Types of Abortion procedures, cost and advantage disadvantage


As soon as the pregnancy is over, a couple does not get puffed up, while the whole family starts chirping happily but sometimes due to physical problems some women suddenly become miscarried. This sudden Abortion procedures makes the woman more mentally weaker than physical. In such a situation, the woman should be helped to recover mentally in order to conceive again so that this shock is gradually removed from her mind.

What is an abortion

If the fetus dies in the womb before the 20th week of pregnancy, it is called abortion. It is also called as spontaneous abortion. A woman’s miscarriage depends on her pregnancy status. There are many types of these. The symptoms of each miscarriage may be different. Early pregnancy miscarriage can occur to many women. it’s common. One in five pregnant women miscarries before the 20th week of pregnancy.

Types of abortion

Missed Miscarriage –

In this, pregnancy ends by itself. During this time there is no bleeding nor any kind of symptoms. In some cases, the fetus remains in the womb even after the miscarriage and it is revealed when the fetus stops developing in the womb. It is detected by ultrasound.

Incomplete abortion –

In this, the woman has heavy bleeding and severe pain in the lower abdomen. Only part of the fetus is able to come out. This is why it is called incomplete abortion. Diagnosis is made by ultrasound.

Complete miscarriage –

Severe abdominal pain and heavy bleeding can be symptoms of complete miscarriage. In this, the fetus comes out completely from the uterus.

Unavoidable abortion

There is bleeding in it and the cervix opens, causing the fetus to come out. During this time, the woman has frequent stomach cramps.

Septic abortion – 

Abortion occurs due to infection in the abdomen.

Signs and symptoms of abortion

The most common symptoms of miscarriage are abdominal cramps and vaginal bleeding. If some such symptoms appear during pregnancy, a doctor should be confused immediately.

Symptoms of pregnancy
Vaginal bleeding: Vaginal bleeding brown or dark red can be the most important symptom of miscarriage. During this, spotting, blood clots or excessive bleeding occurs.

Severe back pain: Back pain is common in pregnancy, but this pain can be unbearable at times. In this case, you should immediately contact a doctor as it may be a sign of miscarriage.

Lower abdominal cramps: Lower abdominal pain is one of the symptoms of miscarriage. This can be a matter of concern as this pain can be as intense or even more intense as the pain during the period of menstruation. Apart from this, there are many times that the symptoms of miscarriage are not felt and the pregnant goes to the doctor for regular checkup, then it is known that the miscarriage has occurred.

Due to miscarriage

hormonal imbalance.
Immunity or blood clotting problem.
Problems like thyroid or diabetes.
Any problem in the womb or uterus.
Smoke too much

Specific reasons for miscarriage

Chromosome abnormality: One reason for miscarriage is also abnormal chromosome. Small small structures present in a person’s body are called chromosomes. These structures carry and carry genes. In any case, when the sperm of a male meets the eggs, there is an error in one of the eggs or sperm, which makes the abnormal combination of a chromosome in the fetus and miscarriage may occur.

Uterine abnormalities and incompetent cervix: When the size of the woman’s uterus and uterine parturition are abnormal, a miscarriage may occur because the fetus cannot be implanted in the uterus. In this, the inner part of the uterus is divided by the muscle or wall of the fibr.

Immunology disorder: Sometimes an immunology disorder can cause a fetus to be implanted in the uterus, causing miscarriage. Immunology disorders can cause problems such as asthma, allergies, autoinflammatory syndrome.

PCOS; Women with polycystic ovary syndrome have an increased risk of miscarriage in women with PCOS . In this situation, the balance of progesterone and estrogen hormones deteriorates due to which eggs do not develop for conception.

Repeated scripted, cause of miscarriage

For women who have frequent miscarriages, chromosomes may be an important reason behind them. Here we are giving some other reasons that can lead to repeated miscarriages, trying to conceive at an older age. Women who try to conceive at the age of 35 years may have repeated miscarriages.

Excessive running or traveling too much: Excessive running during pregnancy or traveling in the first and third trimesters can lead to miscarriage.
Abdominal pressure or injury: If a woman’s abdomen is hurt or pressured during pregnancy, miscarriage can also occur.

It is common for women to have vaginal infections. In such a case, repeated vaginal infections can cause miscarriage.

Natural ways to prevent miscarriage

Take folic acid and prenatal vitamins. To avoid the risk of miscarriage, you are advised to take folic acid and other vitamins before pregnancy and during pregnancy. Doctors recommend taking 400 to 800 mg of folic acid daily.
Regular immunization increases the risk of miscarriage due to some chronic diseases. In such a situation, you can avoid this problem by getting the necessary vaccines.

Abortion procedure
Abortion procedures, missed abortion, cost and advantage disadvantage

Exercise regularly: Light exercise can be beneficial during pregnancy. During this, stretching and doing yoga etc. can reduce the risk of miscarriage. Before doing this, take the advice of your doctor and do it under the supervision of a qualified instructor.

Diagnosis and treatment of abortion

If a miscarriage is diagnosed at the right time, then problems like infection can be avoided. If this is not done, the woman may be in danger.

Pelvic examination:

The doctor will examine the spread of the cervix.
Ultrasound: During ultrasound, a doctor will check the fetal heartbeat to find out if the fetus is developing normally.

Blood test:

During this time, the doctor can take a sample of your blood and compare the level of human chorionic gonadotropin (HCG) with the previous level. If it is changed it can be a sign of problem. Apart from this, you can also check for anemia.

Tissue test:

If the tissue has started coming out of the cervix, the doctor can examine them to find out the abortion.

Chromosome test:

If you have already had an abortion, your doctor can do a blood test for you and your husband to find out chromosome related problems.

What are the types of abortion procedure/process?

Following are the types of abortion procedure:

  • Early non-surgical abortion (therapy): 2–10 weeks of pregnancy.
  • Vacuum aspiration: 2–12 weeks of pregnancy.
  • Dialysis and evacuation: 13–21 / 22 weeks of pregnancy.
  • Induction Abortion: Time 13-21 / 22 Weeks Pregnancy
  • Labor induction: 22 to 29 weeks of pregnancy.
  • Hysterotomy (similar to C-section): 22 to 38 weeks of pregnancy.

How is an abortion done?

Here is the process of abortion and how it is done:

  • Early non-surgical abortion:This miscarriage is done at 2–10 weeks of pregnancy and is based on the medical procedure. In this process, the drug is prescribed to stop the pregnancy process. Consumption of this medicine can cause cramps, bleeding or pelvic pain, clotting problems and often women pass the unborn baby within a few hours.
  • Vacuum aspiration:This abortion is done in 2–12 weeks of pregnancy. A local anesthetic is injected near this or into the cervix, which helps to pull the tube over the cervix. Subsequently, the unborn child and placenta are ejected through the tube. Although this process is completed here, the walls of the uterus are sometimes scraped after this procedure to ensure that the unborn baby and the placenta are removed.
  • Dilation and evolution:This procedure is done at 13-21 / 22 weeks of pregnancy. It contains sponge-like material placed in the woman’s cervix, which helps to open the cervix slowly. He is given medication to cure pain and prevent infection. The mother and child are given general anesthesia. After which, with the help of suction curettage, the unborn child and placenta are forcefully removed from the womb. It is necessary to disintegrate the child on time.
  • Induction Abortion:This is done at 13-21 / 22 weeks of pregnancy. During this procedure, you may need to go to the hospital and the mother is given medicines to end the pregnancy and thus the delivery starts which usually starts in 2-4 hours. In this procedure, the placenta cannot be completely removed during delivery and the cervix is ​​kept open to the doctor to treat suction.
  • Labor induction:This is done at 22–29 weeks of pregnancy. During this procedure, you may need to go to the hospital and the mother is given medicines to end the pregnancy and thus the delivery starts which usually starts in 2-4 hours. In this process, the placenta cannot be completely removed during delivery and the cervix is ​​kept open to treat. But in this miscarriage, it is possible that the child will be alive and if this happens the child will be taken care of by doctors.
  • Hysterotomy (similar to C-section):It is performed at 22–38 weeks of pregnancy and requires a clinical setting. Mostly this is done when there is no possibility or labor induction or it has failed. In this process, the unborn child is removed by cutting the abdomen and uterus, and the unborn child is killed after removal.

How long can you get an abortion?

