Medical Abortion

1 What is a Medical Abortion?

A procedure which uses medication to end a pregnancy is called medical abortion. A person can have a medical abortion at home or in a medical office or clinics with follow up visits to your doctor after the procedure.

This procedure does not require anesthesia or surgery and is most effective during the first trimester of pregnancy.

Medical abortion is a major decision with psychological and emotional consequences so before doing this be sure that you know and understand the effects, risks, complications and outcomes after the procedure.

2 Reasons for Procedure

If a woman is going to have a medical abortion it is because of personal reasons. They can choose this procedure to end an unwanted pregnancy because you might have mixed feelings about being pregnant or to complete an early miscarriage.

Sometimes women chose this because of financial reasons or because you have a mental health problem meaning you are not capable of taking care of children.

In some cases, women chose medical abortion because they have a condition in which it would be life-threatening if they continue their pregnancy.

3 Potential Risks

Some of the possible risks of medical abortion include:

  • Infection
  • Incomplete abortion that may need to be followed by surgical abortion
  • Heavy and prolonged bleeding
  • An ongoing unwanted pregnancy if the procedure does not work
  • Gastrointestinal discomfort
  • Fever

Before undergoing this procedure you must be sure about your decision because your baby may be at risk of significant birth defects if you continue the pregnancy after taking medications for medical abortion. Unless complications develop, medical abortion will not affect future pregnancies.

This procedure is not an option if you:

  • Have an intrauterine device (IUD).
  • If you have been pregnant for more than nine weeks because some abortion is not done after the 7th week of pregnancy.
  • Have certain medical conditions such as bleeding disorders, severe kidney or liver or lung disease, blood vessel diseases, uncontrolled seizure disorder.
  • Have ectopic pregnancy.
  • Have an allergy to the medications used.
  • Taking blood thinners or steroid medications.
  • Do not have access to emergency care or cannot make follow-up visits.

If you want to end your pregnancy but cannot have a medical abortion, your doctor may recommend surgical abortion.

4 Preparing for your Procedure

To prepare for the medical abortion consult and talk to your doctor first.

If doctor is willing to do it, he will:

  • Evaluate your overall health and medical history.
  • Confirm your pregnancy with a physical exam.
  • Do urine and blood tests.
  • Do an ultrasound exam to date the pregnancy and to confirm that it is not an ectopic pregnancy or not a molar pregnancy.
  • Explain how medical abortion works, the side effects and possible risks and complications.

This procedure is a serious decision so better talk to your partner, family, and friends before undergoing a medical abortion. You can also talk to your spiritual adviser or counselor to discuss the impact of this procedure in your life.

Keep in mind that no doctor is required to perform an abortion and there are certain legal requirements that you need to follow before undergoing this procedure in some states/areas.

5 What to Expect

Here’s what you can expect before, during, and after your medical abortion.

This procedure does not require the use of anesthesia or surgery, you can also do this at home but you need to have follow-up visits with your doctor to check the effectiveness of the treatment and also check for complications. 

Medical abortion can be done using the following medications:

  • Oral mifepristone (Mifeprex) and oral misoprostol (Cytotec) – this is the most common type of medical abortion and mostly taken if you are in your 7th week of pregnancy. The U.S. Food and Drug administration approved this type of regimen. The misoprostol can cause the uterus to contract and expel the embryo through the vagina while the mifepristone can block the hormone progesterone which can lead to the thinning of the lining of the uterus and will prevent the embryo from growing. To make sure that the abortion is complete you need to go to your doctor’s office after 7 days.
  • Oral mifepristone and vaginal, sublingual or buccal misoprostol – the buccal, vaginal or sublingual may be more effective and it will lessen the side effects. This type uses the same drugs but with a slow dissolving tablet placed in your mouth between your teeth and cheek (buccal route), or vagina (vaginal route), or under your tongue (sublingual route). This should be taken if you are in your 9th week after the first day of your last period.
  • Vaginal misoprostol alone – this can promote miscarriage but this is less effective compared to the other types of medical abortion.
  • Methotrexate and vaginal misoprostol – this type is rare but can be used for ectopic pregnancy and usually taken within 7 weeks of the first day of your last period anis given as a shot.

The FDA does not approve the use of methotrexate.

The medications that are used for medical abortion causes abdominal cramping and vaginal bleeding and also:

Your doctor will give you medications so you can manage the effects of these medications of medical abortion, and also antibiotics if there will be an infection. You and your doctor will discuss the pain and bleeding that you will feel because during this time you may not do your normal activities.

The possible symptoms that you should look out for after a medical abortion are:

  • Severe back or abdominal pain.
  • Heavy bleeding such as using two or more sanitary pads in an hour.
  • Foul smelling vaginal discharge.
  • Fever higher than 100.4 F (38 C) or if you have a fever lasting than 24 hours.

You may still be pregnant or the abortion is incomplete if you vaginal bleeding does not begin within 48 hours after treatment. If this happens a surgical abortion may be suggested by your doctor.

After the treatment, your doctor will check if you are healing properly and will check your uterine size, and will also check for infections. After the abortion does not use tampons or have vaginal intercourse for two weeks to reduce the risk of infection.

You may ask for a recommendation from your doctor if you want to talk to a counselor after the abortion as you might feel sad, guilty, loss or relieved. Talk to your doctor about contraceptives as soon as the medical abortion is complete so you can prevent pregnancy.

6 Procedure Results

The result of medical abortion may be complete or you may have some minor complications. The most common emotion is a relief.

The possible complications include:

  • Infection, Excessive bleeding, and Cervical damage
  • Hemorrhage
  • Ripping off the uterus or Convulsion
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