How to terminate a baby

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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The Abortion Pill | Get the Facts About Medication Abortion

In This Section

The Abortion Pill
How does the abortion pill work?
What can I expect after I take the abortion pill?
How do I use the abortion pill?

How safe is the abortion pill?
How do I get the abortion pill?
How much does the abortion pill cost?

The Abortion Pill | Planned Parenthood Video

What is the abortion pill?

Medication abortion — also called the abortion pill — is a safe and effective way to end an early pregnancy.

How does the abortion pill work?

“Abortion pill” is the common name for using two different medicines to end a pregnancy: mifepristone and misoprostol.

First, you take a pill called mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing.

Then you take the second medicine, misoprostol, either right away or up to 48 hours later. This medicine causes cramping and bleeding to empty your uterus. It’s kind of like having a really heavy, crampy period, and the process is very similar to an early miscarriage. If you don’t have any bleeding within 24 hours after taking the second medicine, call your nurse or doctor.

Your doctor or nurse will give you both medicines at the health center. When and where you’ll take them depends on state laws and your health center's policies. Your doctor or nurse will give you detailed directions about where, when, and how to take the medicines. You may also get some antibiotics to prevent infection.

How effective is the abortion pill?

The abortion pill is very effective. The effectiveness depends on how far along you are in your pregnancy when you take the medicine.

For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.
For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.
For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times. If you're given an extra dose of medicine, it works about 99 out of 100 times.
For people who are 10-11 weeks pregnant, it works about 87 out of 100 times. If you're given an extra dose of medicine, it works about 98 out of 100 times.

The abortion pill usually works, but if it doesn’t, you can take more medicine or have an in-clinic abortion to complete the abortion.

When can I take the abortion pill?

Depending on where you live, you may be able to get a medication abortion up to 77 days (11 weeks) after the first day of your last period. If it has been 78 days or more since the first day of your last period, you can have an in-clinic abortion to end your pregnancy.

Why do people choose the abortion pill?

Which kind of abortion you choose all depends on your personal preference and situation. With medication abortion, some people like that you don’t need to have a procedure in a doctor’s office. You can have your medication abortion at home or in another comfortable place that you choose. You get to decide who you want to be with during your abortion, or you can go it alone. Because medication abortion is similar to a miscarriage, many people feel like it’s more “natural” and less invasive.

Your doctor, nurse, or health center staff can help you decide which kind of abortion is best for you.

Medical termination of pregnancy in the early stages in Nizhny Novgorod at the Tonus clinic, medical abortion, mini abortion

Termination of pregnancy is an important step in the life of a woman who is going to do this. It is important to think carefully about everything, and also, to choose a clinic where you would like to have an abortion. After you have made up your mind, the question arises, where to have an abortion? Not all clinics are licensed to perform abortions, so if you want to do abortion, clinic , in which it will be performed, must have the appropriate permission.

In our country, at her own request, a woman can have an abortion for up to 12 weeks. There are also various indications for termination of pregnancy. Abortion for social reasons a woman can do up to 22 weeks, for medical - at any stage of pregnancy.

Abortion in this case is performed after determining the indications for it by a gynecologist and related specialists. The reason for termination of pregnancy for medical reasons can be both a serious pathology on the part of the woman and on the part of the fetus. Only a competent and experienced gynecologist will help you decide on the choice of the method of abortion - medical, mini-abortion or surgical.

The best is early termination of pregnancy . Early termination of pregnancy reduces the risk of complications in the future and can be carried out without the use of invasive techniques.

Early termination of pregnancy. Medical abortion

Medical abortion is one of the safest methods and an excellent alternative to surgical abortion. Medical abortion is performed up to 6 weeks of pregnancy. When holding medical termination of pregnancy in the early stages, drugs are used that, by their mechanism of action, inhibit the synthesis of progesterone.

Medical abortion is performed only under the strict supervision of a gynecologist. After medical termination of pregnancy, an ultrasound scan is required to examine the uterine cavity.

Early termination of pregnancy by medical abortion method does not impair the woman's reproductive function. According to many studies, after medical termination of pregnancy, ovulation is restored in the shortest possible time. An additional positive quality of medical abortion is the possibility of its implementation directly on the day of treatment.

Early termination of pregnancy - mini-abortion

Mini-abortion as a method of early termination of pregnancy can be performed from 6 to 12 weeks. The main technique for mini-abortion is vacuum aspiration. The fertilized egg is removed from the uterine cavity using a special electric suction. This option for early termination of pregnancy is more gentle than the standard options for surgical abortion.

We must not forget that the sooner have an abortion , the lower the risk of complications.

