Abortion- What We Need To Know

Introduction

What is Abortion?

A medical technique called abortion removes the embryo or foetus before it can live outside the uterus in an attempt to terminate the pregnancy.

In many nations around the world, abortions are often performed. Most of these procedures occur in underdeveloped countries, where there may not be as much access to safe and authorized abortion services.

Abortion legality is still a sensitive issue in many countries, with varying laws and regulations reflecting the nuanced social and cultural perspectives surrounding the subject.¹What is abortion | Researched based study from guttamacher.irg

This article will discuss the medical aspects of induced abortion, such as its types, indications, contraindications, pre-abortion evaluation and counselling, induction procedures, and potential consequences.

Types

What are the Types of Abortion?

Abortion comes in two primary types: medical and surgical.

Medical Abortion

Medical abortion is a painless way to terminate a pregnancy using medicines. While a surgical abortion requires a procedure to remove the foetus from the uterus, it also involves taking medicine.

• Pregnancies up to 10 weeks are typically advised to have a medical abortion, but pregnancies up to 24 weeks can have a surgical abortion, based on the country’s legislation.

• Up to nine weeks into a pregnancy, a medical abortion is possible.

• A scan will be done to assess whether there is an ectopic pregnancy. Mifepristone and misoprostol are two medications that must be taken over several days to have a medical abortion.

• An approximately 95% success rate for medical abortion makes it safe and efficient. It is also a discreet and practical choice for women who would rather avoid surgery. Heavy bleeding, cramps, nausea, vomiting, diarrhoea, and fever are possible side effects and hazards.

There are several circumstances where a medical abortion may not be advised or cannot be carried out safely.

In what type of cases Medical Abortion is not advised?

• Ectopic pregnancy: An intrauterine pregnancy cannot be safely ended by a medical abortion.

• Incomplete abortion: Medical abortion may not be advised if a woman has previously experienced an incomplete abortion.

• Blood clotting disorders: Women with blood clotting issues may not be advised to have a medical abortion.

• Medication allergy or intolerance: A medical abortion cannot be carried out safely if the woman is allergic to or intolerant to mifepristone or misoprostol.

• Chronic adrenal failure: Some women with chronic adrenal insufficiency may not be able to take mifepristone.

• Chronic use of corticosteroids: Women who take corticosteroids regularly may not be able to take mifepristone.²Medical abortion | Researched based study from Sciencedirect.com

How to prepare for a medical abortion?

• Confirm the pregnancy: Before having a medical abortion, it’s crucial to ensure the pregnancy is still in its early stages and is not ectopic.

• Assess eligibility: as was previously mentioned, not everyone is a good candidate for or safe with a medical abortion. It is crucial to go over eligibility with a medical professional.

• Be prepared for any adverse effects: a medical abortion could result in nausea, vomiting, bleeding, cramps, and nausea. It’s crucial to have painkillers on hand and to be ready for these adverse effects.

• Schedule a follow-up consultation with a doctor: This will allow you to confirm that the medical abortion was effective and talk about your birth control alternatives.

To ensure success and reduce dangers, it is crucial to adhere closely to the directions a healthcare professional gives.

How is Surgical abortion carried out?

A medical treatment called a surgical abortion involves emptying the uterus of its contents to end a pregnancy. Depending on the stage of pregnancy and the clinicians’ preferences, there are many surgical abortion methods.

• Consultation- Before having a surgical abortion, you must talk to your doctor about the operation and ensure that it’s the best course of action for you.

• Examination- The healthcare provider will perform an ultrasound to gauge the length of the pregnancy and provide safe treatment. Also, they will go over the various surgical abortion methods and what to anticipate.

• Vacuum aspiration- During aspiration, a little tube will be placed into the cervix during this procedure, suctioning out the uterus’ contents.

• Dilatation and Curettage (D&C)- For pregnancies between 13 and 16 weeks, D&C is commonly used. A healthcare professional will dilate the cervix throughout the operation.

