Abortion - Methods, Procedure, Causes, Risks, Side Effects

Methods of Termination of pregnancy

The type of method used for the termination mainly depends on the stage of the pregnancy. The termination of pregnancy can be performed using the two methods:

Medical termination

Termination of pregnancy is carried out using the medication. It is a safe and effective method. It is primarily used during the first trimester of pregnancy. It requires anaesthesia and can be performed at the doctor's clinic or the home.

It can be done using the following medications:

Oral mifepristone and oral misoprostol: These are the common type of medicine used for the termination of pregnancy. They are usually taken within seven weeks of the first day of your last period. Mifepristone works by blocking the hormone progesterone, which makes the uterus line thin and prevents embryo implantation and growth. Misoprostol causes the uterus to contract, which finally expels the fetus out from the vagina. The doctor first gives the mifepristone at the clinic, and then misoprostol is taken later at home after 24-48 hours.

Vaginal misoprostol alone: It is less effective than other types of medication. It is mainly effective when used before nine weeks of gestation.

Oral mifepristone and vaginal buccal or sublingual misoprostol: Mifepristone is taken orally, and slowly dissolving misoprostol tablet can be placed in the vagina or your mouth between teeth and cheek, or under the tongue.

These are more effective with fewer side effects and must be taken within nine weeks of the first day of your last period.

Vaginal misoprostol and methotrexate: Methotrexate is given orally or intravenously and misoprostol are taken later at home. It can be used within seven weeks of the first day of the period. However, it can also take up to a month to complete the abortion.

Surgical method

Surgical methods are most effective than medical methods with a lower risk of incomplete abortion. These are also called in-clinic abortions. Surgical abortions are of 2 types which are:

Aspiration abortion: It is one of the common types of surgical abortion. It takes on average 5 to 10 minutes to complete, and your average clinic visit is up to 3 to 4 hours. The doctor will administer numbing medicine, sedative, and medicine to dilate the cervix. Then the cervix is stretched open. Once done, the doctor inserts a tube through the cervix into the uterus. The tube is attached to the suction device. The fetus is emptied through suction from the uterus. Immediately after the procedure, the doctor checks the uterus to ensure it is emptied. This procedure is also called "vacuum aspiration".

Dilation and Evacuation (D&E) abortion: This procedure takes 10 to 15 minutes to complete and is performed after 15 weeks of the pregnancy. The doctor first gave you medication for producing numbing effect and dilating your cervix. Then a tube is inserted through a cervix into the uterus, which has a suction machine and other medical tools attached to it. Using the suction machine, the doctor empties the uterus. Once done, the doctor removes the remaining tissue lining the uterus using a sharp tool called Curette. It ensures the uterus is e

What to Expect at Home

1. These procedures are very safe and low risk. You will likely recover without problems. It may take a few days to feel well.
2. You may have cramps that feel like menstrual cramps for a few days to 2 weeks. You may have light vaginal bleeding or spotting for up to 4 weeks.
3. Your normal period will likely return in 4 to 6 weeks.
4. It is normal to feel sad or depressed after this procedure. Seek help from your health care provider or a counselor if these feelings do not go away. A family member or friend can also provide comfort.

Self-care

1. To relieve discomfort or pain in your abdomen:
2. Take a warm bath. Make sure the bath is cleaned with disinfectant prior to each use.
3. Apply a heating pad to your lower abdomen or place a hot water bottle filled with warm water on your abdomen.
4. Take over-the-counter painkillers as instructed.
5. Follow these activity guidelines after your procedure:
6. Rest as needed.
7. Do not do any strenuous activity the first few days. This includes not lifting anything heavier than 10 pounds or 4.5 kilograms (about the weight of a 1-gallon or 4 liters milk jug).
8. Also, do not do any aerobic activity, including running or working out. Light housework is fine.
9. Use pads to absorb bleeding and drainage from your vagina. Change the pads every 2 to 4 hours to avoid infection.
10. Do not use tampons or put anything in your vagina, including douching.
11. Do not have vaginal intercourse for 2 to 3 weeks, or until cleared by your health care provider.
12. Take any other medicine, such as an antibiotic, as instructed.
13. Begin using birth control right after your procedure. It is possible to get pregnant again even before your normal period resumes. Birth control can help prevent unplanned pregnancies. Be aware though, unplanned pregnancies can occur even when you use birth control.

Call the Doctor 

1. You have vaginal bleeding that increases or you need to change your pads more often than every hour.
2. You feel lightheaded or dizzy.
3. You have chest pain or shortness of breath.
4. You have swelling or pain in one leg.
5. You have continued pain or pregnancy symptoms beyond 2 weeks.
6. You have signs of infection, including fever that does not go away, vaginal drainage with a foul odor, vaginal drainage that looks like pus, or pain or tenderness in your abdomen.