Medical Termination of Pregnancy (MTP) Procedure

MTP stands for Medical Termination of Pregnancy. It refers to ending a pregnancy through medicines. It is usually performed during the early stages of pregnancy before the foetus has developed to a point where it can survive outside the womb.

A registered medical doctor profession carries out MTP following laws and regulations. The procedure is safe and legal. This procedure is not intended to be used as birth control but rather as a way to end a pregnancy when other options are not feasible.

Anatomy of the Female Reproductive System

The female reproductive system works together to produce and support the development of a new life. Hormones help regulate the menstrual cycle, ovulation, and pregnancy. The female reproductive organ includes:

1. Ovaries: These are the two small, oval-shaped organs on either side of the uterus. The ovaries produce and release eggs (ovulation) into the fallopian tubes for fertilization.
2. Fallopian tubes: Fertilization of the egg by sperm usually occurs in the fallopian tube. These are two thin tubes that extend from the uterus towards the ovaries.
3. Uterus: It is also known as the womb, a muscular organ that provides a safe and nourishing environment for a developing fetus.
4. Cervix: The cervix is the lower part of the uterus that connects to the vagina. During childbirth, the cervix dilates to allow the baby to pass through.
5. Vagina: The vagina is the muscular canal that connects the cervix to the outside of the body. It serves as the birth canal during childbirth and is also the site of sexual intercourse.

Getting an abortion done is a highly personal decision. Some of the reasons why women choose to have an abortion include:

1. End Unwanted Pregnancy: To end an unwanted pregnancy, the doctor may consider a medical abortion rather than undergoing a surgical procedure only if the gestation age is less than 9 weeks.
2. Complications During Pregnancy: Women with health complications that can make pregnancy life-threatening, such as severe heart or lung disease. In such cases, the doctor would recommend medical abortion based on the gestation age.
3. Birth Defects: If a pregnant woman has a high risk of having a baby with a congenital or inherited disease, she may choose to terminate the pregnancy.

Medical abortion is terminating a pregnancy without surgery or anaesthesia. The doctor will give an MTP Kit that contains two medicines, which involves taking it either orally or by placing it in the vagina.

The process utilises two drugs, Mifepristone and Misoprostol, which work together to induce an abortion. 

MTP procedure involves the following:

1. Mifepristone: This is the first medicine to be taken. Mifepristone (200 mg) is taken orally at the clinic or at home on the first day.
   
   Mifepristone blocks progesterone, which results in thinning of the uterine lining and prevents embryo attachment. 
2. Misoprostol: It is the second medication. Misoprostol (200 mcg) includes four tablets and is usually taken 24-48 hours later.
   
   It can be taken by placing it under the tongue or inserting it into the vagina. Misoprostol causes the uterus to contract, leading to bleeding and the expulsion of the embryo.

The registered medical practitioner is responsible for giving the patient clear instructions and guidelines regarding the procedure and precautions. Below are some things a patient can expect before and on the day of the procedure:

Before MTP Procedure

1. The doctor physically examines the patient to confirm the pregnancy.
2. An ultrasound is done to check for pregnancy. It helps to determine the length of gestation.
3. The patient will go through blood and urine tests.
4. The doctor will explain the procedure in detail and discuss its risk and benefit so the patient can make an informed decision.
5. The patient will be informed about the complications like pain and bleeding after the medicines are provided.

On the Day of the MTP Procedure

1. The doctor will give you a tablet containing 200 milligrammes of Mifepristone and instructions on taking it.
2. Four pills of Misoprostol (800 micrograms) would be placed in the vagina within 24-48 hours. 
3. From day 7 to day 14, a follow-up appointment would confirm whether the abortion was successful.

Usually, medical abortion doesn’t need hospitalisation. The patient can go home within a couple of hours after the procedure. The patient may expect the following after medical abortion:

The Recovery Process in the Hospital

1. Monitoring: Patients are monitored in the hospital for a short period to ensure that there are no complications, such as heavy bleeding or infection.
2. Medication: Pain medication and antibiotics may be prescribed to help manage discomfort or prevent infection.

