Abortion Pill – The ABC of taking a pill

Abortion Pill – The ABC of taking a pill

The abortion pill is a very commonly used method of inducing a safe abortion. The abortion pill commonly referred to as the ‘Pill’ is best used to medically terminate a pregnancy in the first three months.

Where the pill fails, there are other first trimester options like manual vacuum aspiration and/or D&C which are both surgical in nature
Because the abortion pill is safer and also more non-invasive, it is more popular. The pill is also commonly termed as RU-486

The abortion pill normally contains 2 drugs, it is safe and also minimally invasive when taken under medical supervision

Eligibility for taking the abortion pill?

The first step before popping the pill is to assess the eligibility of the patient. You are not eligible for the abortion pill if you have an

  • Ectopic pregnancy
  • IUD ( that has to be removed prior to the abortion pill)
  • Ovarian mass
  • Bleeding disorders
  • Chronic adrenal failure
  • Severe pelvic infections
  • Corticosteroid use
  • High blood pressure and a few other conditions that your doctor will assess before administration of the abortion pill by careful medical history, clinical examination, blood tests and ultrasonogram. Consent is taken before the start of the process and therefore the individual must be above 18 years of age. This method of abortion is preferred in early pregnancies of up to 9 weeks counting from the first day of your last menstrual cycle and your doctor will confirm the date of the pregnancy by an ultrasound examination.

How does the abortion pill act?

The abortion pill consists of mifepristone and misoprostol. The combination of mifepristone and misoprostol is highly effective (95 % effective) in terminating a pregnancy. The method involved in taking the pill is fairly simple and goes as follows. Mifepristone is taken on the first visit to the abortion clinic. It is taken orally and it acts by blocking progesterone which is a hormone essential for the continuation and growth of pregnancy.

Some people feel nausea and experience some bleeding after mifepristone but it is not common. If you vomit within an hour of taking the pill then the mifepristone may have to repeat. The dosage of mifepristone is around 200 mg.

The next drug misoprostol is given 6- 48 hours after the first pill, which can be placed sublingually or inserted in the vagina. The dosage of misoprostol is 4 tablets each of 200 mcg. Thereby a total of 800 mcg is taken. In sublingual placement, 4 tablets are placed under the tongue for a duration of 30 mins and after 30 mins the rest is washed down with water. An antiemetic can be taken pre-emptively to prevent vomiting. This drug can also be taken at home. Misoprostol is a prostaglandin which causes uterine contractions and this may be experienced as cramps and heavy bleeding.

What are the side effects?

Side effects of the abortion pill are minimal and include:

  • cramping
  • heavy bleeding
  • nausea
  • flushes, sweating
  • diarrhea
  • infections
  • mild fever

Antibiotics may be prescribed along with the abortion pill to counter infections. The abortion pill is effective and only about 8 to 10 percent of women requiring further intervention. There may be bleeding or spotting occurring for 2 weeks following the abortion. One might also feel tired and have cramps for a day or two. It is important to remember to be adequately hydrated during the entire process.

Are there any complications?

Severe complications are extremely rare and signs of impending complications need to be looked for. The signs include:

  • heavy persistent bleeding
  • high grade and persistent fever
  • smell and color of vaginal discharge
  • abdominal pain not settling with painkillers and present continuously
  • no bleeding 24 hours after taking misoprostol

In case of any of these signs occur, the doctor needs to be contacted immediately. In case of extremely heavy bleeding, the individual may require a blood transfusion. The risks associated with an abortion pill are minimal and include pregnancy not being terminated in which case surgical intervention is required as misoprostol can cause serious birth defects and the pregnancy must not be allowed to continue.

At times there might be some pregnancy tissue retained (retained products of conception) even though the pregnancy as such is terminated and this requires surgical help or uterine aspiration.

Life after the abortion pill?

As the abortion starts a new cycle your menstrual cycle will normalize in about 4 to 8 weeks. As fertility will return in 10 days you can start new birth control methods following this and find one that is suitable to your needs. There is no risk to future pregnancies and the abortion pill is a safe and reliable method of terminating pregnancies. A small amount of both the drugs pass on to breast milk but so far all studies have shown no effect to the breastfeeding child. Some women require psychological counseling before and after abortion. Normal activities can be resumed the next day itself.

Where to get an abortion pill?

To get the abortion pill one needs to find a safe abortion clinic close to their home where they can meet the doctor and have access to care in case of an emergency. It is not expensive and is a simple and safe procedure if done with the guidance of doctors and health professionals. It is not advisable to get the pills online as it might not contain the right drug and there is no way to cross-check its side effect profile

Never ever take unprescribed medications sold online for medical termination of a pregnancy

References

  1. Guldi M. Fertility effects of abortion and birth control pill access for minors. Demography. 2008 Nov 1;45(4):817-27.
  2. Ananat EO, Hungerman DM. The power of the pill for the next generation: oral contraception’s effects on fertility, abortion, and maternal and child characteristics. Review of Economics and Statistics. 2012 Feb 1;94(1):37-51.
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