The procedure takes about 5 minutes and the woman can go home within a few hours after the procedure. The uterine mucosa, unlike curettage, is slightly injured. A contraindication to abortion in this way is the presence of infection in the acute period. After the mini-abortion, a control ultrasound examination of the uterine cavity is performed.

Where to have an abortion?

Many women (especially young women), in order not to advertise their pregnancy, start looking for options, where to have an abortion . It must be remembered that it is most correct to have an abortion in a clinic, under the supervision of specialists, and not with the help of folk remedies.

An abortion made outside the walls of a medical institution that has the right to perform this manipulation is called criminal. A self-performed abortion by untested means can lead to serious consequences. In this case, a woman risks not only the possibility of having children in the future, but also her health.

Medical abortion

Termination of pregnancy by indications or at the request of a woman for a period of 6 to 12 weeks can be performed by curettage of the uterine cavity. This procedure is a surgical procedure and requires preparation. As with any other operation, all the necessary tests are given. Termination of pregnancy is carried out on an empty stomach, as the woman is given anesthesia.

In the postoperative period during the month you need to refrain from sexual intercourse, do not go to the sauna, bath, bathing in water, it is not recommended to take a bath. All these measures are aimed at preventing infection.

It is also not advisable to overcool, be subjected to excessive stress and physical exertion for some time. It is necessary to give the body a rest, so that in the future there will be no problems with conception.

After the abortion, it is necessary to visit a gynecologist. During the appointment, the doctor will conduct a comprehensive examination with obligatory ultrasound control, as well as select the optimal method of contraception, which will help to avoid unwanted pregnancies in the future, and therefore new abortions. A large number of abortions brings with it a large number of complications that can affect the reproductive potential of a woman.

Psychological support for a woman is also important, both before and after an abortion. The doctor in this case should be not only a competent specialist, but also a sensitive psychologist who can encourage the patient.

A great role is given to conversations with a woman, since she must understand that the doctor is on her side and in no case condemns the perfect act.

Within a month after the abortion, women should monitor their well-being.

If you experience pain, bleeding, fever or other unusual phenomena, you should definitely visit a gynecologist for a comprehensive examination and identify the cause of the symptoms.

Where to have an abortion in Nizhny Novgorod?

Termination of pregnancy in Nizhny Novgorod is performed by experienced specialists at Tonus Medical Center. It is possible to carry out manipulations at various stages of pregnancy. An abortion performed at Tonus Medical Center is a safe procedure carried out by highly qualified doctors who choose an individual approach to each woman and provide reliable medical care.

You can make an appointment at the Center for Obstetrics and Gynecology by calling 8 (831) 411-11-22

why terminate a pregnancy in the later stages and how it is done in Krasnoyarsk

“Like a bolt from the blue”

“We counted the fingers and toes, saw how the heart was beating. Then there was a short pause, and the doctor asked us to go for a walk so that the baby would roll over and he could finish the study. When we returned, there were already two doctors in the doctor's office. Now they were staring at the monitor together and trying to see something. I understood that there were some problems.

And suddenly, like a bolt from the blue, the phrase sounded: “I can’t see the baby’s bladder. There is some kind of education, but what it is is too hard to understand ", - there are hundreds of stories with a similar beginning.

For many women, becoming a mother is a cherished dream. In most cases, pregnancy ends safely - the birth of a healthy baby. But sometimes families get a disappointing prognosis even at the stage of the first ultrasound and tests. Finding out that a child has serious illnesses is always difficult, especially if the health of the father and mother is all right and there are no prerequisites for terrible diagnoses.

Where to go, what to do, what decisions to make? These are only the first questions that arise in pregnant women who have received a poor prognosis.

It is not customary in society to discuss this topic. In our time, when the question of whether abortion is considered murder is still unresolved, the topic of late pregnancy termination, when the unborn child is not just an embryo, but already looks like a full-fledged baby, is painful even for the medical community.

"No error"

Memories of mothers who have experienced the loss of a child (from the forum of the charity fund "Light in Hands"): "After 12 weeks, no one will terminate a pregnancy without a special consultation of doctors and a clearly established diagnosis. Needless to say, none of the doctors spoke to us normally, no one explained a clear sequence of actions, terms, risks, what does “abortion of pregnancy”, etc. mean in general?

Genetic abnormalities are detected at the stage of pregnancy screenings, there are three in total. Screening is a set of studies that allows you to get the most complete information about the health of the fetus. If the ultrasound doctor has doubts during the examination, the patient is sent to the Medical Genetic Center.

