In the US, about half of pregnancies A follow-up visit is required to confirm resolution of the pregnancy and, if necessary, to provide contraception. After 15 weeks, pretreatment with mifepristone mg 24 to 48 hours before induction reduces induction times. Prostaglandins are used to induce abortion. Options include.
IM injections of prostaglandin F2-alpha dinoprost tromethamine. The typical dose of misoprostol is to mcg vaginally, followed by mcg buccally every 3 hours for up to 5 doses. Adverse effects of prostaglandins include nausea, vomiting, diarrhea, hyperthermia, facial flushing, vasovagal symptoms, bronchospasm, and decreased seizure threshold.
Complication rates increase as gestational age increases. Perforation of the uterus 0. Laceration of the cervix 0. These complications usually occur because placental fragments are retained. If bleeding occurs or infection is suspected, pelvic ultrasonography is done; retained placental fragments may be visible on an ultrasound scan. Mild inflammation is expected, but if infection is moderate or severe, peritonitis or sepsis may occur.
Sterility may result from synechiae in the endometrial cavity Asherman syndrome or tubal fibrosis due to infection. Forceful dilation of the cervix in more advanced pregnancies may contribute to incompetent cervix Cervical Insufficiency Cervical insufficiency formerly called cervical incompetence is painless cervical dilation resulting in delivery of a live fetus during the 2nd trimester.
Transvaginal cervical ultrasonography However, induced abortion probably does not increase risks for the fetus or woman during subsequent pregnancies. Common methods for abortion are instrumental evacuation of the uterus after cervical dilation or medical induction to induce uterine contractions. For medical induction, give mifepristone , followed by misoprostol at mifepristone , then give a prostaglandin eg, dinoprostone vaginally, misoprostol vaginally and buccally, prostaglandin F2-alpha IM, or misoprostol vaginally.
Injury to the uterus and other organs—During a procedural abortion, the uterus, bowel, or bladder can be injured. If this happens, additional surgery at a hospital may be needed to repair the injuries. Rarely, the uterus or cervix can rupture tear during a second-trimester medication abortion. The risk of these complications during a second-trimester abortion is less than 1 in 1, The risk increases the longer a woman has been pregnant. You and your health care professional should talk about what medications you can take for pain.
Ibuprofen or acetaminophen may be an option. You may get a prescription for stronger pain relief if needed. In most cases, it is safe to go back to normal activities soon after an abortion.
Your health care professional should explain if you need to limit your activity. Periods usually return 4 to 6 weeks after an abortion. You can get pregnant even before your period returns. Some birth control methods can be started right away, even the same day as an abortion. The options include. The IUD and implant can be placed right after a procedural abortion. With a medication abortion, the implant can be placed at the time of the first abortion pill or you can get an IUD once your abortion is complete.
A cervical cap or a diaphragm can be used starting about 6 weeks after a second-trimester abortion. This gives the cervix time to return to its normal size. Condoms can be used any time after an abortion to prevent pregnancy and sexually transmitted infections STIs.
Abortion has been legal in the United States since , but health care professionals are not required to provide abortion care.
If your health care professional does not provide abortion care, you should be referred to a professional who will. There also are local and national resources that can help you find abortion care. In some states, there are special rules and waiting periods before having an abortion. If a minor cannot or does not want to have their parents or guardian involved, court approval may be required before the abortion.
To learn about abortion laws in your state, go to www. Also, some state laws may require your health care professional to present you with false information regarding the risks of abortion care. Remember, abortion does not increase the risk of breast cancer, depression, or infertility.
All-Options Counseling www. Volunteer staff are not licensed health care professionals or mental health specialists. NAF also offers limited financial assistance to help pay for abortion care. Birth Control Implant: A small, single rod that is inserted under the skin in the upper arm. The implant releases a hormone to prevent pregnancy.
Complications: Diseases or conditions that happen as a result of another disease or condition. An example is pneumonia that occurs as a result of the flu.
A complication also can occur as a result of a condition, such as pregnancy. An example of a pregnancy complication is preterm labor. The cervix is opened and the contents of the uterus are removed using instruments and a suction device. Epidural Block: A type of pain medication that is given through a tube placed in the space at the base of the spine. Induced Abortion: An intervention to end a pregnancy so that it does not result in a live birth.
Infertility: The inability to get pregnant after 1 year of having regular sexual intercourse without the use of birth control. Intrauterine Device IUD : A small device that is inserted and left inside the uterus to prevent pregnancy. Intravenous IV Line: A tube inserted into a vein and used to deliver medication or fluids. Regional Anesthesia: The use of drugs to block sensation in a region of the body.
