensúlytalanság ellenére is úgy gondolod, hogy neked több jogod van, akkor legfeljebb sajnálni tudlak.

Vannak már guminők, ők nem termékenyek

"mitől kellene védeni???"

Amikor én eltervezem, hogy a PÁROMMAL gyermeket vállalok, akkor alapvetően arra számítok, hogy a párommal KETTEN fogjuk azt a gyereket nevelni, nem egyedülálló anyaként szopni.

Ha pedig már otthagy a pi.ába az előzetes megbeszélés ellenére, én meg annak ellenére mégis csak ragaszkodom ahhoz a gyerekhez, akit már KETTEN sikerült megcsinálni, akkor igen is elvárható, hogy legalább anyagilag járuljon hozzá ahhoz, amit megcsinált.