Definition: A medical abortion is the use of certain medications to end a pregnancy. The drugs help remove the fetus and placenta from the mother's womb (uterus). There are different types of medical abortion. Sometimes the woman has one for a health reason. This is called a therapeutic medical abortion. Other times, she chooses (elects) to end the pregnancy. This is called an elective medical abortion. See also:
Alternative Names: Therapeutic medical abortion; Elective medical abortion; Induced abortion
Description: A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last menstrual period. A combination of prescription hormone medicines are used to help the body remove the fetus and placenta tissue. The doctor may give you the medicines after performing a physical exam and asking questions about your medical history. Medications used to end an early pregnancy include mifepristone, methotrexate, misoprostol, prostaglandins, or a combination of these medications. Most women who use medication do so because of a desire to avoid anesthesia and surgery.
Why the Procedure Is Performed: There are several reasons a medical abortion might be considered: - The developing baby has a birth defect or genetic problem
- The pregnancy is harmful to the woman's health (therapeutic abortion)
- The pregnancy resulted after a traumatic event such as rape or incest
- The woman may not wish to be pregnant (elective abortion)
The decision to end a pregnancy is very personal. Most health care providers recommend careful counseling before making such a decision. Abortion is a controversial issue. A woman who chooses to end a pregnancy may feel she cannot share her decision with others. Therefore, it is important for her to identify those who may help her through what may be a difficult time. Women who are trying to make this difficult decision should find a safe place in which they can obtain counseling regarding all options for pregnancy resolution. If a woman chooses to have an abortion, she should find a safe place to have the procedure performed and obtain the proper support and follow-up care afterwards.
Risks: Risks of medical (nonsurgical) abortion include: - Continued bleeding
- Diarrhea
- Fetus not passing completely from body, making surgery necessary
- Nausea
- Pain
- Vomiting
Before the Procedure: A pelvic examination is performed to confirm the pregnancy and estimate how many weeks pregnant you are. A HCG blood test may be done to confirm the pregnancy. A vaginal or abdominal ultrasound may be done to determine the exact age of the fetus and its location in the womb.
After the Procedure: Physical recovery usually occurs within a few days, depending on the stage of the pregnancy. A small amount of vaginal bleeding and mild uterine cramping should be expected for a few days. A hot bath or use of a heating pad or hot water bottle on the abdomen may help relieve discomfort. Strenuous activity should be avoided for a few days. Tampons may be used after 3 days. Sexual intercourse should be avoided for 2 to 3 weeks. A normal menstrual period should occur in about 4 to 6 weeks. It's important to begin using birth control immediately after the abortion procedure. It is possible to get pregnant again even before having a normal menstrual period. Improved methods of contraception can help prevent many unplanned pregnancies. However, unplanned pregnancies occur even when couples use birth control.
Outlook (Prognosis): Complications rarely occur. Women who have a medical abortion have cramping and bleeding, and pass the pregnancy-related tissue as though they were having a miscarriage. Some women feel ambivalent about ending a pregnancy, and may need psychological and emotional support. It's important to seek counseling before making this very difficult decision.
References: ACOG. Clinical management guidelines of obstetrician-gynecologists. Medical management of abortion. Obstet Gynecol. 2005 Oct;106(4):871-82. Mischell DR. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 14. Simpson JL, Jauniaux ERM. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 24. Annas GJ, Elias S. Legal and ethical issues in obstetric practice. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2007:chap 51.
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