A Glimpse into Medication Abortions

Medication abortions have become a common method for ending pregnancies in the United States, with over half of all abortions performed using the abortion pill, also known as mifepristone and misoprostol. The medication abortion process is a safe and effective way for women to manage their reproductive health, but it can also be a painful and emotional experience.

According to Dr. Daniel Grossman, a professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco, medication abortions are a more prolonged process than vacuum aspirations. After taking the pills, bleeding and cramping can occur over a period of days, with the heaviest bleeding usually occurring when the actual pregnancy is expelled. However, this bleeding typically eases within a few hours, and some mild bleeding can continue for about two weeks.

Pain Management in Medication Abortions

One of the most significant concerns for women undergoing medication abortions is pain management. Dr. Grossman explains that the pain of medication abortion can be quite intense, with an average maximum level of pain reported as a seven to eight out of 10. However, the pain can be brief, peaking just as the pregnancy is being expelled. Research has shown that ibuprofen is better than acetaminophen for treating the pain of medication abortion, and tramadol, a narcotic analgesic, can be helpful if taken prophylactically before the pain starts. Additionally, a TENS device, which works through pads put on the abdomen that stimulate the nerves through mild electrical shocks, can also help with pain.

It’s essential to note that pain can be an overlooked issue in medication abortions because clinicians are not present with patients when they are in their homes going through the process. However, as Dr. Grossman emphasizes, pain control is crucial, and making these options available to patients is vital.

Health Conditions that Make Medication Abortions Unwise

While medication abortions are generally safe, there are certain health conditions that make their use unwise. Dr. Grossman highlights that undergoing a medication abortion can be dangerous if the pregnancy is ectopic, meaning the embryo is developing outside of the uterus. This is rare, happening in about 2 out of every 100 pregnancies. People who have undergone previous pelvic, fallopian tube, or abdominal surgery are at higher risk of an ectopic pregnancy, as are those with a history of pelvic inflammatory disease. Certain sexually transmitted infections can raise risk, as does smoking, a history of infertility, and the use of infertility treatments such as in vitro fertilization.

Additionally, individuals who are on anticoagulant or blood thinning drugs or have a bleeding disorder should not use the abortion pill. The long-term use of steroids is another contraindication for using the abortion pill. People with chronic adrenal failure or who have inherited a rare disorder called porphyria are also not good candidates. Furthermore, anyone using an intrauterine device, or IUD, must have it removed before taking mifepristone because it may be partially expelled during the process, which can be painful.

Warning Signs of Trouble

It’s essential to be aware of the warning signs of trouble after undergoing a medication abortion. Dr. Grossman notes that a low-grade fever in the first few hours after taking misoprostol, the second drug in a medication abortion, is common. However, if someone has a low-grade fever lasting more than four hours or a high fever of over 101 degrees Fahrenheit after taking the medications, they should be evaluated by a healthcare provider. Heavy bleeding, which would be soaking two or more thick full-size pads an hour for two consecutive hours, or a foul-smelling vaginal discharge should also be evaluated. One of the warning signs of an ectopic pregnancy is severe pelvic pain, particularly on one side of the abdomen.

It’s crucial to be aware of these warning signs and seek medical attention if any of these symptoms occur. Dr. Grossman emphasizes that while medication abortions are generally safe, there are certain health conditions that make their use unwise, and it’s essential to be aware of these risks.