Certain medicines can be used to end an early pregnancy. If you are over 9 weeks pregnant, you can have an in-clinic abortion, and some clinics will go beyond 9 weeks for a medical abortion.
Abortion is the removal of pregnancy tissue, products of conception or the fetus and placenta (afterbirth) from the uterus, and in many cases, the first day of your last period has to be less than 9 weeks ago.
In general, the terms fetus and placenta are used after eight weeks of pregnancy, while pregnancy tissue and products of conception refer to tissue produced by the union of an egg and sperm before eight weeks.
Other expressions for an abortion include elective abortion, induced abortion, termination of pregnancy and therapeutic abortion.
Be very certain that you want to end your pregnancy, as it is not safe to stop the medicines once you have started taking them, and doing so creates a very high risk for severe birth defects.
Doctors can use medications, surgery or a combination of both to end a pregnancy, and the method depends on how far along in the pregnancy you are, your medical history and your preference.
Abortions during early pregnancy, before 9 weeks, can be done safely with medications, but abortions between 9 and 14 weeks usually are done surgically, although medications may be used to help soften and open the cervix.
After 14 weeks, abortions can be done using labor inducing medications that cause uterine contractions or by using medicines in combination with surgery.
Abortions completed with medication, are known as medical abortions and can be performed within 64 days of gestation. Gestation days are the number of days beginning on the first day of your last menstrual period.
Medical abortions are preferred by some women because of the following:
- You can use it with an early pregnancy.
- You can do it at home.
- It feels more natural, like a miscarriage, and is less invasive than an in-clinic abortion.
You should not carry out a medical abortion if you fall under the following categories:
- Are over 9 weeks pregnant
- Have a blood clotting disorder
- Have adrenal failure.
- Have an IUD. It has to be removed first.
- Are allergic to the medicines that are used to stop pregnancy
- Taking any medicines that should not be used with medical abortion medicines.
- Do not have access to medical emergency personnel.
A medical abortion of an early pregnancy usually requires three or more visits to get the medication and ensure that all the pregnancy tissue has passed. Bleeding related to the abortion may last up to 14 days.
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Medications Used To Induce Abortion
Such medications Include:
Known as RU-486, mifepristone is taken orally as a pill, and counters the effect of progesterone, a hormone necessary for pregnancy. More than 3 million females in Europe and China have received this drug to end a pregnancy.
Mifepristone is more effective when another medication, such as misoprostol (Cytotec), is taken 24 to 48 hours later, as it causes the uterus to contract.
Between 92% and 97% of women who receive mifepristone in combination with, or followed by, misoprostol has a complete abortion within 14 days.
Misoprostol is almost always taken in conjunction with mifepristone to induce a medical abortion. Misoprostol is a prostaglandin-like drug that causes the uterus to contract.
One form can be taken orally, while the other is inserted into the vagina. The vaginal form is less likely to cause diarrhea, nausea, and vomiting, but is associated with a higher risk of infection.
To decrease the risk of infections, many doctors now prefer the oral form of misoprostol, followed by a week course of the antibiotic doxycycline.
Methotrexate is used less often in comparison to mifepristone. However, methotrexate may be used in women who are allergic to mifepristone or when mifepristone is unavailable.
Methotrexate is typically injected into a muscle. Between 68% and 81% of pregnancies abort within 2 weeks, while 89% to 91% abort after 45 days.
Methotrexate is the medication most often used to treat ectopic pregnancies (pregnancies implanted outside the womb). When doctors give methotrexate to treat ectopic pregnancy, it kills the fast-growing tissue of ectopic pregnancies, but pregnancy hormone levels must be monitored until levels are undetectable in a woman’s bloodstream.
This monitoring is not necessary when methotrexate is used for medical abortions, where the pregnancy is known to be normally implanted in the womb.
Side effects of some of these medications include nausea, vomiting, vaginal bleeding, and pelvic pain, which usually can be treated with medications.
In rare instances, there may be heavy bleeding, and in such cases, you may be admitted to a hospital and given blood transfusions. An incomplete abortion is when part of the pregnancy does not come out, and you will need to have an in-clinic abortion to complete the abortion.
Risks to Ending Pregnancy with Medicine
Medical abortions are typically very safe, and in most cases, does not affect your ability to have children unless you have a serious complication.
Most women have a medical abortion safely, but there are a few risks:
- Heavy bleeding
- Blood clots in your uterus
When to Call the Doctor
Serious problems must be treated right away for your safety, and you should call your doctor or your healthcare provider if you notice the following:
- Heavy bleeding in such a way that you are soaking through 2 pads every hour for 2 hours
- Blood clots for 2 hours or more
- clots that are larger than a lemon
- Signs that you are still pregnant
- Showing signs of infection
- Ruthless pain in your stomach or back
- Vomiting or diarrhea for more than 24 hours after taking the pills
- Bad smelling vaginal discharge
- A fever over 100.4°F (38°C) or
- any fever for 24 hours