A Woman’s Guide To Having A Safe Abortion

Abortion is legal in India, and a woman can end her pregnancy under the Medical Termination of Pregnancy (MTP) Act. According to the MTP Act of 2021, a woman can terminate her pregnancy if it is under 24 weeks. The main aim of the MTP Act is to ensure that women do not approach unqualified healthcare providers or quacks for abortion services and do not put their lives at risk.

Having an abortion is always the individual’s choice. A woman may choose abortion for the following reasons:

1. To end an unwanted pregnancy
2. Risk of inherited or congenital disease
3. To complete an early miscarriage
4. Health complications that could be life-threatening to the mother or the foetus

According to section 4 of the MTP Act, a mentally stable adult woman does not need anybody’s consent to terminate her pregnancy. In the case of minors (age < 18) and women with mental disorder needs permission from a guardian.

Terminating a pregnancy is a personal decision, and millions of women across the globe opt for an abortion every year. Many women deal with an unwanted pregnancy, and around 4 out of 10 women decide to go for an abortion. While the moral decision of ending a life is your decision, legally, abortion is safe in India. 

Aborting a baby who has a genetic disease is better than conceiving a baby who might have life-threatening conditions. It is you who has to decide what is best for you.

There are two methods for abortion, including medical and surgical. 

1. Medical abortion: This method is done when the pregnancy is nine weeks or shorter. The doctor prescribes the pregnant woman two medicines (mifepristone and misoprostol), which are taken through the oral and vaginal routes. This combination of medications induces abortion.
2. Surgical abortion: In this method, the doctor surgically removes the developing baby from the uterus/womb. This process is done under local or general anaesthesia. Women opt for this method for personal preference, failed medical abortion, or too far along in the pregnancy.

The doctor will examine and evaluate the woman in the following way:

1. A physical examination to confirm the pregnancy
2. Urine and blood tests
3. Ultrasound to confirm the pregnancy duration and confirm that it is not an ectopic pregnancy (pregnancy outside the womb)
4. The doctor will explain the procedure, side effects, and risks or complications.

A woman may undergo the following methods:

1. Medical abortion: 
   1. The doctor prescribes a combination of two drugs, mifepristone and misoprostol. These medicines may be taken at home or in a doctor’s clinic.
   2. Mifepristone blocks the action of the hormone progesterone, which makes the uterine lining thin and helps in detaching the developing baby from the uterus.
   3. After 24-48 hours, the woman will take misoprostol which causes contraction of the uterus muscles and leads to bleeding, which makes the developing baby expel from the cervix.
2. Aspiration:
   1. The process is carried out under local anaesthesia.
   2. The doctor opens the womb’s opening (cervix) with metal dilators or laminaria (a porous material that becomes soft in the presence of moisture and opens the cervix).
   3. The doctor then attaches a tubing to a suction machine and puts the tube into the womb. 
   4. The vacuum creates suction, pulls the developing baby out, and detaches the placenta from the uterus wall. 
   5. The foetal parts and placenta are collected in a suction container and discarded.
3. Dilation and Curettage (D&C):
   1.  The doctor dilates the cervix using metal instruments called dilators.
   2.  They then insert a curette (loop-shaped tube) into the uterus.
   3. The curette aids in removing the developing baby and detaches the placenta from the uterus wall.
   4. They scrape out all the remaining parts of the baby from the womb.

A woman may expect the following after an abortion:

1. After any abortion, the woman may have stomach pain/cramps and vaginal bleeding. The bleeding may last for one or two weeks. However, in the case of medical abortion, light vaginal bleeding may last for a month.
2. In the case of medical abortion at home, a woman would need a pregnancy test or scan to ensure that she is not pregnant anymore. She may also notice short-lived side effects like diarrhoea and feeling sick due to the hormones in the blood circulation.
3. In the case of surgical abortion, a woman may have side effects due to anaesthesia (local or general).
4. On the doctor's recommendation, one may take pain-relieving medicines such as paracetamol/ibuprofen to help with discomfort or pain. 
5. She should use sanitary pads till the bleeding stops. Do not use tampons.
6. She can return to usual activities after consulting with the doctor, such as showering or bathing, exercising (swimming), lifting weights, and tampons.
7. If she feels comfortable, she can have sexual intercourse. It is essential to use contraceptives as one is most fertile after the abortion, and there are high chances of becoming pregnant.

Is abortion safe and effective?

Medical and surgical abortion is a highly safe and effective method. 95-97% of women respond successfully to the medicines in the case of medical abortion, and 98% of women have a successful abortion through the surgical method.

Women have all the right to terminate their pregnancy. It is her life, and so it’s her choice to decide. However, you must contact your doctor before going through the abortion process. Also, do not self-medicate; it can lead to complications.

We hope this blog gave you deep insights into the significance of safe abortion. If you have any queries, you can contact our care team; they will answer all your questions. You can also visit Hexahealth to know more.