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Abortion-services

Abortion Pill

Unwanted pregnancy can put a lot of stress on the physical and mental health of a woman. In such situation, Termination of Pregnancy (TOP) or abortion can be a blessing for her. The termination can be safely performed till the 20 weeks of pregnancy safely. There are two types of procedures available for Medical Termination of Pregnancy.

  • Medical Abortion: Use of medicines for termination of pregnancy
  • Surgical Abortion: Use of surgical methods for termination of pregnancy

In this article we will be discussing about Medical Abortion.

When to prefer medical abortion?

  • If woman prefers medications over surgical procedure
  • Up to 70 days of pregnancy, it is considered more effective than surgical abortion
  • If woman has congenital deformity of uterus or narrowing of lower part of uterus (cervix)
  • The woman can take some medicines at home also which is more convenient

Pre-abortion procedures:

Abortion can be a mentally stressful procedure, so counselling holds an important place in pre-abortion procedures. The main objectives of this counselling are

  • Help the woman to take an informed decision
  • Provide knowledge about the procedure
  • Remove the anxiety related to the procedure

This counselling can be performed by a nurse, doctor or even an experienced counsellor. During counselling the woman is given pregnancy options counselling and informed consent related counselling. A woman may have variety of reasons for opting for an abortion. The counselling helps in taking the correct decision without any mental stress. The counselling also gives an opportunity to prepare the woman for possible adverse effects of the medical abortion.
Your doctor will have to ascertain few things before he/she can administer the procedure. These include following investigations.

  • Ultrasonography for confirmation of pregnancy and estimation of duration of pregnancy
  • Measurement of vital signs (Temperature, Pulse, Blood Pressure, Respiratory Rate, )
  • Blood grouping
  • Lab tests for sexually transmitted diseases

Following medicines can be used to induce abortion during early pregnancy

  • Mifepristone and Misoprostol
  • Methotrexate and Misoprostol

Mifepristone and Misoprostol:

This is the most commonly used regimen for an embryo of 7. Misoprostol is an antagonist of progesterone. Progesterone is a hormone essential for continuation of pregnancy. Thereby, misoprostol inhibits the further development of the embryo. Misoprostol is a prostaglandin, a chemical which contracts the uterus. Therefore it is administered after mifepristone. This regimen has shown the success rate of 92-97%.

Contraindications of this regimen:

  • Ectopic pregnancy (implantation of embryo outside uterine cavity)
  • Ovarian tumour
  • Presence of Intra Uterine Device
  • Kidney or liver disease
  • Heart Disease
  • Asthma
  • Problem in blood coagulation
  • Treatment with corticosteroids
  • Aged more than 35 years and
  • Heavy smokers

How this regimen is used (FDA regimen)?

It requires 3 days and at least 2 visits to a clinic are required for this method.

Day 1

During initial visit, history is taken and examination of the woman is done followed by pre-abortion counselling and investigations. Once the consent is obtained and contraindications are excluded, a tablet containing 200 mg of Mifepristone (RU-486) is given orally to the woman and advised to re-visit on day 2-or 3

Day 2 0r 3

She is given the second tablet containing misoprostol (800 microgram) on day 3 at clinic. She is kept under observation for at least 4 hours. Usually following consumption of second tablet, there will be bleeding from vagina and cramps will be felt in the abdomen. This is due to contraction of uterus and expulsion of aborted products of pregnancy. Antibiotics may also be given to prevent the infection. A pain killer medicine can be given to alleviate the pain.

Follow up visit-

She is advised to visit on day 15 for re-examination and to ascertain that the abortion is complete. It also gives an opportunity for a doctor to check the health status of the woman.

The side effects of this regimen:

Abdominal pain and bleeding are the most common side effects. The other side effects include vomiting and diarrhoea. In rare cases, this method may fail and has to be followed up by a surgical method.

Methotrexate and Misoprostol

This was a common method in the past, but following introduction of mifepristone, this method has been used occasionally now a day. Methotrexate is more commonly used in the cancer chemotherapy. It inhibits the multiplication of cells. It mainly affects all those cells which are rapidly multiplying. These also include embryo!

Contraindications of this regimen:

  • Severe anaemia
  • Corticosteroid therapy
  • Diseases of guts, adrenal gland, liver, kidney, cardiovascular system and blood clotting
  • Intra Uterine Device is present
  • Anticoagulant therapy
  • Alcoholism
  • Decreased RBCs, Platelets or WBC
  • Hypersensitivity

How this regimen is used?

It is important to note that this regimen is not approved by FDA for medical abortion. But occasionally when other regimen is contraindicated, this regimen is used. This regimen is less costly but takes longer time (as long as 7 days).

Day 1

All the procedures remain same as in the earlier method except the medicine. Methotrexate (50 mg/m2) orally on the first day and the woman is asked to revisit on the 7th day.