The time of miscarriage is mostly up to the first 3 months of pregnancy and is the safest time. In uncommon cases, abortions are performed in the second trimester which occurs in 4–6 months of pregnancy. Abortion is rarely done in the third trimester because it is not safe and is done only for reasons such as emergency or life threatening. Therefore one should opt for the earlier alternatives as it is safer and cheaper.

How to do safe abortion?

The first trimester, which is the first 3 months, is the safest time to get a safe abortion because at this time the drugs can be used to have an abortion and these drugs usually do not have side effects. Vacuum aspiration procedures can also be used that are also safe. After the first trimester, safe abortions are difficult to obtain and should not be performed unless there is an emergency.

Are there any side effects?

While both medical and surgical abortion procedures are quite safe, every procedure and treatment involves some risk. Risks of miscarriage include:

  • Development of infection in the womb.
  • Excessive bleeding may occur after termination
  • The cervix may be damaged
  • The womb may be damaged

If it is done as soon as possible then abortion is safest. In case of any complications, a doctor should be consulted immediately and relevant treatment should be opted for. Choosing an abortion does not reduce the possibility of future pregnancies.

Precautions After Abortion

After an abortion, a woman needs to be taken care of and well. More care is required if the woman is not fully recovered physically. Here we are telling you what precautions need to be taken after abortion.

  • Take special care of food and drink. Avoid eating raw meat and soft cheese.
  • Don’t think about starting a second pregnancy until your two menstrual cycles are complete after the abortion.
  • After miscarriage one should exercise regularly and keep his weight under the advice of the doctor.
  • If you are experiencing fever after miscarriage, contact a doctor. Do not ignore fever at all, as it may be a sign of infection after miscarriage.
  • Avoid having physical relations for some time after miscarriage.
  • Do not smoke and consume caffeine.

After taking precautions let us look at some myths and facts about abortion.

Some Facts And Myths About Abortion

There are many myths about abortion, which have no scientific evidence. Below we are going to tell about some myths and facts related to abortion:

  • Many people believe that one cannot be pregnant again after abortion, which is completely wrong. With proper care after miscarriage, a woman can become pregnant again and give birth to a healthy baby.
  • Many people believe that miscarriage is a vaginal discharge during pregnancy, but it is not. Mild spotting is common in pregnancy. This problem is common especially in the first three months  .
  • Some people believe that sexual intercourse during pregnancy can lead to miscarriage, but it is not. Abortion and sexual intercourse have nothing to do with each other. In the womb, the baby is completely safe in the amniotic shield, so there is no risk of miscarriage by having sex. Only you need to pay attention to the sex position .

These were some myths that people believe in, which is completely wrong. Let’s look at some questions related to pregnancy.

Frequently Asked Questions :

Can stress cause miscarriage?

There is no scientific evidence as yet that stress can lead to miscarriage  . However, stress during pregnancy definitely affects the growth of the unborn child.

When can I start trying to get pregnant after an abortion?

There is no set time to become pregnant again after an abortion. When the doctors tell you that you are now physically ready for a second pregnancy, you can plan a second pregnancy. In addition, some people may take time to recover from an abortion. It is up to you how long you can overcome it.

We hope you have found the answers to the important questions related to abortion. If you still need answers to any other questions related to this, ask us in the comment box below and share this information with more and more pregnant women.

Government latest stand on Abortion

The proposal related to this was approved in the Union Cabinet meeting chaired by Prime Minister Narendra Modi.

The ‘Medical Termination of Pregnancy (Amendment) Bill, 2020’ will be introduced in the upcoming budget session.

Information and Broadcasting Minister Prakash Javadekar told after the meeting that there was a demand from women to extend the period of abortion. Apart from this, doctors were also recommending it and the court also requested in this regard.

Javadekar said that eight percent of women are believed to die due to unsafe abortion.

PIB press release

According to PIB press release , these deadlines have been extended to specific types of women, which will be defined through amendments to the MTP rules and include rape victims, sexual contact with relatives and other unsafe women (women with disabilities , Minor) will also be included.

According to doctors, a level two scan is done to detect anomaly in the child, the best time is 18 to 22 weeks. This is done to detect congenital disease.

“It also puts financial, mental and physical pressure on the child’s parents. No one wants the child to be born unhealthy.”

Abortion process
Some Facts And Myths About Abortion

The bill will provide abortion for 24 weeks on the advice of two doctors. Since 2014, the government was holding talks with different parties on this matter.

