Medical abortion during the initial trimester, also called as non-surgical abortion employs medications for terminating an early pregnancy in the confines of one’s home. This is a choice that could be availed till 9 weeks from the last occurred menstrual cycle. Some populace of women opt for medical instead of surgical abortion due to the below stated reasons:

• Could be done at home in the initial weeks of pregnancy.
• Needs no surgical intervention.
• No requirement of anesthesia.
• There is likelihood of greater confidentiality.
• Could proffer some women with a feeling of better control over their body.
• Could feel more innate.

There are other women who opt for surgical abortion due to the below stated aspects:

• Needs lesser visits to the doctor’s clinic.
• Requires lesser periods of time.
• Comparatively lesser risk of an unfinished procedure.
• No serious bleeding at home.

Specialists must be consulted prior to going in for either a medical or surgical abortion. Medicines employed for carrying out medical abortion are mifepristone and misoprostol. Medical abortion must not be confused with emergency contraception (EC), also called the ‘morning-after pill’.

Emergency contraception or EC is the utilisation of hormones for averting pregnancy. However, once pregnancy has taken place then EC is no more an option in that scenario.

A medical abortion would necessitate at least 2 trips to the doctor’s clinic. Seldom, further blood tests might be needed for confirming a plummet in the pregnancy hormone.

Medical abortion has an efficacy rate of 95-98% in totally terminating the pregnancy with no requirement of uterine aspiration to conduct the procedure. Comparatively, uterine aspiration is nearly 98% effectual during the initial time.

Special Conditions

When one calls the doctor’s clinic for scheduling an appointment for a medical abortion, one would be queried by the practice associate to ensure that medical abortion is the appropriate choice.

Those opting for medical abortion must take careful note of the following:

• Having someone for assistance and support for the whole day when one inserts the medication into one’s vagina.
• In case one is tending to a child or young infants, then they need to be placed in someone’s care when one is placing the medication in the vagina.
• In case one is breastfeeding, one needs to halt it for several days following the administration of the medicine.

Medications in Use

Mifepristone, also called as ‘Mifeprex’ or ‘RU-486’, is the oral medication that halts the action of the progesterone hormone on the uterus and halts the further development of the pregnancy.

Misoprostol, also known as ‘Cytotec’, leads to cervical softening and the uterine cramping, bleeding and expulsion of the pregnancy. This form of medicine is introduced within the vagina.

Procedure

• 1ST Day – During the visit to the doctor’s clinic, the woman would be given health education and thorough instructions in a private area. Two hundred milligrams (mg) or a single mifepristone tablet would need to be taken. This entire doctor’s office visit would consume near 2 to 3 hours.
• 2nd, 3rd or 4th Day – At home, 4 tablets with strength of 800mcg (micrograms) of misoprostol would need to be placed in the vagina. Nearly 5-7 hours later, the body would start discarding the foetus with vaginal bleeding and probable large-sized blood clots and cramps experienced during this time.
• 7th to 14th Day – One would need to re-visit the doctor’s clinic for a re-exam for confirming a total abortion. Follow-up appointments would also be scheduled during this visit.

Safety and Efficacy Quotient

Mifepristone has been researched for more than two decades with millions of women globally having employed mifepristone and misoprostol or analogous medicines for abortion purposes. All research conducted have proven safe and effectual.

Interim side-effects include:

• Diarrhea.
• Feeling feverish and chills.
• Abdominal cramping ranging from mild to strong.
• Vaginal blood loss that could range from moderate to heavy, inclusive of probable blood clots.
• Feeling nauseous and vomiting.

The effects of mifepristone on the growing embryo are still blurred.

Though uncommon, probable complications could comprise of:

• Excess blood loss that would need uterine aspiration procedure, or in atypical occasions a blood transfusion might be needed.
• Failure in terminating the pregnancy.
• Partial removal of pregnancy tissue needing uterine aspiration.
• Infection in the uterus generally treated using antibiotics course.

In rarest of rare occasions – in case of miscarriage, uterine aspiration and child delivery – death might occur. Deaths being recorded following a medical abortion are quite atypical – lesser than one among one lakh cases that is a rate similar to that for early uterine aspiration and miscarriage. Few data indicate that there would be a slightly lesser likelihood of fatality with uterine aspiration than medical abortion.

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