What if there is no bleeding after abortion pills

THE ABORTION PILL (RU 486)

Admission

The abortion pill has been approved in France since 1988, England and Sweden followed in 1991 and 1992. At the beginning of July 1999, the drug was also approved in Germany. The pill is also available in other countries such as Switzerland, Austria, Belgium, Holland, Denmark, Greece, Finland and Spain.

In the EU, drug termination with the abortion pill is used up to the 63rd day. However, the success rate is slightly lower in the later stage, the bleeding tends to be longer and heavier. The same goes for pain. In addition to voluntary termination of pregnancy, the drug is also approved for medical purposes (in the event of a medically justified termination)

How does the abortion pill work?

The hormone progesterone produced by the female body changes the lining of the uterus in such a way that the fertilized egg can implant itself. Progesterone is necessary for the maintenance of pregnancy. The abortion pill has the opposite effect, so it is an anti-progesterone. It blocks the cells in the uterine lining, making it impossible for the hormone progesterone to develop its effect. The lining of the uterus loosens and is shed - like a menstrual period. To increase the effect of the abortion pill, a small dose of the hormone prostaglandin (cyprostol) is also administered. It causes the uterus to contract, making rejection easier.

The success rate is better in the earlier stages. Therefore, the procedure should be performed as soon as possible.

Up to what point in time is it possible to terminate the SS with the abortion pill?

A drug-based termination of pregnancy with the abortion pill is only possible in early pregnancy, as the effectiveness of the drug decreases as the pregnancy progresses. The drug can be used up to the 63rd day after the start of the last menstrual period.

When is the earliest possible time to terminate the SS?

Drug termination using an abortion pill can be carried out immediately after a positive SS test.

Waiting until the embryo or the heart's action can be seen in the ultrasound is not necessary and contradicts the actual idea of ​​the medical SS abortion. The termination of the SS before the cardiac action appears is much easier for those affected; only an ectopic pregnancy has to be ruled out by taking 2 blood samples. Halving the pregnancy hormone (ß-HCG) within a week definitely rules out an ectopic pregnancy.

In addition, the earlier the termination, the less the bleeding.

How often do you have to see a doctor?

Two visits to the institute are required.

At the first visit, the doctor will determine how long you have been pregnant. In a personal interview, it will be clarified whether a drug-based abortion is an option. If nothing speaks against a drug abortion, take three tablets of the drug under medical supervision. You will be given precise advice on who to turn to if problems (e.g. heavy bleeding) occur. You can then leave the institute. Sometimes bleeding occurs the next day, and in three percent of cases the pregnancy tissue is expelled before the prostaglandin is taken. Most women, however, do not feel any physical change until they take the prostaglandin. 36 to 48 hours after taking the abortion pill, you take two prostaglandin tablets (Cyprostol) at home (if desired also at the institute). These will be given to you by your doctor when you visit the institute for the first time and must be taken orally. Most women have more bleeding in the next few hours after taking the cyprostol tablets orally, which leads to a breakdown. For every fourth woman, however, only after more than 24 hours. In order to increase the effectiveness of the method, a second dose of the prostagland can take place three hours after the first dose, if no bleeding has started by then. The second visit to the institute (approx. 14 days later) serves as a follow-up examination to ensure that the abortion has been completed in full.

How effective is the abortion pill?

The combined use of the abortion pill with prostaglandin leads to complete abortion in around 97 percent of women. In 3% of cases, if the pregnancy has not been terminated or if residual tissue has remained in the uterus, an additional instrumental intervention, i.e. a curettage, is required.

What side effects or complications can occur?

Possible side effects include abdominal pain, nausea, vomiting, and circulatory problems. As with any abortion, bleeding occurs, but this can last up to 12 days after taking the abortion pill. In rare cases, this bleeding may require medical treatment, in which case the patient must be presented to the institute or the nearest medical facility or hospital.

When is it not possible to terminate pregnancy with the abortion pill or only when special precautionary measures are taken?

The abortion pill must not be used

  • if the pregnancy lasts longer than 63 days (calculated from the first day of the last menstrual period),
  • if there is a specific suspicion of pregnancy outside the uterus (e.g. ectopic pregnancy),
  • if there is an intolerance to prostaglandins,
  • if you have allergies to the active ingredient mifepristone or another component of the drug,
  • with chronic adrenal insufficiency,
  • in severe and inadequately treated bronchial asthma.
  • with liver and kidney failure,

Women with a bleeding disorder should clarify whether the use of the abortion pill is possible. In women who are being treated with cortisone, the dose of cortisone must be checked when using the drug.

If the pregnancy has occurred despite the use of an IUD, it must be removed before taking the tablets.

Who can prescribe the abortion pill?

The abortion pill may only be dispensed in clinics or institutes or outpatient clinics that are authorized to carry out abortions. We are the only private institution in Upper Austria with official approval. Which aspects can play a role in the decision for or against a medical termination with the abortion pill?

Experience to date with drug termination shows that different aspects are important for women, for example:

  • Termination is possible at a very early stage in the pregnancy.
  • Anesthesia and instrumental intervention are usually not necessary.
  • There is no risk of injury to the uterus.
  • After the 63rd day, the abortion pill should no longer be taken

Almost all women choose the abortion pill when they have the option of choosing between drug and suction methods.