CNN
–
MifepristonOne of the two drugs used for drug abortion may continue to go by mail to patients without a personal visit with a doctor after Refusal of the trial of the Supreme Court of the United States Experienced regulation of abortion tablets.
“While many women get Abortion of drugs From the clinic or their obstetrics, others receive tablets on their own to self-gover or manage their abortions on their own, ”said Dr. Daniel Grossman, professor of obstetrics, gynecology and reproductive sciences at the University of California at San Francisco.
“The growing volume of research indicates that self-governing abortion is safe and effective,” he said.
Mifepristone blocks the hormone progesterone, which is necessary to continue pregnancy. There is a drug It is approved to put an end to pregnancy for 10 weeks of pregnancy, which is “70 days or less from the first day of the last menstrual period.” According to the Office for Control of Products and Drugs of the United StatesField
In the abortion of drugs, the second drug, the Misoprostol, is taken over the next 24-48 hours. Misoprostol makes the uterus contract, creating spasms and bleeding. Approved for use in other conditions, such as the prevention of stomach ulcers, the drug was available in pharmacies for decades.
Together, two drugs are usually known as “abortion tablets”, which is currently used in more than half of abortion in the United States, According to the Institute of GutmamerA research group that supports the right to abortion.
“Some people do this because they cannot access the clinic, especially in the States with legal restrictions on abortion, because they prefer to care for themselves,” said Grossman, who is also the director Promotion of new standards in the field of reproductive health, A research group that evaluates the pros and cons of the reproductive health policy and publishes research on How abortion affects a woman's healthField
What happens during drug abortion? To find out, CNN spoke to Grossman. This conversation was condensed and edited for clarity.
CNN: What is the difference between the abortion of drugs in the first trimester and Vacuum desire From the point of view of what a woman experiences?
Dr. Daniel Grossman: Vacuum aspiration is most often performed in the combination of local anesthesia and oral painkillers or local anesthetics along with intravenous sedation or what is called conscious sedation.
The injection of the local anesthetic is brought into the area around the cervix, and the cervix is neatly expanding or opens. After the cervix is opened, a small straw tube is inserted into the uterus, and a delicate vacuum is used to remove pregnancy tissue. Contrary to what some say if the procedure is performed up to nine weeks or so There is nothing in the fabric that would be recognized as part of the embryo.
The aspiration procedure takes only a couple of minutes. Then a person is observed for one or two hours, until some sedation is worn out. We also control each patient for very rare complications, such as severe bleeding.
Abortion of drugs is a longer process. After taking pills, bleeding and cramps can occur within a few days. Bleeding, as a rule, is the most severe when the actual pregnancy is supplanted, but this bleeding usually weakens within a few hours. On average, people continues with slight bleeding for about two weeks or so that a little longer than after a vacuum desire.
Nausea, vomiting, fever, chills, diarrhea and headache can occur after using tablets for abortion, and everyone who has a successful abortion of drugs usually report some pain.
In fact, the pain of drug abortion can be quite intense. In the studies that have considered this, the average maximum level of the pain reported by people is about seven out of 10 out of 10, and 10 are the highest. Nevertheless, people also say that the pain can be brief, a peak, when pregnancy is excluded.
The level of spasms and pain can depend on the length of pregnancy, as well as whether anyone gave birth to anyone earlier. For example, a medical abortion after six weeks or less pregnancy usually has less pain and convulsion than one, performed in nine weeks. People who gave birth, as a rule, are less pain.
CNN: What can be done to help with the pain of drug abortion?
Grossman: There are definitely things that can be used to help with pain. Studies have shown that Ibuprofen Better than acetaminophen for treating drug abortion. Usually we advise people to take 600 milligrams every six hours or so as necessary.
Some people take tramadol, a narcotic analgesic or vicodin, which is a combination of acetaminophen and hydrocodone. A recent study, I was involved in the drugs found, such as tramadol, can be useful if it is preventively accepted before the start of pain.
Another successful regime that we studied was united Ibuprofen with a cure for nausea, called metakaropramide, which also helped with pain. In addition to ibuprofen, these drugs require a prescription.
Another study showed that the TENS device, which means a percutaneous electric nervous stimulant, helps with the pain pain. It works through the pads superimposed on the stomach, which stimulates the nerves with soft electric shocks, which interferes with painkillers. This is what people could get without a recipe.
The pain can be a missed problem with abortion of drugs, because, frankly, as clinicians, we are not with patients when they are in our homes, passing through this. But since we conducted more research on the experience of people with abortion of drugs, it became completely clear that pain control was really important. I think that we need to better treat pain and make these options available to patients.
CNN: Are there any health conditions that make the use of drug abortion unreasonable?
Grossman: The abortion of drugs can be dangerous if the pregnancy is ectopic, that is, the embryo develops outside the uterus. This is rare, occurs in about 2 of Every 100 pregnancy – and, it seems, even less often among people looking for medicines.
People who have suffered previous pelvic, phallopium pipe or abdominal surgery are at a higher risk of ectopic pregnancy, like people with an inflammatory illness in history. Some sexually transmitted infections can increase the risk, like smoking, in a history of infertility and the use of infertility treatment, such as in vitro fertilization.
If a person is on anticoagulants or drugs to incite blood or has bleeding, abortion of drugs is not recommended. Long -term use of steroids is another contraindication for using a tablet for abortion.
Anyone who uses the intrauterine device, or iUD, must remove it before taking mifepristone, because it can be partially excluded during the process, which can be painful.
People with chronic insufficiency of the adrenal glands or who inherited a rare disorder called Porfiry Not good candidates.
CNN: Are there any signs of troubles that a woman should follow the abortion of drugs?
Grossman: In the first few hours after the adoption of the Misoprostol, the second drug when abortion of drugs in the abortion of drugs. If someone has a low-class fever-with 100.4 degrees up to 101 degrees Fahrenheit-Kotori lasts more than four hours or has a high temperature of more than 101 degrees in Fahrenheit after taking drugs, they must be evaluated by the medical services by the supplier.
Severe bleeding, which will soak two or thicker full -size gaskets per hour for two hours in a row, or an unpleasant vaginal discharge should be evaluated.
One of the warning signs of ectopic pregnancy is severe pain in the pelvis, especially on one side of the abdomen. The pain can also radiate in the back. Another sign is dizziness or fainting, which may indicate internal bleeding. All these are very rare complications, but it is reasonable to be on the observation deck.
We usually recommend that anyone, who had a medicinal abortion, have someone with them within the first 24 hours after the adoption of the Mizrostol or until the pregnancy passes. Many people specifically prefer to have an abortion of drugs because they can be surrounded by a partner, family or friends.
Most people know that abortion is completed because they cease to feel pregnancy, and symptoms such as nausea and tenderness, usually within a week after pregnancy. A house pregnancy test can remain positive even four to five weeks after a successful abortion of drugs, simply because it takes so much time to disappear to the hormone of pregnancy.
If someone still feels pregnant, I’m not sure that the pregnancy has completely passed or has a positive pregnancy test five A few weeks after taking myffiperon, they must be evaluated by a doctor.
People should know that they can ovulate two weeks after the abortion of drugs. Most options for controlling the birth rate can be started immediately after the abortion of drugs.