Risks

What are the Risks?

Abortion is a safe method, but there are potential dangers and consequences. We’ll talk about some of the typical risks and adverse effects of abortion. 

• Heavy bleeding: also called as haemorrhage, excessive bleeding is a frequent issue following an abortion. It can need medical treatment if it happens during or after the procedure.

• Infection: An additional potential abortion side effect is infection. When bacteria or other microbes enter the uterus during the surgery, it may result in it. By ensuring that the abortion is carried out in a sterile setting by a skilled medical expert, the danger of infection can be reduced. Fever, stomach ache, and an unpleasant discharge are all signs of mat.
• Damage: During an abortion, there is a minimal chance that the uterus or other organs could be hurt. This could happen if the surgical instruments enter the uterus or if a vacuum aspiration is performed with too much suction. ³Risk of abortion| Researched based study from acog.org

• Emotional effects: Those who decide to have an abortion may experience emotional effects. It’s possible for some people to feel guilty, depressed, or regretful. ⁴Risk of abortion | Researched based study from nih.org

• Fertility: There is no evidence to support the claim that abortion affects future fertility. Yet, there is a slight chance of getting Asherman’s syndrome, a uterine scarring condition that can affect fertility.

Those who have had multiple abortions or had abortions conducted by inexperienced practitioners are at a higher risk.

Medical management of the complications

• Bleeding control- Often, the first step in treating abortion-related complications is to treat bleeding. A blood transfusion can be necessary for the woman if the bleeding is severe.

• Medication- The woman can be given medication to assist in controlling the bleeding if the bleeding is light to severe. Antibiotics are used to treat infections. The severity of the disease will determine the antibiotic treatment. The woman might require hospitalization if she has a fever.

• Dilation and curettage- This procedure is used to treat incomplete abortions (D&C). To do this, the cervix must be dilated, and any excess uterine tissue must be removed using a small device. The woman might be granted a D&C if she cannot have one.

Abortion is a standard and generally effective medical treatment. To avoid serious consequences, medical care is required in the case that issues do arise.

Pre-procedure

What is the pre-procedure assessment?

There are usually a few steps in the pre-procedure diagnostic and counselling process.

Physical examination

• Physical examination and blood tests are carried out to ensure the person is healthy enough to have the operation. The individual’s medical background and any medications they are currently taking may also be discussed.

Counselling

• It should cover the procedure’s advantages and disadvantages as well as other possibilities. This might involve discussing options for completing the pregnancy, such as adoption.

• As a part of counselling, you could also talk about the emotional and psychological aspects of the decision and the support system. 

Informed Consent

• One of the most crucial components is informed consent. The process by which individuals are informed about medical procedures, including the risks and benefits, so they can choose whether or not to have the system done is referred to as “informed consent.”
• It ensures that people have authority over their bodies and can make decisions that are consistent with their values and beliefs, this ethical principle is essential in medicine.

• Informed consent is necessary since deciding to end a pregnancy can have profound emotional and psychological impacts.
• This process ensures that individuals are fully informed about the risks and benefits of the procedure and can make a decision that aligns with their values and beliefs. ⁵pre-procedure assessment of abortion| Researched based study from nih.org

Post-procedure

How is the Post- Abortion procedure carried out?

• The woman will be observed for a brief period following the procedure to ensure she is stable and there are no issues. Depending on the type of abortion done, this time frame might be anywhere from a few hours to a day or longer.

• After the surgery, the woman will be instructed to relax and refrain from intense exercise for a few days. During at least two weeks, she should refrain from lifting anything heavy, wearing tampons, or engaging in sexual activity to avoid infection and other problems.

