If there is an unwanted pregnancy due to any reason, then is safe to use abortion pills? Are there women who can’t undergo a medical termination of pregnancy (MTP)? Will there be any side effects? You can find answers to these and other questions here.
Dr. Nupur Gupta, Gynaecologist, Delhi explains in detail about Medical Methods of Abortion in India.
Who can undergo an MTP?
MTP is a reproductive health right for women in India. A woman can undergo the procedure if:
-The woman has a life-threatening condition and the procedure can save her life.
-Continuation of pregnancy poses a risk to her mental and/or physical health.
-There is a likely risk of physical or mental abnormalities in the child.
-Pregnancy is caused as a result of sexual assault or rape.
-Pregnancy occurred as a result of failure of contraception.
-It’s the choice of the woman to abort.
How is pregnancy terminated?
There are two common procedures for terminating an unwanted pregnancy:
-Medical abortion which is done with medicines
-Surgical abortion which involves Dilation and Evacuation (D&E)
In India, there are guidelines which state that medical abortion is allowed up to seven weeks of pregnancy without admitting the woman. In this case, the women can take the prescribed pills at home as per the doctor’s advice. After seven weeks, it has to be done under medical supervision and hence, she has to get admitted for a day. This is because the risk of complications can increase after seven weeks.
What happens to your body after you take the medicine?
Medicines used to induce abortion should only be taken after consulting your doctor. The drugs act by:
-Inhibiting the synthesis or antagonizing the action of progesterone hormones.
-Inducing contraction of the myometrium (middle layer of the uterine wall).
-Inhibiting the development of trophoblast which are the cells that provide nutrition to the embryo and develop into placenta.
What is the procedure for using abortion pills?
The woman has to take two different kinds of pills. After taking the first pill under the doctor’s supervision, the woman has to return after around 36-48 hours for the second pill.
The first medicine prepares the uterus for termination. It softens the cervix, which is responsible for supporting the growing fetus. It works by blocking progesterone and causing the lining of the uterus to break down. The second pill is used to help the uterus contract, expel the embryo and shed the uterine lining.
Generally, abortion pills are recommended during the first few weeks of pregnancy. However, as the pregnancy progresses, the doctor may recommend a surgical abortion.
Although medical abortion is allowed up to 20 weeks of pregnancy, you need consent from two gynaecologists to terminate the pregnancy after 12 weeks, as per the Medical Termination of Pregnancy (MTP) Act guidelines.
Are there any side effects of abortion pills?
Abortion pills can cause these side effects:
– Nausea and vomiting
– Fever with or without chills
– Vaginal bleeding
– Severe pelvic pain and cramps
The gastrointestinal side effects such as nausea, vomiting and diarrhoea are mild and self limiting and pass off without any treatment. But if these symptoms persist, then do consult your doctor.
What are the complications of MTP?
Failed abortion: The abortion pills may fail to work leading to continuation of pregnancy. In some cases, the evacuation of the pregnancy is not complete. Moreover, there is a potential risk of fetal abnormalities if the pregnancy continues. So in such cases, the women may have to undergo a surgical abortion.
Allergy: Some women might be allergic to the active components of the abortion pills. This might lead to allergic reaction along with increasing the risk of failure to terminate the pregnancy. Do consult your doctor if you experience any signs of allergy to prevent any health complications.
Infection: The risk of infection to the uterus is rare when using abortion pills. A follow up is needed to rule out infection and ensure complete abortion. Also, it is advised to avoid intercourse during treatment to prevent infection or use barrier methods to lower the risk of infection.
Post Abortion Care Tips
– After 2 weeks of undergoing an MTP, every woman needs to undergo an ultrasound to confirm that the procedure is complete.
– The woman should be ready for evacuation by vacuum aspiration (VA) if the abortion fails or if there is excessive bleeding.
– Soaking two or more than two pads per hour for more than two hours or heavy bleeding with cramps and fever is a sign to consult a doctor.
– Persistent fever may indicate infection and must be treated with medicines as per the clinician’s advice.
Intercourse:The woman should avoid intercourse till the bleeding stops completely.
Contraception: Contraception such as intrauterine devices (IUD) can be started immediately after confirming that the abortion is complete. However, the presence of infection should be ruled out. Condoms can be used as soon as the woman resumes sexual activity after abortion.
– Abortion pills should never be taken over the counter (OTC). These are to be used only when prescribed by a doctor.
-Although rare, intra uterine device (IUD) failure can also cause pregnancy. In such cases, the woman can take abortion pills but should know that the device needs to be removed as per the doctor’s advice before taking the pills.
– A positive pregnancy test can tell you about pregnancy but not give a clear idea whether it is in the uterus or outside. Hence, an ultrasound is recommended before undergoing MTP to confirm that the pregnancy is inside the uterus.
– If the pregnancy is outside uterus, for example if the foetus is attached to the fallopian tubes, medical abortion is not recommended to terminate the pregnancy.
– Unless there is a rare or serious health complication which is left untreated, there is no risk to future pregnancies. But talk to your doctor about your risks following the treatment to be well aware of the complications.
Handbook on Medical Methods of Abortion by Government of Madhya Pradesh and Ipas to expand access to new technologies for safe abortion.
The Medical Termination Of Pregnancy Act, 1971. (Act No. 34 of 1971)