Take the pill or continue the pregnancy? How is a medical abortion performed?

Medical abortion while breastfeeding

Have an unplanned pregnancy and are you breastfeeding?
Medical abortion may be considered as one of the options for terminating a pregnancy. However, many patients are afraid to carry out interruptions because of this factor.

The choice of method for getting rid of an unwanted pregnancy while breastfeeding depends on many factors:

• from the desire to continue breastfeeding,
• on whether a caesarean section was performed during the last birth,
• from the duration of pregnancy.

A medical abortion takes on average 2-3 days. In the first hours after taking the first drug - mifepristone, which blocks the local action of the pregnancy hormone - progesterone, the concentration of this substance in the blood remains at its peak.

It is during the first day that the chemical compounds of this product reach their maximum value; they also enter breast milk. At the stage of taking the second drug, which contains prostaglandins, which stimulate the contractility of the muscle fibers of the uterus, chemicals from this drug are released into breast milk through the blood.

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Medical abortion is a method of terminating pregnancy caused by medications ( prescribed exclusively by the attending physician - obstetrician-gynecologist and used under the personal supervision of a specialist in the clinic ). This method of non-surgical termination of pregnancy is the safest and most gentle modern method, which does not require hospitalization of the patient and is better tolerated psychologically.

Effect of pharmaceutical products. abortion for lactation

Pharmacological agents used to perform a medical abortion in a clinic that has all the necessary documents for their use to terminate an unwanted pregnancy pass into breast milk and, if ingested by the baby, can provoke allergies or other toxic damage.

Taking these medications does not affect the amount of milk produced. After the removal of residual substances from the breakdown of drugs for medical abortion (4-5 days), the concentration of these drugs is negligible and cannot harm the child.

In what cases is it carried out?

Unplanned pregnancy, alas, is not always desired. In this case, the woman can decide to terminate it (abortion).

A revolutionary method of non-surgical abortion in the 21st century is medical abortion. He gained supporters all over the world.

Thus, in developed countries, the frequency of use of medical abortion in the structure of all methods of abortion ranges from 40-60% (European countries, USA) and up to 80% (Sweden, France).

The effectiveness of medical abortion is 95-98% in early pregnancy (42 days from the 1st day of the last menstrual period or 6 weeks of pregnancy).

The traditional method of terminating pregnancy is surgical abortion (up to 12 weeks) .

There are 2 types of surgical abortion:

• vacuum aspiration;
• scraping the walls of the uterine cavity using surgical instruments.

The complications that can arise when performing a surgical abortion are numerous. The most common ones are:

• mechanical trauma of the uterus and cervix;
• bleeding;
• remnants of the fertilized egg;
• inflammation of the uterus and appendages;
• risk of hepatitis and HIV infection.

In addition, long-term complications of surgical abortion may include the following:

• chronic inflammatory processes of the genital organs;
• ovarian dysfunction and menstrual irregularities;
• ectopic pregnancy;
• infertility;
• incompetence of the cervix (spontaneous miscarriage may occur in subsequent pregnancies);
• anomalies of labor.

However, in modern medicine, new technologies for terminating unwanted pregnancies have emerged that are more protective of women’s health. Their risk to women's health is significantly lower than that of traditional methods.

One of the main advantages of a medical abortion over a surgical abortion is that the health risk is significantly lower, does not affect a woman’s fertility (a woman can become pregnant in the 1st menstrual cycle after a medical abortion), is well tolerated and does not require a hospital stay.

Possible complications

Despite the small number of complications, it is possible to determine why medical abortion is dangerous. In 85% of cases, adverse reactions in the form of abdominal pain and bleeding are moderate and no special treatment is required.

In other cases, manipulation can lead to the following complications:

· severe pain syndrome;

· profuse bleeding;

· temperature;

· incomplete abortion;

· progressive pregnancy.

Pain in the lower abdomen is observed during the period of expulsion of abortion products. Its intensity may vary, but the individual tolerance threshold also matters.

