How To Terminate An Early Pregnancy

An unplanned or accidental pregnancy can be extremely overwhelming and brings in a mix of challenges, emotions, and confusion. This requires immediate medical attention, as it can disrupt your plans. With the help of apt knowledge and support, you can navigate this challenging situation effectively. This article talks about how to terminate an early pregnancy.

Early medical abortion is a great option for women who are unable to continue with their pregnancies. It is a safe procedure that empowers women to take control of their reproductive rights. Read on to understand the process and benefits of this vital procedure, as it might be beneficial for you.

What Is Early Medical Abortion?

Early medical abortion refers to the termination of pregnancy within the first nine to ten weeks [1]. According to the World Health Organization, 73% of abortions are induced worldwide every year [2]. This process involves the use of two medicines named mifepristone and misoprostol over two steps to end the pregnancy [3]. Early medical termination is an effective and safe procedure. One can take these pills from home or in a clinical setting under the guidance of a healthcare provider.

How to Terminate an Early Pregnancy?

Ideally, there are two ways in which pregnancy can be terminated in the first month or for that matter, in the first trimester.

• Medical: In this method, medicines are prescribed to end the pregnancy. These medicines cause contractions of the womb that aid abortion. However, this can be done only in the first 9 weeks of pregnancy. Mifepristone is the medicine used that blocks progesterone and thins out the lining of the womb.
• Surgical: This is done in a clinic; it requires a minor procedure to terminate the pregnancy. This includes any of the following, depending on the patient’s need and condition.
• Abortion by Suction: A special tube (cannula) is inserted into the womb through the vagina and the cervix. It is simple, safe, and takes less time (up to 10 minutes). Suction can be done in the first 12 weeks of pregnancy.
• Abortion by Scraping (D and C): In this, a sharp instrument called the curette is used. It takes about 15 to 20 minutes and in most cases, the patient is under anesthesia during the procedure. In this, the cervix has to be stretched so that the curette can be inserted into the womb, which at times can be quite painful. This can be done within the first month.

What To Expect During The Procedure?

After confirmation of pregnancy and taking a detailed medical history, your doctor will prescribe the drug mifepristone. One can take it from home or from the clinic. It blocks the progesterone in the body, causing the breakdown of the uterine lining [4].

The doctor asks to take Misoprostol after 24-48 hours, orally or vaginally. This drug causes cervical softening and dilatation and also induces strong uterine contractions, resulting in the expulsion of the products of conception [5].

What To Expect After The Procedure?

The physical response to an early termination of pregnancy differs from person to person. Typically, common responses include:

• Bleeding: This may last for a few days to a few weeks. This bleeding is similar to menstrual bleeding and may vary from a heavy flow to light spotting [6].
• Cramping pain: It is a common symptom, and it is quite intense just after the procedure and gradually fades away over a few days [7].
• Mild side effects: Fatigue, nausea, vomiting, diarrhea, and body pains are quite common symptoms that resolve in a few days.

Are Follow-Up Procedures Required?

Follow-up after an early medical abortion is crucial to make sure that the termination is complete and also to ensure the well-being of the woman. It requires a thorough physical examination and measurement of pregnancy hormones in the blood. Usually, after one to two weeks of the procedure, follow-up is scheduled. It is also a very good time to discuss birth control options with your doctor to prevent any unintended pregnancies in the future.

How Long Does a Medical Abortion Take?

Most of the time, products of conception usually pass within 1-6 hours of taking misoprostol. This process may take 2-3 days to complete. Many women experience bleeding and cramping for up to a few weeks.

Risks and Complications of Early Medical Abortion

Usually, early medical abortion is quite safe, but there can be quite a few unlikely complications that may occur. Some of the risks of this procedure include:

• Heavy bleeding that does not stop for many days [8].
• Allergic reaction to the medications given.
• Failure to terminate the pregnancy completely. Around 7.4% of cases require surgical management [9].
• Retained bits of pregnancy tissue [10].
• Infection leads to fever and foul-smelling discharge [11].
• Severe pain.

Who Should Not Have a Medication Abortion?

Medical abortion can be unsafe for a few individuals suffering from pre-existing medical conditions. They include:

• Women with blood clotting disorders [12].
• Women with severe anemia.
• An ectopic pregnancy [13].
• Women on long-term steroids.
• Chronic adrenal failure
• Women with intrauterine devices in situ [14].
• Known allergies to medications used.

How To Prepare Yourself For Medical Abortion?

To ensure a safe and effective medical abortion, it is advisable to follow several steps.

