What Is The Right Procedure For Abortion?
Abortion refers to ending up your pregnancy by removing or expelling your foetus or embryo. If it happens spontaneously, it’s a miscarriage. Nowadays, you can readily seek a highly reputed, trained and experienced gynaecologist for safe abortion if you have an unwanted pregnancy. Based on various kinds of interventions, an abortion can be performed by a professional in different ways. Here’s everything you need to know about the appropriate type of abortion that you require.
Types of abortion
Medical abortion
It involves taking two medications: misoprostol and mifepristone. The timings to take them are advised. But you must take misoprostol only after 2 days from when you take mifepristone. Misoprostol helps your womb to empty. This starts 1-4 hours after taking it. Mifepristone prevents the development of pregnancy. The pregnancy tissue passes from your body within 4-5 hours or more.
Merits
- Surgery isn’t needed.
- Available in your first trimester.
- Anaesthesia isn’t required.
Demerits
- Not available in your second trimester.
- Only part of the procedure happens in a clinic.
- You may have painful cramps.
- Rarely ineffective.
Recovery
- Some spotting/bleeding lasting for many weeks.
- A health check-up to monitor recovery.
Risks
- Nausea
- Dizziness
- Heavy vaginal bleeding
- Fatigue
- Mild fever
- Diarrhoea
Vacuum aspiration
It uses gentle suction to end your pregnancy. It’s typically suggested in your first trimester. A speculum is inserted into your vagina. Then the area is numbed with an injection or medication. Opening your cervix with dilators, a tube is inserted into your uterus. Then a suction tool empties your womb.
Merits
- Available in the first 12 weeks of your pregnancy.
- Quick, lasting for 5-10 minutes.
- Less painful (besides rare cramps, nausea, sweating or a combination)
- Anaesthesia not needed.
Demerits
- Not available in your second trimester.
Recovery
- Resting for about an hour post-treatment
- Having antibiotics to prevent infection
- No sex for a week post-treatment
- Cramping for some days and/or spotting for some weeks (sometimes)
Risks
- Infection and bleeding (although their risk is low)
Dilation and evacuation (D&E)
It’s commonly recommended in the second trimester. General anaesthesia may be needed. A speculum is put inside your vagina. With dilators, your cervix is opened. Your pregnancy tissue is removed with tiny forceps. Any remaining tissue is eliminated with suction.
Merits
- Available in your second trimester.
- Effective and safe.
Demerits
- May need general anaesthesia.
Recovery
- Mainly involves resting
- Mild cramps and pain for some days (post-treatment)
- Some bleeding for about 2 weeks (sometimes)
Risks
- Uterine injuries (rarely)
- Heavy bleeding
- Infection
Labor induction abortion
It’s a late-term way to end a pregnancy in its second or third trimester. It’s rare and only recommended if the woman’s life is at risk. You’re given oral or injected medications to begin labor. Thus, your uterus empties over 12-24 hours. You may also need local anaesthesia or pain relief medications to relieve intense cramping.
Recovery
After treatment, you must rest in the healthcare unit for a couple of hours to 1-2 days as per your health or other factors and as determined by your doctor.
Risks
Minor side effects include:
- Nausea and vomiting
- Diarrhoea
- Fever
Rare complications include:
- Infection
- Cervical injury
- Haemorrhage
- Uterine rupture
- Incomplete removal of your pregnancy tissue
Difference: Safe and Unsafe Abortions
Safe abortion
You’ll have a safe abortion if it’s performed:
- By an experienced and trained gynaecologist
- Using safe instrument and/or medications
- Under clean conditions (any tool used inside your reproductive system must be sterile)
- Within 5 months after you had your last monthly bleeding
When you face an unwanted pregnancy, you’re usually eligible for a safe and legal abortion. In a legal abortion, you can visit a hospital or clinic, pay a fee and receive a safe abortion. This makes sure that no women fall sick or incur death due to complications of abortion. Abortion is legalised in India in different situations. It can be carried out until 24 weeks of your pregnancy. Rarely, a court might allow termination only after the 24th week. You’ll be permitted to receive a legal abortion if no other way can be found to save your life or if you’re raped.
Unsafe abortion
Your abortion would be unsafe if it’s performed:
- By an untrained or inexperienced doctor
- With improper medications or tools
- Under unhygienic conditions
- After 5 months of your pregnancy (unless the procedure is performed in a healthcare unit using special equipment)
Which procedure is the right for abortion?
Usually, a medical abortion may be right for you if you:
- Are comfortable having a miscarriage at home
- Are eligible to receive a telehealth medical abortion or live near to where medical abortion is provided
- Want to avoid surgical abortion
- Are ready for multiple appointments with the doctor
- Are pregnant for fewer than 9 weeks
Usually, surgical abortion may suit you if you:
- Prefer to have your abortion done in one visit to the doctor
- Prefer not being conscious of the method
- Have access to surgical abortion services
- Are comfortable with surgical intervention and anaesthesia
Some other factors which determine the best method of abortion for you include:
- Location If you stay near a gynaecologist for safe abortion or one who offers both medical and surgical abortion, the professional can help choose the best method for you. This prevents the options of your abortion from being limited in the first place.
- Gestation The trimester of your pregnancy in which you receive an abortion determines the type of abortion suiting your case.
- Cost Surgical abortion (due to surgical intervention) naturally costs more than medical abortion. The cost that you can afford also becomes a factor.
- Health factors Certain health factors can make one procedure of abortion preferable to another. For instance, mifepristone (taken in medical abortion) won’t be suggested if you already take blood-thinning drugs or have high blood pressure. There can be other factors as well, including low pain threshold or fear of injections.
Where to get help?
- A gynaecologist for safe abortion (Dr Madhu Goel is a highly trained, reputed and experienced gynaecologist in Greater Kailash 2, South Delhi)
- Dial 108, which is a toll-free medical emergency number to call an ambulance in India
- The nearest hospital emergency department