Bleeding is considered significant if you have to change two pads in an hour, and this condition lasts for at least 2 hours. In this case, vacuum aspiration of the contents of the uterus is indicated in order to stop it. In severe cases, surgical cleaning is performed.

In 2-5% of cases, medical abortion is incomplete. Then it is also necessary to perform vacuum aspiration or curettage of the uterine cavity. Less than 1% of cases result in pregnancy progression. If a woman insists on an abortion, then invasive methods are used. Those who have changed their decision must be informed about the possible teratogenic effect of the drugs on the fetus. But there is not enough data to confirm this fact.

Taking medications may cause a slight increase in temperature, but this lasts no more than 2 hours. If the fever lasts for 4 hours or more or occurs one day after taking Misoprostol, this indicates the development of an infectious process. A woman with these symptoms should consult a doctor.

Other complications in the form of dyspeptic symptoms may be a sign of pregnancy itself. For allergic reactions, treatment with antihistamines is necessary.

Stages of medical abortion

A medical abortion requires 3 visits to the doctor.

Visit 1

On the day of treatment, the obstetrician-gynecologist talks, examines the patient, and gives her:

1) Ultrasound for the purpose of:

• confirm pregnancy;
• establish that pregnancy develops in the uterus;
• establish the duration of pregnancy (no more than 6 weeks or 42 days from the first day of the last menstruation).

2) minimal examination, which includes:

• taking a smear on the flora;
• referral for a blood test (for syphilis, AIDS, hepatitis; determination of blood type and Rh factor).

Then, during the first consultation, the doctor will tell you in detail how the procedure should be carried out and indicate the order of repeat visits, as well as inform you about what the symptoms may be and how to behave in such cases.

The doctor will definitely warn you that in a small number of cases (2-5%) the method may be ineffective, and then you will have to terminate the pregnancy surgically.

Medical termination of a non-developing (frozen) pregnancy

Medical termination of a non-developing pregnancy is a gentle, non-surgical technique used for periods of 6 to 8 weeks, in case of arrested development and/or death of the fetus.

The medications used are those that are progesterone antagonists (for example, mifepristone), as well as prostaglandin analogues. As a result of the action of medications, the previously dead fertilized egg is rejected and released.

The need for medical termination of a frozen pregnancy

Fetal death mainly occurs in the first trimester (in approximately 85% of women). During this crucial period, the embryo is especially vulnerable, since the laying of vital organs occurs, as well as a number of serious “restructurings” in the woman’s body.

As a result of serious violations, the death of the embryo occurs. This pathology can cause a strong psychological blow to the affected woman. But in this difficult time, it is necessary to act without delay, since the current situation is extremely dangerous for the patient’s health and the possibility of having a baby in the future.

To prevent such serious consequences as blood poisoning, extensive inflammation of the genital organs, it is necessary to urgently localize the dead fetus from the woman’s body.

The principle of action of medications

Medical termination of pregnancy in gynecology is regarded as a less radical, but at the same time effective measure for removing a dead embryo. The use of special drugs eliminates the need for surgical intervention, which often leads to injuries to the cervix, uterine cavity and obstruction of the fallopian tubes.

At the Happy Family clinic, gynecologists, after verifying the diagnosis, will prescribe a drug that will provoke dilatation of the cervix and further rejection of the endometrium, which will lead to the evacuation of the fertilized egg.

At the next stage, it is necessary to take prostaglandin; it will trigger the contractile mechanism of the uterus, as a result of which the remains of the embryo will be expelled from the uterine cavity. This stage is carried out under the control of ultrasound monitoring to monitor the process of complete elimination of the dead fetus, assess the endometrium and the general condition of the uterus.

Favorable prognosis for conception

Stopping development or death of the fetus is one of the terrible results of pregnancy. Of course, for families who were expecting a baby, this can be a serious tragedy. But it is worth remembering that this is not the end!

