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How to get rid of unwanted pregnancies


Ending pregnancy with medicines: MedlinePlus Medical Encyclopedia

More About Medical Abortion

Some women prefer the use of medicines to terminate a pregnancy because:

  • It may be used in early pregnancy.
  • It may be used at home.
  • It feels more natural, like a miscarriage.
  • It is less invasive than an in-clinic abortion.

Medicines can be used to end an early pregnancy. In many cases, the first day of your last period has to be less than 9 weeks ago. If you are over 9 weeks pregnant, you can have an in-clinic abortion. Some clinics will go beyond 9 weeks for a medicine abortion.

Be very certain that you want to end your pregnancy. It is not safe to stop the medicines once you have started taking them. Doing so creates a very high risk for severe birth defects.

Who Should Not Have a Medical Abortion

You should not have a medicine abortion if you:

  • Are over 9 weeks pregnant (time since the start of your last period).
  • Have a blood clotting disorder or adrenal failure.
  • Have an IUD. It must be removed first.
  • Are allergic to the medicines that are used to end pregnancy.
  • Take any medicines that should not be used with a medical abortion.
  • Do not have access to a doctor or an emergency room.

Getting Ready for a Medical Abortion

The health care provider will:

  • Do a physical exam and ultrasound
  • Go over your medical history
  • Do blood and urine tests
  • Explain how the abortion medicines work
  • Have you sign forms

What Happens During a Medical Abortion

You may take the following medicines for the abortion:

  • Mifepristone - this is called the abortion pill or RU-486
  • Misoprostol
  • You will also take antibiotics to prevent infection

You will take mifepristone in the provider's office or clinic. This stops the hormone progesterone from working. The lining of the uterus breaks down so the pregnancy cannot continue.

The provider will tell you when and how to take the misoprostol. It will be about 6 to 72 hours after taking mifepristone. Misoprostol causes the uterus to contract and empty.

After taking the second medicine, you will feel a lot of pain and cramping. You will have heavy bleeding and see blood clots and tissue come out of your vagina. This most often takes 3 to 5 hours. The amount will be more than you have with your period. This means the medicines are working.

You may also have nausea, and you may vomit, have a fever, chills, diarrhea, and a headache.

You can take pain relievers such as ibuprofen (Motrin, Advil) or acetaminophen (Tylenol) to help with the pain. Do not take aspirin. Expect to have light bleeding for up to 4 weeks after a medical abortion. You will need to have pads to wear. Plan to take it easy for a few weeks.

You should avoid vaginal intercourse for about a week after a medical abortion. You can get pregnant soon after an abortion, so talk with your health care provider about what birth control to use. Make sure you are using an effective contraception before you resume sexual activity. You should get your regular period in about 4 to 8 weeks.

Follow up with Your Health Care Provider

Make a follow-up appointment with your provider. You need to be checked to make sure the abortion was complete and that you are not having any problems. In case it did not work, you will need to have an in-clinic abortion.

Risks to Ending Pregnancy with Medicine

Most women have a medical abortion safely. There are a few risks, but most can be treated easily:

  • An incomplete abortion is when part of the pregnancy does not come out. You will need to have an in-clinic abortion to complete the abortion.
  • Heavy bleeding
  • Infection
  • Blood clots in your uterus

Medical abortions are typically very safe. In most cases, it does not affect your ability to have children unless you have a serious complication.

When to Call the Doctor

Serious problems must be treated right away for your safety. Call your provider if you have:

  • Heavy bleeding - you are soaking through 2 pads every hour for 2 hours
  • Blood clots for 2 hours or more, or if the clots are larger than a lemon
  • Signs that you are still pregnant

You should also call your doctor if you have signs of infection:

  • Bad pain in your stomach or back
  • A fever over 100.4°F (38°C) or any fever for 24 hours
  • Vomiting or diarrhea for more than 24 hours after taking the pills
  • Bad smelling vaginal discharge

Abortion pill

Lesnewski R, Prine L. Pregnancy termination: medication abortion. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 114.

Mullins EWS, Regan L. Women's health. In: Feather A, Randall D, Waterhouse M, eds. Kumar and Clarke's Clinical Medicine. 10th ed. Philadelphia, PA: Elsevier; 2021:chap 29.

Oppegaard KS, Qvigstad E, Fiala C, Heikinheimo O, Benson L, Gemzell-Danielsson K. Clinical follow-up compared with self-assessment of outcome after medical abortion: a multicentre, non-inferiority, randomised, controlled trial. Lancet. 2015;385(9969):698-704. PMID: 25468164 pubmed.ncbi.nlm.nih.gov/25468164/.