Recovery Process / Expectations After Hospital Discharge

1. Rest: Get plenty of rest for the first few days after discharge.
2. Pain Management: Over-the-counter pain relievers such as acetaminophen or ibuprofen can be taken as directed to manage any discomfort.
3. Physical Activity: Strenuous physical activity should be avoided for at least a week after the procedure, but light exercise such as walking is encouraged.

First Follow-up Appointment

The patient must visit the doctor after 7-14 days of the procedure to ensure the abortion is complete. The doctor examines the patient to check if she is healing properly. 

The patient may need an ultrasound or a surgical abortion if the doctor detects an ongoing pregnancy. They also examine the uterine size and check for any signs of infection. 

The doctor may ask the following questions:

1. Does the patient still feel pregnant?
2. Did the patient witness the expulsion of the gestational sac or the embryo?
3. How much bleeding did the patient have? 
4. Whether the patient is still bleeding? 

Medical abortion is a safe and effective way to terminate a pregnancy. Here are some benefits:

1. Non-invasive Procedure: Medical abortion is non-invasive and does not require surgery or anaesthesia. It is done by taking medication, which makes it less painful and more comfortable than surgical abortion.
2. High Success Rate: It has a success rate of up to 98% within the recommended timeframe. This means that the procedure is highly effective in terminating a pregnancy.
3. Lower Risk of Complications: Abortion through medicines is associated with a lower risk of complications, such as infection and bleeding, than surgical abortion.
4. Privacy: It can be done at home, which provides more comfort and privacy to the patient.
5. Low Cost: Medical abortion is generally less expensive than surgical abortion, making it a more affordable option for those who may not have access to health insurance or have limited financial resources.

Medical abortion is a relatively safe procedure; just like any other procedure, it has few complications. The risks and complications of medical abortion include:

1. Heavy Vaginal Bleeding: This is one of the most common side effects of the MTP procedure. While some bleeding is expected, if it is excessive or prolonged, it may indicate a complication.
2. Incomplete Abortion: In some cases, the MTP procedure may not successfully terminate the pregnancy. It can lead to an incomplete abortion, which may require further medical attention to complete the termination.
3. Infection: It is a potential risk of the MTP procedure. Signs of infection may include fever, chills, and abdominal pain.
4. Fever: A low-grade fever is a common side effect of the MTP procedure and is usually not a cause for concern.
5. Allergic Reactions: The medications used in the MTP procedure can have some allergic reactions. They are rare but can occur. The symptoms may include hives, difficulty breathing, and swelling of the face or throat.

When is Consultation with the Doctor Needed?

The patient must contact the doctor immediately if she notices any of the following symptoms:

1. Heavy bleeding
2. Fever lasting for more than 24 hours
3. Severe abdominal back pain
4. Foul-smelling vaginal discharge
5. If periods didn’t come after two months

Some risks are associated with a delay in medical abortion, typically over ten weeks of pregnancy. These risks include :

1. Increased Physical Pain: As the gestation period increases, so does the size of the foetus, which can make the procedure more painful and uncomfortable.
2. Higher Risk of Complications: The longer the pregnancy has progressed, the higher the risk of complications such as heavy bleeding, infection, or incomplete abortion.
3. Reduced Effectiveness: The effectiveness of the medical abortion procedure decreases as the pregnancy advances. Medical abortion is effective only till 9 weeks of pregnancy. The delayed procedure may require additional interventions, such as a surgical abortion.

The cost of Medical Abortion ranges from ₹3,000 to ₹8,000. The cost varies based on the following factors:

1. The fee for consultation
2. Diagnostic examinations related to Medical Abortion Risks Recovery
3. The type of surgical procedure required
4. Admission fee
5. The patient's current medical condition
6. Age of the patient
7. Type of hospital chosen for the procedure
8. The type of room preferred for recovery
9. The location or city where the hospital is located

A woman can decide to have an abortion on her own without needing permission from anyone else. It's important to talk to a doctor about any worries or questions. They can help you during this challenging time. 

HexaHealth can provide guidance and support to individuals who are considering terminating their pregnancy. They can offer information on the different methods of abortion, answer any questions about the process, help ensure that the termination process is done safely and effectively, and provide follow-up care as needed.

Suggested Reads

To read more about abortion, you can visit the following: