CNN
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mifepristoneone of two drugs used in medication abortions, can then still be mailed to patients without an in-person visit from a doctor. US Supreme Court dismisses lawsuit Challenging the regulation of abortion drugs.
“While many women are gaining medical abortion “Some people get the drugs from a clinic or obstetrician/gynecologist, but others get the drugs themselves to induce or self-administer an abortion,” said a professor of obstetrics and gynecology at the University of California, Sun. said Dr. Daniel Grossman, professor in the Department of Reproductive Sciences. Francisco.
“A growing body of research shows that self-administered abortion is safe and effective,” he says.
Mifepristone blocks the hormone progesterone, which is necessary for the pregnancy to continue. The medicine is It is approved to terminate pregnancy by the 10th week of pregnancy “within 70 days from the first day of the last menstrual period”. According to the US Food and Drug Administration.
In a medical abortion, a second drug, misoprostol, is taken within 24 to 48 hours. Misoprostol causes the uterus to contract, causing cramping and bleeding. The drug has been approved for use in other conditions, such as preventing stomach ulcers, and has been available in pharmacies for decades.
Together, these two drugs are commonly known as the “abortion pill” and are currently used in more than half of abortions in the United States. According to the Guttmacher Institutea research group that supports abortion rights.
“Some people do this because they can’t get to a clinic or prioritize self-care, especially in states with legal restrictions on abortion,” said Grossman, who is also the center’s director. Promoting new standards in reproductive health; A research group that evaluates the strengths and weaknesses of reproductive health policies and publishes research on them. The impact of abortion on women’s health.
CNN spoke to Grossman to find out what happens during a medical abortion. This conversation has been condensed and edited for clarity.
CNN: What is the difference between a medical abortion in the first trimester and an abortion? vacuum suction When it comes to what women experience?
Dr. Daniel Grossman: Vacuum aspiration is most commonly performed with a combination of local anesthetic and oral analgesics, or local anesthetic and intravenous sedation, or so-called conscious sedation.
A local anesthetic is injected around the cervix to slowly dilate, or widen, the cervix. Once the cervix is opened, a small straw-like tube is inserted into the uterus and a gentle vacuum is used to remove the pregnancy tissue. Contrary to what some people say, if the surgery was done about 9 weeks ago; There is nothing within the tissue that is recognizable as part of the embryo.
The aspiration procedure takes only a few minutes. You will then be observed for 1 to 2 hours until the sedation wears off. We also monitor each patient for very rare complications such as heavy bleeding.
Medication abortion is a longer process. Bleeding or cramping may occur for several days after taking the tablets. Bleeding is usually heaviest when the actual pregnancy is expelled, but the bleeding usually subsides within a few hours. On average, mild bleeding lasts about two weeks, which is slightly longer than after vacuum aspiration.
Nausea, vomiting, fever, chills, diarrhea, and headache can occur after using abortion pills, and people who successfully have a medical abortion usually report some pain.
In fact, the pain of medical abortion can be very intense. Studies that have looked at this show that the average maximum level of pain that people report is 7 to 8 out of 10, with 10 being the highest. However, it is also said that the pain is temporary and may peak just as the pregnancy is being expelled.
The level of cramping and pain varies depending on the length of your pregnancy and whether you have given birth. For example, a medical abortion performed at 6 weeks or less is usually less painful and less painful than one performed at 9 weeks. People who have given birth generally experience less pain.
CNN: What can be done to ease the pain of medical abortion?
Grossman: There are certainly things you can use to relieve pain. Research shows that ibuprofen Medicinal abortion pain is better treated than acetaminophen. We typically advise people to take 600 milligrams every 6 hours as needed.
Some people take tramadol, a narcotic painkiller, or Vicodin, a combination of acetaminophen and hydrocodone. A recent study I was involved in found that drugs like tramadol are effective when taken prophylactically before pain begins.
Another successful regimen we studied combined ibuprofen with an anti-nausea drug called metoclopramide, which also helps with pain. These drugs, except ibuprofen, require a prescription.
Another study found that TENS devices, short for transcutaneous electrical nerve stimulators, can help reduce the pain of medical abortions. It works through pads placed on the abdomen, stimulating nerves with mild electrical shocks and disrupting pain signals. It is something that people can get without a prescription.
Pain is often overlooked in medical abortions because, let’s face it, as clinicians, we can’t be with our patients when they’re experiencing pain at home. However, as we looked further into people’s experiences with medical abortion, it became clear that pain control was extremely important. I think we need to do a better job of treating pain and making these options available to patients.
CNN: Are there any health conditions in which medical abortion is not advisable?
Grossman: Medication abortion can be dangerous if you have an ectopic pregnancy, meaning the fetus is developing outside the uterus. It rarely happens, about once in two times. It occurs in every 100 pregnancies, but appears to be even rarer among people seeking medical abortion.
People who have had previous pelvic, fallopian tube, or abdominal surgery are at increased risk of an ectopic pregnancy, as are people with a history of pelvic inflammatory disease. Certain sexually transmitted diseases may increase your risk, as can smoking, a history of infertility, and the use of infertility treatments such as in vitro fertilization.
Medication abortion is not recommended if you are taking anticoagulants or blood thinners or have a bleeding disorder. Long-term use of steroids is another contraindication in the use of abortion pills.
People using an intrauterine device (IUD) should remove it before taking mifepristone. Because it can be partially expelled during the process and can be painful.
People who have chronic adrenal insufficiency or have inherited a rare disease called porphyria Not a good candidate.
CNN: Are there any signs of trouble that women should look out for after undergoing a medical abortion?
Grossman: After taking misoprostol, the second drug in a medical abortion, it is common to have a low-grade fever for the first few hours. If you have a low-grade fever of 100.4 degrees Fahrenheit to 101 degrees Fahrenheit for more than 4 hours, or if you develop a high fever of more than 101 degrees Fahrenheit after taking the medication, you should see your health care provider.
Heavy bleeding, such as soaking two or more thick, full-sized pads per hour for two consecutive hours, or foul-smelling discharge should be evaluated as well.
One of the warning signs of an ectopic pregnancy is severe pelvic pain, especially on one side of the abdomen. The pain may also spread to your back. Dizziness and fainting are also signs, which can indicate internal bleeding. These are all very rare complications, but it is wise to be aware of them.
We typically recommend that those undergoing a medical abortion have someone accompany them for the first 24 hours after taking misoprostol, or until the pregnancy has passed. Many people specifically choose medical abortion because it allows them to be surrounded by their partner, family, and friends.
Most people know that their abortion is complete because they usually no longer feel pregnant within a week of pregnancy and symptoms such as nausea and breast tenderness disappear. A home urine pregnancy test may remain positive even 4 to 5 weeks after a successful medical abortion. This is because pregnancy hormones take time to disappear from the bloodstream.
If someone still feels pregnant, they don’t know if the pregnancy is complete or if the pregnancy test is positive. A few weeks after taking mifepristone, you should be evaluated by a clinician.
You should know that it is possible to ovulate as early as two weeks after a medical abortion. Most contraceptive options can be started immediately after a medical abortion.
