mifepristone and misoprostol

Mifepristone and Misoprostol

A medical abortion, often referred to as an abortion with pills, is commonly known as a method for self-induced abortion, self-managed abortion, or do-it-yourself (DIY) abortion.

When using abortion pills, one can expect to undergo bleeding and cramping, which mimics the symptoms of a menstrual period or a natural miscarriage.

The term “abortion pills” typically encompasses the use of either Mifepristone and Misoprostol in sequence or the use of Misoprostol alone.

Mifepristone:

Mifepristone is a medication that hinders the action of progesterone, a hormone crucial for supporting pregnancy. The absence of progesterone prevents the pregnancy from developing. Mifepristone is one component of what is commonly referred to as the abortion pill, but it is not effective in terminating a pregnancy on its own.

Additionally, Mifepristone softens the cervix, which enhances the effects of Misoprostol.

Mifepristone alone is insufficient for inducing an abortion; Misoprostol is also necessary.

Mifepristone is primarily employed for abortion or managing miscarriages, and its availability can vary depending on the laws and regulations in each country.

Misoprostol:

Misoprostol is a medication that induces contractions in the uterus, facilitating the expulsion of the pregnancy with cramping and bleeding.

While a medical abortion can be performed with Misoprostol alone, the combination of both medications is more effective.

Misoprostol has various medical applications beyond abortion, such as inducing labor, addressing postpartum hemorrhage, and treating ulcers, making it more widely accessible.

Both Mifepristone and Misoprostol are recognized as essential medications by the World Health Organization, intended for safe abortion procedures.

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Contraindications for Abortion Pills

Abortion pills are generally safe for most women, with only a few medical conditions serving as contraindications.

Mifepristone should be avoided if a person has been using long-term steroids like Prednisone or Dexamethasone.

Both Mifepristone and Misoprostol should be avoided if a person is using anticoagulants (blood thinners), has a bleeding disorder like Porphyria, suffers from chronic adrenal failure, or is allergic to Mifepristone, Misoprostol, or prostaglandins.

If someone has an ectopic pregnancy, the abortion pills will not terminate the pregnancy but won’t cause harm either. Seeking medical care is essential in such cases.

Having an intra-uterine device (IUD) is not a contraindication, but precautions are necessary, and it is safer to remove the IUD before using abortion pills.

Effects and Symptoms of Abortion Pills

Following the use of abortion pills, the expected symptoms are similar to a menstrual period or a miscarriage. Mifepristone typically does not cause symptoms, with most occurring after Misoprostol usage.

Expected symptoms include cramping, bleeding, and the possible passing of blood clots, usually peaking within the first 48 hours after Misoprostol use.

Misoprostol may lead to temporary side effects like fever, chills, diarrhea, nausea, vomiting, and headaches, which typically resolve within 48 hours.

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Determining the Effectiveness of Abortion Pills

If the medications are used according to recommended instructions and substantial bleeding occurs, similar to a menstrual period, it is likely that the medical abortion was successful. Pregnancy symptoms should gradually improve and disappear around 5 days after using abortion pills.

Additional confirmation can be obtained through a urine test (urine hCG) after approximately 4 weeks, a blood test (quantitative hCG) with a medical visit, or an ultrasound, which should be performed at least 2 weeks after using the pills.

If 48 hours have passed after the last dose of Misoprostol without bleeding or with significantly reduced bleeding, the abortion may not have been successful, and it may be necessary to try the abortion pills again.

Medical Care After Abortion Pills

If the expected symptoms occur and there are no warning signs, medical care is typically unnecessary. There is no need for a pregnancy test, ultrasound, or surgical intervention like a D&C.
Fertility and Menstruation After Abortion:

Following an abortion, whether surgical or medical, the menstrual cycle will restart, and ovulation is expected approximately 10 days later.
If pregnancy prevention is desired, appropriate methods should be considered.
The next menstrual period is anticipated to return in approximately 4 to 6 weeks after using abortion pills.

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