“Of course, most of all we are tuned in to early diagnosis, namely, to identify some abnormalities up to 12 weeks, less often up to 21-22 weeks. But sometimes there are cases when deviations can be detected only in the second half of the term: usually this happens either when a woman registers late and has never been examined before, or when the pathology manifests itself late. Then a decision is already made on a more detailed examination and on the possible termination of such a pregnancy, ”said Tatyana Elizaryeva, head physician of the medical genetic center.

The Medical Genetic Center of Krasnoyarsk sees patients from all over the Krasnoyarsk Territory. In the event that the doctor has doubts about the health of the child during the screening, the pregnant woman is sent for a more detailed examination

If the woman has passed all the examinations and the diagnosis is confirmed, she is invited to the medical commission of the genetic center. You can come to it either alone or with your husband or family members, usually the patient is asked how it is convenient for her. The commission includes several specialists: an ultrasound diagnostician, a neonatologist, an obstetrician-gynecologist, a doctor specializing in a particular pathology (cardiac surgeon, neurosurgeon, pediatric surgeon, etc.). There, the woman is told in detail about what is happening, what kind of pathology the child has, whether it can be treated and what kind of treatment it is.

“It is important to let a woman understand what she is facing and offer all possible options. If these are chromosomal disorders and an intellectual deficiency in the fetus, for example, Down's syndrome, we explain that a child can be born and, in the absence of any physical disabilities, even be able to develop - sit, perhaps write and draw, communicate a little. But we also make it clear that such a child will never be able to live independently, especially after the departure of parents or other guardians, such a child requires rather large financial costs, which not every family is ready for, such a child will always require more attention and strength, and for his parents will have to fight every step in his development. All this is necessary so that families understand what they are getting into in both cases. In any situation, we, as doctors, are obliged to respect their choice,” emphasizes Tatiana Elizarieva.

After a medical consultation, any couple has time to think and make an informed decision. Doctors note that today the equipment and technology of the medical genetic center excludes even the very possibility of making an incorrect diagnosis. In addition, in each case, the results of the tests are processed by several doctors, each giving an opinion and recommendations on pregnancy.

“This is a forced measure”

Up to 22 weeks, pregnancy can be terminated, including by medication. The procedure is carried out in the Krasnoyarsk maternity hospital No. 4.

“Medical indications for termination of pregnancy from 12 to 22 weeks are fetal developmental anomalies incompatible with life, which are not amenable to surgical correction,” said Lyudmila Popova, chief physician of maternity hospital No. 4.

This is a chromosome analysis. In a healthy person, all chromosomes are paired, in the picture at number 21 there are three chromosomes instead of two. This is what Down syndrome looks like

According to doctors, a woman can choose to terminate her pregnancy or report it. But often mothers do not fully realize what they doom themselves and their families to when they give birth to children with serious pathologies or non-viable ones.

Memoirs of mothers who experienced the loss of a child from the forum of the charity fund "Light in Hands"): "The diagnosis was terrible, the doctors said that children with such pathologies are born dead or die in infancy. Realizing that losing a baby, a long-awaited daughter, after her birth would be simply fatal for me, I agreed to an abortion for medical reasons. To be honest, I still don’t understand if I did the right thing, and I blame myself that I went along with my relatives and doctors by agreeing to this abortion.”

“It's very hard to survive. Walk for 9 months and know that a child can die on the first or second day. What is more difficult: walking and knowing that it will be so, or terminating a pregnancy in the middle? Usually women agree with the opinion of doctors, but sometimes they still decide to leave the child, ”says Lyudmila Popova.

In general, most often, before the 22nd week, women agree and go for an abortion.

“This is not just an abortion at the request of a woman, this is a forced measure. Because then supporting the lives of these children is a colossal burden. It happens that mothers then refuse them, because they cannot cope, they give them to the Homes for the Disabled, and then the state takes care of these children, ”concluded Lyudmila Popova.

“After 22 weeks, this is already a full-fledged birth”

Until 2019, in the Krasnoyarsk Territory, pregnancy was not terminated at later stages (after 22 weeks of pregnancy) due to indications from the fetus (congenital malformations incompatible with life, which for some reason have not been previously identified). Women had only one way out - to give birth to a child with a pathology. And only at the end of 2018, the clinical protocol of the Ministry of Health of the Russian Federation "Artificial termination of pregnancy at a later date for medical reasons in the presence of fetal developmental anomalies" was approved, on the basis of which this medical technology was introduced in the Krasnoyarsk Regional Clinical Center for Maternal and Child Health.

The procedure for terminating a pregnancy at a later stage is the same throughout Russia: an anesthetic is administered to the fetus in utero, after which the elimination (cardiac arrest) of the fetus is carried out, and labor is induced. The procedure is performed by an ultrasound doctor, an anesthesiologist, an anesthetist nurse and a laboratory assistant.

