Maximum period for safe termination of pregnancy

Questions:

Termination of pregnancy: until what period can you have a medical abortion?
How dangerous is medical abortion during the first pregnancy? Is it possible to terminate a pregnancy beyond 12 weeks? Is it possible to take any medication to terminate a pregnancy on your own? Answers:
There is no absolutely safe abortion; any method of abortion can lead to complications in the form of bleeding, inflammation, and subsequently cause failure to carry the desired pregnancy. Therefore, the decision to have an abortion should be well thought out and weighed from all sides by the couple who have decided to take this serious step. If circumstances still force you to terminate your pregnancy, then the most gentle method is medical abortion. Especially if this is the first pregnancy.

Many women are interested in the question, until what period is an abortion performed?

No matter what scientific terms are used to replace simple words when describing the process of abortion, abortion is the murder of an unborn child. In our country, abortion is legally justified only in cases of rape, death of the child's father during pregnancy, deprivation of parental rights, threat to the mother's life and fetal pathology.

An abortion can be performed up to 22 weeks of pregnancy.

Starting from the eighth week of gestation, the baby’s nervous system begins to form. On the sixteenth day, the baby makes the first more or less conscious movement - he begins to respond to sounds.

Termination of pregnancy performed at a later stage is called premature birth.

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Termination of pregnancy up to 12 weeks

is called early abortion and this procedure is performed at the request of the woman.

6 weeks until pregnancy

You can have a medical abortion (using pills).

Termination of pregnancy at a later stage, more than 6 weeks, can only be performed through surgical intervention (so-called curettage).

If the gestation period exceeds 12 weeks, an abortion can be performed only in the presence of serious medical (for example, the presence of intrauterine pathology of the fetus, decompensated diseases of the mother - epilepsy, diabetes mellitus) or social indications (rape, death of the husband, imprisonment).

remember until what time an abortion is performed , because terminating a pregnancy at a longer period is very dangerous.

Recently, termination of pregnancy (abortion) is increasingly performed by medication.

At the same time, medical abortion has a limited period.

This manipulation can be performed up to 49 days (up to 6 weeks of pregnancy), if you count from the first day of the last menstruation.

It is during this period that the fertilized egg is still weakly attached to the uterine cavity, so taking certain medications promotes increased contractility of the uterus and rejection of the fertilized egg.

If you perform a medical abortion and do not delay the timing , this has some advantages for the woman:

• there is no mechanical damage to the uterus
• no need for anesthesia
• infection is prevented from entering the uterine cavity.

For young girls who plan to have children in the future, medical termination of pregnancy is the method of choice.

Yes, and psychologically it is much easier to endure termination of pregnancy with the help of a drug than agreeing to surgical termination of pregnancy.

If you have already decided to have a medical abortion, do not delay the deadline, because the slightest delay can reduce the effectiveness of this method to zero.

Consult a specialist doctor in time, take care of your women's health!

What problems can arise with a medical abortion?

Firstly, the pregnancy may not be terminated. In this case, it can no longer be saved for medical reasons. A mini-abortion is performed. Secondly, there may be very heavy bleeding. In this case, too, sometimes you have to resort to surgery. Thirdly, it can be very painful, you can feel nauseous, and your blood pressure increases.

The undoubted advantage of this method is the absence of surgical intervention, and therefore the possibility of uterine injury and infection.

The legislative framework

According to the Ministry of Health, about 3 million women a year consent to an abortion procedure. In public medical institutions, abortion is performed free of charge. 30% of women experience complications, and 10% of patients become infertile. From the legal side, there are 3 types of abortion:

• At the personal request of the woman. In this case, termination of pregnancy should be carried out during the first trimester. The latest date is 12 weeks. The smaller the size of the fertilized egg, the easier the procedure will be.
• For social reasons. Abortion is performed before 22 weeks. Abortion is permitted only in cases of impregnation due to rape. Until 2003, social reasons included the death of a father, having many children, poor living conditions, etc.
• For medical reasons. Medical factors include fetal abnormalities that are incompatible with its life, serious illnesses that threaten the health or life of the woman.

Medical abortion (6 to 12 weeks or 13 to 24 weeks after your last period).

This surgical abortion is performed during the second trimester of pregnancy. Up to 12 weeks, you can have a regular or surgical abortion. It will feel the same as a mini-abortion, but instead of a tube, a special instrument is inserted into the uterus, which is used to remove the fertilized egg. The same rule applies very clearly here - the longer the period, the more difficult the operation, the more complications there may be.