• The woman should also avoid taking medications without a doctor’s prescription. To avoid infection or lessen pain following the treatment, the lady could be given painkillers or antibiotics. ⁶Post procedure assessment | Researched based study from nih.org

Follow-up

• After an abortion, the lady needs to attend a follow-up appointment with her doctor. Depending on the type of abortion done, the follow-up appointment will need to be scheduled at a particular time. However, it is typically advised to do so 2-4 weeks following the procedure.
• The medical professional will evaluate the woman’s physical and emotional well-being at the follow-up session. They will ensure the woman’s reproductive system is mended appropriately and look for any issues. To avoid unexpected pregnancies, the healthcare provider may also give the woman information on family planning and contraception.

Contraception

Contraception and Abortion

• Abortion and contraception are related because using a reliable method can aid in avoiding unplanned pregnancies.
• According to the data, abortion occurs in 50 percent of unwanted pregnancies.
• The number of accidental pregnancies and consequent abortions might be decreased by increasing access to and use of effective contraception. ⁷Contraception and abortion| Researched based study from nih.org

Miscarriage

What is the difference between Abortion and Miscarriage?

• These are two distinct terms used to describe the termination of a pregnancy. While miscarriage refers to the natural termination of a pregnancy before the 20th week, it frequently occurs as a result of genetic abnormalities, hormonal issues, or other health conditions.
• Abortion is a choice, whereas miscarriage is typically uncontrollable and can cause emotional distress. Because they involve distinct medical procedures, it is essential to comprehend the differences between the two.
• An essential component of reproductive health care is having access to contraceptive and abortion services.

Complications

Abortion and Medical complications

The decision to have an abortion is much more difficult when there are medical considerations involved.

• Heart disease- Pregnancy complications may be more likely in women with heart disease or other chronic conditions. Abortion may be required in some circumstances to protect the mother’s health and wellbeing. They are more likely to experience unfavourable maternal and foetal outcomes.

• Diabetes- Foetal macrosomia and premature birth are risk factors for diabetes in women. For the best results, it’s essential for women with chronic conditions to discuss their pregnancy plans with their healthcare professionals and to receive specialised treatment during the pregnancy.⁸Medical complications and abortion| Researched based study from who.int

• Pre-eclampsia: This condition can result in complications like swelling, elevated blood pressure, and protein in the urine. For both the woman and the foetus, it may possibly be fatal. Occasionally, the only treatment for pre-eclampsia is to deliver the baby or abort the pregnancy.

• Cancer – Radiation and chemotherapy can be harmful to a foetus that is still growing. The health of the mother and foetus could be safeguarded in such situations by the recommendation of an abortion. If a pregnant woman is diagnosed with cancer and her choices for treatment are limited, she might need to have an abortion for more aggressive cancer treatments.

• Foetal abnormalities- A foetus may also have a medical condition incompatible with life in some circumstances. In these situations, the choice to have an abortion could be taken to protect the foetus from discomfort.

A coordinated strategy between the woman’s obstetrician and other medical specialists, such as cardiologists or oncologists, is necessary to treat abortion in the presence of medical problems.

The particular medical issues present, as well as the stage of pregnancy, will determine the timing and procedure of the abortion.

Drugs may be used in some circumstances to induce labour and deliver the foetus, while surgery may be utilized in others.

It is necessary that women who are considering abortion and have medical issues have kind and informed care from their doctors to ensure safety.

Takeaway

Key Takeaways

A safe, legal, medical practice that can be carried out in a variety of locations is abortion. While there are dangers and adverse effects associated with medicinal and surgical abortion, they can be handled with suitable medical attention.

To reduce the risks involved with the procedure, it’s crucial to obtain treatment from a licensed healthcare professional and to adhere to all pre- and post-abortion care recommendations

Furthermore, limiting women’s access to safe and legal abortions may harm their health and well-being. It may result in more unwanted pregnancies, unsafe abortions, and higher maternal mortality rates. Women’s health, safety, and autonomy must be protected by providing access to safe and authorized abortion procedures. 

It is crucial that women have the freedom to decide for themselves what to do with their bodies and have access to the medical treatment they require.