The possibility of conceiving again and giving birth to a healthy baby is quite high. The main thing is not to despair, but to gain strength in order to undergo further examination and plan your pregnancy again.

At the Happy Family clinic, you can consult with leading obstetricians and gynecologists, use our algorithms to get the pregnancy you want, and in the future purchase a “Pregnancy Management Program.”

8(495) 788-9-799

Consultation with a psychotherapist (at the patient’s request)

After the fact of pregnancy is confirmed, the obstetrician-gynecologist will definitely offer you a consultation with a psychotherapist. This consultation before termination of pregnancy is recommended as a prevention of the psychological consequences of abortion.

Psychological counseling for women planning artificial termination of pregnancy will help to adequately assess possible risks and consequences, as well as understand whether a conscious decision was made. The purpose of the consultation is not to dissuade a woman from having an abortion; it is carried out with the intention of supporting the patient during a difficult period of life.

After a conversation with a specialist, you are given 2 days to think about it, after which, if your decision to terminate the pregnancy remains firm and unshakable, you sign an informed consent to the subsequent procedure at the clinic and, under the close supervision of a gynecologist, proceed to the next stage .

Feeding regimen for medical abortion

If a woman, together with a gynecologist, has chosen a pharmacological method of terminating pregnancy, then it is necessary to adjust breastfeeding.

After taking the first pills, you cannot breastfeed the baby, but at the same time, if a woman wants to maintain lactation at the same volume, she must regularly express milk. Expressed milk is not suitable for feeding a baby, but it is necessary to pump with the same frequency and regularity as if a child were doing it. With this mode of pumping, milk production will remain the same.

On the fifth day, after a miscarriage has occurred, which is confirmed by an ultrasound protocol, you can continue breastfeeding the baby. Mothers should know that if a child refuses to breastfeed, this may be caused by a change in his taste due to the very fact of pregnancy and subsequent miscarriage, or poor-quality pumping.

In most cases, breastfeeding is fully restored and continues. When breastfeeding is resumed, there is no need to do breast milk tests; its indicators remain normal.

Due to the temporary interruption of breastfeeding, and the inconvenience associated with it, the choice of terminating an unwanted pregnancy early in nursing mothers often opts for the vacuum method.
This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

How the procedure itself is carried out

After receiving the examination results, in the absence of contraindications to termination of pregnancy and written confirmation of consent to this service, you take the Mifepreston tablet (trade name Mifegin, Miropriston, Mirolian) in the presence of a doctor. This drug blocks receptors in the uterus for progesterone, a hormone that promotes the development of pregnancy. Mifepreston also increases the sensitivity of the uterus to contractile agents, primarily to prostaglandins (Mirolyut, Topogin, Misoprostol).

Some women experience spotting on the 1st day after taking Mifeprestone, and 5% of women may experience a complete abortion.

Visit 2

The action of Mifepreston reaches its maximum effect 36–48 hours after the first visit to the doctor . Your return visit to the clinic is scheduled for this period.

Under the influence of Mifepreston, the fertilized egg peels off from the walls of the uterine cavity. The next stage is its expulsion from the uterine cavity.

For this purpose, the clinic will give you a drug (“Mirolyut”). This drug is a prostaglandin: it causes uterine contractions. After taking Mirolut, most women begin to experience bleeding from the genital tract, the onset of which may be accompanied by symptoms that are predictable and remediable:

• Pain : Complaints of pain vary greatly among women, depending on their personality type and pain threshold. For severe pain, it is allowed to use analgesics (paracetamol, analgin, etc.).
• increased body temperature and chills . Prostaglandins are sometimes the cause of increased body temperature. Typically, such an increase does not exceed 38 * C and lasts no more than 2 hours. The use of paracetamol eliminates these symptoms.
• nausea and vomiting. In patients coming for a pharmacological abortion, nausea may be associated with the pregnancy itself. However, abortifacient drugs can also cause nausea and, rarely, vomiting. Usually these symptoms go away on their own, and antiemetic drugs can also be used.
• diarrhea (loose stools) . The occurrence of diarrhea is associated with taking drugs to contract the uterus. This symptom is rare, short-term in nature, and goes away on its own. There is no need for treatment.
• bleeding _ Termination of pregnancy is accompanied by bleeding, similar to menstrual or more abundant. Such spotting rarely leads to a decrease in hemoglobin and/or requires any treatment. This is the normal course of a pharmacological abortion. You need to know that bleeding is considered heavy if 2 sanitary pads of the maximum size are completely saturated with blood within an hour, and this continues for 2 hours in a row or more. In this case, you should immediately contact your doctor.

Visit 3

(on the 14th day after the first)

A third visit to the clinic is necessary to assess the effectiveness of medical termination of pregnancy: complete abortion, incomplete abortion, continuing pregnancy.

The effectiveness of the method is 95-98%. If the method is ineffective, assessed on the 14th day after taking Mifeprestone, the woman completes the abortion surgically.

Both drugs used to terminate pregnancy are not hormonal.

Already in the 1st cycle after a pharmacological abortion, the woman’s fertility is restored, i.e. she can get pregnant again. Therefore, you should definitely discuss the issue of contraception with your doctor.

There are contraindications to medical termination of pregnancy, which can be found out at your doctor’s appointment.

Tablets for medical abortion Mifepristone - reviews

Larisa
https://lekotzyvy.com/preparat/m/mifepriston/

Advantages: High efficiency

Flaws:

Price, severe pain, consequences

With his help, I had a medical abortion in the clinic. I don’t recommend taking the pills yourself, girls, it’s dangerous.

The drug can be used for up to 12 weeks. I bought the drug myself, but it was very expensive. To terminate a pregnancy, take 600 mg once, 3 tablets of 200 mg each. I didn’t feel anything at all for about a day, but I was in the clinic. But then in the evening I felt very bad. The pain was simply hellish, as if someone was cutting from the inside with a knife, it twisted, and I began to feel very sick. There was severe vomiting, then more diarrhea, the room was spinning before my eyes. They looked after me as best they could, after about four hours it passed. For some reason it just stopped abruptly, and after another hour or two I began to feel absolutely normal.

After 36 hours, they give you another pill, but it’s Misoprostol, so that the rejected material comes out. My discharge was very profuse, it became a little scary, but it turned out to be painless. They don’t do an ultrasound right away, only ten days later. Then the doctor told me that everything went fine.

But the drug has a lot of side effects. Despite the fact that the abortion itself was successful, I later had severe inflammation of the uterus, which had to be treated for a long time. There were no periods at all for six months, and when they started, they were terribly painful, heavy, and the spotting lasted a long time. The cycle always got confused, the hormonal levels began to fluctuate. Then they discovered an ovarian cyst. And although it is not officially written anywhere that this is a consequence of a medical abortion, in reality this is so - my new gynecologist turned out to be smart, explained that the drug is popular, but far from safe, so I would not give it a plus.

I

https://www.medcentre.com.ua/mifepriston.html#otzyv

no way

Girls, don't buy these pills!!!! I almost lost my life!

Natalia

https://razuznai.ru/mifepriston.html#comment-9358

and after taking Mifepristone, I almost gave my soul to God. I really regretted everything in the world at that moment. I felt so bad that it would be easier to give birth to a child. Now I have sworn off taking something like that in the future. Although it is easily tolerated by many.

