Abortion - medical
Medical abortion is the use of medicine to end an undesired pregnancy. The medicine helps remove the fetus and placenta from the mother's womb (uterus).
There are different types of medical abortions:
- Therapeutic medical abortion is done because the woman has a health condition.
- Elective abortion is done because a woman chooses (elects) to end the pregnancy.
An elective abortion is not the same as a miscarriage. Miscarriage is when a pregnancy ends on its own before the 20th week of pregnancy. Miscarriage is sometimes called a spontaneous abortion.
Surgical abortion uses surgery to end a pregnancy.
Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion
A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last period. A combination of prescription hormone medicines is used to help the body remove the fetus and placenta tissue. Your health care provider may give you the medicines after doing a physical exam and asking questions about your medical history.
Medicines used include mifepristone, methotrexate, misoprostol, prostaglandins, or a combination of these medicines. Your provider will prescribe the medicine, and you will take it at home.
After you take the medicine, your body will expel the pregnancy tissue. Most women have moderate to heavy bleeding and cramping for several hours. Your provider may prescribe medicine for pain and nausea if needed to ease your discomfort during this process.
Why the Procedure Is Performed
Medical abortion might be considered when:
- The woman may not wish to be pregnant (elective abortion).
- The developing baby has a birth defect or genetic problem.
- The pregnancy is harmful to the woman's health (therapeutic abortion).
- The pregnancy resulted after a traumatic event such as rape or incest.
Risks of medical abortion include:
- Continued bleeding
- Pregnancy tissue not passing completely from body, making surgery necessary
Before the Procedure
The decision to end a pregnancy is very personal. To help weigh your choices, discuss your feelings with a counselor, provider, or a family member or friend.
Tests done before this procedure:
- Pelvic exam is done to confirm the pregnancy and estimate how many weeks pregnant you are.
- An HCG blood test may be done to confirm the pregnancy.
- A blood test is done to check your blood type. Based on the test result, you may need a special shot to prevent problems if you get pregnant in the future. The shot is called Rho(D) immune globulin (RhoGAM and other brands).
- Vaginal or abdominal ultrasound may be done to determine the exact age of the fetus and its location in the womb.
After the Procedure
Follow-up with your provider is very important. This is to make sure the process was completed and all the tissue was expelled. The medicine may not work in a very small number of women. If this happens, another dose of the medicine or a surgical abortion procedure may need to be done.
Physical recovery most often occurs within a few days. It will depend on the stage of the pregnancy. Expect some vaginal bleeding and mild cramping for a few days.
A warm bath, a heating pad set on low, or a hot water bottle filled with warm water placed on the abdomen may help ease discomfort. Rest as needed. DO NOT do any vigorous activity for a few days. Light housework is fine. Avoid sexual intercourse for 2 to 3 weeks. A normal menstrual period should occur in about 4 to 6 weeks.
You can get pregnant before your next period. Be sure to make arrangements to prevent pregnancy, particularly during the first month after the abortion.
Medical and surgical abortions are safe and effective. They rarely have serious complications. It is rare for a medical abortion to affect a woman's fertility or her ability to bear children in the future.
American College of Obstetricians and Gynecologists. Practice bulletin no. 143: medical management of first-trimester abortion. Obstet Gynecol. 2014;123(3):676-692. PMID: 24553166 www.ncbi.nlm.nih.gov/pubmed/24553166.
Nelson-Piercy C, Mullins EWS, Regan L. Women's health. In: Kumar P, Clark M, eds. Kumar and Clark's Clinical Medicine. 9th ed. Philadelphia, PA: Elsevier; 2017:chap 29.
Rivlin K, Westhoff C. Family planning. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 13.
John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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