Day 7

She is given Misoprostol (800 micrograms) inside vagina. This usually induces the bleeding and uterine contractions. The dose of misoprostol may have to repeat after 24 hrs, in case the first dose fails. A pain killer medicine may be given to alleviate the pain.

Follow up visit-

Just like in the earlier regimen the woman is asked for a follow up visit on the 15th day.

The side effects of this regimen:

These include nausea, vomiting and diarrhoea. In rare cases there may be suppression of bone marrow leading to decreased red and white blood cell counts. It has been said that the failure rate of this regimen is higher than the earlier regimen.
Apart from these two regimens, misoprostol alone can also be used for medical abortion, but the failure rate is too high.

 

Frequently Asked Questions:

According to guidelines by Food and Drug Administration of United States, these regimens are highly effective and should be used for termination of pregnancy of less than 70 days.
The pain associated with medical abortion is varied but one should expect some degree of mild
to moderate abdominal pain depending on their pain threshold and the gestational age
of the pregnancy.
The price of a medical abortion would depend on the center where the abortion is carried out,
the type of abortion that is done and the gestational age of the pregnancy. So generally the price would vary.
Most insurance companies would cover a medical abortion but it is always important to check with your insurance company just to be sure.
Minors would generally require their parent’s consent, but it is also important to find out about abortion laws relevant to your state of residence.
Women who are rhesus negative would need to receive this anti-D immunoglobulin after a medical abortion to prevent miscarriages in subsequent pregnancies.
After taking the second tablet, you may feel abdominal cramps and the product of pregnancy starts coming out with blood. But there is no need to freak out. You can take a pain killer and let the pill do its work.
Consult your doctor for this matter. You may not be advised to take the bath immediately. This is to prevent water entering the exposed area and prevent infection due to it.
You can do that. But always remember that it may take few weeks before the pregnancy test becomes negative. So if you will do it immediately, you will get positive result.
If you are doing abortion with qualified doctors and nurses, they will always maintain their patients’ confidentiality. There is no need of worry about your information being leaked out.
It is said that medical abortion is more effective than surgical abortion in the early pregnancy. For pregnancy of less then 7 weeks old, this method will be 98% effective. After that the effectiveness will decrease, but still remains as high as 93%.
Yes. Mifepristone and methotrexate need some time for their work. Only after that the misoprostol will be effective in expulsing all the content. So you need to keep some distance between two pills.
There are some regimens available, but rarely used. Sometimes single pills are also used. But the studies have shown them to be much less effective than the combination.
For mild to moderate pain, you can take paracetamol (500-1000 mg). If pain is more you may take ibuprofen (200 mg). In very severe cases, even codeine is prescribed.
If you have fever, nausea, vomiting or diarrhoea after medical abortion, you can suspect infection. You should immediately contact a doctor as this is a dangerous condition to be in.
If medical abortion fails, it can be followed by surgical abortion. There are not enough evidences available to show that abortion pills can cause anomaly in embryo except for methotrexate.

VIP Services

VIP Patients may elect to have the entire facility and staff dedicated solely to their needs and care, in which case we close the facility to any other patient on that particular day. No other patient will be scheduled or seen during your entire visit, thus keeping our clinic completely private. Our entire staff will be dedicated to your care, and your care alone.

To schedule an VIP abortion appointment in Los Angeles, please call at – 213-394-0530

Surgical Abortion

Introduction

For those who are not conversant with medical terminologies, abortion generally refers to the termination of a pregnancy before that age of intrauterine life by which it is able to survive outside the mother either by itself or through the aid of medical intervention. Abortion can either be on personal or medical grounds. They may occur spontaneously or through medical or surgical procedures. It is said that a good percentage of spontaneous early pregnancy abortions are due to a severely malformed foetus or genetic anomaly. There are also a host of reasons why people may want to consider an abortion and there are medical related scenarios where an abortion can be life saving for the mother. These are however beyond the scope of this current article. In this article the aim would be to discuss surgical abortion and 20 of the frequently asked questions about it. We would try to answer these questions as a way to help you further understand and better appreciate the whole concept of surgical abortion.

Surgical Abortion

Before going on to ask about the frequent questions on surgical abortion, it is important to know what exactly surgical abortion is? Surgical abortion refers to the emptying of the contents of the uterus between 12 to 14 weeks of pregnancy. This implies 12 to 14 weeks after a missed period or early in the 1st trimester of pregnancy. It can however also be performed around 20 weeks which is about the mid trimester of pregnancy. There are different procedures that can be used to carry out an abortion and the choice would depend on the stage of pregnancy at which the abortion is to be done and other features of the pregnancy as well as the woman in question. Three of the procedures are highlighted below:

  • Vacuum Aspiration: this is usually done with the aid of a vacuum aspirator and this is carried out for pregnancies that are generally below 16 weeks of gestation.
  • Dilatation and Evacuation (D & E): This is the procedure that has replaced the previously known D & C which is dilatation and curettage, this D & E is much safer and avoids the predisposition to uterine scarring or puncture that was quite common with D & C, especially in the hands of inexperienced abortionists. D & E is done for pregnancy that are between 12 and 20 weeks.
  • Dilatation and Extraction: Also referred to as D & E, this surgical abortion procedure is done for those who are above 21 weeks pregnant.

