Early Medical Abortion Vs. Surgical Abortion Procedure: Which Is Best?
One of the most frequent phone calls that Physicians are asked by patients who are early in pregnancy is whether or not the medical or surgical abortion procedure is best. The answer is that it depends on what the patient feels is the right procedure to use to terminate her pregnancy once the benefits and risks of each technique is discussed and there are no contraindications to one or the other procedure. More women are using the abortion pill since it was FDA approved in the year 2000.
Contraindications in providing the medical abortion procedure are the following: 1) distance the patient lives from the medical office. If the patient lives more than two hours from the office, she is not a candidate. 2) Chronic use of corticosteroids, 3) bleeding disorders, 4) possible ectopic pregnancy, 5) IUD in the intrauterine cavity, 6) unable to return to the office for follow-up sonogram to assure that the pregnancy tissue has been expelled, 7) allergic to the medications used to perform the abortion pill procedure (misoprostol, and RU 486), 8) refuse to have a surgical procedure if the medical abortion procedure fails, 9) if the length of pregnancy is beyond 14 weeks gestation. Most studies have not gone beyond 9 weeks in determining the safety and effectiveness of the abortion pill procedure. There are European and South American studies that show the medical abortion procedure being highly effective and safe up to 14 weeks from the patients last menstrual period. The further along in the number of weeks pregnant, there is a higher failure rate. The success rate is between 94 to 98 percent for medical abortions up through 14 weeks gestation. Patients who elect to have the surgical abortion procedure performed have greater than a 99.9 percent success rate up to 14 weeks.
For the medical abortion procedure, the RU 486 tablet is given prior to leaving the office and the misoprostol pills are administered 2 to 4 days after discharge from the medical facility. Patients need to return for at least one follow-up visit and sometimes more to assure that the gestational tissue is absent from the intrauterine cavity. A ultrasound is used to determine if there are retained products of conception, or the presence of a continuing pregnancy. This is done 7 to 14 days after the initial office visit. For surgical procedures, only one office visit is necessary. Surgical abortion procedures usually require 2 to 4 minutes to perform.
Patient who have the medical abortion or surgical abortion procedure say that the pain discomfort is similar. With the surgical abortion, women describe the discomfort as moderate cramping. On a pain scale of 1 to 10 with 1 being little to no discomfort and 10 being the most pain they ever experienced in their life, most say that it is a 4 to 5 out of 10 that last for 8 to 10 minutes. With the medical abortion, the uterine cramps generally start 4 to 6 hours after taking the cytotec tablets and may last for 6 to 24 hours. The pain is described as 4 out of 10 in pain discomfort as well. It is rare that pain medication is required, but if needed Tylenol or Motrin are used to take care of the discomfort in over 90 percent of cases.
The cost of the medical and surgical abortion procedures are near the same though the medical abortion cost are increasing due to the increase cost of the abortion pills used to carry out the abortion procedure.
Patients who have the surgical procedure generally recover within 15 minutes after the procedure is performed. If less than 6 weeks pregnant, patients are allowed to return to their routine duties the same day and have sex the following day. With the abortion pill procedure, vaginal bleeding normally lasts for 8 to 14 days, but it can last up to 30 days in a few instances and it is rare to last 60 days.
In summary; the abortion procedure that a patient decides to have done is ultimately up to her as long as there are no contraindications. The abortion pill procedure is now available in some abortion facilities up to 14 weeks. Please contact your nearest abortion facility for further information.
Contraindications in providing the medical abortion procedure are the following: 1) distance the patient lives from the medical office. If the patient lives more than two hours from the office, she is not a candidate. 2) Chronic use of corticosteroids, 3) bleeding disorders, 4) possible ectopic pregnancy, 5) IUD in the intrauterine cavity, 6) unable to return to the office for follow-up sonogram to assure that the pregnancy tissue has been expelled, 7) allergic to the medications used to perform the abortion pill procedure (misoprostol, and RU 486), 8) refuse to have a surgical procedure if the medical abortion procedure fails, 9) if the length of pregnancy is beyond 14 weeks gestation. Most studies have not gone beyond 9 weeks in determining the safety and effectiveness of the abortion pill procedure. There are European and South American studies that show the medical abortion procedure being highly effective and safe up to 14 weeks from the patients last menstrual period. The further along in the number of weeks pregnant, there is a higher failure rate. The success rate is between 94 to 98 percent for medical abortions up through 14 weeks gestation. Patients who elect to have the surgical abortion procedure performed have greater than a 99.9 percent success rate up to 14 weeks.
For the medical abortion procedure, the RU 486 tablet is given prior to leaving the office and the misoprostol pills are administered 2 to 4 days after discharge from the medical facility. Patients need to return for at least one follow-up visit and sometimes more to assure that the gestational tissue is absent from the intrauterine cavity. A ultrasound is used to determine if there are retained products of conception, or the presence of a continuing pregnancy. This is done 7 to 14 days after the initial office visit. For surgical procedures, only one office visit is necessary. Surgical abortion procedures usually require 2 to 4 minutes to perform.
Patient who have the medical abortion or surgical abortion procedure say that the pain discomfort is similar. With the surgical abortion, women describe the discomfort as moderate cramping. On a pain scale of 1 to 10 with 1 being little to no discomfort and 10 being the most pain they ever experienced in their life, most say that it is a 4 to 5 out of 10 that last for 8 to 10 minutes. With the medical abortion, the uterine cramps generally start 4 to 6 hours after taking the cytotec tablets and may last for 6 to 24 hours. The pain is described as 4 out of 10 in pain discomfort as well. It is rare that pain medication is required, but if needed Tylenol or Motrin are used to take care of the discomfort in over 90 percent of cases.
The cost of the medical and surgical abortion procedures are near the same though the medical abortion cost are increasing due to the increase cost of the abortion pills used to carry out the abortion procedure.
Patients who have the surgical procedure generally recover within 15 minutes after the procedure is performed. If less than 6 weeks pregnant, patients are allowed to return to their routine duties the same day and have sex the following day. With the abortion pill procedure, vaginal bleeding normally lasts for 8 to 14 days, but it can last up to 30 days in a few instances and it is rare to last 60 days.
In summary; the abortion procedure that a patient decides to have done is ultimately up to her as long as there are no contraindications. The abortion pill procedure is now available in some abortion facilities up to 14 weeks. Please contact your nearest abortion facility for further information.
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