|
What
is "Abortion by Pill"?
Definition of Medical
Abortion
A
medical abortion is one that is brought about by taking medications
that will end a pregnancy by inducing a miscarriage. The alternative
is surgical abortion, which ends a pregnancy by emptying the uterus
(or womb) with special instruments and a vacuum device. A medical
abortion is done without entering the uterus. Mifeprex, a new
medication approved by the Food and Drug Administration (FDA)
for pregnancy termination, can be used for medical abortion.
Mifeprex, a non-invasive
early option pill is taken orally and allows you to avoid anesthesia
and surgery in most cases. This medication, taken together with
another medication, misoprostol, and will end a pregnancy in
a high percentage of instances. Termination is accomplished
in 95% of the patients who are 7 weeks LMP or less.
Determination of
Length of Pregnancy
Before any abortion can be done, a medical professional must
confirm that a woman is indeed pregnant and determine exactly
how long she has been pregnant. The length of a pregnancy is usually
measured by the number of days that have passed since the first
day of the woman's last menstrual period (abbreviated as LMP)
using ultrasound. Medical abortions can be performed as early
as a pregnancy can be confirmed. In fact, the shorter the time
that a woman has been pregnant, the better the medications will
work. Because they do not work as well later in pregnancy, medical
abortion is not usually an option after seven weeks (or 49 days)
LMP. After that, surgical abortion is the safest and best option.
How the Medications Work
Mifeprex:
taken orally blocks a hormone needed to maintain pregnancy.
When followed by Misoprostol, Mifeprex ends pregnancy.
Misoprostol:
2 days after taking Mifeprex , a second drug, Misoprostol is
taken orally. The Misoprostol causes the uterus to contract
and empty its contents. This ends the pregnancy.
This step is repeated on day 5.
How Long Do Medical
Abortions Take?
Medical
abortion can take anywhere from 3 to 4 days bur bleeding and spotting
usually last about 9-16 days. Medical Abortion requires two visits
to the clinic or medical office. An initial visit and a return
visit which is very important since there is no other way to be
sure that the abortion has been completed. With the Mifeprex /
misoprostol combination, 95 % of women will abort within 4 days.
A small number of women who try medical abortion will need to
have a surgical abortion because of heavy bleeding or because
the medication does not work for her .
During and After
a Medical Abortion
Step 1
A clinician or counselor will explain the process to you
and answer all your questions. A doctor will review your medical
history, do a pregnancy test, an ultrasound, blood work, a urinalysis
and a physical exam. You will read and sign an informed consent.
After that the doctor will give you the medication to take.
You may have some bleeding after this first medication, but
very few women will have a complete abortion before using the
second medication.
Step 2
Two days later at home, you will take 4 tablets. Within
a few hours you will probably start to have strong cramps and
bleeding more than with your period. You may pass some blood
clots. pain medication and a heating pad can help with the cramps.
You may also have nausea, vomiting, diarrhea, fever, chills
or feel tired. These symptoms usually last a short time and
stop on their own. If you soak more than two maxi pads per hour
for two hours in a row, you should call us.
Step 3
Two days later you will take another 4 Misoprostol.
Step 4
It is very important to come back to the office in two weeks
to make sure that the abortion is complete. At that time you
will have another pregnancy test and an ultrasound. A small
number of women , even if they have had bleeding, may need to
use more misoprostol or wait several more days or rarely, a
few weeks for the abortion to be complete. If the pregnancy
is still growing, surgical abortion is strongly advised because
the medicine can cause birth defects. The doctor or counselor
will talk to you about birth control methods to use once your
abortion is complete
The most common side
effects of medical abortion are caused by misoprostol, the medication
taken after the Mifrprex. The side effects may include: cramps
similar to those with a heavy menstrual period, headache, nausea,
vomiting, diarrhea, and heavy bleeding.
The amount of bleeding
that a woman has will be greater with medical abortion than
with surgical abortion. Most women have cramps for several hours,
and many pass blood clots as they are aborting. In some cases,
the blood clots will be larger than the embryo and other tissue
from the pregnancy which will also be passed. The embryo will
probably not be seen among the blood clots. For example, at
49 days LMP, the size of the embryo will be about one-fifth
of an inch. In an earlier pregnancy, it might be much smaller
than that. Cramps and bleeding usually begin to ease after the
embryonic tissue has been passed, but bleeding may last for
a week or more after medical abortion.
Women report that
their first regular menstrual penod usually occurs 4 to 8 weeks
after a medical abortion and may be heavier, or longer, or in
some other way different from normal for them. By the second
period after the medical abortion, their cycles should be back
to normal.
Possible Complications
Medical
abortion is irreversible once the mifrprex has been taken. . If
the pregnancy is not expelled after using these medications, a
suction procedure (surgical abortion) must be done to empty the
uterus and complete the abortion
The most common immediate
complication of a medical abortion is heavy bleeding. For this
reason, a woman must have access to a telephone and transportation
in case emergency treatment is needed. In rare cases, a woman
will need an emergency D & C or a blood transfusion to stop
the bleeding.
There do not appear
to be any long-term complications associated with use of these
drugs to induce a medical abortion.
Follow-up Care
Because
there is no way to know for sure that the abortion is complete
without an examination by a health care professional, keeping
appointments with the clinic for follow-up care is very important!
In addition, a woman must report any problems she has during the
medical abortion to a health care professional.
|
