For more than 25 years, the possibility exists of non-surgical interruption of unwanted pregnancy. The use of special drugs can make an abortion even in the very early stages of pregnancy. What are the advantages and disadvantages of medical abortion?
What is a medical abortion: a brief description of the procedure
Medical abortion (or abortion without surgery) is the termination of an unwanted pregnancy without surgery, but with the help of special drugs.
The idea of termination of pregnancy with the help of medicines was long nurtured by doctors and scientists, but it was only in the 70s of the last century that there was a real opportunity to do this effectively and relatively safe for a woman. At that time, a drug substance mifepristone was developed in France, which is an antiprogestin. In the early 1980s, large-scale studies of mifepristone as an abortion drug began in Geneva, and already in the late 1980s, the method of medical abortion of unwanted pregnancies using mifepristone, prostaglandins and other drugs began to be applied in France.
As shown by social and medical studies conducted in Europe, women prefer medical abortion for various reasons. On the one hand, there is a fear of surgery. And secondly, medical abortion is easier to hide from loved ones if a woman does not want her relatives or friends to learn about this procedure.
What are the main benefits of medical abortion over surgical?
In addition to the absence of the need for surgical intervention and the ability to hide the abortion from their loved ones, medical abortion does have many advantages, including:
- Medical abortion can be performed at the earliest possible stages of pregnancy: from the first day of menstruation and up to 6-7 weeks. At this time, the ovum is still poorly attached to the uterus, and pronounced hormonal changes are not yet observed. After a prescribed period, the effectiveness of medical abortion is markedly reduced. Termination of pregnancy at very early stages allows to minimize the hormonal stress for the body.
- When medical abortion eliminates the risk of infection, the development of adhesive processes, injuries of the uterine cavity, the development of endometritis and other gynecological complications that take place during surgical abortion.
- Medical abortion is a painless procedure (especially for women who have given birth). In women who have not given birth, there may be a slight pain that does not require anesthesia.
- Eliminates the risk of contracting severe viral diseases (for example, hepatitis or HIV).
- Eliminates the risk of secondary infertility.
- Medical abortion is very similar to heavy menstruation, and the woman psychologically perceives it as a natural process.
- For a medical abortion, a woman does not need to go to the inpatient department.
- Medical abortion is also suitable for women at a young age who are forced to end an unwanted pregnancy.
How is a medical abortion – a description of the procedure
Medical abortion is a procedure that must necessarily take place under the supervision of a physician after all necessary examinations. Medical abortion takes place in several stages, including:
- Preliminary inspection. After pregnancy is detected, the woman is sent for a consultation with a gynecologist for a preliminary examination. The doctor examines the patient, carries out an ultrasound scan to determine the duration of the pregnancy and to establish the fact that the fetus develops in the uterus. Then the patient must confirm the desire to terminate the pregnancy and sign the relevant documents.
- Analyzes After the establishment of the pregnancy, the woman should undergo blood tests (for blood type, Rh factor), Wasserman reaction and a smear for flora. If tests are normal, and there are no contraindications, then the doctor gives the woman to take the drug (usually 3 tablets of 200 mg). 2 hours before and 2 hours after taking mifepristone can not eat.
- The second visit to the doctor after 36-48 hours after taking the drug. The next stage of medical abortion is the expulsion of the ovum from the uterus. To do this, women give out prostaglandins and clearly instruct about all the possible sensations that may arise when the fetus is expelled from the uterus. As a rule, during 24 hours a woman is asked to stay in the clinic to monitor her condition. Sometimes a woman is allowed to go home on the condition that she will strictly adhere to all recommendations, and in case of occurrence of severe pains, she will definitely contact the doctor in charge or accept approved painkillers.
- The first control ultrasound. After 3 days after taking the drug, the woman should appear on the first control ultrasound. In the case when in the uterus remains of the ovum are detected, the doctor decides how to proceed.