The case started with the Bombay High Court, when three women filed a petition demanding permission to have an abortion even after 20 weeks.

Last actions

After this, the Madras High Court, taking automatic cognizance on the basis of a news report, asked the Government of India to amend the Medical Termination of Pregnancy (MTP) Act, 1971.

The court had asked the Government of India how long it would take to amend the abortion deadline from 20 weeks to 24 weeks. On this, the Government of India was asked to reply by June.

The Madras High Court said in its order that about 27 million children are born every year, out of which 17 lakh children are born with congenital anomalies. Doctors say that in case of late arrival in rural areas, it is not possible to have an abortion in 20 weeks.

But the possibility of the baby being born alive

The biggest challenge to have an abortion in 24 weeks is that the baby can come out alive. In this case, the issue of his treatment and responsibility for raising him remains as long as he remains alive.

According to Dr. Manju Khemani, “Abortions are delivered in 20 or 24 weeks, both. Because the child is older, it cannot be brought out in any other way. But in 20 weeks the baby would have been born dead. And can survive even in 24 weeks. Who will take the responsibility of that child? “

Such a situation has also been mentioned in the Bombay High Court order. The court has said, “If the abortion is done under legal purview and the child comes out alive then the state and its agencies will have to take responsibility for the child if the parents do not take responsibility.”

However, doctor Renu Malik says that abortion is safe for 24 weeks. “There may be problems after this. Even if a 24-week-old baby is alive and breathes initially, he cannot survive for long.”

What is the cost of treatment in India?

In India, abortions can range from Rs 5000 to Rs 30,000, depending on the procedure.

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Abortion what is it? Facts, Learn, Risk factor & Complementary approaches

Abortion what is it

Abortion what is it? It can be spontaneous, that is to say occur without being researched (health problem, genetic, etc.), or provoked and therefore voluntary.

  • Spontaneous abortionWe also talk about miscarriage. By definition, it is the death or expulsion from the mother’s body of an embryo or fetus weighing less than 500 grams or less than 22 weeks gestation or without periods (= 20 weeks of pregnancy). If the miscarriage occurs later in pregnancy, it is called “fetal death in utero”.
  • The induced abortion , also called “abortion” (or abortion) can be triggered in several ways, including taking medication “abortifacients” or the aspiration of the fetus. The laws governing access to abortion (or its ban) differ from country to country.
  • Medical termination of pregnancy (GMI) is an induced abortion, performed for medical reasons, often because of an abnormality or disease of the life-threatening fetus after birth or leading to serious health problems, or when the mother’s life is in danger.
Whether psychologically or medically, induced abortion is very different from spontaneous miscarriage, although there are many commonalities. This fact sheet will therefore deal with these two subjects separately.

Spontaneous abortion: prevalence and causes

Miscarriages are a very common phenomenon. They are, for the most part, linked to a genetic or chromosomal abnormality of the embryo, which is then expelled naturally by the mother.

We distinguish :

  • early miscarriages, occurring during the first trimester of pregnancy (less than 12 weeks of gestation). They concern 15 to 20% of pregnancies but sometimes go unnoticed when they occur in the very first weeks because they are sometimes confused with the rules.
  • late miscarriages, occurring in the second trimester, between about 12 and 24 weeks of gestation. They occur during approximately 0.5% of pregnancies.
  • fetal deaths in utero, in the third trimester.

There are many causes that can lead to miscarriage or even recurrent miscarriages.

Among these causes, there are first of all genetic or chromosomal abnormalities of the embryo, implicated in 30 to 80% of early miscarriages.

Other possible causes of spontaneous abortion are:

  • an abnormality of the uterus (eg septate uterus, yawning of the cervix, uterine fibroids, uterine synechiae, etc.), or DES syndrome concerning women who have been exposed in utero to distilbene (born between 1950 and 1977).
  • hormonal disorders, which prevent pregnancy from being completed (thyroid disorders, metabolic disorders, etc.).
  • multiple pregnancies that increase the risk of miscarriages.
  • the occurrence of an infection during pregnancy. Many infectious or parasitic diseases can indeed cause a miscarriage, in particular malaria, toxoplasmosis, listeriosis, brucellosis, measles, rubella, mumps, etc.
  • certain medical exams, such as amniocentesis or trophoblast biopsy, can cause miscarriage.
  • the presence of an IUD in the uterus at the time of pregnancy.
  • Certain environmental factors (consumption of drugs, alcohol, tobacco, drugs, etc.).
  • Immunological (immune system) disorders, mostly involved in repeated miscarriages.

