How is a medical Abortion, non-surgical abortion performed? ( Abortion by pill.)
A chemical or medical abortion is carried out without having to use surgical instruments or methods to end a pregnancy in the first trimester.
This chemical/medical abortion process goes by several different names:
- instrument-free
- non-surgical abortion
- RU 486 (Mifepristone, Mifegyne)
- Abortion Pill
- Abortion by pill
- Medical Abortion
The most common name used for a chemical or medical abortion is the Abortion Pill.
The Abortion Pill is performed using the combination of two medications:
- Mifepristone and
- Cytotec (Misoprostol)
During the first visit after performing the Sonogram (Ultrasound) to determine the length of the pregnancy, the Physician will give Mifepristone.
Mifepristone blocks the hormone Progesterone. It is required for the maintenance and growth of the pregnancy. The absence of Progesterone causes the fetal and pregnancy tissue to separate from the Uterine (womb) wall.
Cytotec is a Prostaglandin E1 that is taken either at the same time as Mifepristone or as far out as 120 hours. Misoprostol works by attaching to the Prostaglandin receptors on the Uterine wall. This causes Uterine contractions and the fetal tissue to be expelled.
Misoprostol may be inserted vaginally or taken orally (by mouth) buccally (between cheek and gum) or sublingually (under the tongue).
Generally; within 15 minutes to 6 hours of taking the Misoprostol tablets, patients begin experiencing bleeding and cramping similar to a menstrual period.
The majority of women pass the fetal tissue within 3 to 4 hours of taking the Misoprostol tablets.
On the second visit (generally 3 to 4 weeks after the first office visit) the Physician will perform a sonogram to determine if the pregnancy tissue has been eliminated.
The success rate of a chemical abortion is approximately 94 to 99%. The earlier in pregnancy the abortion procedure is performed, the higher the successful completion rate.
If determined the procedure was incomplete, there are two options that may be considered:
- Misoprostol reinserted in hope of complete elimination of the pregnancy tissue, or
- Surgical vacuum aspiration performed.
If Misoprostol reinsertion is chosen, women are asked to follow-up in a week to 10 days to assure the process is complete.
Are There Other Medications That Can Be Used To Terminate Pregnancies?
Methotrexate Medication (tablets or injections) are used to terminate pregnancies 8 weeks or less in gestation.
Methotrexate used alone has a 40 to 90% success rate in termination of pregnancy. It may take 2 to 6 weeks for the process to complete.
If Misoprostol tablets are given 5 to 7 days after receiving Methotrexate, the abortion process is complete within a week.
The success rate is slightly higher with the combined use of Mifepristone and Misopr0stol vs Methotrexate and Misoprostol (94 to 98% vs 88 to 96%).
The Abortion Pill can be used for pregnancy terminations in the first trimester (3 to 14 weeks), second trimester (14.1 to 28 weeks) third trimester (28.1 weeks or further) or late term abortions (23.1 weeks or further).
The out patient and in clinic abortion process can be started and completed within 24 hours in a safe and efficient manner over 99% of the time. There is less than a 1% chance of complications or side effects.
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