Rivlin K, Davis AR. Contraception and abortion. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 13.

Updated by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Is it possible to get rid of an unwanted pregnancy after 4 weeks, naturally? 

By Kendall @ Planned Parenthood | Jan. 12, 2021, 10:01 p.m.

Category: Abortion

Someone asked us:

How can I get rid of unwanted pregnancy after 4 weeks naturally?

Throughout history and across different cultures, people have used plants and herbs to try to cause an abortion. Some of these plants and herbs include wormwood, rue, salvia, licorice root, mint pennyroyal, and calendula.

Doctors usually recommend that pregnant people avoid these herbs because there’s a chance they can cause a miscarriage. But there is also not enough scientific evidence to show that these plants and herbs work to cause an abortion, or are safe to use to end a pregnancy. And using herbs, plants, or other untested chemicals can put you at risk for things like poisoning, an allergic reaction, or an incomplete abortion. It's also not a good idea to try and hurt yourself to end a pregnancy, because it may cause you serious harm and may not work. If you have complications that are not treated in time by a doctor or nurse, it could lead to a serious infection or even death. 

But there are ways to safely have an abortion at home. You can use abortion pills (AKA medication abortion) up to 11 weeks after the first day of your last period to safely end your pregnancy. This is sometimes called "at-home abortion."

You can get abortion pills from many abortion providers, including some Planned Parenthood health centers. Depending on what state you live in, you may be able to have a video or phone visit with a doctor or nurse for the abortion pill and then have the pills mailed to you.

Abortion laws vary by state, and some states have banned abortion or made it very difficult to get. So some people may choose to have self-managed abortion — this is when you find and take abortion pills to end a pregnancy without the help of a doctor or nurse.

Research shows that self-managing an abortion with abortion pills (mifepristone and/or misoprostol) can be safe and effective — especially if you: 

  • Usually have regular periods, know the first day of your last period, and it’s been less than 10 weeks from the first day of your last period
  • Have good information about how to take abortion pills
  • Don’t have medical reasons why you shouldn’t use abortion pills (like inherited bleeding disorders, heart or kidney disease, still have an IUD in place, or think you have an ectopic pregnancy)
  • Could get urgent medical care if you need it

There may be legal risks to buying and using abortion pills outside of the health care system. Repro Legal Helpline* has more information about this.

Plan C* has more information about the difference between self-managed abortion and getting an abortion from a doctor or nurse, including legal considerations.

After taking abortion pills, it’s normal to have fever, chills, nausea, strong cramping, and heavy bleeding for a day. But go to an emergency room if you have other symptoms that worry you, like: 

  • soaking more than 2 maxi pads an hour for more than 2 hours in a row
  • heavy bleeding for several days
  • dizziness, chills, and/or fever lasting more than 24 hours

Emergency doctors and nurses can care for you whether or not they know about a self-managed abortion. In fact, the symptoms after taking abortion pills are the same as a miscarriage, and the medications in abortion pills don’t show up in blood tests. 

If you have any concerns about your health, including any symptoms you’re experiencing during or after an abortion, Planned Parenthood is here to help (even if we didn’t provide your abortion).

*Note: Planned Parenthood is not responsible for nor does it endorse any legal, medical, or other advice or information provided by any of the entities identified or referenced herein or by any other third parties, whether referenced herein or not.

Tags: Abortion, pregnancy

Termination of pregnancy at early and late stages

1 Termination of pregnancy in the early and late stages

Early termination of pregnancy

Up to 12 weeks of pregnancy, a woman can have an abortion of her choice, for medical and social reasons. Early pregnancy can be terminated by both surgical and non-surgical methods. Surgical methods include vacuum aspiration and surgical abortion. Non-surgical methods include medical abortion. nine0003

It is known that if for some reason a woman needs to get rid of an unwanted pregnancy, then it is best to do it in its early stages. However, situations are often created when a late abortion has to be done.

Late pregnancy termination

After 12 weeks of pregnancy, the possibility of abortion at the request of the woman herself is already excluded. Late abortion is performed only for medical or social reasons. The decision on the need for such an abortion is made by the medical council or the court. nine0003

The causes of late abortion can be: the death of the breadwinner during gestation, the social failure of the mother, the presence of a serious illness in the mother, pathology of the fetus.

Termination of pregnancy at 20 weeks is performed in inpatient or outpatient facilities only for medical reasons.