• Firstly, you need to visit your healthcare provider in order to confirm the location of pregnancy and gestational age. You need to have a good understanding of the procedure as well.
• You must have in-depth knowledge about what to expect during and after the procedure. This also includes knowing about the possible complications and the follow-up care.
• You might need to take a few days off from work in order to ensure a good recovery.
• You must discuss with your doctor regarding the possible interactions of any medicine that you are already taking.

Early medical abortion plays an important role in managing unplanned pregnancies. It is a great option for women who are seeking autonomy over their reproductive health. It is a safe and effective way to help you with an unintended pregnancy. Also, it greatly empowers women to make decisions about their future. If you choose to go ahead with this option, then it is always better to consult your healthcare provider.

FAQ’s

1. What To Do If I Get Pregnant And Don’t Want It?

In the event of an unintended pregnancy, you can seek the help of your healthcare provider about the possible ways to terminate the pregnancy. Early medical abortion is a safe and effective way to terminate early pregnancy.

2. What To Do If You’re 3 Weeks Pregnant And Don’t Want It?

If you are 3 weeks pregnant and you decide not to continue with it, then the best way to manage it is with the help of early medical abortion. This process involves the use of two medications that may help terminate your unplanned pregnancy.

3. How Can I Overcome Unwanted Pregnancy?

Overcoming an unwanted pregnancy requires certain steps. Firstly, you need guidance regarding the ways to terminate the pregnancy. Seeking professional help and support groups can be really helpful in overcoming this difficult situation.

4. How To Avoid 2 Months Of Pregnancy?

If you are two months into an unwanted pregnancy, then you can seek the help of your healthcare provider to decide upon the best available option to terminate it. If your pregnancy is within 10 weeks, then medical abortion is a safe option for you.

5. Does Medical Abortion Pain Feel Like Labor Pain?

The pain experienced during a medical abortion varies widely from woman to woman. For some women, it feels like a menstrual cramp, while others compare it to early labor pains.

References

1. Decide, National Abortion TeleHealth Services – https://decide.org.nz/en/abortion-services/abortion-types/early-medical-abortion-the-procedure/
2. World Health Organization, Abortion – https://www.who.int/news-room/fact-sheets/detail/abortion
3. U.S Food And Administration Questions and Answers on Mifepristone for Medical Termination of Pregnancy Through Ten Weeks Gestation – https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation
4. Blake M. Autry; Roopma Wadhwa, South Carolina Department of Mental Health – https://www.ncbi.nlm.nih.gov/books/NBK557612/
5. Allen R, O’Brien BM. Uses of misoprostol in obstetrics and gynecology. Rev Obstet Gynecol. 2009 Summer;2(3):159-68 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760893/
6. HSE, Physical side effects after having an abortion – https://www2.hse.ie/conditions/abortion/after/physical-side-effects/
7. Grossman D, Raifman S, Bessenaar T, Duong LD, Tamang A, Dragoman MV. Experiences with pain of early medical abortion: qualitative results from Nepal, South Africa, and Vietnam. BMC Womens Health – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6794877/
8. Bridwell RE, Long B, Montrief T, Gottlieb M. Post-abortion Complications: A Narrative Review for Emergency Clinicians. West J Emerg Med. 2022 Oct 23;23(6):919-925. – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9683756/
9. Ronit Haimov-Kochman, Department of Obstetrics and Gynecology, Hadassah University Hospital, Mount Scopus, PO Box 24035, Jerusalem, 91240, Israel. E – REVITAL ARBEL, Division of Obstetrics and Gynecology, Hadassah Hebrew University Hospital, Jerusalem, Israel –
   https://obgyn.onlinelibrary.wiley.com/doi/full/10.1080/00016340701203632
10. Daniela A Carusi, MD, MSc, Associate Professor of Obstetrics, Gynecology, and Reproductive Biology Brigham & Women’s Hospital  Harvard Medical School – https://www.uptodate.com/contents/retained-products-of-conception-in-the-first-half-of-pregnancy/
11. Carlsson I, Breding K, Larsson PG. Complications related to induced abortion: a combined retrospective and longitudinal follow-up study. BMC Womens Health. 2018 Sep 25;18(1):158 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6156848/
12. Lisa Oldham, MD, Ob/ Gyn , Ascension Illinois Saint Francis Hospital Evanston, Department of Gynecology – https://hemaware.org/womens-health/having-abortion-with-bleeding-disorder
13. Alcove Health, What will happen if i take the abortion pill with an ectopic pregnancy? –  https://alcovehealth.org/abortion-pill-with-an-ectopic-pregnancy/
14. Pregnancy Resource Center, IUD Removal Before An Abortion – https://www.prcmedicalclinic.com/iud-removal-before-abortion/