Medical Abortion
Abortion is defined as an interruption or threat to interruption of a pregnancy. Abortions can either be spontaneous or induced. We will concern with the induced abortions in this articles.
There are many possible reasons why women would want to abort their pregnancy. Maybe they are not in the right position emotionally or financially to care for the child. Some women may have serious medical or mental health problems which necessitate abortion. Many times it is un planned or out of wed lock. Whatever be the reason for abortion it is important that pregnancy be terminated in a safe and secure manner. The earliest methods of termination of pregnancy involved use of sticks to irritate the uterus to expel the fetus. Sometimes these sticks were smeared with chemical like castor oil to increase efficacy. However most of these earlier methods were crude and unsafe. With advent of modern concepts of asepsis and anaesthesia abortion became a surgical procedure and it remained within the realm of the surgeon till the last few years when it has become possible to induce abortion with drugs.
The induction of abortion with drugs is called as medical abortion and it has become popular over a short period of time. The major advantages of medical abortion are:
- It can be done either in the doctor’s office or home, thus it affords a lot of privacy
- There is no requirement to check into a hospital
- There is no anaesthesia or surgery involved
On the other hand medical abortion is not without its risks. The potential risks include incomplete abortion, heavy bleeding, infection and damage to the uterus. Apart from this medical abortion is only an option in early pregnancy within nine weeks since the missed period. Other than this if you smoke excessively or take a blood thinner or steroid or suffer from serious medical disorders, then you may not be suitable for medical abortion.
Before you undergo medical abortion, a doctor should evaluate your suitability for it> A doctor is likely to take a history of you periods. Ensure to give the correct date of your missed period. The doctor will also do a pelvic exam to estimate the size of the uterus. And lastly you will need to undergo an ultrasound exam and few blood tests.
There are three common drugs used for medical abortion.
- Mifepristone
- Misoprostol
- Methotrexate
The commonest regimen used is a combination of oral mifepristone and misoprostol. Mifepristone is anti progesterone which thins the lining of the uterus and causes abortion. Misoprostol induces contraction of the uterus to expel the foetus. Many other regimens are used like oral mifepristone with vaginal misoprostol and injections of methotrexate and oral misoprostol.
Vaginal bleeding should start within 48 hours of taking the medicines. Bleeding may be heavy and also be associated with cramping pain in the lower abdomen and back. The doctor would have prescribed painkillers for this. Sometimes you may be able to see the expelled products of conception. Once the abortion is complete you will again have to be examined by a doctor to ensure that the abortion is complete. The doctor will once again do a pelvic exam and ultrasound to determine this.
The medicines used to induce abortion have side effects and common amongst them are
- Nausea
- Vomiting
- Fever
- Chills
- Diarrhea
Apart from this they may also cause allergic reactions in some women. There are some warning signs which should alert women that things are going wrong. If anybody should have the following symptoms then they should immediately consult their doctor:
- Heavy bleeding — soaking two pads an hour for two hours and still bleeding
- Severe abdominal or back pain
- Fever higher than 100.4 F (38 C) or lasting more than 24 hours
- Foul-smelling vaginal discharge
Normal menstruation will start within four to six weeks after medical abortion. Women should bear in mind that they can get pregnant even before they their first period and hence must use contraception. It is also not advisable to use tampons or vaginal intercourse for a couple of weeks after a medical abortion.
After the abortion you may feel a range of emotions. It may range for relief to sadness to despair. If you find these emotional changes distressing you should consult a counsellor to help you deal with these problems.