Sometimes the circumstances in a woman’s life can develop in such a way that pregnancy is undesirable. And then you have to make a decision about its interruption – to have an abortion. The reasons that force a woman to go on abortion are mostly purely individual. For someone, the birth and upbringing of a child is complicated by financial problems, for others – by health problems, or by some other serious reasons. If you decide to have a medical abortion- to take an abortion pill, make sure that you fully understand what you are doing and what side effects and complications this procedure may cause.
Medical abortion (other names: pharmacological, chemical, the phrase “safe abortion” is often used as an advertising course) – is the method of artificial termination of pregnancy in the early stages, which does not require surgical intervention. It is carried out with the help of orally taken medicines (i.e., in the form of pills).
Abortion pill is considered to be the safest for women’s health method of termination of pregnancy in the early stages. Medical abortion is carried out under the strict supervision of a gynecologist during the entire time when a woman takes pharmacological preparations that help to terminate a pregnancy.
The procedure does not require anesthesia and surgical intervention. But keep in mind that it can be done only in the early stages of pregnancy.
Drugs for Medical Abortion
- Mifepristone (also available under the names Mifegyne, Mifeprex, Mifolian, RU-486);
The intake of these drugs after conception has a complex chemical effect on the woman’s organism, leading to the rejection and death of the child.
The fertilized egg in this case is nothing more than a human embryo, which is at the very first stage of its formation. Destruction of the embryo, of course, as in the case of surgical abortion, leads to the termination of pregnancy.
Abortion Pill: The Procedure and Mechanism of Action
During the medical abortion, two drugs are used: Mifepristone and Misoprostol.
Mifepristone, or the “first pill” is taken during the first visit to the doctor or at another agreed time. Mifepristone does not allow the hormone of the yellow body functioning. This, in turn, triggers the abortion process, and also increases the susceptibility of the uterus to misoprostol and softens the cervix. After taking Mifepristone, bleeding or abdominal pain may occur, but not necessarily.
Usually, 36-48 hours after taking the first abortion pill, women take Misoprostol. Misoprostol causes uterine contractions, as well as softens the cervix and promotes its opening. Depending on the facility, the patient remains for several hours under observation or is allowed to go home immediately after the administration of the pills. The effect is manifested (bleeding from the genital organs) as a rule, within 2-6 hours.
As a result of painful contractions of the uterus, caused by the joint action of two drugs, pregnancy leaves the uterus. Bleeding is the main sign of it. It is mostly more plentiful and longer than during menstruation. Bleeding can last for 2-3 weeks.
If bleeding did not start at the beginning of the next day after taking misoprostol, then you should go to the same hospital where pregnancy was terminated again.
Advantages of Medical Abortion
- Safe method of abortion.
- Efficiency is up to 95% with interruption of pregnancy for up to 63 days.
- A cheaper method.
- A more natural process.
- Anesthesia and surgical cleaning of the uterus are not needed.
- Low risk of infertility. Taking pharmacological preparations is absolutely safe for the mucous membrane of the uterus. This significantly reduces the likelihood of further secondary infertility.
- Absence of complications. Unlike surgical termination of pregnancy, which is accompanied by a risk of inflammation and traumatized cervix, the possibility of developing complications after taking pills for early termination of pregnancy is very small.
- Out-patient treatment. The drug interruption is carried out without hospitalization. The body of a woman is very quickly restored. In general, you can return to your usual rhythm of life the next day.
- There may be side effects: nausea, vomiting, fever, pain in the lower abdomen, profuse and prolonged bleeding.
- You may need more visits to the doctor.
- The doctor should confirm that the abortion took place during the re-control.
- Sometimes it can happen that the pregnancy is not terminated.
- Later, there may still be a need for a surgical procedure, but this happens rarely.
Side Effects and Complications of Abortion Pill
When conducting medical abortion in 2-10% of cases, the following side effects and complications are possible:
- chills and an increase in temperature (sometimes to high values), which usually lasts no more than 2 hours;
- general malaise and weakness;
- dizziness, headache, fainting;
- a feeling of discomfort and minor pain, mainly in the lower abdomen, associated with spastic uterine contractions (sometimes, in 5-15% of cases, the pain can be quite intense, requiring analgesic and / or antispasmodics);
- bloating, nausea (in 50%), vomiting (in 30%), diarrhea (in less than 25%);
- allergic reactions in the form of skin rashes (rarely);
- incomplete abortion, due to insufficient effectiveness of drugs – the longer the gestation period, the higher is the risk of incomplete abortion. In this case additional surgical intervention may be required;
- severe bleeding, which is a threat to life;
- damage to the uterus (up to irreversible damage, preventing future conception and bearing of the child);
- development of infectious inflammatory processes;
- severe bleeding, which is a threat to life.
Bleeding is the most serious and dangerous complication. As a rule, this bleeding is more prolonged and pronounced, in comparison with the menstrual flow. At the same time, it does not lead to a decrease in the hemoglobin level of the blood. However, approximately in 0.2-2.6% it can be quite intense. In these cases, it may be necessary to perform anticoagulation reversal, surgical termination of bleeding by performing vacuum aspiration or curettage, transfusion of blood substitutes, blood plasma, and erythrocyte mass.
Absolute contraindications are:
- Individual intolerance to one of the drugs or their components.
- The assumption of the possibility of having an ectopic pregnancy.
- Long-term use of glucocorticoid drugs, due to a certain concomitant pathology, and / or chronic adrenal insufficiency.
- Chronic renal or hepatic insufficiency.
- Hereditary porphyria.
- Severe concomitant extragenital pathology, as well as the presence of glaucoma, arterial hypertension, chronic obstructive pulmonary disease, severe bronchial asthma.
- Hormonal-dependent tumor formations, as well as dysfunction of endocrine glands, including diabetes mellitus.
- Absence of menstruation (with confirmed pregnancy) is more than 63 days. The need for misoprostol and mifepristone with a longer duration of pregnancy requires hospitalization to the gynecological department.
- The presence of significant uterine myomas, which is a risk factor for bleeding.
- The initial hemoglobin content in the blood is less than 100 g / l, which increases the risk of even more severe anemia due to possible blood loss.
- Violations of blood clotting, including the use of anticoagulants and non-steroidal anti-inflammatory drugs, which dramatically increases the risk of hemorrhage.
- Acute inflammatory processes of the female genital area (despite the fact that medical abortion does not increase the risk of developing an ascending infection, nevertheless, simultaneous use of antibacterial agents is desirable).
- Smoking of women over 35 years of age, because they are at risk for cardiovascular disease. Prior to the appointment of the above drugs, it is necessary to conduct an examination by a therapist.
- The period of breastfeeding. It must be canceled for 7 days, counting from the day of taking Mifepristone, and for 5 days – from the day of taking Misoprostol.
- The development of pregnancy on the background of the use of intrauterine contraceptive. Before taking the abortion pill, you must remove the intrauterine device.
- Long-term use of oral hormonal contraceptive drugs, which increase the risk of coagulation disorders. Although this contraindication is relative, nevertheless, a preliminary study of the coagulogram is necessary.
Prevention of Pregnancy After the Procedure
A normal menstrual cycle usually begins 5-6 weeks after taking the abortion pill. However, keep in mind that you can get pregnant even a few days after the abortion. Talk to your doctor in advance about the methods of contraception that you can use after the procedure.