Abortion Options and Their Health Impacts - Obstetrics and Gynecology

Regarding abortion?

In August, I accidentally became pregnant, and I want to terminate the pregnancy.
What methods are available, and how do they affect health?

Qingchun Meinv Shaonü, 20~29 year old female. Ask Date: 2003/09/15

Dr. Wang Jionglang reply Obstetrics and Gynecology

Hello, in response to your question.
Current methods of abortion include surgical and medical procedures to terminate early pregnancies.
According to Article 9 of the Maternal and Child Health Act, a pregnant woman may voluntarily undergo an abortion if diagnosed or proven to have any of the following conditions: 1.
The woman or her spouse has hereditary, infectious diseases, or mental disorders that hinder reproductive health.
2.
A blood relative within the fourth degree of kinship of the woman or her spouse has hereditary diseases that hinder reproductive health.
3.
There are medical reasons sufficient to determine that pregnancy or childbirth poses a risk to life or threatens physical or mental health.
4.
There are medical reasons sufficient to determine that the fetus is at risk of congenital malformations.
5.
The pregnancy is a result of rape, statutory rape, or sexual relations that are legally prohibited.
6.
Pregnancy or childbirth will affect the woman's mental health or family life.
The surgical method involves the use of a vacuum aspirator to remove embryonic tissue from the uterus through the vagina under good anesthesia.
The procedure takes about fifteen minutes; after the surgery, it takes about one to two hours for the anesthesia to wear off before the patient can go home, and normal work can be resumed the next day.
There may be light vaginal bleeding post-surgery, which typically lasts about a week and will stop on its own.
The medical method refers to the use of the drug RU-486 to terminate a pregnancy in the early stages (up to seven weeks, or three weeks after a missed period), with a success rate of about 95%.
Patients needing a medical abortion must first undergo an ultrasound to confirm the size and location of the pregnancy to ensure suitability for medical abortion before medication can be prescribed (this is a controlled substance and must be taken under medical supervision).
However, vaginal bleeding after taking the medication may last longer (possibly around two weeks), and a follow-up visit to the hospital is required about a week later to ensure that the abortion is complete; if not, surgical intervention may be necessary.
Risks associated with surgery include anesthesia risks, uterine perforation, bleeding, infection, and adhesions in the uterine cavity.
Risks associated with taking RU-486 include incomplete abortion leading to heavy bleeding or bacterial infection, and some users may experience severe abdominal pain, nausea, vomiting, diarrhea, headaches, fatigue, and skin rashes.
Additionally, individuals who smoke (more than ten cigarettes a day), are over thirty-five years old, suspect they have cardiovascular diseases, liver failure, kidney failure, clotting disorders, are undergoing anticoagulant therapy, have asthma, glaucoma, hypertension, or are long-term steroid users should avoid using RU-486.
Finally, it is important to emphasize the need for contraception, as "prevention is better than cure," and multiple abortions can be harmful to the body!

Reply Date: 2003/09/15

More Info

When considering abortion options and their potential health impacts, it is essential to understand the various methods available and the associated risks. In the United States, there are primarily two types of abortion: medication abortion (also known as medical abortion) and in-clinic abortion (also referred to as surgical abortion).

1. Medication Abortion:
This method involves taking two different medications. The first medication, mifepristone, is taken at a healthcare provider's office. It works by blocking the hormone progesterone, which is necessary for the pregnancy to continue. The second medication, misoprostol, is taken at home 24 to 48 hours later. This medication causes the uterus to contract and expel the pregnancy. Medication abortion is typically effective up to 10 weeks into the pregnancy.

Health Impacts:
- Physical Effects: Most women experience cramping and bleeding, which can be similar to a heavy menstrual period. Some may also experience nausea, vomiting, diarrhea, or fatigue. These symptoms usually resolve within a few days.

- Emotional Effects: Women may experience a range of emotions following a medication abortion, including relief, sadness, or guilt. It is important to have access to emotional support during this time.

- Long-term Health: Research indicates that medication abortion does not affect future pregnancies or fertility.

2. In-Clinic Abortion:
There are several surgical methods for in-clinic abortions, including aspiration (suction curettage), dilation and curettage (D&C), and dilation and evacuation (D&E). The choice of method often depends on how far along the pregnancy is and the provider's recommendation.

Health Impacts:
- Physical Effects: Surgical abortions are generally safe, but like any medical procedure, they carry some risks. These can include infection, heavy bleeding, injury to the uterus or cervix, and complications from anesthesia. Most women recover quickly and can return to normal activities within a few days.

- Emotional Effects: Similar to medication abortion, women may experience a range of emotions afterward. Counseling and support can be beneficial.

- Long-term Health: Surgical abortions do not affect future fertility or the ability to carry a pregnancy to term.

Considerations:
- Timing: The method of abortion may depend on how far along you are in your pregnancy. Early abortions (within the first trimester) are generally safer and have fewer complications.

- Consultation: It is crucial to consult with a healthcare provider to discuss your options, understand the procedures, and receive appropriate care. They can provide information tailored to your specific situation and health history.

- Legal and Emotional Support: Depending on your location, there may be legal considerations regarding abortion access. Additionally, emotional support from friends, family, or counseling services can be invaluable during this time.

In conclusion, both medication and surgical abortions are generally safe and effective options for terminating a pregnancy. Each method has its own set of potential health impacts, and it is essential to consult with a healthcare provider to make an informed decision that aligns with your health and personal circumstances. Remember, seeking support and information is crucial in navigating this decision.

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