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Elective Medical Abortion
Alternate Names : Induced Abortion, Interruption of Pregnancy
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When a woman chooses to end a
pregnancy,
the procedure is called an elective abortion. The fetus may be removed from the
uterus by means of an elective surgical abortion
or an elective medical abortion. A medical abortion is done by giving the woman
medicines that will end the pregnancy.
Who is a candidate for the procedure?
Any woman who chooses to end a pregnancy for health or
personal reasons is a candidate for an elective abortion. Abortions are
legal in the United States during the first 12 weeks of pregnancy. After that,
abortion is regulated by each state.
How is the procedure performed?
Before an abortion is done, a doctor will confirm that a woman is
pregnant. The length of a pregnancy will be measured by noting the number
of days that have passed since the first day of her last menstrual period, known as the
LMP. A medical abortion can be done as soon as the pregnancy is confirmed.
Medical abortions do not work as well later in pregnancy, so they are not
generally used past 7 weeks after LMP. After 7 weeks, an
elective surgical abortion
can be used.
To prepare for an abortion, a pelvic exam
might be done to confirm the size of the uterus. Lab studies will rule out
anemia,
determine the woman's Rh factor,
and screen for sexually transmitted diseases.
The woman should be taught what to expect during and after the procedure,
and psychological support
should be given as needed. Medicines used for a medical abortion include:
methotrexate, a medicine approved by the Food and Drug Administration,
called the FDA, for cancer
treatment. Methotrexate is most often given as a shot, but it also can be
taken by mouth. Methotrexate stops the fertilized egg from implanting in
the uterine lining during the first few weeks after conception.
mifepristone, known as RU-486, which was recently approved by the FDA for
medical abortions. Mifepristone works by blocking the female hormone
progesterone. As a result, the lining of the uterus breaks down and is
passed out of the uterus, along with the fetus, through the cervix.
misoprostol, which is taken a few days after the woman takes either
methotrexate or mifepristone. Misoprostol is given by tablets that are
either swallowed or inserted into the vagina. It causes the uterus to
contract and expel the fetus through the vagina.
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Author: Eva Martin, MD Reviewer: Kathleen A. MacNaughton, RN, BSN Date Reviewed: 10/10/02
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