testing

Why is medical abortion done?

Medical abortions are performed for a variety of reasons. It is an option for completing an early miscarriage or terminating an undesirable pregnancy. Medical abortion is also considered if the expecting mother has a medical condition that makes continuing a pregnancy life-threatening.

What is the procedure of medical abortion?

The following drugs can be used to perform a medical abortion:

1. Oral mifepristone (Mifeprex) and oral misoprostol (Cytotec)

   These are the most prevalent types of medical abortion drugs. These drugs should be taken within seven weeks of the last period's first day. Mifepristone inhibits progesterone production, causing the uterine lining to thin and the embryo to get implanted and grow. Another type of drug, misoprostol, causes the uterus to contract and the embryo to be expelled through the vaginal canal.

2. Oral mifepristone and vaginal, buccal or sublingual misoprostol

   The same medications as the previous procedure are used, but a slowly dissolving misoprostol tablet is put in the vagina (vaginal route), in the mouth between the teeth and cheek (buccal route), or under the tongue for this type of medical abortion (sublingual route).

   Side effects are reduced, and the vaginal, buccal, or sublingual route may be more successful. These pills must be taken between nine weeks of the last period's beginning day.

3. Methotrexate and vaginal misoprostol

   Methotrexate (Otrexup, Rasuvo, and other brands) is rarely used for unplanned pregnancies. However, it is still used for pregnancies outside the uterus (ectopic pregnancies). This type of medical abortion must be done within seven weeks of the last menstrual period, and methotrexate treatment can last up to a month. Misoprostol is used at home after methotrexate is given as an injection or vaginally.

4. Vaginal misoprostol alone

   When taken before the embryo reaches nine weeks of gestation, vaginal misoprostol alone can be effective. However, vaginal misoprostol is less effective than other medical abortion methods.

What are the possible risks of having a medical abortion?

Medical abortion carries the following risks:

• Incomplete abortion may need to be followed up with a surgical abortion
• If the operation fails, an undesired pregnancy will continue.
• Bleeding that is both heavy and prolonged
• Infection
• Fever
• Discomfort in the digestive system

Unless difficulties arise, medical abortion has not been demonstrated to harm future pregnancies.

If the expecting patient falls under the following criteria, medical abortion is not an option:

• The patient has reached the end of the pregnancy. If the pregnancy is for more than nine weeks, the woman shouldn't try to have a medical abortion (after the start of the last period). After seven weeks of pregnancy, some methods of medical abortion are not performed.
• Have a contraceptive device implanted in the uterus (IUD).
• Discovered a pregnancy outside of the uterus (Ectopic pregnancy).
• Having medical conditions like bleeding disorders, certain heart or blood vessel diseases, severe liver, kidney, or lung disease, or an uncontrollable seizure disorder.
• Having blood-thinners or steroid drugs.
• The expecting patient cannot return to the doctor for follow-up appointments or does not have access to emergency treatment.
• Have an allergy to the drugs that are being utilized.

For women who are unable to have a medical abortion, a surgical procedure known as dilation and curettage (D&C) may be a possibility.

What is medical abortion?

Medical abortion is a non-surgical method of terminating a pregnancy through medication. As they don't require any surgery or anesthesia, they can be performed in a doctor's office or at home, with follow-up visits to the doctor. It is the safest and most effective during the first trimester of pregnancy.

It is 95-98 per cent effective in clinical practice and involves at least two to three visits to the doctor's clinic for confirming the pregnancy, for medication, and to ensure the termination of the pregnancy. The medication can also be taken at home with a doctor's advice.

What can you expect during post-surgical care for medical abortion?

Following a medical abortion, the patient may have the following signs and symptoms, which may necessitate medical attention:

• Heavy bleeding – soak two or more pads for two hours at a time.
• Severe abdominal or back discomfort
• Fever that lasts more than 24 hours
• Vaginal discharge with a foul odour

The patient will need to see the doctor again after a medical abortion to make sure she is healing properly and to assess the uterine size, bleeding, and any signs of infection. Do not have vaginal intercourse or use tampons for two weeks following the abortion to avoid the risk of infection.

The doctor will probably question:

• If the patient is still pregnant
• If the patient noticed the gestational sac or embryo is expelled
• How much bleeding was experienced
• If the patient is still bleeding

The patient may need an ultrasound and potentially a surgical abortion if the doctor detects an incomplete abortion or a continued pregnancy.

The woman will probably feel a mix of feelings after a medical abortion, including relief, grief, sadness, and guilt. These emotions are common, and it might be beneficial to discuss them with a counsellor.