Splashing across the news headlines, abortion has been a major issue cropping up recently. Whether that’s through the Texas Abortion Law, the more recent American Abortion Law, or the close watch behind the Polish Elections, there have been many drastic changes to the legalisation of this avenue of healthcare.
With 73 million abortions taking place worldwide each year, and 29% of all pregnancies ending in induced abortion, it raises a question: how much do we as a society know about the medicine behind it? The main reason behind societies’ lack of fundamental knowledge can be attributed to social stigma. It can and does shroud the healthcare aspect of abortion with shame and secrecy, significantly tampering with our understanding of its medicinal aspects.
How much do we truly comprehend beyond the surface-level information the news provides us? What are the different ways to access it? What are the risks associated with it? Let’s strip away this social stigma and take a look below the surface into the medicine behind abortion.
What is Abortion?
Abortion is classified by the British Pregnancy Advisory Service as “the ending of a pregnancy so that it does not result in the birth of a child”. This can be called the “termination of pregnancy”.
Two legalised ways of inducing an abortion exist. This can either be through Surgical Abortion or The Abortion Pill. Two different types of abortion pills can be taken depending on the stage of pregnancy.
In the UK, no matter which abortion route the participant decides to undertake, there is a set of procedures that must be carried out before this. Per the NHS rules and regulations, the participant must:
Discuss their reasons for an abortion with a trained professional.
Have an individual conversation with a doctor or a nurse about the different methods of abortion available to them as well as the risks of pursuing it.
Undergo multiple blood tests that highlight any prior medical issues.
Furthermore, they will be offered the following:
A chance to discuss their procedure with a professional counsellor.
An ultrasound scan of the foetus.
A test for any underlying sexually transmitted infections.
This ensures that the participant can make a fully informed decision about the procedure; they will be aware of any potential risks of their chosen method in addition to having the secure knowledge that this procedure is the right one for them. This preceding knowledge can also be incredibly beneficial to the healthcare provider; they too are fully informed of the issues presented by their patients personally and medically. This in turn can ensure that the hospital is aware that the patient undergoing this procedure has made a wholeheartedly conscious and consenting decision that will not worsen any present medical issues while simultaneously ensuring that it will provide the best outcome for the patient. This consent is arguably the most important information required by the patient and can be rescinded at any time up to the beginning of the abortion.
Surgical Abortion
Surgical abortion can be accessed up to 23 weeks and 6 days of the pregnancy. It is known as a safe and simple procedure with a 96.5% success rate that takes approximately 20 minutes to perform.
First, the cervix will need to be prepared for the procedure, to make it as safe as possible.
If the patient is below 19 weeks pregnant, they are provided with the drugs Misoprostol and Mifepristone. According to the BPAS, Mifepristone (previously known as RU486) can aid the ending of a pregnancy by blocking the action of the hormone progesterone. Progesterone aids the thickening of the uterine lining during pregnancy, thus blocking it will ultimately thin the uterine lining, culminating in the uterus being unable to support the fertilised egg. In addition, the use of the drug Misoprostol further secures the release of this aforementioned egg; it causes the cervix to soften and the uterus to contract, thus expelling the pregnancy. If the patient is over 19 weeks pregnant, the healthcare provider will place small rods in the cervix on the day of the procedure.
Following this, there are two methods of surgical abortion.
If the abortion occurs before 15 weeks of gestation, the pregnancy is removed using vacuum aspiration. This involves using a suction device to manually remove the contents of the uterus through the cervix and vagina and is typically carried out under light anaesthesia. It takes approximately 15 minutes to perform.
After 15 weeks, the abortion is carried out via Dilation and Evacuation. This procedure involves using slender, specialised instruments and suction to successfully remove the foetus. Again, this method removes the pregnancy through the cervix and the vagina and is typically done using a lighter or heavier anaesthetic, depending on the patient’s preference. This takes approximately 20 minutes to perform.
The Abortion Pill
Medical abortion can also be accessed up to 23 weeks and 6 days of pregnancy. It has an approximately 93% success rate and is carried out over 2 days.
There are two different medications for abortions. One is the Misoprostol-only pill. This procedure can take place at the patient’s home. The patient takes 800 micrograms of misoprostol (4 pills), placing it under the tongue by the cheek or inserting it vaginally every 3 hours for a total of 12 pills. According to research from KFF Women’s Health Policy a medication abortion has a complication rate of less than 1%, so it is deemed very safe, effective, and easily accessible to patients.
Additionally, there is a Misoprostol and Mifepristone pill. Approximately 600mg of Mifepristone is taken, and then 24-48 hours later Misoprostol is taken. Both methods then cause heavy cramping, pain, and bleeding to expel the pregnancy. The pills can be taken at home or in the hospital/clinic, depending on patient preference. Although both pill methods expel the pregnancy within 48 hours, the residual pain and cramping can last for up to 2 weeks, potentially even more depending on the patient’s body.
Although all of these varying procedures are classified as low-risk, many issues still have the potential to occur. These are the basis of many tragic stories regarding abortion and childbirth presented in the media.
Both Misoprostol and Mifepristone, whether the chosen procedure is Surgical or Medication, have numerous side effects and risks associated with them including:
Maternal Fever
Chills
Nausea
Vomiting
Diarrhoea
Abdominal Pain
Hyperthermia
Flatulence
Constipation
Dyspepsia
Intense vaginal bleeding
Heavy, painful cramping
Risk of haemorrhaging
Menstrual irregularity.
Surgical risks
The complication rate is a mere 2%, but the various, potentially dangerous, and discomforting side effects can take a major toll on not only the patient’s body but also their mental well-being. These physical risks and side effects only pile onto the lingering sadness that many patients feel after an abortion as well as the emotional instability that occurs due to the hormones inhibited by mifepristone and misoprostol.
Conclusion
In conclusion, although abortion is widely accessed throughout the world, it does indeed have its complications. Being knowledgeable about a subject that is receiving such scrutiny throughout the media can not only aid us in breaking through the social stigmas surrounding abortion, but it can also aid us in forming our own, individual opinions. It teaches us to be compassionate to everyone undergoing this procedure and to have the capability to discuss what is such a delicate subject in society today with maturity and a deeper understanding.