What a medication abortion is like, according to a doctor

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Miffepristone, one of the two drugs used for drug abortions, can continue to be sent to patients without visiting in person with a doctor following the rejection of the United States Supreme Court of a trial contesting the regulation of the abortion pill.

“While many women obtain an abortion of drugs from a clinic or their Ob-Gyn, others obtain the pills by themselves to undress or self-repair their abortion,” said Dr. Daniel Grossman, professor of obstetrics, gynecology and reproductive sciences at the University of Calisco in San Francisco.

“An growing set of research indicates that self-managed abortion is safe and effective,” he said.

Miffepristone blocks the progesterone hormone, which is necessary for pregnancy to continue. The drug is approved to end a pregnancy for 10 weeks of gestation, which is “70 days or less since the first day of the last menstrual period”, according to the US Food and Drug Administration.

In a drug abortion, a second medication, misoprostol, is taken in the next 24 to 48 hours. Misoprostol means that the uterus contracts, creating cramps and bleeding. Approved for use in other conditions, such as prevention of stomach ulcers, the drug has been available in pharmacies for decades.

Together, the two drugs are commonly called “abortion pill”, which is now used in more than half of the abortions in the United States, according to the Guttmacher Institute, a research group that supports abortion rights.

“Some people do it because they cannot access a clinic – especially in states with legal restrictions on abortion – or because they have a preference for personal care,” said Grossman, who is also the director of the progress of new reproductive health standards, a research group that assesses the advantages and disadvantages of reproductive health policies and publishes studies on the way in which of a woman.

What is happening during an abortion of medication? To find out, CNN spoke with Grossman. This conversation was condensed and published for more clarity.

CNN: What is the difference between an abortion of drugs in the first quarter and A vacuum suction Regarding what a woman lives?

Dr Daniel Grossman: A vacuum aspiration is most often carried out under a combination of local anesthetic and analgesic drugs or local anesthetic with an intravenous sedation, or what is called conscious sedation.

An injection of local anesthesia is given to the area around the pass, and the cervix is ​​slowly dilated or open. Once the cervix is ​​open, a small straw -shaped tube is inserted into the uterus and a soft vacuum is used to eliminate the pregnancy fabric. Contrary to what some say, if the procedure is carried out before approximately nine weeks, There is nothing in the fabric which would be recognizable as part of an embryo.

The suction procedure takes only a few minutes. Then the person is observed for one to two hours until any sedation has dissipated. We also monitor each patient for very rare complications, such as heavy bleeding.

An abortion of drugs is a more prolonged process. After taking the pills, bleeding and cramps can occur over a period of days. Bleeding is generally the heaviest when real pregnancy is expelled, but bleeding usually settles in a few hours. On average, people continue to have light bleeding for about two weeks, which is a little longer than after a vacuum suction.

Nausea, vomiting, fever, chills, diarrhea and headache can occur after using the abortion pill, and all those who have succeeded in drugs generally signal pain.

In fact, the pain of abortion by drugs can be quite intense. In the studies that have examined it, the average level of maximum pain that people report is about seven to eight in 10, 10 being the highest. However, people also say that pain can be brief, culminating when pregnancy is expelled.

The level of cramps and pain may depend on the duration of the pregnancy as well as if someone has already given birth or not. For example, a medical abortion at six weeks or less gestation generally has less pain and cramps than that made at nine weeks. People who gave birth usually have less pain.

CNN: What can we do to help the pain of an abortion by medication?

Grossman: There are certainly things that can be used to help pain. Research has shown that ibuprofen is better than acetaminophen to treat pain in drug abortion. We generally advise people to take 600 milligrams every six hours approximately.

Some people take tramadol, a narcotic analgesic, or Vicodin, which is a combination of acetaminophen and hydrocodone. Recent research, I have participated in drugs found like tramadol can be useful if they are taken prophylactically before the start of pain.

Another successful diet that we studied combined the ibuprofen with a nausea medication called metoclopramide which also helped pain. In addition to ibuprofen, these drugs require a prescription.

Another study has revealed that a device of tens, which means transcutaneous electrical nerve stimulator, helps the pain of abortion by drugs. It works through pads put on the abdomen that stimulates the nerves through light electric shocks, thus interfering with pain signals. This is something that people could get without a prescription.

Pain can be a neglected problem with drug abortion because, honestly, as clinicians, we are not there with patients when they are at home. But as we have done more research on people’s experiences with drug abortion, it has become clear that pain control is really important. I think we have to do a better job to treat pain and make these options available to patients.

CNN: Are there any health problems that make the impression of an abortion of drugs?

Grossman: Being an abortion of drugs can be dangerous if pregnancy is ectopic, which means that the embryo develops outside the uterus. It is rare, occurs in about 2 of Every 100 pregnancies – and it seems to be even rarer in people looking for an abortion of medication.

People who have undergone previous Pelvians, fallopian tubes or abdominal surgery are more at risk of extra-uterine pregnancy, just like those with history of pelvic inflammatory disease. Some sexually transmitted infections may increase risks, as well as smoking, history of infertility and the use of infertility treatments such as in vitro fertilization.

If a person is under an anticoagulant or blood medication or suffers from a bleeding disorder, an abortion of medication is not advised. The long-term use of steroids is another contraindication for the use of the abortion pill.

Anyone using an intrauterine device, or IUD, must have it removed before taking mifepristone because it can be partially expelled during the process, which can be painful.

People with chronic adrenal insufficiency or who inherited a rare disorder called porphyria are not good candidates.

CNN: Are there any signs of problems that a woman should monitor after suffering an abortion of medication?

Grossman: It may be common to have a low grade fever in the early hours after taking misoprostol, the second medication in a drug abortion. If someone has a low -grade fever – 100.4 degrees at 101 degrees Fahrenheit – which lasts more than four hours, or has a high fever of more than 101 degrees Fahrenheit after taking medication, it must be assessed by a health care provider.

Heavy bleeding, which would dip two or more top -sized pads per hour for two consecutive hours, or a nauseating vaginal flow should also be assessed.

One of the warning signs of an ectopic pregnancy is severe pelvic pain, especially on one side of the abdomen. Pain can also radiate backwards. Another sign is to stun or pass out, which could indicate internal bleeding. These are all very rare complications, but it is wise to be on the lookout.

We usually recommend that someone to have a drug abortion has someone with him for the first 24 hours after taking the misoprostol or until the pregnancy has passed. Many people specifically choose to have an abortion of drugs, as they can be surrounded by a partner, a family or friends.

Most people know that abortion is complete because they cease to feel pregnant, and symptoms such as nausea and the sensitivity of mammals disappear, generally in the week following the passage of pregnancy. A pregnancy test with domestic urine can remain positive even four to five weeks after a successful abortion of drugs, simply because it takes so much time for the pregnancy hormone to disappear from the bloodstream.

If someone always feels pregnant, I don’t know if the pregnancy has completely passed or has a five -time pregnancy test five A few weeks after taking mifepristone, they must be assessed by a clinician.

People should know that they can ovulate from two weeks after an abortion of medication. Most contraception options can be started immediately after an abortion of drugs.