- The second control ultrasound and inspection. The second time a woman should come for a re-examination after 7-14 days after taking the drug (the doctor will inform you about the timing exactly). If necessary, the doctor directs to conduct various tests, in particular, the determination of human chorionic gonadotropin.
Medical abortion: periods of pregnancy at which it is permissible to terminate a pregnancy
Medical abortion can be performed up to 42-49 days from the first day of the last menstruation. The effectiveness of medical abortion increases when it is conducted in the early stages. After the allotted 42-49 days, the effectiveness of drug-induced abortion is markedly reduced, which may necessitate the use of other methods of abortion (vacuum aspiration, surgical abortion).
After taking mifepristone after 36-48 hours, the woman should take prostaglandins. Then after 3 days you need to appear at the control examination. Another examination takes place 7–14 days after taking mifepristone.
Consequences of medical abortion
What happens during a medical abortion? After taking 600 mg of mifepristone, a process aimed at the death of the fetus is started. Mifepristone binds to progesterone receptors, thereby blocking the action of a hormone that stimulates endometrial growth. In this case, the woman recovers the sensitivity of the myometrium to the hormone oxytocin. Myometrium begins to decline strongly, which leads to abortion.
After 36-48 hours after taking mifepristone, a woman takes prostaglandins, under the action of which the uterus begins to shrink strongly, which leads to the expulsion of the fetus from its cavity.
Complications of Medical Abortion
Medical abortion is considered the safest method of abortion, and at the same time it is not without flaws. In particular, when taking medications (especially large doses of prostaglandins), there may be adverse reactions, among which most often the following occur:
- Pain sensations. With medical abortion, various pain sensations that require pain relief are possible. In this case, everything will depend on the characteristics of the woman’s body, her emotional state and the threshold of pain sensitivity. Beforehand, the doctor will tell the woman about possible painful sensations and recommend antispasmodics and analgesics. To take their own drugs is strictly not recommended.
- Nausea and vomiting. Such symptoms can be caused by the pregnancy itself, which causes toxicosis. However, prostaglandins prescribed by a doctor can also cause nausea and vomiting. As a rule, such side effects are extremely rare. They pass independently, but in some cases the use of antiemetic drugs is permissible.
- Heat. In some cases, prostaglandins, assigned to a woman to enhance the contractile activity of the uterus, contribute to an increase in body temperature. As a rule, the temperature does not rise above 38 degrees and lasts for several hours. If the high temperature lasts more than 4 hours, then, as a rule, it is not associated with medication, but rather is the result of an infectious-inflammatory process. These symptoms should be told to your doctor. May require special treatment.
- Diarrhea – occurs relatively often, but is of a short-term nature and does not require the use of antidiarrheal drugs.
- Heavy bleeding. As with menstruation, medical abortion is accompanied by heavy bleeding. Severe bleeding is possible in cases where a woman has problems with blood clotting.
- Hematometer This is an accumulation of blood clots in the uterine cavity, which may occur after medical abortion. Such a condition develops due to a spasm of the cervix of the uterus, and the hematometer can be removed with the help of medications prescribed by a doctor.
Contraindications for medical abortion
There are some circumstances in which medical abortion is contraindicated:
- chronic adrenal insufficiency;
- long-term use of glucocorticoids;
- acute inflammatory diseases of the female genital organs;
- myoma of the uterus of impressive size;
- bleeding disorders;
- extragenital pathology of severe forms;
- ectopic pregnancy.
After medical abortion
Immediately after a medical abortion, a woman should start using contraceptives, since subsequent pregnancy may occur even before the appearance of menstruation.
It should be borne in mind that in very rare cases, after a medical abortion, pregnancy is not interrupted. And if the woman then decided not to interrupt the pregnancy, then she must understand that the fetus may have some congenital abnormalities while taking medication for medical abortion. In particular, there are cases of teratogenic effects of prostaglandins on the fetus. According to statistics, there are 10 congenital defects per 1,000 births after a failed medical abortion.