Timing of termination of pregnancy

According to statistics, an average of 50 million abortions are performed on the planet every year. Unfortunately, situations often occur when a woman does not want to keep her pregnancy for one reason or another. If a pregnant woman decides to have an abortion, she should know both the timing of the termination of pregnancy and the essence of this procedure, as well as all possible risks and dangers.

Up to what period can a pregnancy be terminated?

Artificial termination of pregnancy (abortion) can be done both in the presence of compelling medical indications and at the insistence of the woman herself, who does not want to carry and give birth to a child. One of the conditions for this procedure is the term, and, if possible, it should not be more than twelve weeks. The term of pregnancy is one of the first questions that the doctor will ask you, because the method of performing an artificial abortion may depend on it.

The deadline for terminating a pregnancy is up to 22 weeks: such an abortion is considered late.

Currently, there are many known ways to perform an artificial abortion, and here are the main ones:

• medical termination of pregnancy – this option is one of the safest, but is used only up to 6 weeks of pregnancy;
• vacuum termination of pregnancy – used in the early stages of pregnancy. The method involves creating negative pressure in the uterus to extract the contents;
• Surgical termination of pregnancy is one of the most common classical methods of terminating pregnancy, performed under general anesthesia using surgical instruments.

A pregnant woman who plans to terminate the pregnancy should be aware of the possible consequences and complications of abortion: the development of bleeding or an inflammatory reaction of the reproductive system, suppression of the function of the appendages and adrenal system, the inability to have children in the future, the risk of ectopic pregnancy, mastopathy.

After an artificial termination of pregnancy, it is necessary to use contraception for at least 12 months. Pregnancy following an abortion should be monitored by a doctor from the very beginning of its development, as there are risks of spontaneous abortion.

Medical termination of pregnancy, the period of which exceeds 6-8 weeks, is not recommended. For medical abortion, a fairly well-known contraceptive drug Postinor is often used. This drug is most effective in the first few days after unprotected intercourse, then its effectiveness is significantly reduced. If implantation has already occurred, the use of this drug is inappropriate. Keep in mind that Postinor can cause some side effects, including dyspeptic disorders, bleeding, and vomiting.

If the pregnancy period is no longer counted in days, but in weeks, you will have to turn to stronger drugs:

• mifegin is an antiprogestogen drug used to terminate early pregnancy (up to 42 days). The drug regimen is determined by the doctor and is supervised by him;
• mesoprostol is a synthetic analogue of prostaglandins, causes contractions of the uterine walls, used up to 6-8 weeks of gestation;
• mifepristone is an antiprogestogen, can be used independently or in combination with mesoprostol. It can also be used at a later stage to potentiate labor in case of intrauterine fetal death;
• methotrexate is a cytostatic drug, an antimetabolite. The drug is effective, but has many side effects: diarrhea, stomatitis, mouth ulcers, bleeding gums, hair loss, anemia, bleeding tendency, inflammatory processes in the liver and kidneys.

There are quite a few known contraindications to medical abortion. First of all, it is the term - only up to 6-8 weeks. Contraindications also include endocrine pathologies, diseases of the urinary system, liver, heart, and central nervous system.

Termination of pregnancy at early stages

The least dangerous abortion is one performed immediately upon detection of an existing unwanted pregnancy, i.e. as early as possible. In the early stages of pregnancy, the fetus is still extremely small, which allows the procedure to be performed, minimizing the possibility of complications.

Most often, vacuum aspiration (mini-abortion) is performed before 5-6 weeks. This method involves cleaning the uterine cavity by creating a vacuum. The advantages of this method are the absence of mechanical damaging effects on the mucous membranes of the uterus.

If a pregnant patient seeks help in time, she will take a smear and undergo an ultrasound to confirm the uterine development of pregnancy. A smear is necessary to determine whether there is a hidden infection that can provoke the development of complications during an abortion. Sometimes, before an abortion, it is necessary to treat an inflammatory process in the genitals, which takes a lot of time to lose the opportunity to perform an artificial abortion in the early stages of pregnancy.

The period for termination of pregnancy with pills is up to 6-8 weeks. During this period, drugs prescribed by the doctor are taken, which can provoke contractile activity of the uterus, thereby terminating the pregnancy. Some drugs do not affect the muscles of the uterus, but make its walls unsuitable for fixing the fertilized egg, so the pregnancy is interrupted. After taking the pills, the pregnancy can be terminated immediately or after a few days: as a rule, this is accompanied by general malaise and the release of a large amount of blood from the genital tract. This condition of the patient must be fully monitored by a doctor. The use of drugs for medical termination of pregnancy on your own is STRICTLY PROHIBITED. After this type of abortion, the doctor examines the woman for another two weeks to make sure that the uterus has cleared completely. If this has not happened, surgery may be prescribed.