Induced abortion: state of play

Worldwide induced abortion statistics

The World Health Organization (WHO) regularly publishes reports on induced abortions around the world. In 2008, around one in five pregnancies were said to have been terminated voluntarily.

In total, nearly 44 million abortions were performed in 2008. The rate is higher in developing countries than in industrialized countries (29 abortions per 1,000 women aged 15 to 44 compared to 24 per 1,000, respectively).

According to a study published in 2012 , the world abortion rate decreased from 35 to 29 per 1000 women between 1995 and 2003. Today, there are on average 28 abortions per 1000 women.

Abortion is not legalized everywhere in the world. According to the Center for Reproductive Rights , more than 60% of the world’s population lives in countries where abortion is allowed with or without restrictions. On the contrary, around 26% of the population lives in states where this act is prohibited (although it is sometimes authorized if the woman’s life is in danger for medical reasons).

The WHO estimates that out of the approximately 210 million pregnancies that occur each year worldwide (2008 figures), approximately 80 million of them are unwanted, or 40%.

Statistics on induced abortion

In 2011, 222,300 voluntary terminations of pregnancy were carried out. This number has been stable since 2006, after a decade of increase between 1995 and 2006. On average, the rate of abortion is 15 induced abortions per 1000 women.

The rate is comparable, with approximately 17 abortions per 1,000 women, or approximately 27,000 per year.

In Canada, rates vary between 12 and 17 abortions per year per 1,000 women of reproductive age, depending on the provinces (100,000 abortions in total reported in 2003).

In these two countries, around 30% of pregnancies result in an abortion.

In Canada as in France, voluntary termination of pregnancy is legal . This is also the case in most European countries.

Abortion can only be performed before the end of the 12th week of pregnancy (14 weeks of amenorrhea). It is the same in Belgium and Switzerland, in particular.

As for Canada, it is the only western country where there are no laws that limit or regulate late abortions. According to studies conducted in 2010, abortions after 20 weeks of pregnancy, however, represent less than 1% of abortions, or about a hundred cases per year.

Abortion what is it
Abortion what is it? Learn, Risk factor & Complementary approaches

Who is affected by induced abortions?

Induced abortions concern all age groups in women of reproductive age, and all social backgrounds.

The abortion rate is higher among women aged 20 to 24. Four-fifths of the abortions performed there relate to women between 20 and 40 years of age.

In two thirds of cases, abortions are performed in women who use contraception.

Pregnancy occurs due to failure of the method in 19% of cases and following its incorrect use in 46% of cases. For women on oral contraception, forgetting the pill is involved in more than 90% of cases.

In developing countries, more than contraceptive failure, it is especially the complete lack of contraception that leads to unwanted pregnancies.

Possible complications of abortion

According to the WHO, a woman dies every 8 minutes worldwide due to complications related to an abortion.

Of the 44 million abortions performed each year worldwide, half are performed in unsafe conditions, by a person “who does not have the necessary skills or in an environment that does not meet minimum medical standards , or both “.

There are about 47,000 deaths directly linked to these abortions, 5 million women suffering from complications after the act, such as hemorrhages or septicemia.

Unsafe abortions are one of the most preventable causes of maternal mortality (they were responsible for 13% of maternal deaths in 2008).

The main causes of death related to abortions are:

  • hemorrhages
  • infections and septicemia
  • poisonings (due to the consumption of plants or abortifacient drugs)
  • genital and internal injuries (intestine or perforated uterus).

Non-fatal sequelae include scarring problems, infertility, urinary or fecal incontinence (linked to physical trauma during the procedure), etc.

Almost all illegal or unsafe abortions (97%) are performed in developing countries. The African continent alone accounts for half of the mortality attributable to these abortions.