Because the developing baby doubles in size between the 11th and 12th weeks of pregnancy, its body is too large to be crushed by suction and pass through the tube. In this case, the cervix should be open wider than during a 1st trimester abortion. Therefore, kelp is administered a day or two before the abortion itself. After the cervix is ​​open, the doctor removes the baby's body parts with forceps. In order to easily remove the child’s skull, it is first crushed with forceps.

Only these three methods of terminating a pregnancy are permissible and are not considered a “criminal abortion” in our country, with the exception of termination of pregnancy according to a doctor’s testimony in the later stages.

Drugs recommended for medical abortion

A woman who decides to have an abortion using pills should familiarize herself with the list of special medications. The following are the names of the most popular of them: in particular, those made on the basis of mifepristone (this is a synthetic steroid drug).

1. Mifeprex is a fairly effective Russian drug: pregnant women up to 1.5 months tolerate it well.
2. Postinor – 2 tablets. It is administered orally. The first tablet is taken no later than 3 days after unprotected sexual intercourse, the second - another half a day after taking the first. According to doctors, this drug is not so reliable, since termination of pregnancy occurs in no more than 85% of cases. It can be taken without consulting a specialist. However, you should be prepared for the fact that hormonal levels are disrupted under the influence of postinor.
3. Mifolian is a Chinese-made drug. Used before 7 weeks of pregnancy, leads to miscarriage.
4. Mifegin is a French steroid drug. Taking it also leads to miscarriage in early pregnancy.
5. Pencrofton is a Russian-made hormonal drug for pharmaceutical abortion. Suitable for women who have not yet given birth.
6. Mifepristone is also available in tablets in Russia. It is recommended to take 3 tablets at once. The drug promotes rejection of the fertilized egg from the endometrium. Taking the drug does not lead to complications after an abortion.

Late term abortion

After 12 weeks, abortion on request is prohibited in our country. They do it only for medical and social reasons: a court decision to limit parental rights, pregnancy as a result of rape; death of a husband during a woman's pregnancy. Pregnancy is terminated in the later stages, either by artificially inducing labor or by performing a minor caesarean section. That is, there will be childbirth, but there will be no child. So, you know, it’s better not to let it come to this.

This medical abortion is performed:

From 20 weeks after the last menstrual cycle. The procedure to terminate a late pregnancy takes 3 days. During the first two days, the cervix is ​​dilated and the woman is given antispasmodic drugs. On the third day, the woman takes a medication that induces labor. After labor has begun, the doctor does an ultrasound to determine the location of the baby's legs. Grabbing the legs with forceps, the doctor pulls the child out, leaving only the head inside. In this case, parts of the child’s body can be torn off from the body itself and pulled out through the vaginal canal. The rest of the body is pinched and pulled outward. The baby's head is pinched and crushed in order to pass through the vaginal canal. The placenta and remaining parts are sucked out of the uterus.

Previously, saline abortion or saline filling was used, but this method was not effective enough, as did Homeopathy (efficiency no more than 20%), Acupuncture (effect up to 40% with a short delay and depends on the qualifications of the specialist), Magnetic induction (“magnetic cap” with in the absence of contraindications, it is effective in 50% of cases with a delay of no more than 3-5 days)

Medication method, its features

Pharmacological abortion using hormonal drugs is an alternative to surgical abortion. It is carried out in the early stages, and its essence is that a spontaneous miscarriage occurs.

Advantages of pharmacological abortion:

• high, almost 100 percent, efficiency;
• there are no risks that the use of anesthesia may cause;
• not dangerous for HIV infection;
• since surgical intervention is not expected, there is no likelihood of injury to the uterus;
• the woman does not risk getting ascending infections;
• possible use in women pregnant for the first time, since the impact on health is minimal;
• characterized by a low level of stress, the traumatic situation is also minimized.

In this case, the woman does not need to stay in the hospital for a long time: the patient takes medications that will cause a medical abortion, and she can wait for the bleeding to begin at home.

What is preferable, abortion using a vacuum aspirator and surgical instruments or pharmacological? The decision is made on an individual basis. However, the risk of complications in the first case is much higher.

How does medical abortion occur?

Talking about how the pharmabort is performed, the doctor explains the stages of the procedure. Beforehand, a woman needs to undergo a short examination, which is prescribed on the day of treatment:

• Ultrasound of the uterus;
• microflora smear;
• blood test for syphilis.