Regina

https://razuznai.ru/mifepriston.html#comment-29463

I made 2 abortions with Mifepristone for an “unwanted” pregnancy (under the supervision of a doctor): in 2009 and in 2010 - as a result, subsequent “wanted” pregnancies in 2011 and 2012 ended in a frozen pregnancy. Moreover, for the same periods at which there was an interruption. Now I can’t get pregnant at all, endometriosis has started, I go to doctors, spend money on endless medications, ultrasounds, consultations. And pregnancy became just a dream! So, dear girls, don’t make the same mistakes - if God gave you a doll, then so be it. Let it grow, leave it))

Pausest

https://otzyv.expert/zhirniy-minus-1891094

Advantages:

No

Flaws:

only disadvantages

I don’t know who says that this is easier than a surgical abortion, but to see a fertilized dead egg you need to have remarkable mental endurance... So first. I went to the Medial clinic in Pavlovsky Posad, Moscow region, the doctor prescribed 5-6 weeks, took tests and was on my way. After taking Pencrofton 200 mg, 24 hours later I started to feel sick and have a spotting. The next day I was at home, as prescribed by the doctor, and took Misoprostol 400 mg. The doctor gave me her phone number. After half an hour, I started to feel so sick, I almost hit an oak tree, vomiting, diarrhea, terrible pain, like during childbirth at the very end. So 4 hours, the doctor didn’t pick up the phone, she just turned it off, why bother, the money was paid. After 5 hours an egg fell out, that’s where the test is... You can go crazy when you see it. After 7 hours I felt better, but I was bleeding a lot, the doctor still didn’t answer, she’s a bitch.

General impression:

FAT MINUS!

little light

https://www.tiensmed.ru/news/post_new9043.html

Hello, I want to tell my story. I was diagnosed as pregnant at 6 weeks and the doctor advised a medical abortion. In short, on Wednesday I took three tablets of mifepristone at 12.00, I’m lying there waiting... nothing happened... no bleeding started... somewhere on Thursday evening it started brown discharge... on Friday I took 2 tablets of miroluta, after about an hour pains began in the lower abdomen and my periods began...... at first the pain was tolerable, and then something unimaginable began, I really thought that I would die from the pain, I was vomiting, I was climbing the wall, I was shivering, my head started to hurt, then my fertilized egg came out, and my periods just started, very heavy….and in the end I suffered for almost 9 hours…..then the pain stopped, thank God…..that’s how my abortion went. And you wouldn't wish it on your enemy.

Nana13

https://otzovik.com/review_527026.html

Advantages:

It does not hurt

Flaws:

There is a high probability that not all the leftovers will come out

I want to share my experience, maybe it will help someone make the right decision. At the 5th week of pregnancy, I decided to have a medical abortion; I was convinced that this was the most gentle method, and nothing could be simpler. After the pills, blood began to flow, pieces came out, and the fertilized egg came out. I bled profusely for 6 days, then less, then spotting. After 10 days, they did an ultrasound, which showed residue coming out of the uterus. They gave me 2 more tablets, supposedly the bleeding would increase and the remainder would come out. The profuse bleeding went away, but the bleeding remained. The next ultrasound showed small residues upon exit, they told me to walk around until my period (in 2 weeks) and everything will come out with them. My period started on time, very heavily, after 5 days the bleeding decreased, but did not stop. And then an ultrasound showed even larger residues in the uterus, which had already begun to grow, and an endometrial polyp formed; from taking pills and hormone failure, a huge cyst formed on the ovaries.

The situation was already neglected and there was nothing that could be cleaned up other than promptly. Yesterday we had a hysteroscopy, it’s like curettage only with a camera that is inserted into the uterus. The operation is performed under general anesthesia. They pulled out many more remnants and clots, and in addition, polyps not related to pregnancy began to grow due to the failure of hormones. In general, I spent a lot of money, nerves, ruined my health, but in the meantime I’m waiting for at least some positive results for recovery. I don’t recommend these pills, not everything is as simple as they say and say, everything depends on the individual body. Find out more about other methods, such as vacuum. And if someone has already taken the pills and the bleeding has not stopped after 10 days, urgently consult with several doctors, and go to the hospital or scrape or collect with a vacuum.

General impression:

A very big risk, I ruined my health myself