Medical and Surgical Abortion

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Medical Abortion:

Medical abortion, also known as a non-surgical abortion, involves using medication to terminate a pregnancy. It is typically used in the early stages of pregnancy.

• Types:

  • Mifepristone and Misoprostol: This is the most common medical abortion method. Mifepristone is taken first to block the hormone progesterone, which is necessary for pregnancy to continue. After 24-48 hours, Misoprostol is taken to induce uterine contractions and expel the pregnancy.

  • Methotrexate and Misoprostol: Less commonly used, this method involves taking Methotrexate to stop the growth of the pregnancy and Misoprostol to induce the expulsion of the pregnancy.

• Symptoms:

  • Cramping and Bleeding: Similar to a heavy menstrual period, with bleeding often lasting several days to a few weeks.

  • Nausea and Vomiting: Common side effects of the medications.

  • Fatigue and Diarrhea: Also potential side effects.

  • Emotional Effects: Emotional responses can vary, and some women may experience sadness or relief.

• Advantages:

  • Non-Invasive: No surgical procedure is involved, making it less physically invasive.

  • Privacy: Can be done at home or in a private setting, with follow-up care usually required.

  • Early Stage: Effective within the first 10 weeks of pregnancy.

• Disadvantages:

  • Incomplete Abortion Risk: Sometimes, additional medical procedures may be needed if the abortion is incomplete.

  • Bleeding and Cramping: Can be more intense compared to surgical methods.

  • Not Suitable for All: Not recommended for pregnancies beyond the first trimester or in women with certain health conditions.

 

**Always to be taken under supervision of a registered gynaecologists for medicolegal reasons and health of the woman**

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Surgical Abortion:

Surgical abortion involves a procedure to remove the pregnancy from the uterus. It is usually performed in a clinical setting.

• Types:

  • Aspiration (Suction Curettage): A suction device is used to remove the pregnancy from the uterus. This method is typically used in the first trimester.

  • Dilation and Curettage (D&C): Similar to aspiration but involves scraping the uterine lining to ensure complete removal of pregnancy tissue.

  • Dilation and Evacuation (D&E): Used in the second trimester, this method combines suction with instruments to remove the pregnancy.

• Symptoms:

  • Cramping and Bleeding: Similar to menstrual cramps and bleeding that can last for several days.

  • Nausea and Dizziness: Common after the procedure due to anesthesia or medication.

  • Emotional Effects: Some women may experience emotional distress or relief, depending on personal circumstances.

• Advantages:

  • Quick Procedure: Usually completed within a short period, often in a single visit.

  • High Effectiveness: Provides a more definitive and complete termination of pregnancy compared to medical abortion.

  • Suitable for Later Stages: Can be performed at later stages of pregnancy than medical abortion.

• Disadvantages:

  • Invasive Procedure: Involves surgical instruments and may require anesthesia.

  • Risk of Complications: Potential risks include infection, injury to the uterus, and incomplete abortion.

  • Recovery Time: May require a short recovery period and follow-up visits.

 

Contraception

 

1. Types of Contraception:

• Hormonal Methods:

  • Birth Control Pills: Daily oral contraceptives that prevent ovulation and thicken cervical mucus.

  • Hormonal Patches: Worn on the skin to release hormones that prevent ovulation.

  • Intrauterine Devices (IUDs): Hormonal IUDs release hormones locally in the uterus to prevent pregnancy.

  • Hormonal Implants: Small rods inserted under the skin to release hormones that prevent ovulation.

• Barrier Methods:

  • Condoms: Worn on the penis or inside the vagina to prevent sperm from entering the uterus.

  • Diaphragms and Cervical Caps: Placed inside the vagina to cover the cervix and prevent sperm from reaching the egg.

• Intrauterine Devices (IUDs):

  • Copper IUDs: Non-hormonal devices that release copper to prevent sperm from fertilizing the egg.

  • Hormonal IUDs: Release hormones to prevent ovulation and thicken cervical mucus.

• Permanent Methods:

  • Tubal Ligation: Surgical procedure that involves blocking or sealing the fallopian tubes to prevent eggs from reaching the uterus.

  • Vasectomy: Surgical procedure for men that involves cutting and sealing the vas deferens to prevent sperm from reaching the semen.

• Emergency Contraception:

  • Morning-After Pill: Pills taken after unprotected sex to prevent ovulation or fertilization.

  • Copper IUD: Can be used as emergency contraception if inserted within five days after unprotected sex.

  • High risk of ectopic pregnancy associated with both methods 

 

2. Symptoms and Side Effects:

• Hormonal Methods: May cause nausea, weight gain, mood changes, and spotting.

• Barrier Methods: May cause allergic reactions or irritation in some individuals.

• IUDs: Can cause cramping, irregular bleeding, or expulsion.

• Permanent Methods: Risks associated with surgery, including infection or complications.

 

3. Comparison and Advantages:

• Effectiveness: Hormonal methods and IUDs are highly effective in preventing pregnancy. Permanent methods offer permanent solutions but are irreversible.

• Convenience: Hormonal methods and barrier methods can be used as needed, while IUDs and implants provide long-term contraception with minimal daily management.

• Health Benefits: Some hormonal methods can help manage menstrual symptoms or acne, and IUDs can be a good option for women with specific health conditions.

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This overview covers the primary aspects of medical and surgical abortion, as well as contraception methods. Each method has its advantages and considerations, and choosing the right option depends on individual needs and circumstances.