How to Practise Safe Abortion

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What is a Safe Abortion?

Abortion is a common and generally safe medical procedure used to end a pregnancy. There are two main types of abortion: surgical and medical. Surgical abortion involves a minor surgical procedure performed in a clinic, while medical abortion uses medication (pills) to end the pregnancy.

Globally, approximately 29% of pregnancies—nearly one in three—are ended by abortion each year. In the UK, about one in three women will have an abortion in their lifetime. In the United States, this figure is about one in four women.

A safe abortion is defined by the World Health Organization (WHO) as a procedure carried out using recommended methods, suitable for the stage of pregnancy (the number of days or weeks since the last menstrual period), and performed by qualified professionals using the necessary equipment.

There are two main methods for a safe abortion:

Medical Abortion

Surgical Abortion

 

Understanding Medical Abortion

A medical abortion, also known as a medication abortion, is a non-surgical method for terminating a pregnancy using prescribed medications. It is a common and effective option for ending a pregnancy, particularly in its early stages. This approach provides an alternative to surgical procedures, allowing individuals to manage the process with the assistance of medication.

Definition of Medical Abortion

Medical abortion involves taking two types of medication to terminate a pregnancy. The process typically includes:

Mifepristone

This medication is taken first. Mifepristone works by blocking the hormone progesterone, which is necessary for the pregnancy to continue. Without this hormone, the lining of the uterus breaks down, preventing the embryo from staying implanted.

Misoprostol

After taking mifepristone, misoprostol is taken usually 24 to 48 hours later. Misoprostol causes the uterus to contract and expel the pregnancy tissue. This is similar to how the body naturally expels a miscarriage.

The combination of these medications effectively ends the pregnancy, typically within a few days. The process is usually completed at home, though follow-up visits to a healthcare provider are recommended to ensure the abortion is complete and to check for any potential complications.

When Medical Abortion Applies

Medical abortion is suitable for pregnancies up to 10 weeks gestation, which is measured from the first day of the last menstrual period. The appropriateness of a medical abortion depends on several factors:

Gestational Age

Medical abortion is most effective and recommended within the first 10 weeks of pregnancy. Beyond this period, the procedure might still be possible but may require different management or alternative methods.

Health and Medical History

 

Not everyone is a candidate for medical abortion. Individuals with certain medical conditions or contraindications might need a different approach. A thorough medical evaluation is necessary to determine if this method is safe and appropriate.

Access to Medical Care

Since medical abortion involves multiple steps and follow-up care, it is important for individuals to have access to medical services. This includes initial consultation, obtaining medications, and follow-up appointments to ensure the procedure is completed successfully

Personal Preference

Some individuals may choose a medical abortion because they prefer a non-surgical option or wish to manage the process in a more private setting. This method allows for a more natural experience of ending the pregnancy, as it mimics a miscarriage.

Procedure and Follow-Up

The medical abortion process begins with an initial consultation with a healthcare provider to confirm the pregnancy and determine the gestational age. After receiving the prescription for mifepristone and misoprostol, individuals take the medications as directed.

A follow-up appointment is typically scheduled within a week or two to ensure that the abortion is complete and to address any concerns or complications. It is crucial to attend this follow-up to confirm that the pregnancy has been terminated and to check for any potential side effects.

Understanding Surgical Abortion

Surgical abortion is a medical procedure used to terminate a pregnancy through a surgical intervention. This method involves removing the pregnancy tissue from the uterus using specialized instruments. It is a well-established and effective approach for ending a pregnancy, particularly when it is not suitable or preferred to use medication. Surgical abortion can be performed at various stages of pregnancy, and the choice of technique depends on the duration of the pregnancy, the patient’s health, and other factors.

Definition of Surgical Abortion

Surgical abortion involves a range of techniques, all aimed at removing the pregnancy from the uterus. The most common types of surgical abortion include:

Aspiration (Suction Curettage)

This method is typically used in the first trimester (up to 12 weeks gestation). It involves inserting a thin tube into the uterus through the cervix. A suction device then gently removes the pregnancy tissue from the uterine lining. The procedure is often performed in a clinic or outpatient setting, and it usually lasts about 10 to 15 minutes.

Dilation and Curettage (D&C)

A D&C is similar to aspiration but involves the use of a curette, a spoon-shaped instrument, to scrape the uterine lining after suction. This method is used for pregnancies up to about 14 weeks gestation. It is also performed in a clinical or outpatient setting.

Dilation and Evacuation (D&E)

This technique is used for pregnancies beyond the first trimester, generally between 13 and 24 weeks gestation. It involves dilating the cervix and using a combination of suction and surgical instruments to remove the pregnancy tissue. A D&E is typically performed in a hospital or specialized clinic.

Induction Abortion

Used for pregnancies beyond 16 weeks, this method involves inducing labor to expel the pregnancy. It is less commonly used compared to other surgical methods but may be considered in certain situations.

When Surgical Abortion Applies

Surgical abortion is appropriate for various scenarios:

Gestational Age

Surgical abortion is often used when the pregnancy is beyond the early stages (more than 10 weeks) where medical abortion might not be suitable. It can be performed later into the pregnancy, depending on the method chosen and local regulations.

Medical Conditions

In cases where an individual has medical conditions that contraindicate the use of medication for abortion or when a medical abortion has not been effective, surgical abortion provides an alternative.

Personal Preference

Some individuals may prefer surgical abortion due to personal reasons, including a desire for a quicker procedure or the need for a definitive and complete termination of the pregnancy.

Complications

If there are complications with a medical abortion or if the pregnancy is not fully expelled, a surgical abortion might be necessary to ensure complete removal of the pregnancy tissue and to prevent infection or other health issues.

Procedure and Follow-Up

Surgical abortion typically begins with a consultation to confirm the pregnancy and discuss the appropriate method based on the gestational age and health status. The procedure is performed under local anesthesia, sedation, or general anesthesia, depending on the method and the patient’s preference.

After the surgical abortion, follow-up care is essential to ensure that the procedure was successful and to monitor recovery. A follow-up appointment is usually scheduled within a week or two to check for any complications and to provide emotional and medical support.

In Conclusion

In conclusion, surgical abortion is a well-established and effective method for terminating a pregnancy, especially when medical abortion is not suitable or preferred. Understanding the different types of surgical abortion, such as aspiration, D&C, D&E, and induction abortion, helps individuals make informed decisions based on their specific circumstances, such as the gestational age of the pregnancy, medical conditions, and personal preferences.

Surgical abortion is applicable for pregnancies beyond early gestation, in cases where a medical abortion is not feasible, or when immediate and definitive termination is desired. The procedure is performed under various types of anesthesia, with follow-up care crucial for monitoring recovery and ensuring the complete expulsion of pregnancy tissue.

Ultimately, the choice of abortion method should be made in consultation with a healthcare provider, who can provide guidance based on medical needs and personal considerations. Both medical and surgical abortions are safe when performed according to established guidelines, emphasizing the importance of accessing care from qualified professionals. By understanding these options, individuals can make choices that align with their health and well-being, ensuring a supportive and informed approach to reproductive health.

Note Better

The safety of an abortion largely depends on following WHO guidelines and using appropriate methods for the pregnancy stage. According to a study by the University of California, San Francisco, which reviewed over 50,000 abortions, more than 97% of these procedures were completed safely and effectively.

Services provided by organizations like MSI Reproductive Choices adhere to WHO standards. They use recommended methods and ensure that all procedures are carried out by trained professionals, guaranteeing a safe and reliable process.

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