Medical termination of pregnancy (abortion) is a procedure that uses prescription drugs to terminate a pregnancy in its early stages. A combination of two drugs, mifepristone and misoprostol, is most commonly prescribed. Mifepristone blocks progesterone, a hormone necessary for maintaining pregnancy. Misoprostol causes spasms and bleeding.
When can medical abortion be performed?
Medical abortion at the woman's request is permitted up to 9 weeks of pregnancy (8 weeks and 6 days) when there are no contraindications and the woman has signed all the necessary documents.
Detailed information about medical abortion
How should I prepare for a medical termination of pregnancy?
Your doctor will provide specific instructions on how to best prepare. It is recommended that you avoid taking aspirin, anti-inflammatory drugs, or anticoagulants for one week prior to the procedure, as these may increase the risk of bleeding. Preparation may also include:
- Confirmation of pregnancy;
- Laboratory blood and urine tests;
- Ultrasound examination to determine the duration of pregnancy;
- For patients with a negative Rhesus D factor, anti-D immunoprophylaxis is prescribed within 72 hours;
- Discussion of the procedure, risks, and side effects.
What happens during a medical abortion?
A medical abortion involves taking pills by mouth or vaginally. First, you will take mifepristone to terminate the pregnancy. Then you will take misoprostol to cause uterine contractions and bleeding.
- Mifepristone works by blocking progesterone. Without progesterone, the pregnancy stops developing.
- Misoprostol causes uterine contractions, bleeding, and termination of the pregnancy. This medicine comes in tablet form, which you can take by mouth or in the vagina. Misoprostol taken by mouth should be taken 24 to 48 hours after taking mifepristone. Misoprostol inserted into the vagina can be taken 0 to 48 hours after taking mifepristone.
Most people begin to feel the effects of the medication shortly after taking the second tablet (misoprostol). You can expect:
- Bleeding and cramping, which begins 1-4 hours after taking the second tablet;
- Severe cramping and bleeding with blood clots within a few hours;
- A slight fever or chills that lasts for about one day after taking the second pill;
- Some people may experience fatigue, nausea, diarrhea, or dizziness.
What happens after medical termination of pregnancy?
Bleeding usually occurs a few hours after taking the second pill, followed by menstrual-like bleeding for several days, and slight bleeding may continue for several weeks. A follow-up consultation with an obstetrician-gynecologist is recommended 7-14 days after medical termination of pregnancy. During the consultation, the obstetrician-gynecologist will assess the woman's health and confirm that the pregnancy has been successfully terminated. If the pregnancy continues, the obstetrician-gynecologist will schedule a date and time for a repeat termination.
FAQs about medical abortion
How long does medical abortion take?
Medical abortion takes about 2-6 hours after taking the second pill, but in some cases it may take longer. During this period, a gentle regimen is recommended.
Is the pain of medical abortion similar to labor pain?
Medical abortion is most similar to severe menstrual cramps. The intensity and severity of pain varies from person to person. If you experience severe pain, medication for pain relief is recommended.
How long can you bleed after a medical abortion?
The intensity of bleeding varies from person to person. It also depends on the length of the pregnancy. Bleeding will be heavier for one or two days. Bleeding usually decreases within two to three weeks.
What happens during the follow-up visit after a medical abortion?
A follow-up visit with your obstetrician-gynecologist is recommended 7-14 days after a medical abortion. Your obstetrician-gynecologist may ask you to take a pregnancy test, have laboratory tests, or undergo an ultrasound examination to confirm that the pregnancy has been successfully terminated. If the pregnancy continues, the obstetrician-gynecologist will schedule a date and time for a repeat termination of pregnancy.
What are the advantages of medical termination of pregnancy?
- You can terminate the pregnancy at an early stage;
- Termination of pregnancy may seem more natural;
- No surgical intervention is required;
- No hospitalisation is required, you can stay at home.
What are the side effects of medical abortion?
- Unsuccessful abortion or remaining pregnancy tissue;
- Heavy bleeding that does not stop;
- Diarrhea and digestive problems;
- Allergic reaction to medication;
- Infection (symptoms to watch for: unpleasant vaginal odor and fever lasting longer than 24–48 hours).
When is medical abortion not recommended?
- The pregnancy is too advanced;
- You are allergic to the medications used;
- Ectopic pregnancy;
- Long-term use of glucocorticoids;
- Blood clotting disorders;
- Severe anemia;
- Chronic adrenal insufficiency;
- You do not have access to emergency care.
How effective is medical abortion?
When using a combination of mifepristone and misoprostol, it is about 98% effective. It is a safe and effective way to terminate a pregnancy.
How long after a medical abortion can I have sex?
After a medical abortion, wait at least 2-3 weeks before having sex. This will help prevent vaginal infections.
When can I get pregnant again after a medical abortion?
Your normal menstrual cycle should return within 4-6 weeks after the procedure, although your first menstrual cycle may be slightly irregular due to hormonal changes related to the procedure.
When should I see a doctor after the procedure?
- No bleeding 24 hours after taking misoprostol;
- Heavy bleeding;
- Signs of infection (fever lasting longer than 24 hours and unpleasant-smelling vaginal discharge);
- Severe abdominal or back pain;
- No menstruation after two months;
- You have symptoms of pregnancy.
