Self induced abortions have been known since historical times. The methods commonly used in ancient times included use of abortifacient herbs, heavy physical labour, introduction of sharp instruments, different forms of physical abuse such as throwing themselves down the stairs, blows to the lower abdomen, etc. Most of these methods were barbaric and resulted in severe damage to the mother.
In the modern times, many women still try these methods to induce abortion. They seek these methods as a result of desperation, where they cannot seek medical help for legally inducing abortion. However, with drugs such as mifeprestone and misoprostol being approved by the FDA, it has become easier for the women to carry out self induced abortion.
Mifeprestone, also known as RU-486 is endorsed by the World Health Organization for abortion up to 63 days of gestation (9 weeks of pregnancy). It works optimally when taken between 4-6 weeks of gestation. Misoprostol is another drug which is taken in combination with mifeprestone. This combination is considered more effective than use of Mifeprestone alone. According to the WHO, Mifeprestone 200mg should be taken as a single dose medication followed by Misoprostol within 1-3 days. Misoprostol is administered in a dose of 800µg through the vaginal route. Vaginal route has lesser risks of adverse effects than the sublingual route, though sublingual route can also be used for administering the drug.
It is important to note that both Mifeprestone and Misoprostol are prescription drugs and should be used only under the guidance of a registered medical practitioner. It is important to get examined by a doctor and give complete medical history to the doctor, including what medications the woman is currently taking. They can adversely react with various drugs and can cause life threatening side effects. They are used as medical methods of terminating pregnancy and all the legalities apply. In India, the drugs can be obtained only after consultation with a registered gynaecologist who supervises the procedure. These drugs cannot be used in ectopic pregnancy. Ectopic pregnancy occurs when the fetus is implanted outside the uterine cavity, most commonly in the fallopian tubes. Women who seek to induce abortion at home by using these pills are often unsure if there is an ectopic pregnancy. Taking these drugs in such cases causes life threatening adverse effects like haemorrhage. Incomplete abortion can also occur with these drugs, though the chances are low if taken before nine weeks. Many women are unaware of the symptoms of incomplete abortion. Prolonged and heavy bleeding is a symptom of incomplete abortion which is ignored by the women. As a result, the products of conception remain within the uterus, which later on get infected. Fever is the earliest symptom. If medical help is not sought at this stage, the subsequent complications endanger the life of the woman.
Though these drugs have made medical abortion more accessible, it has to be remembered that there can be several adverse effects. Therefore, it is important to take these drugs only after consulting a doctor.
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