Medical services

Medical abortion

Drug-induced abortion is the use of two different drugs to end a pregnancy: Mifepristone and Misoprostol.

The doctor prescribes and gives to take the first pill, Mifepristone, in the clinic. The effect of mifepristone is on the effect of progesterone at the receptor level. Pregnancy needs a hormone called progesterone so that the fetus can grow normally. Mifepristone blocks a woman's own progesterone. During this time, the doctor will also prescribe antibiotics to prevent the occurrence of infection.

The second medicine, misoprostol, is used in 6-48 hours, usually at home. This medicine causes cramps and bleeding to empty the uterus. This process is very similar to an early miscarriage.

This method is very effective. For women who are 6 weeks pregnant or less, this method works about 98 out of 100 times.

When can I do this procedure

It is usually possible to have a medical abortion up to 42 days (10 weeks) after the first day of the last menstruation. If 43 or more days have passed since the last menstruation, it is possible to have an abortion using other methods in the clinic to terminate the pregnancy.

Why do people choose medical abortion

The woman herself can choose the method of abortion, depending on personal preferences and situation. With medical abortion, some people like the fact that they do not need to go through the procedure in the doctor’s office.

You can have an abortion at home or in another convenient place. The woman herself decides with whom she wants to be during her abortion, or can do it alone. Because the medical method of abortion is similar to miscarriage, many women feel more "natural" and less invasive. A doctor can help a woman decide which type of abortion is best for her.

Studies of this method show that if a woman takes the first medicine, but not the second, abortion pills are less likely to work. Therefore, if a woman started the abortion process with an abortion pill, but then changed her mind about doing it, you need to consult a doctor or nurse to talk about the next steps and what to expect.

Using Misoprostol alone to induce abortion will be successful in 90% of cases.

Some women attempt an abortion by placing sharp or dirty objects in the uterus or punching the belly. This is very dangerous for life, because there is a very high risk of injury to the internal organs of a woman, infection, heavy bleeding and even death.

For many women, termination of pregnancy is a difficult decision. When a woman cannot discuss abortions or alternatives to this method with a doctor, you need to discuss this with a good friend or relative. It is recommended that any young girl talk to her parents or another adult whom she trusts her situation, her decision and the abortion procedure.

How does medical abortion work

Misoprostol for medical abortion works best in the first 6 weeks of pregnancy. After that, there is an increased risk of complications and the need for medical care. Misoprostol is used to induce uterine contractions. As a result, the uterus excludes pregnancy. A woman may experience painful cramps, vaginal blood loss more than normal menstruation, diarrhea, vomiting, and nausea. There is a risk of severe bleeding, for the treatment of which you need to consult a doctor.

The probability of a successful abortion with Misoprostol is 90%. Misoprostol in almost all countries is available in pharmacies.

The experience and risk of abortion caused by misoprostol is similar to that of spontaneous miscarriage. Miscarriage occurs spontaneously in 15-20% of all pregnancies. Treatment of complications is the same as for spontaneous abortion (miscarriage). Tactics of treatment will be the same as with spontaneous miscarriage.

Before you make the procedure of medical termination of pregnancy, a woman needs to make sure that there is a pregnancy. It is necessary to do a laboratory test for pregnancy and undergo an ultrasound.

Medical abortion should only be used if the woman is 100% sure that she wants to end the pregnancy. Before you make an abortion, a woman must have an ultrasound, because the ultrasound shows the localization of the pregnancy to make sure that it is uterine and shows the duration (weeks) of the woman’s pregnancy.

This method should not be used after 6 or more weeks of pregnancy have passed.

A six week pregnancy means 42 days (6 weeks) from the last menstrual period. If a woman thinks she is pregnant for more than six weeks, or if the ultrasound shows this, then abortion is not recommended for this method. The drug is still working, but the risk of severe bleeding, serious pain and complications increases with the length of the pregnancy.

Procedure algorithm

First, a woman is examined to determine whether this type of medical abortion is possible. Do not interrupt pregnancy with this method if a woman has one of the following conditions: ectopic pregnancy, polycystic ovary, IUD, use of corticosteroids, impaired adrenal function, anemia, bleeding disorders or the use of anticoagulants, asthma, liver or kidney disease, heart disease, or high arterial pressure. During this procedure, antibiotics should be taken to prevent infection.

Mifepristone is taken during the first visit to the doctor. Mifepristone blocks progesterone, causing destruction of the uterine lining, preventing the possibility of continuing pregnancy.

Misoprostol tablets are taken orally or inserted vaginally 36-72 hours after taking Mifepristone. The pills will cause contractions and force out the fruit. This process usually takes several hours or up to several days.

Two weeks later, a physical examination is performed to complete the abortion and check for complications.

Side effects and risks

Side effects and risks include the following:

  • cramps;
  • nausea;
  • vomiting;
  • diarrhea;
  • severe bleeding;
  • infection.