According to the WHO, “these deaths and disabilities could have been avoided if these induced abortions had been performed within a legal framework and in good safety conditions, or if their complications had been properly managed beforehand, if the patients had access to sex education and family planning services. ”

In countries where abortion is performed in a safe manner, the associated mortality is around three deaths per one million abortions, a tiny risk. The main complications are, when the abortion is done by surgery:

  • uterine perforation (1 to 4 ‰)
  • cervical tear (less than 1%).
Contrary to certain beliefs, in the long term, abortion does not increase either the risk of miscarriage, or that of fetal death in utero, ectopic pregnancy, or sterility.

Symptoms of spontaneous abortion

Depending on the case, spontaneous abortion can result in:

  • stopping the course of pregnancy without expulsion (often marked by disappearance or reduction of signs of pregnancy such as nausea or breast pain);
  • expulsion of the embryo or fetus.

Symptoms are generally:

  • more or less heavy vaginal bleeding. However, bleeding during pregnancy is not systematically linked to a miscarriage, far from it.
  • abdominal cramps, stomach or lower back pain.
  • vaginal loss of fluid, blood clots, or debris from the uterus.

After a voluntary termination of pregnancy , abdominal cramps and bleeding may occur, with varying intensity, for a few days. Symptoms related to pregnancy gradually disappear as the amount of pregnancy hormones in the blood decreases.

Risk factors for spontaneous abortion

In the first trimester of pregnancy, early miscarriages are frequent and should not cause undue concern. The vast majority of these are sporadic events that correspond to a natural process of elimination of non-viable embryos. Having a single miscarriage does not increase the risk of having another during the next pregnancies.

For about 1 to 2% of couples wanting a child, however, miscarriages occur repeatedly (at least three pregnancies terminated spontaneously before 12 weeks of pregnancy, by definition).

The higher the number of miscarriages, the greater the risk in subsequent pregnancies. This risk is therefore:

  • 17 to 35% after 2 spontaneous miscarriages
  • 25 to 46% after 3 miscarriages
  • greater than 50% after 6 miscarriages.

The factors likely to increase the risk of natural miscarriage are:

  • age (35 and over)
  • health problems (infections, blood clotting problems, endocrine, autoimmune diseases, uterine or ovarian problems, etc.)
  • consumption of alcohol, drugs or tobacco.
  • exposure to certain chemicals, such as pesticides
  • taking certain medicines or herbs

Risk factors for voluntary termination of pregnancy

Although abortions affect all women, of all ages and all social classes, certain factors are associated with an increased risk of resorting to abortion:

  • lack of easy access to contraception
  • lack of sex education programs
  • having already had an abortion, which is a risk factor for having it a second time, or several other times 
Can we prevent?
It is obvious that preventing voluntary terminations of pregnancy is tantamount to preventing unwanted pregnancies by means of adequate contraception and by sexual information and education.As for miscarriages and terminations of pregnancy linked to a medical problem, concerning either the fetus or the mother, their prevention is rarely possible, except when the cause is well identified and treatment exists.Some data on contraception: According to the 2010 Health Barometer of the National Institute for Prevention and Education for Health (Inpes), 90.2% of women sexually active in the past 12 months, not sterile, having a male partner, not pregnant and not trying to have a child use contraception, according to the 2008 Population Health Survey, 67% of sexually active women regularly used a contraceptive method in the year before the survey. The proportion of women aged 15 to 24 who use contraceptives is 90%.The pill is by far the most used contraceptive by women. Worldwide, according to INED, 63% of couples use a contraceptive method.The most widely used method is sterilization (37% worldwide). The other most common methods of contraception are the IUD (23%), the pill (14%), the condom (10%) and withdrawal (4%).According to the WHO, however, 215 million women living in developing countries do not have access to modern contraceptives despite the desire to limit births. 82% of unintended pregnancies in developing countries, for example, occur in women whose contraceptive needs are not met.There are still many fears (side effects, in particular), beliefs, family pressures or from the husband, in addition to difficult and sometimes expensive access to contraceptives, which hinder women’s access to contraception .

Two techniques are used to achieve a voluntary termination of pregnancy:

  • The drug technique
  • Surgical technique
Whenever possible, women should be able to choose the technique, medical or surgical, as well as the mode of anesthesia, local or general.

The drug technique

Medicated abortion is based on taking medication to bring about the termination of pregnancy and the expulsion of the embryo or fetus. It can be used up to 9 weeks of amenorrhea. In 2011, more than half of abortions (55%) were done by medication.

