What are the different types of abortions? What are the risks?

by Shatakshi Gupta

Many women find themselves burdened by an unwanted pregnancy. There could be a variety of causes, such as an unfit mother, an unwed pregnancy, and so on. In India, unlike in other countries, it is not difficult for women to avoid unwanted pregnancies.

If you’re considering having an abortion, it’s a good idea to educate yourself on the various methods available so you can determine which is best and easiest for you.

While there are numerous centres that provide the service, it is best to choose good doctors and clinics that follow the proper procedures. It is also critical to choose the safest type of abortion based on gestational age.

What Is Abortion?

Abortion is the procedure used to end a pregnancy at the mother’s request and with her consent. Abortion must be performed by a Registered Practitioner to ensure success and safety. The MTP Act of 1971 makes terminating pregnancy up to 24 weeks legal in India. A registered medical practitioner’s opinion is required for medical termination of pregnancy until 20 weeks, and two listed medical practitioners are required after 20 weeks.

Abortion Methods

Women can terminate their pregnancy by taking pills or having surgery. The method of abortion varies depending on the stage of pregnancy. The decision to use the most appropriate and safe method is made jointly by the patient and the doctor. Before choosing the best procedure, a number of factors are taken into account, including the age of the foetus, the mother’s health, and her comfort.

Abortion by medicine

To remove the foetus from the uterus during this kind of abortion, the patient is given oral medications. The procedure is risk-free and free of the discomfort and dangers associated with surgery. Staying in the hospital is not necessary. The procedure can begin at the patient’s home or at the doctor’s office. Both need to be followed up with in order to verify their success.

How Are Medical Abortions Performed?

Women who are less than ten weeks pregnant undergo this abortion procedure. The most typical method is to give the pregnant woman both medications orally. Most of the time, a pregnant patient cannot take her first medication without being present in the doctor’s office. Sometimes the patient is allowed to begin the medication at home.

This medication prevents the hormone progesterone from being produced. It stops the pregnancy from developing and thins the uterine walls. The pregnant patient is then given the all-clear to return home. After 24 hours, the physician will instruct her to take one Misoprostol tablet. The medications begin to work right away, but the abortion can last up to 24 hours.

What Takes Place Following the Procedure?

  • Women who have taken both medications during pregnancy begin to feel the effects right away.
  • The pain typically begins within 30 minutes and is more intense than typical period pains.
  • Along with these symptoms, they could also have headaches, fevers, dizziness, and diarrhoea.
  • One to four hours after taking the medication, bleeding begins. It can contain blood clots and is heavier than during periods.
  • The bleeding stops after six hours and reaches the level experienced during periods. For three to seven days, this goes on.
  • Periodic or prolonged bleeding may last for up to four weeks following a medical abortion.
  • After two weeks, a follow-up appointment with the doctor is required to make sure the pregnancy has truly ended.

Operative Abortion

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When the pregnancy is more than ten weeks along, this method is used. The surgical removal of the foetus from the uterus can be accomplished in a number of ways. The decision is based on the pregnancy’s age. The most popular techniques for surgical abortions are listed below.

Vacuum Aspiration:

 Using suction, the embryo is extracted during vacuum aspiration. The uterus’s contents are removed manually or with the aid of suction devices after a tube is inserted.

  • For pregnancies that are less than 12 weeks old, this procedure is suitable.
  • No special uterine or cervix preparation is required.
  • The vagina is held open by the insertion of a speculum.
  • To avoid infection, antiseptic medication is applied to the cervix and vagina.
  • To keep the cervix numb, an anaesthetic is injected into it.
  • The uterus is entered through a tube that has a suction pump on the exterior.
  • Through the tube, the embryo and placenta are extracted.
  • Most patients are able to leave the hospital that day.

Following the Surgery

  • To ensure that the procedure is finished, the tissues taken from the uterus are examined.
  • Doctors must certify that a patient is healthy before allowing them to leave the hospital.
  • The following day, regular operations can resume.
  • After two weeks, sexual activity is permitted again.

Advantages

  • The process only requires 5 to 10 minutes.
  • Contrary to medical abortion, patients experience cramping for a shorter amount of time.
  • After the procedure, patients can return home the same day.

Risks

  • Unfinished abortion
  • Uterine perforation Infection
  • Uninjured cervix Remaining uterine tissues
  • Intense uterine bleeding

Dilation and Curettage:

In the second trimester of pregnancy, it is carried out. The method makes use of both suction and surgical instruments like forceps.

  • 13 to 20 week pregnancies can use this procedure.
  • Osmotic dilators were used the day before to dilate the cervix.
  • Soft sticks called osmotic dilators are applied to the cervix. They enlarge, which causes the cervix to enlarge.
  • Before starting the procedure, the patient receives a general anaesthetic.
  • The cervix and vagina are cleaned by the doctor with an antiseptic solution.
  • In addition to suction devices, experts take the embryo and placenta out of the uterus using forceps and a curette.
  • The patient must remain in the hospital until the anesthetic’s side effects subside.
  • When the anaesthesia wears off, the patient can leave the procedure.
  • Painkillers are recommended by doctors.
  • Prescriptions for antibiotics are given to stop infections.
  • If there is bleeding, the patient might need to wear pads for a few weeks.
  • Tampons and sexual activity must be avoided by women for two weeks following surgery.

Advantages

  • This approach fails less frequently.
  • It is more affordable.
  • The likelihood of complications is lower.

Risks

  • The uterus still contains tissue.
  • Urinary system injury
  • Cervix damage
  • A little to a lot of vaginal bleeding

Induction Abortion

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One way to end a pregnancy in the second trimester is through induction. Medicines are used to induce labour. The drug-induced contractions cause the foetus to be expelled.

  • Another technique for 13 to 20-week-old pregnancies is this one.
  • To start labour, doctors inject a drug into the patient.
  • To ensure the foetus’s death, an injection may occasionally be given into the abdomen.
  • The medication’s effects begin between two and four hours after administration.
  • Through the vagina, the placenta and embryo exit.
  • To remove the remains of the foetus from the uterus, doctors might need to perform a curettage.

Following the Surgery

  • The length of the hospital stay will depend on how quickly the embryo and placenta emerge.
  • Drugs are prescribed by doctors to treat cramping pain.
  • For two weeks, patients must abstain from sexual activity.

Advantages

  • For second-trimester pregnancies, this approach is effective.
  • There are none of the usual risks associated with surgery.

Risks

  • An unsuccessful procedure may necessitate completing it with surgery.
  • A lot of bleeding
  •  Infection