19 common FAQs about Surgical Abortion

There is no definitive time. It could be like a few hours, but generally it depends on the individual and if there are any difficulties encountered from the decision process to the procedure itself.
Generally you would be given some form of aesthetic during a surgical abortion so there should not be any significant pain during the surgical abortion process itself. However, depending on individual pain threshold one could experience mild pelvic aches or cramps after the procedure.
Generally, an abortion is one of the safest surgical female procedures especially in the hands of a professional abortionists. There is however risks and complications that could range from minor bleeds to pains.
This is chiefly individual dependent, some people may require emotional support after a surgical abortion others may not.
No, According to california law, A pregnant women is an emancipated minor. She can give her consent. We as providers , highly recommed parents to notied and be part of this process if possible.
Abortion is a state-wide issue, so depending on where you are, you would want to find out with your physician or abortionist any relevant law that you must be aware of.
A surgical abortion should have you on your feet by the next day under normal circumstances. However, due to minor complications or emotional reactions of some ladies, it may take them a little while longer to recover from a surgical abortion.
A follow up appointment is usually decided upon by your physician, it could be in a few days or in a week, depending again on the individual and the abortion process.
Generally an early first trimester abortion with a vacuum poses little or no risks to subsequent pregnancies. What happens to the percentage risks with subsequent or later abortions is still unclear with many conflicting research as to the risk if any and to what extent the risks exist. This is of course because there are many factors that can affect a pregnancy and so determining a previous abortion as a singular factor responsible for a complicated pregnancy is not easy to establish.
You would want to avoid wearing tight fitted clothing when going for your surgical abortion appointment. You would want to wear maybe a skirt and a top or a loose fitting clothing. It is also good to go with an underwear that can allow for a sanitary towel or pad to be worn with it.
The price of an abortion usually varies from centre to centre and would depend on the type of abortion and the procedure to be used. This means that the price would vary based on the gestation of the pregnancy.
While it is true that a lot of insurance companies would cover abortion it is very important that you do not assume and you seek clarification on this before you have your abortion. So it is important that you discuss with your abortionist about the price of the abortion and find out from your insurance company if it is covered.
This is something people want to know whenever surgical abortion is mentioned. They want to know about medical abortion because many people feel very uncomfortable about going in for any surgical procedure. Well, there is medical abortion and it usually involves most times the use of a drug to induce the abortion. It is a more natural process but is associated with sometimes more blood loss, more pain as severe menstrual cramps and it usually takes a longer time.
Just as like sated above, a surgical abortion is usually quicker and more reassuring than a medical abortion. The pain associated with it is usually minimal and women are happy to get it over with in a short time and get back to business as soon as possible.
Again this would depend on you and how your approach to abortion has been. Some people may require pre and post abortion counselling while some people may not.
An important part of any abortion is the woman’s blood group or more like the woman’s rhesus status. This plays an important role in subsequent pregnancies and that is why it is of utmost importance. The first thing is that a woman who is rhesus positive has no problem just as a woman who is rhesus negative carrying a rhesus negative child would have no problem. But a woman who is rhesus negative who is carrying a rhesus positive child, is not the same issue. This is because during the abortion process, some of the blood of the foetus may get into the mother. This would cause the mother’s body to develop anti bodies that will fight her subsequent pregnancies. So she may be having recurrent miscarriages in subsequent pregnancies. This is why her rhesus status is important before an abortion procedure is carried out.
This is the immunoglobulin that is given to a woman who is rhesus negative after the procedure to prevent her body from forming those antibodies that would cause subsequent miscarriages in her. So if a woman is rhesus negative it is important that she receives this immunoglobulin injection after the procedure.
For a lot of people it does. This is why it is good especially with a close friend or family member that they can trust. If it is a decision made by a couple then talking to your spouse about it could also help. You can always seek a professional counsellor or speak to your doctor or specialists about the procedure.
An abortion due to an unplanned pregnancy is always better prevented and that is why the issue of contraception is equally important. There are many contraceptives methods that include pills, injections, implants, barrier methods etc. This is such that it is always possible to find one that is both safe and convenient for you to use. You should always discuss contraception with your doctor and specialist especially after an abortion due to an unplanned pregnancy.