After receiving the results, an exact time is assigned when a medical abortion will be performed, the timing of which is indicated above. During the second visit, the doctor talks with the woman again, clarifies the seriousness of her intentions, and whether she has changed her mind. The patient is then given the drug, which she drinks in the presence of a doctor. Under the influence of the drug, endometrial growth stops, and the muscle layer begins to contract. The woman is observed for 2–3 hours, after which she leaves the clinic.

The patient is given a tablet of another drug that stimulates uterine contractions. It is taken after 36–48 hours, as directed by the doctor. Under the influence of the drug, the dead embryo is expelled out. Only after this is the medical abortion considered complete. A woman records bloody discharge.

Medical termination of pregnancy - drugs

A woman, even if she wants, cannot carry out a pharmaceutical abortion on her own - pills for its implementation are not sold in the pharmacy chain. When performing a medical abortion, drugs are used with a high content of hormones, so they are issued by a doctor in a medical facility. To carry out medical abortion, the following groups of drugs are used:

1. Antigestagens
   - suppress the action of natural gestagens at the receptor level. A representative of this group is Mifepristone, Mifegin. For pharmaboration, 600 mg of the drug is used.
2. Prostaglandins
   – enhance the contractility of the uterine myometrium. Most often from this group they use Mirolut. 400 mg of the drug is prescribed. Taken 36–48 hours after the antigestagen.

How do you know that the pharma abortion was successful?

Complications are possible with any medical procedure, so women often ask doctors how to understand that a medical abortion was unsuccessful. In order to exclude possible violations, after 14 days the woman must visit the clinic and undergo a control ultrasound. The doctor must make sure that the fertilized egg and its remains have completely left the uterine cavity. They examine the organ itself, determining its size. In a woman, the doctor clarifies the nature of the discharge, the presence and severity of pain. Often, after a pharma abortion, the test is positive - this is due to altered hormonal levels.

What to do after

You can reduce negative consequences to a minimum by creating the following recommendations within 3-4 weeks after an abortion:

• It is not allowed to take a bath, swim in open water or go to the pool.
• Watching for timely emptying of the intestines and bladder, you can’t hold on.
• Observe enhanced personal hygiene rules.
• Sexual abstinence. The uterine cavity is an open wound on which any microbes introduced from the outside can multiply. Due to this, it is not only impermissible to have sexual activity, but also to penetrate the vagina with foreign objects, for example, during douching.
• Do not lift heavy objects and do not get too cold.

Complications and consequences of induced abortions

The abortion procedure carries not only the possibility of serious psychological discomfort and even depression for the woman, but also the risk of complications associated directly with the manipulation performed.

In the early period, during the operation and after an abortion, the most common complications are:

1. Perforation of the uterine wall with sharp instruments;
2. Hematometra, when blood accumulates inside an organ due to a violation of its outflow;
3. Damage to the cervix due to careless actions of a doctor, as well as in cases of insufficient dilation;
4. Heavy bleeding;
5. Incomplete abortion, when parts of the embryo and membranes are retained in the uterus with the subsequent formation of the so-called placental polyp, the development of acute endometritis, metroendometritis, parametritis, pelvic peritonitis, sepsis, etc.;
6. Inflammatory process - post-abortion endometritis, peritonitis, myometritis;
7. Adhesions and adhesions (synechia) inside the uterus;
8. Infertility.

Some experts list mental disorders as complications. There have been no large-scale studies that would prove the connection between the latter and abortions, but there is evidence that after a surgical abortion the risk of depression and exacerbation of existing mental illnesses is still higher due to serious psychological trauma and hormonal imbalance.

The consequences of terminating a pregnancy may appear many years later. For example, a young girl underwent curettage due to an unwanted pregnancy, having decided to postpone reproductive plans until later in life, but by then irreversible changes may have occurred in the uterus. Pregnancy after an abortion becomes impossible, and the woman remains infertile forever.

The main long-term consequence of an abortion is infertility, the risk of which after surgical removal of the fertilized egg is many times higher than that with a “vacuum” and medical abortion, because the curette injures the mucous membrane of the uterine body, and can even completely remove it along with the basal layer, due to which it usually regeneration and preparation for potential pregnancy occurs after each menstruation.
Healing of the uterine mucosa after surgical abortion in the second trimester is often accompanied by the formation of adhesions and adhesions, which will further interfere with the fixation of the fertilized egg, impede the patency of the fallopian tubes, and interfere with the normal development of the placenta. Endometritis, which appears after surgical manipulations, can permanently make this organ unsuitable for the life of the embryo, manifesting itself in persistent infertility.

Abortion is legal in many countries around the world, and where the bans are the most stringent, they are still carried out for medical reasons. In this regard, it is impossible to completely exclude the likelihood of the described consequences, and the World Health Organization has developed a number of recommendations to minimize the frequency of complications.