The procedure is unsuccessful in about 8–10% of cases when an additional surgical abortion procedure is required to complete the abortion.

This method of abortion is contraindicated in the presence of such diseases and conditions:

  • anemia;
  • bleeding disorders:
  • liver disease;
  • kidney disease;
  • convulsive syndrome;
  • acute inflammatory bowel disease;
  • when using intrauterine devices (IUD).

After taking the first dose of misoprostol, the patient should expect bleeding and cramps. Bleeding usually begins within four hours of using the pill, but can sometimes occur later. Bleeding is often the first sign of an abortion. If the abortion continues, the bleeding and cramps become more serious. Bleeding is often more severe than normal menstruation, and there may be clots. The longer the pregnancy, the harder the cramps and bleeding. If the abortion is completed, the bleeding and cramps decrease. The moment of abortion can be seen with the peak of more severe blood loss and pain and cramps.

Bleeding after abortion

Bleeding continues 1–3 weeks after an abortion, but sometimes shorter or longer. The body of each woman is different. The normal menstrual period usually returns after four to six weeks.

Some women bleed without an abortion. Therefore, it is important that the woman is convinced that the abortion actually occurred. It may take two to three weeks before the pregnancy test becomes negative. Therefore, you need to undergo an ultrasound a week after the abortion, to make sure that the pregnancy is over. It is normal that some blood and tissue remain in the uterus after 7-10 days; it will come out with the next menstrual period. As long as there is no fever, pain, heavy bleeding, or vaginal discharge that remains in the uterus, this is not a problem.

Cases when you need to go to the hospital

You need to go to the hospital if:

  1. If there is severe bleeding. Heavy bleeding is considered to be bleeding, which does not stop for 2-3 hours or more, and absorbs more than 2-3 centimeters of sanitary pads per hour. The feeling of dizziness can be a sign of too much blood loss and means that there can be a danger to the health of the woman.
  2. If heavy bleeding does not stop after 2–3 hours, this can be a sign of an incomplete abortion (the fetus remains in the uterus), which needs treatment. This can happen a couple of hours after taking the drugs, but also two weeks after the abortion.
  3. If fever occurs. Chills are a normal side effect of Misoprostol, as well as a slight increase in body temperature. However, if a woman has a fever (> 38 degrees Celsius) for more than 24 hours or her temperature is above 39 degrees, you should see a doctor because an infection can occur as a result of incomplete abortion, and further treatment will be necessary (with antibiotics and / or vacuum aspiration).

If the method did not work

When there was no bleeding at all after taking the medicine, or there was a slight bleeding, but the pregnancy is still continuing, this means that the abortion did not occur. There is a slight increased risk of birth defects, such as deformities of the legs and arms, and problems with the fetal nervous system if the pregnancy continues after attempting an abortion with these medicines. Because of this low risk of birth defects, vacuum aspiration should be performed, if there is no abortion, after taking these medications.

If the abortion was incomplete, the woman may need dilatation and curettage (D & C) or vacuum aspiration, during which the doctor will remove the remaining tissue from the uterus.

After the method

Vomiting and nausea may occur after taking Mifepristone. If vomiting occurs within 1 hour after taking the pill, you should inform the doctor about it soon, as you may need to take the pill again.

The second medication is Misoprostol tablets, which are placed in the vagina. They can be placed in the vagina on their own, or with the help of a medical professional. You need to try to insert them as high in the vagina as possible. Do not worry about the exact position of the tablets in the vagina; it is not important for them to be in a certain place to be effective.

The woman will also be given some antibiotics, pain medications, instructions for use and tips on how to take care of herself.

Misoprostol tablets cause cramps and bleeding in women. This usually starts 2 hours after using Misoprostol, but may start earlier.

Bleeding and cramps usually last for several hours, and the patient will probably need pain relief at this stage.

During an abortion, a woman may see large blood clots or tissue. The fabric will be more and recognizable at higher gestational periods. A 10-week fruit is the size of a large grape, and a woman can recognize its shape. If the patient is worried about what she can see when the abortion is taking place, it is worth discussing this with your doctor.

Most women discontinue the pregnancy within 4 or 5 hours after taking the medicine. For others, it may be faster or take longer. Almost all women abort pregnancy for several days.

It is normal to have bleeding up to 4 weeks after an abortion, it is recommended to use sanitary pads to facilitate the monitoring of bleeding.

Recommendations after medical abortion

In the future, it is recommended to use good contraception to prevent new unwanted pregnancies.

An IUD can be inserted by a doctor as soon as the bleeding is over and a pregnancy test shows a negative result, or when an ultrasound shows no pregnancy. Oral contraceptives can be taken after the bleeding is complete, but they will not be completely safe for the first month. Additional contraceptives should be used, such as condoms for additional protection during the first month.

Watch the video: Off-label use of misoprostol linked to abortion deaths (December 2019).