Medical Termination of Pregnancy (MTP) - Medical Abortion Procedure, Risks and Recovery

Listed below is the step by step procedure of medical termination of pregnancy:

  1. What is MTP?
  2. Why is MTP Required?
  3. Pretreatment Preparation
  4. Day Before Treatment
  5. Procedure Day
  6. Methods/Techniques of MTP
  7. Post Procedure
  8. Risks and Complications

What is MTP?

Medical termination of pregnancy or medical abortion is a procedure of ending a pregnancy through oral medication. It is a non-invasive procedure which is private and confidential. Medical abortion (abortion through medicines) is preferred during the initial phase of pregnancy till the 8th or 9th week. It is a non-invasive technique with lower risks compared to surgical termination of pregnancy and proves effective in more than 95% of pregnancy cases. The medication used in medical abortion prevents progesterone (pregnancy hormone) not to let the pregnancy from progressing any further.   

Why is MTP Required?

With motherhood comes many lifelong responsibilities. Hence, a woman must be fully prepared physically, mentally, and emotionally to become a mother. However, sometimes, women are unwilling to go along with the pregnancy for several reasons. Thus, they may choose to get a medical abortion in case of an unwanted, unsupported, or unexpected pregnancy. In any of these situations, a female can go for MTP without compulsory consent from anyone else. Furthermore, MTP is also required in case of harmful pregnancies, such as ectopic pregnancies, where the embryo starts growing in the fallopian tube and may lead to bursting and, thus, fatal complications. Other scenarios where MTP is required are: 

  • The fetus is unhealthy, physically or mental
  • The woman is not financially ready or socio-economically stable
  • The pregnancy is a result of sexual assault

(Note: Females with ovarian mass, hypertension, IUIDs (intrauterine devices), and chronic ailments are not eligible to undergo MTP.)

Pretreatment Preparation

If you decide to terminate your pregnancy, many doubts and apprehensions may lie ahead of you. You need to be fully prepared, both physically and mentally, to undergo the medical termination of pregnancy. Usually, gynecologists advise the following things to prepare yourself better for MTP.  

  • Be Well-informed: Learn about medical abortion from reliable or verified online and offline sources. The more educated you become about MTP, the more it helps in recovering faster. Talk to a gynaecologist and seek out information that enables you physically, mentally, and emotionally. Discuss Choose a licensed clinic and certified doctor: Medical abortion is a safe gynaecological procedure only certified specialists should perform. Not every clinic or healthcare provider is licensed to conduct MTP. Thus, it is necessary to ensure that you only choose a certified healthcare provider for medical abortion to avoid life-threatening post-surgery complications. As per CDC’s (Centers for Disease Control and Prevention) studies, the chances of lethal complications from abortion are significantly lower if certified, and experienced professionals perform the treatment and guide the patient at every step of recovery.   
  • Garner Emotional Support From Your People: It can be challenging to go through MTP alone without help from family or friends. Hence, it is highly advised to be open to people close to you or who can support your decision without offering too much advice. However, it is natural to feel like screaming or isolating, but to allow yourself some ease and comfort, sharing your feelings and concerns is the right step.

Day Before Treatment

You may feel overwhelmed with the waves of emotions one day before the treatment. The key is not to spiral down into negative thoughts. Express your worries, journal, talk about them, and do whatever you make feel lighter. Also, ensure to have proper meals throughout the day and stay hydrated. Refrain from smoking or drinking as advised by your gynaecologist. And remember that it is okay to reach out for support. 

Procedure Day

When the patient takes the second pill of medical abortion, it is the final step of medical abortion. The doctor may keep you under observation for a few hours. Also, if the patient is stable, there is no need for an overnight hospital stay; they can return home. However, it should be kept in mind that driving on your own is not advisable or traveling long distances right after MTP. Complete rest and light meals help on the final procedure day and a few weeks after.

Method/Technique of MTP

The process of medical abortion includes the following steps: 

  1. The gynaecologist starts the procedure of medical termination of pregnancy with a detailed consultation and health assessment. The doctor also performs ultrasounds and blood tests to evaluate if you are fit to undergo MTP.
  2. As undergoing an abortion can be a sensitive and challenging decision, the gynaecologist gives all the necessary details and information about the medical abortion. The gynaecologist will also discuss the impact of MTP on your physical and emotional health so that you make a well-informed decision. They will also guide you on the pain management involved in the procedure. 
  3. When you are ready for MTP, you will need to sign a consent form comprising all the relevant details regarding the treatment.
  4. After completing the paperwork, the gynaecologist gives Mifepristone table, the first abortion pill for MTP. You can take medicine at the treatment centre. Mifepristone blocks progesterone, and within 24 - 48 hours after taking this tablet, the doctor gives the second pill named Misoprostol which makes the cervix softer and flexible to aid in easier passage of the remnants of the pregnancy. MTP completes a few hours after taking the second pill, which results in heavy vaginal bleeding, usually lasting for 1-2 weeks.
  5. You may also notice more extensive blood clots or clamped tissues than usual menstrual bleeding. Usually, the bleeding is quite heavy, almost like a miscarriage, and complete bed rest is highly advised to recover better. It is crucial to note that if the bleeding does not occur within 24 hours following the second pill, you must call your doctor immediately and undergo proper tests.

Post Procedure

Once you take the second abortion pill, you are likely to go through the following things within a few hours:

  • Diarrhoea, nausea, headache, and fever
  • Pain and cramps in the lower abdomen, along with bleeding
  • Within six hours, the vaginal bleeding becomes slightly less, like menstrual bleeding
  • Abdominal cramping and bleeding usually stop within 5-10 days
  • Spotting for a few weeks
  • Mood swings and physical discomforts due to medication may lead to emotional meltdowns or distress
  • Generally, the normal menstrual cycle resumes within 4-8 weeks following MTP

Physical Care:

Make sure you have someone reliable around you all the time after medical abortion, and strictly avoid strenuous activities. Using heat pads and gentle massage in the lower back helps relieve pain and discomfort. Take medication for pain management prescribed by the gynaecologist as and when required and go for timely follow-up visits to the doctor to keep track of recovery.

Emotional Care:

After a medical abortion, estrogen and progesterone levels decrease drastically, creating low moods. It is common to experience a phase of anxiety, worries, mild depression, and irregular sleeping patterns while going through the post-abortion phase. This phase becomes better and passes away within a few weeks when the patient receives enough care and support. Doctors advise taking a break from work, having heart to heart conversations with a partner, family, or friend, and not suppressing any emotion to have complete emotional healing.

Risks and Complications

Chances of complications after medical abortion are meager when one chooses the right doctor and licensed healthcare provider. They take care of the patient throughout the MTP procedure. However, in some cases, the following complications may arise when proper

  • Severe infection and abdominal pain
  • Severe bleeding where the female needs to change sanitary pads every 1-3 hours
  • Persistent pain that remains even after taking painkillers
  • Fever and chills
  • Abnormal vaginal discharge

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