Medical abortion

Pregnancy, unfortunately, is not always good news for a woman. According to statistics, about a quarter of all pregnancies in Ukraine are unplanned. Today, medical abortion is one of the methods of terminating a pregnancy for up to 9 weeks (63 days), based on taking drugs that interfere with its normal development. Medical abortion usually consists of several stages. At the first stage, a woman takes a pill that blocks the production of a hormone necessary for the continuation of pregnancy. Then, 24-48 hours later, a second medication is administered to help remove the contents of the uterus. It would seem that the procedure is as simple as possible - you just need to take the pill. That is why many women mistakenly believe that they can perform the procedure on their own. In fact, to ensure that the impact on the body is as safe as possible, the procedure should be performed under medical supervision.

Dobrobut medical centers do not provide medical abortion services. If necessary, we provide medical abortion services, which means termination of pregnancy with surgical intervention. To make an appointment for a consultation with an obstetrician-gynecologist, call our contact center.

Features of the procedure

Medical termination of pregnancy does not require surgical intervention and a long recovery period.

The features of the procedure are:

• the ability to terminate a pregnancy at an early stage, up to 9 weeks (63 days after the date of the last menstruation);
• the need for minimal preliminary preparation;
• lack of surgery and the need for anesthesia;
• low risk of infection, formation of adhesions, obstruction of the fallopian tubes, and, as a result, infertility;
• suitable for previously nulliparous women;
• fast restoration of the normal cycle;
• psychologically tolerated by the patient is easier than surgical termination of pregnancy.

Contraindications

Medical abortion has its contraindications, such as:

• pregnancy over 9 weeks or 63 days (after the start of the last menstrual period). Some types of medical abortion should not be done after seven weeks of pregnancy;
• the presence of an intrauterine device (IUD);
• some medical condition, such as a blood clotting disorder, heart or blood vessel disease, severe liver, kidney, or lung disease; 
• suspicion of ectopic pregnancy;
• if the woman is taking blood thinners or certain steroid medications on an ongoing basis;
• subject to the impossibility of visiting a doctor or receiving emergency care;
• the presence of an allergic reaction to the medications used.

Preparing for the procedure

The preparation process for medical abortion includes some diagnostic procedures. First of all, a consultation with a gynecologist is necessary, during which the doctor will collect a detailed history, clarify complaints, the presence of chronic diseases, conduct a gynecological examination and prescribe further diagnostic measures. The usual routine examinations before a medical abortion are bacterioscopy of the vaginal smear, ultrasound of the pelvic organs, and a blood test for beta-hCG. In some cases, a specialist may additionally prescribe a coagulogram, ECG, etc.

A few days before the procedure, it is recommended to give up alcohol, avoid stress and heavy physical exertion.

How is the procedure going?

The process of medical abortion involves taking drugs of two groups: the first drug blocks the production of the hormone "pregnancy" - progesterone, which leads to the cessation of the growth of the endometrium, and as a result, the termination of pregnancy. The second drug causes uterine contractions and promotes the expulsion of the embryo from the uterine cavity as a "miscarriage". The procedure consists of the following steps:

• on the first day, under the supervision of a doctor, a woman takes the drug of the first group, after which she either goes home or remains in the medical center;
• at the second stage, after 24-48 hours, the introduction of the drug of the second group is shown. It is possible to use both oral and vaginal forms of the drug.
• Both stages of taking medication should be carried out in the presence of a doctor. To exclude the development of undesirable consequences, a woman should be under the supervision of medical personnel for another two hours.
• within 4-6 hours after taking the second medicine, the lining of the uterus collapses, causing contractions and bleeding.

The normal symptoms that most women experience after a medical abortion include:

• Painful sensations and spasms - begin a few hours after taking the second medicine. To relieve pain, a specialist may prescribe pain medications.
• Bleeding - This can range from mild bleeding to heavy bleeding with blood clots and pregnancy tissue. The duration of bleeding can also vary - in many women, the bleeding lasts up to 14 days.
• Headaches, nausea, or vomiting, which may be accompanied by chills and/or hot flashes.
• Emotional reactions lasting 2–3 weeks, often influenced by changes in pregnancy hormones. It is normal to experience one or more emotions, such as relief, guilt, sadness, or grief.
• On the 10-14th day after the medical abortion procedure, a control ultrasound of the pelvic organs is shown to evaluate the results.

Recommendations after medical abortion

To reduce the risk of complications, within a few weeks after the procedure, the woman is recommended:

• do not use tampons and menstrual cups, replace them with sanitary pads;
• avoid doing any heavy load, including sports or physical work; 
• exclude sexual intercourse;
• choose a method of contraception to avoid an early new pregnancy;
• do not visit baths and saunas.

Bibliography

1. Sarah Marshall, Adam Husney - Medical Abortion Care | Michigan Medicine. Published online October 8, 2020.
2. The Abortion Pill | Get the Facts About Medication Abortion. Last updated 2021.
3. Medical abortion - Mayo Clinic Published online. May 14, 2020.