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Abortion

Medical termination of Pregnancy

Abortion (medical termination of pregnancy) is a safe and legal way to end pregnancy. The decision to have an abortion is very personal, and only you can decide what’s best for you. But we’re here to help answer whatever questions you may have, and make sure you get the care you need.

There are two ways of ending a pregnancy:

1. Medical
2. Surgical

Medical Abortion

procedures are available for terminating a pregnancy during the early weeks of the first trimester.
For women seeking a medical abortion procedure, a sonography is recommended to determine if the pregnancy is uterine (non-ectopic pregnancy) and for accurate pregnancy dating.

Mifepristone and misoprostol is a medical abortion procedure used up to 7 weeks of pregnancy (can be done upto 9 weeks). It is also referred to as RU-486 or the abortion pill.
The method of termination will depend on the weeks of gestation.

1. A physical examination is done in order to determine eligibility for this type of medical abortion procedure. You are not eligible if you have any of the following: ectopic pregnancy, ovarian mass, IUD, orticosteroid use, adrenal failure, anemia, bleeding disorders or use of blood thinners, asthma, liver or kidney problems, heart disease, or high blood pressure. You will be given antibiotics to prevent infection.

2. Mifepristone is given orally during your first  visit. Mifepristone blocks progesterone from the uterine lining, causing the lining to break down, preventing the ability to continue a pregnancy.

3. Misoprostol tablets are taken orally or inserted vaginally about 36 to 72 hours after taking the mifepristone. The tablets will cause contractions and expel the fetus. This process may take a few hours or as long as a few days.

4. A physical examination is done two weeks later to ensure the abortion was complete and to check for complications.

The side effects and risks of Mifepristone and sMisoprostol include the following:
1. Cramping, nausea, vomiting diarrhea, heavy bleeding, infection
2. The procedure is unsuccessful approximately 8-10% of the time with the potential of requiring an additional surgical abortion procedure to complete the termination.

Breastfeeding during Medical Abortion
If you are breastfeeding at the time of your abortion, please be aware that a small amount of both mifepristone and misoprostol will pass into the breast milk. Studies so far do not show that this causes any problems or adverse effects for breast fed infants. Breast feeding may continue uninterrupted but if you wish to suspend breast feeding during treatment, please talk to your doctor to work out a plan.

Pain Control
After a medical abortion, most women will have strong cramping, similar to period pains. There are many ways to lessen the pain:
1. Stay in a familiar and relaxing place
2. Apply a heating pad or hot water bottle to your lower stomach
3. use pain medicine like ibuprofen

Important
Serious complications have warning signs. You should start to feel better each day after the abortion. Contact the hospital straight away if you have:
1. Heavy bleeding that soaks through 2 sanitary pads an hour, for 2 hours or more in a row
2. Abdominal pain or discomfort that is not helped by medication, rest, a hot water bottle, or a heating pad
3. A fever of 38°C or higher
4. An unpleasant-smelling discharge from your vagina
5. Signs that you are still pregnant 6. Ao bleeding 24 hours after using misoprostol

Surgical Abortion

There are two ways of ending a pregnancy:

1. Vacuum aspiration
2. Dilatation and Evacuation

1. Carried out under general anaesthesia.
2. The pregnancy is removed using narrow forceps through the neck of the womb (cervix).
3. You will need cervical preparation on the day of surgery or possibly the day before.

How is it performed?

1. Your doctor will give you medication for pain and possibly sedation. You will lie on your back with your feet in stirrups, and a speculum is inserted to open the vagina.

2. A local anesthetic is administered to your cervix to numb it. Then a tenaculum (surgical instrument with long handles and a clamp at the end) is used to hold the cervix in place for the cervix to be dilated by dilators that vary in size.

3. The procedure usually lasts 10-15 minutes, but recovery can require staying at the hospital for a few hours. Your doctor will also give you antibiotics to help prevent infection.

What are the side effects and risks of suction aspiration?

1. Common side effects of the procedure include cramping, nausea, sweating, and feeling faint. Less frequent side effects include possible heavy or prolong bleeding, blood clots, damage to the cervix and perforation of the uterus.

2. Infection due to remaining tissue or infection caused by an STD or bacteria being introduced to the uterus can cause fever, pain, abdominal tenderness and possibly scar tissue. Contact your healthcare provider immediately if your side effects persist or worsen.

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