Ultrasound Exam: A test in which sound waves are used to examine inner parts of the body. Processes among Young Women. Clinical diagnosis of completeness of medical abortion by nurses: a reliability study in Mozambique.
Choosing early pregnancy termination methods in urban Mozambique. Who is excluded when abortion access is restricted to twelve weeks? Evidence from Maputo, Mozambique. Instituto Nacional de Estatistica. Maputo; Accessed 14 Aug Mozambique; Accessed 07 Oct Accessed 14 Oct Advocacy, communication and social mobilization for TB control: a guide to developing knowledge, attitude and practice surveys. Geneva: World Health Organization; Accessed 08 June Geneva; Studying Unsafe Abortion: a practical guide.
Accessed 08 Oct Geleto A, Markos J. Awareness of female students attending higher educational institutions toward legalization of safe abortion and associated factors, Harari Region, Eastern Ethiopia: a cross-sectional study. Awoyemi BO, Novignon J. Health Econ Rev. Accessed 04 Mar Knowledge and attitude of women of childbearing age towards the legalization of abortion, Ethiopia. J Sci Innov Res. Accessed : Knowledge and perception of the Nigerian abortion law by abortion seekers in South-Eastern Nigeria.
J Obstet Gynaecol. Knowledge of the abortion legislation among south African women: a cross-sectional study. Trends in Attitudes Toward Abortion: — Am Assoc Public Opinion Res.
Accessed 24 July Arch Gen Psychiatry. Accessed 03 Apr Guttmacher Institute. Fact Sheet: Abortion in Africa. New York; Accessed 04 Aug PLoS One. Estimating abortion incidence among adolescents and differences in post abortion care by age: a cross-sectional study of post abortion care patients in Uganda. Stud Fam Plann. Conceptualising abortion stigma. Cult Health Sex. Understanding abortion-related stigma and incidence of unsafe abortion: experiences from community members in Machakos and Trans Nzoia counties Kenya.
Pan Afr Med J. Abortion incidence between and global, regional, and subregional levels and trends. Telalagic S. Book Google Scholar. Vubo EY. Afr Study Monographs. Lesthaeghe RJ. Accessed 10 June Arnfred S. In: Arnfred S, editor. Hospital centarl de Maputo. Voluntary termination of pregnancy: Moral concerns and emotional experiences among black South.
S Afr J Psychol. Accessed 19 July Matsinhe JM. Programa Geracao Biz. Sihvo S. J Epidemiol Community Health. The role of advocacy in implementing the south African abortion law. UNPFA; Accessed 11 Mar Amsterdam: KIT — Health; Guia para Activistas sobre Aborto seguro. Who Cares? Afr J Reprod Health. Accessed 29 Aug PubMed Google Scholar.
Varga CA. Pregnancy Termination among South African Adolescents. Stud Fam Plan. Accessed 06 Mar USA; Accessed 10 Dec Download references. The authors of this study wish to express their gratitude to all women who accepted to take part in it. The funding body had no role in the design of the study and data collection; analysis and interpretation of data; in writing and review of the manuscript; as well as on the decision to submit the manuscript for publication.
You can also search for this author in PubMed Google Scholar. MF participated in the design, data collection, and analysis, as well as writing in the initial manuscript. KM participated in design, analysis and manuscript writing and editing. PD and OD participated in conception, design, and editing. CA, EK participate in data analysis and editing. AJ participated in the analysis and interpretation of data. All authors have read and approved the manuscript. We also obtained authorization from the Minister of Health and local authorities at the provincial and community levels.
The participants were interviewed within their residences. Each woman was asked to sign the informed consent form after the interviewer had explained the study objective and procedures for the interview. For illiterate women, we involved a witness and also asked the participant to sign across their name by use of fingerprint.
This process of obtaining consent was approved by the ethical committee. Counseling for a second-trimester abortion may be more involved than for an early abortion because of the length of the pregnancy and the reason for the abortion. If you have continuing emotional reactions after an abortion, seek counseling from a grief counselor or other licensed mental health professional. Depression can be triggered when pregnancy hormones change after an abortion. If you have more than 2 weeks of symptoms of depression, such as fatigue, sleep or appetite change, or feelings of sadness, emptiness, anxiety, or irritability, see your doctor about treatment.
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Treatment Overview Starting inducing labor and delivery in the second or third trimester of a pregnancy is done using medicines. Medicines to start early labor can be: Injected into the amniotic sac surrounding the fetus instillation or injected into the fetus. Substances injected include salt water saline , digoxin, or potassium chloride.
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