Abortion - Medical abortion - Pill thrill
Pill Thrill (week 1-12)
In the second part of this seven part series, we bring to you a filtered and simplified yet accurate compilation of the latest medications available for you. Know all about your abortion pills, how they work and their risks and benefits.
“Why is there bleeding after taking abortion pills? Is it normal?”
“What risks do I run into with these pills?”
“Why do we have different pills for different trimesters of pregnancy?”
Find answers to all these questions and many more troubling you so you can make a much more informed decision for your body and you.
Options for the First Trimester :
The uterus or the womb is the pre natal home for your baby. The wall is lined with a rich network of capillaries and it is in the wall, somewhere on the roof of this little crib that the young cells first take their roots in. The ball of cells (cool medical word being – blastocyst) places itself in a nice cosy spot where the maternal capillaries serve them with food, oxygen and remove the toxins accumulated. Later, the same network develops into a heavy blood filled disc weighing around 500gms called the placenta. The placenta then takes over the job of nursing the growing embryo. So the lining assumes an important role here for the survival of the baby.
What keeps this lining intact and prevents it’s disintegration? What is it that brings a stop to your menstrual cycles during the 9 months of your pregnancy? (Much to our relief to some extent)
It is the hormone – progesterone. Too many consonants on the tongue but this is a word you would want to keep in mind for your pregnancy and abortion. This is the hormone we target in medical abortion. Initially it is released by the corpus luteum. (short pause for what you probably just read as corpse something something. The ova in your ovary that released the egg for your baby has a remnant left in the ovary. While the egg embarks on a glorious journey to be seen and grabs the limelight as one half of your baby, there is a remnant of the same ova called corpus luteum that works behind the stage for the embryo to grow and eventually dies). Later the same progesterone is released by the placenta.
Mifepristone blocks the action of this progesterone. It does not prevent its release but makes sure it knocks on closed doors when it reaches the uterine wall that chooses to not respond to it’s call. Eventually, the inner lining of the wall begins to break down, the well established network of capillaries or placenta (depending on which week of pregnancy we are talking about) breaks down with it, and there is bleeding. Similar to the kind you experience during your menstrual cycles because both are caused by a deficiency of either levels of progesterone or action of progesterone. The ball of cells flows out through the vagina along with the blood.
Misoprostol adds to the efficiency of this procedure. More coming up in the series to follow on how exactly it achieves that.
Best period for this combination : This combination is effective up to 63 days but works best when taken within 49 days of gestation.
Protocol :
Day 1 : 200mg of mifepristone orally
Day 2 : Jump, dance, shop. Healthy advice for those who like to worry a lot. And oh, no tablets for this day.
Day 3: 400 microgm orally or 800 micrograms vaginally of Misoprostol. You would be required to stay at your doctor’s clinic for a minimum of 4 hours during which he/she would keep you under observation. The doctor would like to monitor the amount of blood lost, your general condition and vital stability before he/she sends you back home smiling.
And a little poor by the pocket too maybe? Not really.
Benefits :
Word of caution : If you are over 35 years of age, or a heavy smoker, or on long term steroid therapy, mifepristone might not be the best drug for you. But don't worry, here is another alternative for you.
Methotrexate or MTX (sounds like dynamite, works like it too) attacks the DNA forming machinery of the cell. It blocks the supply of nutrients essential to DNA formation and without the DNA, the cells eventually die.
But your cells have DNA too. How does it know if it is killing the mother cells or the baby cells? We don't mean to be rude but it is primarily because you are too old for MTX’s choice. MTX specifically targets rapidly dividing young immature cells, like the ones seen in an embryo or a tumour. The cells in your body divide too, but not at a speed as rapid as that of an embryo. MTX also targets one of the layers in the network of capillaries established in the uterine wall. This not just weakens but entirely inhibits the process of rooting in of the embryo in the uterine wall.
Best period for this combination : It is effective up to 50-56 days of gestation but highly successful if taken within 49 days of pregnancy.
Protocol :
Day 1: 50 mg/m2 of your body surface area given intramuscularly or 50mg orally methotrexate
Day 2-7 : More drug holiday days in this option. No tablets for this week.
Day 8 : 800 microgram of Misoprostol given vaginally. This may have to be repeated a day later if failure of procedure occurs.
Does this sound like a more expensive option to you? On the contrary, it is cheaper than the previous combination.
Benefits :
Word of caution : If failure of procedure occurs, it is confirmed by an ultrasound examination first before a surgical procedure of suction evacuation is done. Talk to your doctor for more viable options.
In the second part of this seven part series, we bring to you a filtered and simplified yet accurate compilation of the latest medications available for you. Know all about your abortion pills, how they work and their risks and benefits.
“Why is there bleeding after taking abortion pills? Is it normal?”
“What risks do I run into with these pills?”
“Why do we have different pills for different trimesters of pregnancy?”
Find answers to all these questions and many more troubling you so you can make a much more informed decision for your body and you.
Options for the First Trimester :
- Mifepristone (RU-486) and Misoprostol :
The uterus or the womb is the pre natal home for your baby. The wall is lined with a rich network of capillaries and it is in the wall, somewhere on the roof of this little crib that the young cells first take their roots in. The ball of cells (cool medical word being – blastocyst) places itself in a nice cosy spot where the maternal capillaries serve them with food, oxygen and remove the toxins accumulated. Later, the same network develops into a heavy blood filled disc weighing around 500gms called the placenta. The placenta then takes over the job of nursing the growing embryo. So the lining assumes an important role here for the survival of the baby.
What keeps this lining intact and prevents it’s disintegration? What is it that brings a stop to your menstrual cycles during the 9 months of your pregnancy? (Much to our relief to some extent)
It is the hormone – progesterone. Too many consonants on the tongue but this is a word you would want to keep in mind for your pregnancy and abortion. This is the hormone we target in medical abortion. Initially it is released by the corpus luteum. (short pause for what you probably just read as corpse something something. The ova in your ovary that released the egg for your baby has a remnant left in the ovary. While the egg embarks on a glorious journey to be seen and grabs the limelight as one half of your baby, there is a remnant of the same ova called corpus luteum that works behind the stage for the embryo to grow and eventually dies). Later the same progesterone is released by the placenta.
Mifepristone blocks the action of this progesterone. It does not prevent its release but makes sure it knocks on closed doors when it reaches the uterine wall that chooses to not respond to it’s call. Eventually, the inner lining of the wall begins to break down, the well established network of capillaries or placenta (depending on which week of pregnancy we are talking about) breaks down with it, and there is bleeding. Similar to the kind you experience during your menstrual cycles because both are caused by a deficiency of either levels of progesterone or action of progesterone. The ball of cells flows out through the vagina along with the blood.
Misoprostol adds to the efficiency of this procedure. More coming up in the series to follow on how exactly it achieves that.
Best period for this combination : This combination is effective up to 63 days but works best when taken within 49 days of gestation.
Protocol :
Day 1 : 200mg of mifepristone orally
Day 2 : Jump, dance, shop. Healthy advice for those who like to worry a lot. And oh, no tablets for this day.
Day 3: 400 microgm orally or 800 micrograms vaginally of Misoprostol. You would be required to stay at your doctor’s clinic for a minimum of 4 hours during which he/she would keep you under observation. The doctor would like to monitor the amount of blood lost, your general condition and vital stability before he/she sends you back home smiling.
And a little poor by the pocket too maybe? Not really.
Benefits :
- It is an easy, simple and non invasive procedure.
- Safe and effective
- Minimal or no complications at all.
- Light on the pocket.
Word of caution : If you are over 35 years of age, or a heavy smoker, or on long term steroid therapy, mifepristone might not be the best drug for you. But don't worry, here is another alternative for you.
- Methotrexate and Misoprostol :
Methotrexate or MTX (sounds like dynamite, works like it too) attacks the DNA forming machinery of the cell. It blocks the supply of nutrients essential to DNA formation and without the DNA, the cells eventually die.
But your cells have DNA too. How does it know if it is killing the mother cells or the baby cells? We don't mean to be rude but it is primarily because you are too old for MTX’s choice. MTX specifically targets rapidly dividing young immature cells, like the ones seen in an embryo or a tumour. The cells in your body divide too, but not at a speed as rapid as that of an embryo. MTX also targets one of the layers in the network of capillaries established in the uterine wall. This not just weakens but entirely inhibits the process of rooting in of the embryo in the uterine wall.
Best period for this combination : It is effective up to 50-56 days of gestation but highly successful if taken within 49 days of pregnancy.
Protocol :
Day 1: 50 mg/m2 of your body surface area given intramuscularly or 50mg orally methotrexate
Day 2-7 : More drug holiday days in this option. No tablets for this week.
Day 8 : 800 microgram of Misoprostol given vaginally. This may have to be repeated a day later if failure of procedure occurs.
Does this sound like a more expensive option to you? On the contrary, it is cheaper than the previous combination.
Benefits :
- Easy, simple, non invasive
- Safe and effective
- Out patient procedure
- Cheaper than the Mifepristone + Misoprostol combination
Word of caution : If failure of procedure occurs, it is confirmed by an ultrasound examination first before a surgical procedure of suction evacuation is done. Talk to your doctor for more viable options.
