Abortion is the process of terminating pregnancy in general. Medicated or surgical techniques are used to remove the embryo from the uterus. Medicated abortion can be carried out at home and in the first weeks of pregnancy, under the supervision of a doctor. Prescription drugs on the market under the name of abortion pill are extremely dangerous. For this reason, it should never be used. The surgical method is safe when applied by a trained and licensed specialist surgeon. However, like any surgical procedure, it carries a risk of bleeding and infection. Rarely, reproductive organs can be damaged. For this reason, it is important that the health institution has a full-fledged and all medical devices against possible risks.
What is Abortion?
Abortion is the removal of the embryo in the uterus by medical methods. In traditional surgical abortion, the embryo is removed from the uterus through curettes (medical devices). It is also used in the diagnosis (biopsy) treatment of women’s diseases. Currently, vacuum abortion is preferred. The medicated method is suggested as an alternative to surgical abortion.
How is Abortion Done?
Medicated (medical) or surgical method may be preferred depending on the duration of pregnancy and suitability of the cervix.
Abortion Pill: The second drug misoprostol is drunk to complete abortion 24-48 hours after the first drug mifepristone. Side effects of this drug; nausea, vomiting, diarrhea, dizziness and headache. A stronger pain begins in half an hour than menstrual pain. Severe and large clotted bleeding is observed in a maximum of 4 hours. The abortion process usually ends in 6 hours and the severity of bleeding decreases and it can return to normal in 3-7 days.
- It is an alternative to surgical abortion, low risk, 99% effective and safe method that can be applied in the first 9 weeks of pregnancy.
- It can be used medically up to 24 weeks of pregnancy. However, in early pregnancy, the success rate is higher and the risk of complications is lower.
- It offers the opportunity to have a medical abortion in its privacy and, if desired, alone.
- The abortion takes 1 to 2 days to complete.
Sometimes there may be irregular or prolonged bleeding and severe cramps for 4 weeks.
- To make sure that the procedure is completed, a follow-up appointment is made 2 weeks later and the hormone level can be measured with a blood test.
- If miscarriage has not occurred, additional tablets or surgical intervention may be required.
- It may be necessary to take more doses of misoprostol and stay in the hospital after 9 weeks of pregnancy.
Note: Medications may rarely work. If pregnancy is 9 weeks old, medications may be repeated, otherwise surgical abortion may be required. If bleeding does not occur 24 hours after the last drug, help should be sought immediately. Abortion is medically recommended this time, since drugs can mutate the fetus when pregnancy cannot be terminated.
Who Cannot Take Medicated Abortion?
- Patients with conditions such as bleeding questions, adrenal insufficiency or high blood pressure,
- Those who have used steroids or blood thinners for a long time,
- It is not recommended for people who are at risk of developing an allergic reaction to the active ingredient of the drug.
Surgical abortion, which can be applied from the 5th week of pregnancy, can be applied to any woman whose cervix is wide enough to allow surgical instruments to enter. As the gestation period increases, surgical abortion process becomes difficult. In abortions earlier than the 5th week, pregnancy may continue despite abortion. Therefore, abortion should not be done before the specified time. The procedure of surgical abortions applied with anesthesia varies depending on the type.
- Curettage (scraping method): Curettes and scoop are used to scrape the embryo out of the uterus. This method, which has been used frequently in the past, is mostly used in scraping biopsy, biological tissue and residues today.
- Vacuum aspiration (vacuum abortion): It is today’s surgical curettage technique and can be applied medically up to 12 weeks (3 months) pregnancy. First, a tablet-shaped drug is inserted into the vagina, which softens and expands the cervical region. If necessary, it is also given orally after a few hours. When the cervix is prepared for the abortion, a small plastic tube is inserted from the vagina into the uterus to a vacuum medical device and the embryo is pulled from the uterus like a broom. It is performed with local anesthesia or injection sedation. General anesthesia is not required. It is a 5-10 minute procedure.
- Surgical dilation (pregnancy evacuation): It is applied on the 15th week of pregnancy and after. The first stage is similar to vacuum surgery; The cervix is softened and loosened with auxiliary drugs. When the cervix expands a little, a medical device is inserted into it. This device swells for several hours until it expands the cervix well. Sometimes this process may take 1-2 days, requiring hospital stay. When the uterus is prepared for the abortion, the cervix is opened gently by applying sedation or general anesthesia, and the embryo is removed through the scoops and vacuum tube. It may take 10-12 minutes.
The advantages of surgical abortion are:
The procedure is short and there is less bleeding than drug abortion. Since it is applied in the hospital, the risk of complications is low. You can return home after at least 2 hours of surveillance.
It is uncomfortable to insert foreign medical instruments into the vagina. Side effects of anesthesia and painkillers can be seen. Being aware of the process, including the noise of the vacuum aspirator, can be frustrating if local anesthesia is administered. It can be applied as early as after the 5th week of pregnancy.
Where is Abortion Legal?
Abortion is carried out in licensed private hospital-clinics and public hospitals. It is important that these health institutions are full-fledged and hygienically clean and use modern medical devices. The procedure is usually performed by expert-experienced gynecologist surgeons. Internal medicine surgeons also have an abortion license. General practitioners can participate in training programs and obtain an abortion by obtaining a license.
What are the Abortion Risks?
- Infection: Uterine infection is common and incomplete abortion, sexually transmitted microbe etc. can be caused by reasons. The typical symptom is high fever. If not treated urgently, it may be the cause of infertility. Pelvic inflammatory disease (PID), a chronic infection, may develop. As a precaution, antibiotics can be prescribed before and after the procedure.
- Excessive bleeding: May indicate an abortion has not been completed. A second curettage and rarely blood transfusions may be required.
- Uterus damage: Surgical instruments used in abortion can sometimes pierce the uterus. This can rarely lead to abdominal infection (peritonitis) and severe blood loss. It can be noticed and treated immediately.
- Cervical injury: If cervical dilation procedures are applied intensely, the cervix may weaken and this is called ‘inadequate’ cervix. It increases the risk of miscarriage during pregnancy after abortion.
What Happens After Abortion?
Symptoms similar to menstrual period after abortion, namely pain-cramps and vaginal bleeding may occur. Symptoms can last for 1-15 days. There is nothing to worry about during slow recovery, it is perfectly normal.
- Bleeding after abortion: It is a bleeding similar to the menstrual period. If large blood clots are coming and at least 2 pets are needed to be replaced in 2 hours, this may indicate that the abortion is not complete. Clinically should be sought. After medicated abortion, mild vaginal bleeding may take 1 month. No strenuous activity, including sports and heavy physical work, should be done until bleeding stops.
- Menstruation after abortion: The first menstruation occurs 3-6 weeks after the abortion is stopped. If there is no menstruation for up to 6 weeks, menstrual-contraceptive pills are used. In addition, against the risk of adhesion in the uterus, the uterus film is pulled and checked. Sometimes menstrual bleeding may not be seen for several months in connection with the psychological effect for no important reason.