Abortion what is it
Abortion what is it? Learn, Risk factor & Complementary approaches

There are several “abortion” drugs, but the most common method is to administer:

  • an anti-progestogen, which inhibits progesterone, the hormone that allows pregnancy to continue;
  • in combination with a drug from the prostaglandin family (misoprostol), which triggers contractions of the uterus and allows the evacuation of the fetus.

Thus, the WHO recommends, for pregnancies of gestational age up to 9 weeks (63 days) the taking of mifepristone followed 1 to 2 days later by misoprostol.

Mifepristone is administered orally. The recommended dose is 200 mg. Misoprostol administration is recommended 1 to 2 days (24 to 48 hours) after taking mifepristone. It can be done vaginally, buccally or sublingually for up to 7 weeks of amenorrhea (5 weeks of pregnancy).

The effects are mostly related to misoprostol, which can cause bleeding, headache, nausea, vomiting, diarrhea and painful abdominal cramps.
In practice, drug abortion can therefore be performed up to the 5 th week of pregnancy without hospitalization ( at home ) and until the 7 th week of pregnancy with a few hours of hospitalization.

From 10 weeks of amenorrhea, the drug technique is no longer recommended.

In Canada, mifepristone is not authorized, due to possible infectious risks (and no company has made a request to market this molecule in Canada, at least until the end of 2013). This non-marketing is controversial and denounced by medical associations, which judge the use of mifepristone safe (it is widely used in 57 countries). Medical abortions are therefore much less common in Canada. They can be done with another drug, methotrexate, followed by misoprostol, but with less effectiveness. Methotrexate is usually given by injection, and five to seven days later, misoprostol tablets are inserted into the vagina. Unfortunately, in 35% of cases,

The surgical technique of abortion

Most abortions in the world are performed by a surgical technique, usually the suction of the contents of the uterus, after dilation of the cervix (either mechanically, by inserting larger and larger dilators, or medically). It can be performed whatever the term of the pregnancy, either by local anesthesia or by general anesthesia. The intervention generally takes place during the day. Aspiration is the recommended technique for surgical abortion up to a gestational age of 12 to 14 weeks of gestation, according to the WHO.

Another procedure is sometimes used in some countries, dilation of the cervix followed by curettage (which involves “scraping” the uterine lining to remove debris). WHO recommends that this method be replaced by suction, which is safer and more reliable.

When gestational age is more than 12-14 weeks, dilation and evacuation can be recommended as well as medication methods, according to the WHO.

Abortion procedures

In all countries that allow abortion, its realization is framed by a well defined protocol.

It is therefore necessary to inquire to know the procedures, the deadlines, the places of intervention, the legal age of access , the modalities of refund.

You should know that the procedures take time and that there are often waiting times. It is therefore important to consult a doctor quickly or to go to a facility performing abortions as soon as the decision is made, so as not to delay the date of the act and risk arriving at a date of pregnancy where it will be more complex.
For example, two medical consultations are compulsory before abortion, separated by a reflection period of at least one week (2 days in an emergency). “Consultation-interviews” can be offered to women before and after the intervention, in order to allow the patient to talk about her situation, the intervention and receive information on contraception.

Psychological follow-up after an abortion

The decision to terminate a pregnancy is never easy and the act is not trivial.

Having been unwanted and having an abortion can leave psychological marks, raise questions, leave a feeling of doubt or guilt, sadness, sometimes regret.

Obviously, reactions to an abortion (whether natural or induced) are diverse and specific to each woman, but psychological counseling should be offered to all.
However, several studies show that abortion is not a long-term psychological risk factor.

The emotional distress of women is often up before the abortion and then decreases significantly between the period before abortion and that makes him immediately after.

Doctor’s opinion

The place of the man is often forgotten in pregnancy, and in the decision to keep the child or to consider an abortion. In my opinion, this would be an essential element to consider in the sexual education of adolescents. In fact, many women suffer from having an abortion or experiencing a miscarriage without sufficient support from their partner. This results in sometimes deep and lasting couple tensions, intense resentments which could be avoided by the simple communication of a couple allowing to express each other’s feelings. So it is as important to teach young women to ask for support as it is for young men to behave as supportive partners.   Dr Catherine Solano

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