This article has been compiled by Vaibhavi Kodnani, a content writer at Proactive For Her.
What is the Medical Termination of Pregnancy?
Medical Termination of Pregnancy (MTP) or medical abortion is a non-surgical method of terminating a pregnancy. In this method, as the name suggests, medicines of two kinds are used for abortion. This method of abortion is allowed until 7-9 weeks of pregnancy also called, early pregnancy termination. For a pregnancy that has succeeded more than that, surgical abortion is preferred.
Please note: The medicines used for Medical Termination of Pregnancy are not over-the-counter drugs. Only your doctor can prescribe them to you if you prove eligible for it after an appropriate diagnosis. Do not self-prescribe; it is neither allowed nor advisable and can result in severe complications if consumed without prescription.
When is a Medical Termination of Pregnancy done?
The doctor may suggest you opt for medical termination of pregnancy if:
- It is an unwanted pregnancy for the mother due to personal circumstances.
- The pregnancy poses a health risk to the mother.
- There is a high probability for the baby to be susceptible to a medical condition that poses a risk to its long term health or survival.
Who is eligible for medical termination of pregnancy?
In India, according to the Medical Termination of Pregnancy Act, the indications for opting for an MTP are:
- When the continuation of pregnancy is a risk to the life of the pregnant woman or of grave injury to her physical or mental health;
- When there is a substantial risk that the child, if born, would be seriously handicapped due to physical or mental abnormalities;
- When pregnancy is caused by rape. (presumed to cause grave injury to the mental health of the woman);
- When pregnancy is caused due to failure of contraceptives used by a married woman or her husband. (presumed to constitute a grave injury to the mental health of the woman).
Who cannot opt for medical termination of pregnancy?
Under some situations, medical termination of pregnancy may not be suitable for you. The circumstances include:
- Previous allergic reaction to one of the drugs involved in MTP
- Inherited porphyria - a bleeding disorder
- Chronic adrenal failure (Your adrenal glands are the ones on top of your kidneys that make your stress hormones and other hormones)
- Known or suspected ectopic pregnancy ( An ectopic pregnancy is one that lies outside the uterus)
Apart from the above-mentioned conditions, there is caution required if:
- The woman is on long-term corticosteroid therapy. (including those with severe, uncontrolled asthma)
- She has severe anaemia.
- She has pre-existing heart disease or cardiovascular risk factors (e.g. hypertension and smoking). In this case, surgical abortion is advised.
What is the effectiveness of MTP?
Medical abortion is a safe procedure and does not have any severe side effects. It is around 98% effective before 8 weeks of pregnancy.
What is the procedure of MTP?
Medical abortion is a non-invasive 2-stage procedure with very few complications.
Before the procedure:
Before starting the process, the doctor will perform a series of tasks to confirm if you are eligible for a medical abortion.
- Pregnancy test: The doctor will first perform a pregnancy test to confirm the pregnancy.
- Ultrasound test: If the result is positive, they will do an ultrasound exam to check the age of the pregnancy. It is also to confirm that it is not an ectopic pregnancy (fertilised egg implants outside the uterus) or molar pregnancy, wherein a non-cancerous tumour develops in the uterus. But there is a risk of malignancy, i.e. cancerous cells develop.
- Other tests: The doctor will also check for anaemia, any Sexually Transmitted Diseases (STDs), and your blood group.
Medical Termination of Pregnancy:
You have to take two different medicines in the two stages.
Stage 1:
During the first stage, the doctor will give you an oral tablet called mifepristone in the clinic or the hospital. This medicine blocks the hormone progesterone that is necessary for the pregnancy to continue.
Stage 2:
After taking the first medicine, your doctor will give you a second medicine called misoprostol, which is to be taken at home after 48 hours. Misoprostol helps to expel the contents of the uterus (womb) through the vagina within 4-6 hours, thus resulting in the termination of pregnancy. During the abortion, you will also be given pain relief medicines as you will experience cramps which are slightly more painful than period cramps.
After the procedure:
- You will experience vaginal bleeding: After the procedure, the vaginal bleeding can continue for up to 10-14 days. It is like regular menstruation, but heavier and prolonged. However, if you feel the bleeding is unusually excessive or if you observe clots passing, you must report it to your doctor immediately.
- Follow-up with your doctor: After roughly 14 days of taking mifepristone, you must schedule a follow-up visit with your doctor. They will determine whether the pregnancy is completely terminated or not and assess the degree of your bleeding. The doctor will decide the further course of action after your check-up.
- Next menstruation: After taking misoprostol, the vaginal bleeding will continue for about a fortnight. You can expect your next menstruation to start approximately a month after the bleeding stops.
- Sexual intercourse after abortion: You can resume sexual activity once the bleeding stops. However, don’t forget to use contraception.
- Use contraception: Always use proper contraception when you start having sex again after the medical abortion. If you don’t do so, there are high chances you can conceive again even before your coming periods.
What are the advantages of MTP?
Compared to surgical abortion, here are some advantages of medical abortion:
- You can avoid surgeries: Medical abortion is via medications, and generally, there is no need for surgery. However, it may be required in case of incomplete abortion.
- You don’t require anaesthesia: Surgical procedures require the administration of anaesthesia. But with the use of only oral medicines, the need for it is eliminated.
- There is no need to get admitted: For this process, you don’t need to get admitted to a hospital or clinic. You can take the medicines at home after your doctor prescribes them. However, it is crucial to follow the instructions given to you by your doctor. If you notice any unusual changes, call your doctor without further delay to prevent complications.
- It is a non-invasive method: Medical abortion does not involve the use of any instruments. You only have to take oral tablets.
What are the possible side effects of MTP?
You can experience problems during the process of medical abortion or after the process.
At the time of abortion, problems include:
- Excessive vaginal bleeding: Around 1 in every 1000 abortions will experience excessive vaginal bleeding. The number increases to 4 in every 1000 abortions with increased gestational age. If you present excessive bleeding, the doctor will perform a scan for retained tissues in the uterus. If yes, then the doctor will remove them via surgery.
After the abortion, problems include:
- Infection: If vaginal infections are detected, the doctor will prescribe antibiotics for treatment.
- Incomplete abortion: If all the contents in the uterus do not get emptied, there may be a need for surgery to remove the remaining pregnancy tissues within the uterus.
How soon can you recover and return to your normal activities?
You can expect heavy bleeding for 4-5 days after stage two of medical abortion. You can return to your normal activities after that provided there are no complications. In case of any suspicion of unusual symptoms, contact your doctor for further advice.
Bottom line
Medical Termination of Pregnancy is executed after guidance and consultancy with the doctor. It is a beneficial procedure if performed within 9 weeks of pregnancy. It is not allowed to self-prescribe the drugs used for medical abortion. Please let the doctor decide on an appropriate course of treatment for you after your diagnosis.
Disclaimer: This information is educational and should not be construed as medical advice. Please consult your doctor before making any dietary changes or adding supplements.
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