The presence of indications for late termination of pregnancy is established by a medical commission, which consists of an obstetrician-gynecologist, a specialist in the disease, and the head of a medical institution. If a mental or sexually transmitted disease becomes the cause of a late abortion, then the documentation is sent to the obstetric and gynecological institution. nine0003

Late abortions: types

At the late stage of pregnancy, the fetus is already formed, so the only possible way to remove it is surgery, artificial birth or caesarean section. Any surgical intervention should be performed only in specialized medical institutions that have the appropriate license.

Late abortions are carried out in strict accordance with established rules, namely:

If there is any doubt about the verdict of the doctors, a woman can always be re-examined at another clinic.

How the late abortion procedure works

The late abortion procedure usually takes about 3 days. During the first day, the cervix is ​​dilated. However, the woman is prescribed anti-spasmodic drugs, which are designed to reduce pain. At the beginning of the 3rd day, a woman takes certain medications that start the process of childbirth. The uterus contracts and contractions begin. nine0003

An obstetrician-gynecologist uses ultrasound to find out the position of the fetus and performs the necessary surgical procedures to extract it.

After that, the remains of the fetus and the placenta are taken out or sucked out with a special device. If the abortion turned out to be incomplete, then additionally the bottom of the uterus is scraped from blood clots and tissue remnants.

For more than 25 weeks' gestation, a caesarean section is performed.

Any abortion is a great stress for a woman's body, and, of course, it is better to try to avoid an unwanted pregnancy than to carry out such difficult interventions with a high risk of complications. nine0003

Literature

  1. Federal Law of the Russian Federation dated November 21, 2011 No323-F3 "On the Fundamentals of Protecting the Health of Citizens in the Russian Federation" (as amended).
  2. Dicke G.B., Yarotskaya V.A., Erofeeva A.V. Strategic assessment of policies, programs and services in the field of unplanned pregnancy, abortion and contraception in the Russian Federation (Joint study of the Ministry of Health and Social Development of the Russian Federation and WHO). reproduction problems. - 2010. - No3. - S. 92-97.
  3. Trubnikova L.I., Trubnikov V.C., Egorova O.A. Comparative characteristics of modern methods of terminating early pregnancy II Proceedings of the first regional forum "Mother and Child". - Kazan, 2007. - S. 346-347. nine0060

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Termination of pregnancy - Adolesmed - Portal for professionals working in the field of adolescent health and medicine Termination of pregnancy in minors, to a greater extent than in adult women, causes legal, medical, social and mental problems. nine0003

Safe and unsafe termination of pregnancy

According to the recommendations of the World Health Organization (WHO), it is necessary to allocate unsafe and safe abortion . Unsafe abortion is a procedure for terminating an unwanted pregnancy performed by individuals without the necessary skills and/or in conditions that do not meet minimum medical standards. In Eastern Europe and Central Asia, unsafe abortion is usually criminal abortion. nine0003

A significant number (14%) of all unsafe abortions in low- and middle-income countries occur among women aged 15–19 years. Approximately 2.5 million adolescent girls undergo unsafe abortion every year, which leads to more severe complications in adolescence than in adulthood.

In developed countries, teenage girls resort to unsafe abortion, as a rule, because they do not want their parents, acquaintances, friends to know about their pregnancy, or because of a lack of funds to pay for the abortion procedure in a licensed medical institution. In Russia, Belarus, Kazakhstan, Ukraine and other countries of Eastern Europe and Central Asia, the provision of medical care and, in particular, artificial termination of pregnancy to minors under 16 years of age is possible only with the consent of the parents. nine0003

Abortion rate among women under 20

in Eastern Europe and Central Asia

(number of legal abortions per 1,000 women aged 15-19)

Source: Database TransMonEE http://www.transmonee.org/ 2014 (Date of access: 30.09.2014.)

Unsafe abortion is one of the leading causes of maternal death in the world. Complications of unsafe abortion include bleeding, sepsis, peritonitis, damage to the vagina, cervix and body of the uterus, other pelvic organs, and abdominal cavity. Approximately 20–30% of unsafe abortions are accompanied by infections of the genital organs, 20–40% of them are infections of the uterus and its appendages. One in four women who have had an unsafe abortion may develop temporary or permanent complications that require medical attention. nine0003

Abortion is considered safe if it is carried out in a specialized medical institution by qualified personnel in accordance with the necessary WHO standards. It is important to note that in fact there are no absolutely safe abortions. Any abortion poses a threat to women's health. The performance of an induced abortion by a qualified physician in a medical setting provides some assurance that the operation will have a favorable outcome. nine0003

