Before talking about abortion in any space and conversation, we should start by answering the following question: what do we mean when we talk about safe abortion, since it is most likely that in the same conversation there will be different opinions on the subject, but also doubts, prejudices, myths and misinformation.
According to the World Health Organization (WHO), abortion is the termination of pregnancy when the product is not yet viable outside the womb of the pregnant woman or person. It is often thought that for an abortion to be safe, the procedure must be performed surgically by a health professional in a clinic or hospital; however, for several years it has been possible to perform it at home and at the time of your choice.
The person can decide whether to perform the procedure alone or with the remote accompaniment of a health professional or other informed and trained person, as long as they have accurate information, quality-assured medications and access to health services, should the need arise.
People can safely and effectively self-manage medical abortion up to 13 weeks of pregnancy, either with mifepristone and misoprostol, or with misoprostol alone. And to begin talking about abortion at home, one of the most frequent doubts surrounding this topic needs to be clarified:
How can pregnancy be terminated with medication?
The drug procedure has been performed for many years, although it became more widespread during the Covid-19 pandemic.
Currently, there are two options for terminating pregnancy with medication: using the combined regimen of misoprostol and mifepristone, or using misoprostol alone. Here we will discuss the second option.
Currently, there are two options for terminating pregnancy with medication: using the combined regimen of misoprostol and mifepristone, or using misoprostol alone. Here we will discuss the second option.
Misoprostol is an absolutely safe medication, indicated and authorized by the WHO to terminate pregnancy. By taking misoprostol, contractions are produced in the uterus and the cervix is dilated, which allows the evacuation of the pregnancy product in the following days. The procedure is non-invasive, that is, it does not require clinical instruments, nor must it be performed in a hospital, health center or by a health professional, and the risk of complications is minimal.
For an abortion with misoprostol only take into account these recommendations:
- Make sure you have at least 12 misoprostol tablets of 200 mcg each.
- It is usually necessary to administer 3 doses of four 200 microgram tablets 3 hours apart, i.e., administer four tablets, wait 3 hours and administer the next four tablets, wait 3 more hours and administer the next four tablets.
- You may require an additional dose of misoprostol if bleeding, cramping or expulsion of debris has not occurred after at least 3 hours since the last dose of misoprostol. This additional dose, like the previous doses, should consist of four tablets of 200 micrograms each.
- The routes for administering misoprostol are: sublingual (under the tongue) or between the cheeks and gums two pills on each side (this route is called buccal); let them dissolve on their own, wait 30 minutes and swallow the residue with water.
- You can also use the vaginal route for misoprostol (some countries have this presentation): you insert the tablets through the vagina with your fingers, as deep as possible, then you must remain in a horizontal position for 30 minutes until the tablet melts.
- In countries where access to abortion is restricted, it is not recommended to administer them vaginally, as traces of the pills may remain after several hours.
Misoprostol can be purchased in pharmacies, even without a prescription.
To reduce the pain of cramping, you can take ibuprofen or other available non-steroidal anti-inflammatory drugs (if you do not have allergies) approximately 30 minutes before your first dose of misoprostol. Being in a quiet, comfortable environment is important; and if you feel comfortable, you can be in the company of someone you trust. It may also help to place a hot water bottle on your belly.
When side effects do occur, most disappear within a few hours. Most of these occur after taking misoprostol, and can be:
- Nausea and vomiting: if you vomit within 30 minutes after taking mifepristone or misoprostol, you should take the medication again.
- Mild fever and chills: you can use a cold compress or take paracetamol to relieve symptoms.
- Diarrhea: try to drink plenty of fluids to avoid dehydration.
We share with you a video detailing each step of the procedure:
And is it effective? The answer is yes.
Several international studies have proven that misoprostol has an 84% to 93% effectiveness rate, so once you have made the decision, the sooner you do it, the better.
A large part of the success of home abortion with misoprostol is that you have adequate and sufficient information, so that you are confident in your decision to terminate the pregnancy in this way.
By having an abortion with misoprostol you not only have the freedom to decide about your body and future, you also have the possibility to choose when you want to do it and under what circumstances.
If you are considering self-managing your abortion, although it is very rare for an emergency to occur, it is best to be prepared with information in case you need to go to a health service.
You should consider:
- The location of a 24-hour emergency health facility, i.e., one that is open day and night. This may be the nearest health facility, especially one that provides postabortion care services.
- How to get to that health service as quickly as possible.
- How to pay for services, if necessary.
- What to tell the health care provider, in case you do not want to tell them that you have taken abortion drugs or for fear of criminalization, depending on where you live and the situation you are in. Keep in mind that the treatment of the emergency does not change whether or not you report that it was self-managed. You can say that it was a spontaneous abortion.
Consider that abortion is totally penalized in some countries, in others it is allowed under certain circumstances (grounds), so you should get information depending on your locality. If you have doubts about this point, here you can check the information of your country or state: abortoenmipais.ipaslac.org
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