Ways to reduce the incidence of post-abortion complications include:

• Increasing the proportion of medical abortions and vacuum aspirations in the total number of pregnancy terminations, with a decrease in the number of surgical curettages, which should be prescribed only to those women for whom less traumatic methods cannot be performed;
• If possible, use gradual medicinal dilation of the cervical canal, abandoning mechanical dilation using metal dilators, which injure the neck and subsequently contribute to isthmic-cervical insufficiency;
• If there are indications or a woman desires to get rid of pregnancy, abortion should be carried out as soon as possible, since every two weeks of embryo growth the risk of perforation of the organ wall increases by 20%.

According to reviews of patients in gynecological hospitals who underwent a surgical abortion procedure, memories of this event remain for the rest of their lives. Most women experience a feeling of remorse, remorse for an interrupted life, regret about the action they committed. Even in cases where a pregnancy is involuntarily terminated due to medical reasons, it is difficult for a woman to recover from what happened.

The intervention itself usually does not cause significant physical discomfort. Abortion under general anesthesia is painless and quick, and the menstrual cycle is restored in a fairly short time. After vacuum aspiration, recovery takes even less time due to minimal trauma to the uterine mucosa.

Vacuum aspiration

Vacuum aspiration is considered a fairly safe method of termination; the procedure is carried out by suctioning the fertilized egg with a special vacuum device and is carried out under anesthesia or general anesthesia. Mini-abortion has some features and requires compliance with a number of requirements. Features of mini-abortion:

1. The maximum period for this type of interruption is 7 weeks. If the optimal time is observed, vacuum aspiration of the fertilized egg takes place without any particular complications or negative consequences for the woman’s body. This procedure, compared to surgical curettage of the uterine cavity, is considered safer and gentler, since instruments that expand the cervical canal are not used during a mini-abortion.
2. Only a special suction is introduced, as a result of which there is almost no possibility of perforation of the uterus and its walls. When performing a mini-abortion, timely restoration of the monthly cycle ends after 43 days. The procedure lasts only a few minutes, and after several hours the woman can safely go home.
3. Termination of pregnancy using vacuum aspiration almost does not lead to any dangerous complications for the body. After the termination, the woman will feel characteristic pain in the uterus, which is more like the sensations during menstruation, but they will soon pass. In some cases, after a mini-abortion, part of the fetus still remains in the uterus, so five days after the procedure, the woman is sent for a control ultrasound of the uterine cavity.

About the safety of manipulation

If everything is clear about the timing of the procedure, then you need to carefully consider at what time of gestation it is safest to carry out an abortion.
Doctors note that it is best to have an abortion in the first trimester, the deadline is two months. The safest procedure is one that is performed in the first weeks after conception. In this case, it is allowed to use vacuum aspiration or pharmabort. At a later date, specialists will perform surgery to remove the unwanted fetus. The safest option is to interrupt pregnancy before 8 weeks. If the abortion time exceeds the optimal indicator, doctors can only perform curettage, which is considered a rather dangerous method. Such procedures in most cases lead to deformation of the uterine walls and tissues. They are complicated by infection and various difficulties with the hormonal system, affecting the possibility of re-pregnancy, normal gestation, as well as proper labor.

Are there consequences?

After a pill abortion, as after a surgical termination of pregnancy, there may be complications. It is worth noting that the consequences of such manipulation are not so dangerous. Thus, during gynecological curettage or curettage, perforation of the uterine wall may occur. Due to medical termination of pregnancy, this is impossible. Also, the adhesive process, which often occurs after cleaning, is excluded when exposed to drugs containing mifepristone. Let's consider the main consequences that pill abortion has.

Timing of pharmaboration

There is also a limited time for pharmabort. This type of abortion is allowed to be carried out until the sixth week of gestation, but the maximum result can be achieved only when performed in the fifth week. With a later abortion, small parts of the fetus may remain in the uterus. In this case, a special operation is performed to scrape out the contents of the uterus.

This therapy is not allowed for every woman. It is prohibited to do it if there is a suspicion of ectopic attachment of the fetus, or if there are difficulties with the gastrointestinal tract. The procedure is prohibited for girls under the age of eighteen and women over 35, as well as during conception during which the woman was using oral contraception. Termination of pregnancy is prohibited if the patient is being treated with anti-inflammatory or steroid drugs.

If the main contraindications and prohibitions are not observed, bleeding may begin and the functioning of the gastrointestinal tract may be disrupted.