If a minor girl and/or her parents or guardians decide to have an abortion, then the following conditions must be met to minimize the risk of negative consequences:

  • Performing this medical procedure in an adolescent-friendly facility. Employees should provide maximum support to the girl.
  • Preliminary full obstetric, gynecological and somatic examination, including ultrasound and laboratory diagnostics. nine0060
  • Providing psychological support before and after termination of pregnancy.
  • If necessary, restore the normal microbiocenosis of the vagina.
  • Choosing the optimal timing and termination of pregnancy.
  • Choosing the optimal method of abortion for each girl.
  • Post-abortion rehabilitation to restore reproductive, somatic and mental health and prevent recurrent unwanted pregnancies. nine0060

Adolescent abortion methods

Medical induced abortion is an abortion with the use of drugs. The term "non-surgical induced abortion" is sometimes used to refer to such an abortion.

Surgical methods of abortion ( surgical induced abortion ) are associated with the use of transcervical surgical interventions for the expansion (dilatation) of the cervical canal and evacuation (curettage) or vacuum aspiration of the fetus. nine0003

Each of the methods has its own indications and limitations depending on the gestational age, medical and social background. According to WHO recommendations, in the first trimester of pregnancy, instead of the method of surgical abortion, the method of vacuum aspiration or the method of medical abortion should be used. Medical abortion is the most benign. Detailed information on safe abortion practices can be found in the 2013 WHO Guidelines on Safe Abortion: Policy and Practice Recommendations for Health Systems (available at http://www.euro.who.int/__data/assets /pdf_file/0018/125370/WQ440r.pdf)

Consequences of abortion

Termination of pregnancy, even if it meets all the criteria for "safe abortion",

is not an absolute guarantee of the subsequent health and well-being of the girl. Artificial abortion is often accompanied by various complications that arise during the medical procedure itself or in the days following it. Among these complications: ineffective termination of pregnancy (developing pregnancy, incomplete abortion), bleeding, infectious complications, damage to the walls of the uterus, complications of anesthesia. Quite often there are also somatic changes: anemia, endogenous intoxication, liver and thyroid dysfunction, autonomic dysfunction, urinary tract infections. The long-term effects of an abortion may appear several years later. Abortions are especially dangerous during the first pregnancy. nine0003

A month or more after the abortion, delayed medical complications may appear , such as:

  • menstrual irregularities;
  • chronic infection of the pelvic organs;
  • secondary infertility;
  • spontaneous abortions in the future;
  • increased chance of ectopic pregnancy;
  • increased chance of preterm birth in the future; nine0060
  • mental disorders: feelings of guilt, fears, depression;
  • reduced chances of having a healthy baby.

Early pregnancy is the result of many individual, social, legal and health-care factors. To improve the health of adolescents, action must be taken at all these levels, with the active participation of young people themselves.

nine0003

Counseling for adolescents and their parents

When a teenage girl and her parents apply to a medical institution for artificial termination of pregnancy, the doctor should talk with them, talk about possible complications (bleeding, inflammation) and long-term consequences (infertility, miscarriage, chronic gynecological diseases) for the reproductive function of the girl, as well as further choice of contraceptive method. Psychological preparation and subsequent psychological support are no less significant. In the course of counseling, first of all, it is necessary to discuss the option of maintaining the pregnancy. nine0003

After an abortion, the doctor or paramedical worker should provide information about modern methods of contraception for adolescents, including emergency contraception in emergency situations, discuss with the patient the most appropriate means or method, inform the patient about the risk of contracting STIs through unprotected sex, changing partners, and about the important role of the condom in protecting against STIs/HIV and unwanted pregnancies.

The girl should be under the supervision of a gynecologist until the menstrual function and the vaginal ecosystem are fully restored, as well as to prevent the long-term negative consequences of abortion for the girl's reproductive system. Often, girls who have experienced artificial termination of pregnancy need the help of a psychologist, and in difficult cases, a psychotherapist to prevent depression and psychosomatic conditions. nine0003

Legal regulation of termination of pregnancy

In the countries of Eastern Europe and Central Asia, similar provisions have been established that determine the grounds and maximum allowable terms for artificial termination of pregnancy at the request of a woman, for medical and social reasons: the age from which a girl can independently apply for an abortion, and the age until which consent of parents, guardians. nine0003

In addition to legal restrictions, termination of pregnancy in adolescents under the age of majority, including adolescents at risk, is often a big problem also because: