Are There Other Characteristics To Be Considered Before Medical Abortion?

Before a woman decides to have an abortion with pills, there are certain factors other than 10 weeks of gestation that she may have to mind. While many qualifications for eligibility for having an abortion with Mifepristone and Misoprostol are known, there are other characteristics that many consider being contra-indications, but which in fact are not.

Below are the 9 conditions that you may or may not have to consider before a medical abortion.

1. Breastfeeding

It is very likely that the Mifepristone you take passes onto the breast milk. Studies have shown the endocrine effects of mifepristone on the fetus and found increased levels of adrenocorticotropic hormone and cortisol. The clinical implications of this, however, are unclear.

On the other hand, small amounts of Misoprostol soon enter the breast milk after administration. Nevertheless, it is the effect of Misoprostol on the infant is not known. As Misoprostol levels decline swiftly once administrated, it is recommended that the woman breastfeeds before taking the drug, then again 4 hours or later after administration, if taken buccally, i.e. in cheek pouches.

While, if the drug is taken vaginally, the dosage lasts in the body for longer and it is recommended to breastfeed six hours or more after administration.

2. Age

Neither adolescence nor old age [for e.g. over the age of 35] should be considered as a contraindication to medical pregnancy termination, i.e. it should not be considered as a case where abortion with pills is not allowed.

3. Thyroid Disorder/ Insulin-dependent diabetes

There is no evidence that abortion pills cause problems for women with either of these disorders.  Mifepristone, however, has been shown to alter insulin levels in-vitro, these effects may or may not be reflected in insulin levels and blood sugar.

4. Anemia

Anemia need not be necessarily considered as a ‘contra-indication’. Nonetheless, anemia detected during the pregnancy termination should be treated. Bleeding in medical abortion will be heavier compared to surgical pregnancy termination, therefore women with anemia must consider the incidence of heavy bleeding.

5. Smoking

Although there is no evidence of negative interactions between the risk of smoking and terminating with medication, smoking is a major cause of cardiovascular diseases. As cardio-vascular conditions are a contraindication to abortion pills, this factor should be considered while having a medical abortion.

6. Multiple pregnancies

There is no evidence that suggests that there is a higher failure rate of medical pregnancy termination or a different dosage/ regimen of abortion pills in case of multiple pregnancies.

7. Previous Caesarean section delivery

Evidence proved by research found that medical abortion is unaffected by any previous deliveries – including C-sections

8. Obesity

No study suggests that Mifepristone and Misoprostol abortion pills have any adverse effect on or cannot be given to obese women.

9. Uterine malformations [acquired or congenital] / previous cervical surgeries

There is no evidence or any research that suggests that the above should be considered contraindications.