Let's talk about medical abortion.

Deciding to terminate a pregnancy is a very personal and sensitive matter. It is normal to have questions, fears, and uncertainties at a time like this. Whatever the reasons for this decision, it is important for you to have accurate medical information about it. So today, we will talk about "Medical Abortion," a method of terminating a pregnancy in its early stages without surgery, using pills.

Simply put, what is medical abortion?

Medical abortion is a non-surgical procedure that uses two types of pills prescribed by a doctor to terminate a pregnancy in the early stages (usually within the first 10 weeks). There are two main types of medication:

1. Mifepristone: This medication works by blocking the action of the hormone progesterone, which is essential for maintaining pregnancy. When this hormone is lost, the lining of the uterus thins and the pregnancy no longer survives.

2. Misoprostol: This second pill is taken 24 to 48 hours after the first pill. It causes the uterus to contract, causing bleeding and cramping, and completely expelling the contents of the uterus.

This is a different procedure than a D&C (Dilation and Curettage) , which is a surgical procedure performed if the pregnancy is advanced.

Why would someone choose this method?

This decision is completely personal. It can be influenced by various reasons. Think about it, maybe this is an unplanned pregnancy. Or, continuing the pregnancy may be a risk to your life or health. Sometimes, parents may make this decision when they learn that the baby in the womb has a serious congenital disease.

In addition, sometimes doctors use these same medications to cleanse the uterus, even if the baby dies in the womb (missed miscarriage), and in cases where it does not expel on its own.

Who is this method not suitable for?

As with any medical treatment, this is not suitable for everyone. It is important to discuss your health conditions with your doctor to make sure this is safe for you. This procedure can be risky in the following cases:

What happens when you take the medication and what should you expect?

Your doctor will explain the process to you in detail. It usually goes like this:

1. Step 1: You take the Mifepristone pill at your doctor's office. Some people may experience some nausea or light bleeding after this, but most people don't feel much of a difference.

2. Step 2: Within 24 to 48 hours of taking the first pill, you will need to take the Misoprostol tablets at home. These can be dissolved in the inside of your mouth (buccal) or inserted vaginally (vaginally), as your doctor may advise.

Things to expect:

• Severe abdominal pain and bleeding: This is similar to the severe cramps that occur during menstruation. Blood clots may be passed along with the blood. This lasts for several hours.
• Fever and chills: You may feel a slight fever or chills for about a day after taking the second dose.
• Other symptoms: Fatigue, nausea, vomiting, and diarrhea may occur.

To control the pain, applying a hot water bottle to your stomach and taking a painkiller (such as ibuprofen) recommended by your doctor may help. Never take any medication without consulting your doctor.

What happens after this process?

• Bleeding: Heavy bleeding may last for a day or two, then light bleeding may occur for two to three weeks, like a normal period. Use sanitary pads instead of tampons during this time. This will make it easier to monitor how much you are bleeding.
• Follow-up: You should see your doctor again in about two weeks. Then, they will do a scan or other test to make sure the medication is working properly and the pregnancy is completely terminated. This is a must-do step.
• Recovery: Physically, you should be back to normal in a day or two. However, mentally, you may feel a variety of emotions. Maybe relief, sadness, anger, or guilt... all of these are normal. Talking about this with someone you trust, or if necessary, a mental health counselor, can be very helpful.
• Sexual intercourse and getting pregnant again: To prevent infection, avoid having sex for two to three weeks. After this procedure, your normal menstrual cycle will resume in 4-6 weeks. You will be able to get pregnant again soon, in as little as two weeks. This procedure usually does not affect your future fertility.

When should you see a doctor immediately?

This is the most important part. If you experience any of the following red flags , see your doctor immediately or go to the nearest hospital Emergency Department (ETU).

• If no bleeding has started 24 hours after taking the second pill (misoprostol).
• If you are bleeding heavily (for example, if two thick sanitary napkins are completely soaked within an hour).
• If you are showing signs of infection (such as fever lasting more than 24 hours, foul-smelling vaginal discharge).
• If you have unbearable, severe stomach or back pain .
• If you haven't had your period for two months.
• If you are still experiencing pregnancy symptoms (such as nausea, breast tenderness) .

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