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Medical Abortion

Medical Abortion

Medical abortion is a method of terminating a pregnancy that involves the use of medication. Medical abortions do not necessitate surgery or anesthesia. It can begin in a medical office or home, with follow-up visits to your doctor. It is most effective and safe during the first trimester of pregnancy.

A medical abortion is a major decision with emotional and psychological ramifications. If you’re considering this procedure, make sure you’re aware of the risks, side effects, complications, and alternatives.

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Why is it done?
Medical abortions are performed for a variety of personal reasons. Medical abortion can be used to complete an early miscarriage or to end an unintended pregnancy. If you have a medical condition that makes carrying a pregnancy dangerous, you can also choose to have a medical abortion.

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Medical abortion may pose the following risks:

Incomplete abortion, which may necessitate surgical abortion
If the procedure fails, the pregnancy will continue.
Prolonged and heavy bleeding
Discomfort in the digestive system
If you continue the pregnancy after taking the abortion medication, your pregnancy may face major complications.

Unless complications arise, medical abortion has not been shown to affect future pregnancies.

You cannot have a medical abortion if you:

You’ve gotten too far along in your pregnancy. If you’ve been pregnant for more than nine weeks, you should not attempt a medical abortion (after the start of your last period). After seven weeks of pregnancy, some types of medical abortions are not performed.
Have a current intrauterine device (IUD) in place.
Have a possible pregnancy outside the uterus. This is known as an ectopic pregnancy.
Have certain medical issues. Examples include bleeding disorders, certain heart or blood vessel diseases, severe liver, kidney, or lung disease, or an uncontrolled seizure disorder.
Take a blood thinner or steroid medication.
You cannot return to your provider for follow-up visits or do not have access to emergency care.
Have an allergy to the medication.
If you cannot have a medical abortion, a surgical procedure known as dilation and curettage (D&C) may be an option.
How do you prepare?
Before performing a medical abortion, your doctor will most likely:

Examine your medical history and general health.
A physical examination will confirm your pregnancy.
Perform an ultrasound exam to date the pregnancy and ensure that it is not outside the uterus (ectopic pregnancy) or a tumor that has grown inside the uterus (molar pregnancy)
Perform blood and urine tests
Explain how the procedure works, the risks and complications, and any side effects.
Deciding to have an abortion may be difficult. As you consider your options, consider seeking support from your partner, a family member, or a friend. Speak with your doctor to get answers to your questions, to help you weigh your options, and consider the impact the procedure may have on your future.

Abortion is not required to be performed by a health care provider. Elective abortion may be illegal in some states. Alternatively, there may be legal requirements and waiting periods to meet before having an elective abortion. There are no special legal requirements or waiting periods if you have an abortion procedure for a miscarriage.
Medical Abortion
What to anticipate
Medical abortion does not require any surgery or anesthesia. The procedure can begin in a doctor’s office or clinic. A medical abortion can also be performed at home, but you should still see your doctor to ensure no complications.

During the procedure, the following medications can be used:

Mifepristone (Mifeprex) and misoprostol (oral) (Cytotec). The most common form of medical abortion. These medications are typically taken seven weeks after the first day of your last period.

Mifepristone (if-uh-PRIS-tone) inhibits the progesterone hormone, causing the uterine lining to thin and preventing the embryo from remaining implanted and growing. Misoprostol (my-so-PROS-tol), a different medication, causes the uterus to contract and the embryo to be expelled via the vagina.

You can get mifepristone at your doctor’s office or clinic. The misoprostol can then be taken at home, hours, or days later.

You’ll need to see your doctor again about a week later to ensure the abortion is complete. The Food and Drug Administration has approved this regimen (FDA).

Mifepristone (oral) and misoprostol (vaginal, buccal, or sublingual). You take a mifepristone tablet by mouth during this type of medical abortion. The next step is to insert a slowly dissolving misoprostol tablet into your vagina (vaginal route), between your teeth and cheek (buccal route), or under your tongue (sublingual route) (sublingual route).

The vaginal, buccal, or sublingual route is less likely to cause side effects and may be more effective. These medications must be taken within nine weeks of the first day of your last period to be most effective.

Methotrexate and misoprostol vaginally. Methotrexate is rarely used for unintended, elective pregnancies, but it is still used for pregnancies outside of the uterus (ectopic pregnancies). This medical abortion must be performed within seven weeks of your last period’s first day. Methotrexate can take up to a month to complete the abortion. Methotrexate is given to you as a shot or as a pill you take orally. Misoprostol is then used at home.
Misoprostol vaginally only. When used before nine weeks of embryo gestation, vaginal misoprostol alone can be effective. However, vaginal misoprostol is less effective than other forms of medical abortion.
Medical abortion medications cause vaginal bleeding and abdominal cramping. They may also result in the following:

Vomiting \Fever \Chills
Diarrhea \headache
You may be given pain medication during and after the medical abortion. Antibiotics may also be administered, though infection following a medical abortion is uncommon.

Depending on how many weeks you are pregnant, your doctor will tell you how much pain and bleeding to expect. You may be unable to go about your normal daily routine during this time, but bed rest is unlikely. Make sure you have a sufficient supply of absorbent sanitary pads.

If you have a medical abortion at home, you will need access to a health care provider who can answer questions over the phone as well as emergency services. You must also be able to recognize complications.

Following the procedure
Following a medical abortion, the following signs and symptoms may necessitate medical attention:

Heavy bleeding — two hours of soaking two or more pads per hour
Abdominal or back pain that is severe
Fever that lasts more than 24 hours
Vaginal discharge that stinks
Following a medical abortion, you’ll need to see your provider to ensure you’re healing properly and to assess your uterine size, bleeding, and any signs of infection. Avoid putting anything into your vagina for two weeks after the abortion to reduce the risk of infection.

Your doctor may ask whether you are still pregnant if you witnessed the expulsion of the gestational sac or embryo, how much bleeding you experienced, and whether you are still bleeding. If your provider suspects an incomplete abortion or an ongoing pregnancy, an ultrasound and possibly a surgical abortion may be required.

You may experience various emotions following a medical abortion, including relief, loss, sadness, or guilt. If these emotions bother you, you should talk to a counselor about them.

avoiding pregnancy
Ovulation can happen as soon as two weeks after a medical abortion, and another pregnancy can happen even before your period starts. Discuss contraception with your provider before the abortion so you can begin using it as soon as the procedure is completed.
The next step in developing your final project(Medical Abortaion) is to construct a draft version of a budget for your final project. In considering your proposed policy response, and accompanying intervention and/or advocacy, think about the needed resources and how they would be directed.

Please utilize the sample budget justification shared in an earlier PP slide deck to outline your budget and accompanying narrative (e.g. justification). By no means does your submission have to be as long as the sample version.

Ideally, your (somewhat detailed) budget should be 1 (Excel table) page in length, and the narrative should be 1-2 pages (Word document) at most, using the following categories:

Salaries and Benefits
Facilities and Equipment
Supplies and Materials
Indirect – Overhead/Administration
Please try to be realistic in constructing your budget for a target amount of $500,000, in your selected state, over a one to two-year timeframe.

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