“Like any manipulation, the interruption procedure has certain risks associated with both the use of medications and the operation. Bleeding may develop, there may be negative consequences from drugs - side effects, allergies. Any intervention in a woman's body, even at the present stage of the development of medicine, is always a health risk that can lead to complete deprivation of reproductive function. Many couples decide to prolong the pregnancy, hoping for a miracle, for a diagnostic error, ”says Pavel Baurov, head of the advisory clinic at the Regional Clinical Center for Maternal and Childhood Welfare.

Head of the advisory polyclinic of the Regional Clinical Center for Maternal and Childhood Pavel Baurov

Women who refuse to terminate a pregnancy in case of medical indications, most often name their personal beliefs as the reasons, as well as their families. In the case when a decision is made to leave a non-viable child, the patient continues to be observed in the consultation.

How to survive the impossible

Late pregnancy termination is a severe psychological trauma. After the procedure itself, each woman is waiting for the rehabilitation process, a psychologist always works with her. Now there are such specialists at every antenatal clinic. A psychologist from the Center for Maternal and Childhood Welfare talks with a patient before and after the procedure.

“A woman in such a situation has a lot of difficult experiences. And one of the most difficult that appears at such moments is the feeling of guilt. Thoughts often arise in the mother’s head: “How could I allow this to be done?”, even if the situation is completely hopeless. The moment of choice also leaves an imprint - the woman still decides whether to terminate her pregnancy or keep it. Guilt, as a rule, is irrational, not corresponding to the real situation, ”the psychologist notes.

Memories of mothers who have experienced the loss of a child (from the forum of the charitable foundation "Light in Hands"): “Two years have passed. And yes, we still gave birth to a child, a beautiful daughter. But there was not a day that I did not remember my first daughter. I wake up in the middle of the night and remember those days. I keep these memories as the only thing left of my child.”

Medical termination is exactly the same antenatal loss ( situation where the baby dies at during pregnancy — ed. ). A woman loses a baby for a long time, despite the fact that from the end of the first trimester she already perceives him as a person, interacts with him, communicates internally.

A psychologist has no influence on a woman's choice - such is the professional position. It helps to realize some things, provides psychological support. Sometimes the situation itself can be completely hopeless when a diagnosis of a pathology that is incompatible with life is made, but even this does not always affect the final choice of a couple. A psychologist helps to dispel any doubts, relieve tension and at least slightly alleviate the moment of suffering.

After the interruption, the woman goes through the process of mourning, as after any other loss. If adaptation is disrupted for too long and a person cannot live a full life, then psychologists talk about pathological mourning, which requires more serious treatment. It is very important that the environment of the woman also helps to survive the crisis.

“Unfortunately, no one taught us sympathy, our society, and usually people feel discomfort next to those who have suffered a loss. As a rule, a woman's relatives think that the most important thing is that she stopped worrying . This is where all these tips start: “stop crying”, “live on”, “get together”, and so on. But a woman doesn’t need this, she needs to live her grief, cry out her tears, she needs to speak out, ”says psychologist Svetlana Chursina.

Rehabilitation usually takes months, but even when a woman returned to normal life, this difficult moment will remain in her memory forever, it is impossible to erase it. From time to time, with tears, she will still remember her unborn baby.

Clinical psychologist of the Center for Maternal and Child Health Svetlana Chursina

Patients often ask the question: “What should I do with the child? What will happen to him after I give birth to him?

“The doctor cannot insist, but still it is better if you look at the baby and say goodbye to him. It is better to keep some of his things related to pregnancy, ultrasound scans and so on. Firstly, the brain is arranged in such a way that until it sees it, it will not believe that this is final, therefore subconsciously it will not give you rest, there will always be doubts: “What if he were alive, but if he were healthy? “. Secondly, after some time, women who could not look at the child and say goodbye may regret it. Still, over time, this is perceived as the loss and death of a loved one, so you should not completely depersonalize the baby. But in any case, the choice is up to the woman herself. You can offer, but in no case insist,” advises Svetlana Chursina.

At the Center for Maternal and Child Health, a woman receives 1-2 consultations, after which the doctors recommend (if necessary) that she contact a psychologist at the antenatal clinic, or visit free support groups. In Russia, the charitable foundation "Light in Hands" works with mothers who have suffered perinatal loss. You can get advice and find out all the working conditions on the fund’s hotline.

Psychologists advise relatives, friends and colleagues to start from the desires of a woman - do not impose help, insist on talking if she does not want it. “Time heals” is one of the main principles of recovery, so the main thing is to give a woman this time.