A period of more than six weeks is usually an indication for surgical termination of pregnancy.

Late term termination of pregnancy

At the latest stages, when it is still possible to terminate a pregnancy (from 13 to 22 weeks), this is done solely for the health of the woman or the development of the fetus.

Medical indications for artificial termination of pregnancy are:

• severe pathology of the heart and blood vessels, central nervous system, urinary system, serious metabolic disorder, blood disease in women;
• complicated pregnancy, development of bleeding, preeclampsia;
• chromosomal abnormalities in the fetus, embryonic developmental defects, death of the unborn child.

Among the methods of interrupting the process of gestation at late stages, the following can be distinguished:

• surgical method (performing a cesarean section, vaginally or abdominally);
• a medicinal method of increasing the contractile ability of the uterus (the so-called artificial labor).

Termination of pregnancy at a late stage can result in the development of various complications for a woman. Therefore, the patient must be informed about the possible consequences of abortion:

• rupture of the cervix. If this occurs, it is sutured, but later, when the woman becomes pregnant and wants to carry the baby to term, some difficulties may arise. These include the development of isthmic-cervical insufficiency, or incomplete opening of the cervix during labor;
• damage to the walls of the uterus. It occurs rarely, but is considered a rather dangerous complication of an artificial abortion. If this happens, emergency surgery is used;
• development of bleeding. This complication most often occurs with medical termination of pregnancy;
• residual elements of the fertilized egg in the uterus. Requires mandatory timely treatment.

Among the complications that arise not immediately after an abortion, but some time later, the following should be highlighted:

• an inflammatory process of the endometrium that develops in response to the entry of an infectious agent during the procedure of termination of pregnancy. It can provoke the development of purulent pathology, disruption of the structure of the endometrial tissue, which can subsequently become one of the factors of infertility;
• inflammatory reaction in the appendages and tubes, which can lead to the development of tubal obstruction and adhesive disease;
• menstrual cycle irregularities due to hormonal imbalance;
• endometrioid tissue growths;
• severe course of subsequent pregnancies, risk of miscarriage or premature birth;
• the risk of developing an ectopic location of a subsequent pregnancy due to tubal adhesions;
• inability to conceive a child.

To somewhat reduce the risk of complications after an abortion, you should always follow your gynecologist's advice. Sometimes you have to undergo antibacterial prophylactic treatment to protect yourself from possible infection during the termination of pregnancy.

If an abortion was performed for any medical reason, then before the next pregnancy it is necessary to undergo a full examination and, possibly, treatment to avoid a repetition of events.

Cost of medical termination of pregnancy

Before making an appointment with a doctor regarding the issue of termination of pregnancy, most women try to find out how much the procedure costs and what types of services should be included in its price.

The cost of a medical termination of pregnancy is usually made up of the total cost of the included services:

• a pregnancy test, which is carried out to accurately determine the gestational age (most often, a blood test for β-hCG is performed for this purpose);
• general blood test, cervical canal smear for infection;
• specialist consultation (usually there are two: before the abortion and after it);
• the cost of the medications used to terminate a pregnancy;
• Ultrasound examination before and after the procedure.

Treatment of possible complications and additional days of hospital stay are usually not included in the preliminary stated cost.

In budget (state) clinics, the ward and some procedures may be free, while private institutions provide only paid services. For this reason, in order to make the termination of pregnancy as cheap as possible, many women turn to budget clinics and women's consultations.

It should be noted that independent purchase and use of abortive drugs is not only unreasonable, but also strictly prohibited. Perhaps, initially you will save some money. But in the future you can lose not only your health, but also your life.

For the same reason, it is not recommended to save money by making an appointment at an unknown, dubious clinic that does not have the necessary documentation to allow the relevant procedures to be performed. Remember that any clinic must be accredited. This accreditation is always accompanied by documents that indicate the list of procedures permitted to be performed at this medical institution. This list should also include medical abortion. If the clinic has provided you with a license but has not shown you the accreditation documents, it is highly recommended that you do not have an abortion at this clinic.

The cost of medical termination of pregnancy in medical institutions in Kyiv varies from 1350 to 3000 UAH. Always check in advance (!) at the clinic's cash desk whether the stated cost is final, or whether you will have to pay extra for any services later.

After a medical termination of pregnancy, it is recommended to remain under the supervision of a specialist until menstrual function is restored. Sexual activity is permitted after 14 days after the procedure.

Before going to the clinic to have an abortion, be sure to weigh all the pros and cons, evaluate the timing of the termination of pregnancy, remember that the price of terminating the pregnancy may be your health and the integrity of your family.