Proper preparation with all diagnostic measures will help prevent such processes. It is forbidden to do pharmaboration yourself, since in this case the reaction to such a drug can be different, up to the onset of severe bleeding. That is why only a doctor can determine what time an abortion is performed in a certain case, and also perform it.

Postoperative period

The postoperative period, provided that the abortion technique and preventive measures are followed to prevent complications, proceeds favorably; no additional treatment is usually required, but if there is a high risk of infection or inflammatory process, antibacterial and anti-inflammatory drugs can be prescribed.

After a surgical abortion performed by vacuum aspiration, a control ultrasound examination is indicated, in which the doctor must make sure that no elements of the fertilized egg or membranes were left in the uterus.

Bloody discharge after a surgical abortion lasts no more than a week, gradually decreasing. They are not considered a pathology, but a woman should be alerted if they become more intense, change color, have an unpleasant odor, or increase in body temperature. These signs may indicate the addition of an infection with the development of endometritis, the possible retention of parts of the embryo in the uterus, and therefore should be a reason to seek help.

Women who have undergone a surgical abortion must follow a number of rules in the postoperative period to restore the reproductive system and prevent complications:

1. After the operation, sexual activity should be excluded for at least a month, and its resumption is possible only after the first menstruation after the intervention;
2. During the first week after an abortion, it is recommended to limit physical activity, avoid hypothermia and regularly measure body temperature, and if it increases, you should immediately consult a doctor due to the risk of infectious complications;
3. Careful hygiene of the genital tract is extremely important;
4. Swimming in a pool, pond, or taking a bath is possible no earlier than two weeks after a surgical abortion;
5. If you experience bloody discharge from the genital tract, fever, or pain in the lower abdomen, you should go to the gynecologist.

Two weeks after the operation, the woman should be examined by a doctor and also discuss with him the issue of further contraception. Menstruation after an abortion occurs after 30-35 days; over the next few months, the cycle gradually shortens and returns to normal length. Some experts recommend taking hormonal contraceptives, which help the patient recover faster.

A surgical abortion can be done in any gynecological hospital or even a antenatal clinic. Vacuum aspiration can be performed on an outpatient basis, but curettage requires an operating room setting. Many private medical centers also offer this service, but for a fee.

In state clinics and hospitals, abortion is carried out free of charge, with a compulsory medical insurance policy, after passing the appropriate examinations. Often women decide to have an abortion for free. The cost of a surgical abortion depends on the location, the qualifications of the doctor, and the comfort of the woman’s stay in the medical facility.

The price for vacuum aspiration averages 3-5 thousand rubles, in some institutions, however, it reaches 20-30 thousand. Surgical abortion by curettage will cost more - 10-15 thousand and more. Medical abortion is the cheapest, since in this case the woman will only have to spend money on a pharmacological agent that provokes a miscarriage.

Contraindications

There are a number of contraindications for medical interruption. The absolute ones, when the procedure is prohibited, include the following:

• ectopic pregnancy;
• pregnancy period is more than 9 obstetric weeks;
• presence of scars on the uterus;
• allergic reactions to the drugs used;
• the presence of neoplasms and inflammatory processes in the organs of the reproductive system;
• severe diseases of the heart and blood vessels, kidneys, and liver.

There are also relative contraindications to pharmabort, in the presence of which the patient may be denied the procedure (the issue is decided by the doctor):

• age less than 18 and more than 35 years;
• menstrual irregularities;
• poor blood test (low hemoglobin, clotting problems);
• smoking within the last five years;
• epilepsy;
• long-term use of drugs with antithrombotic effects.

Surgical intervention

Termination of pregnancy by surgical intervention is considered the most dangerous method of all possible, as it brings severe stress to the body. When performing surgical removal of the fetus, the cervical canal is moved apart with a special device. Using a curette, the egg located in the uterus is removed.

Most often, doctors prescribe surgical intervention when there is a particular danger to a woman’s life or when genetic and physiological pathologies are identified in the developing fetus. If the pregnancy proceeds normally, then termination using this method can lead to certain difficulties.

Surgical abortion is allowed up to twelve weeks, but if there are special indications, it can be performed up to the twenty-second week.

conclusions

You now know what a pill abortion is. Remember that even such a safe termination of pregnancy is an interference in the smooth functioning of the female body. It often causes negative consequences and various complications. That is why this manipulation must be carried out under the supervision of a doctor. Otherwise, you will not be able to receive timely medical care if necessary. Use contraceptives and you will not need a medical termination of pregnancy. Good health to you!