Abortion Care: Medical and D&C Procedures According to WHO Standards

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Abortion is a sensitive and controversial topic that is often associated with a range of complex issues such as ethics, religion, and politics. Despite these complexities, it is a fact that termination of pregnancy is a critical aspect of reproductive health care for millions of people worldwide. According to the World Health Organization (WHO), around 25 million unsafe abortions occur every year, and they result in the death of approximately 22,000 women.

To prevent the negative consequences of unsafe abortions, it is essential to provide safe and legal abortion care services. In this post, we will discuss the two most common abortion procedures recommended by the WHO: Medical Abortion and Dilatation and Curettage (D&C).

Medical Abortion

Medical abortion is a non-surgical procedure that involves taking medication to end a pregnancy. The medication used for terminating pregnancy is a combination of two drugs, mifepristone, and misoprostol. These drugs work together to cause the uterus to contract and expel the pregnancy.

Who is eligible for Medical Abortion?

The eligibility criteria for medical abortion vary depending on the country and the healthcare provider. However, generally, medical abortion is recommended for people who:

• Are in the first trimester of pregnancy (up to 10-12 weeks).
• Are not allergic to the medication.
• Are not taking any medications that interact with the abortion pills.
• Have a confirmed intrauterine pregnancy.
• Do not have any medical conditions that could make the procedure unsafe

How is Medical Abortion performed?

Medical abortion is performed in a healthcare setting or at home under the guidance of a healthcare provider. The procedure typically involves the following steps:

1. Initial Consultation: Before the procedure, the healthcare provider will conduct a physical exam and review the person’s medical history. They will also perform an ultrasound to confirm the gestational age of the pregnancy.
2. Mifepristone Administration: The first medication, mifepristone, is given orally in the healthcare setting.
3. Misoprostol Administration: The second medication, misoprostol, is given 24-48 hours after taking mifepristone. It can be taken orally or vaginally.
4. Follow-up: A follow-up visit is necessary to confirm that the pregnancy termination was successful and to monitor the person’s health.

It is important to note that medical abortion is only recommended for pregnancies up to 10 weeks gestation and should only be done under the supervision of a healthcare provider.

What are the risks and side effects of Medical Abortion?

As with any medical procedure, medical abortion does carry some risks and potential side effects. Here are some of the most common:

1. Cramping and bleeding: The most common side effects of medical abortion are cramping and bleeding, which can be similar to a heavy menstrual period.
2. Nausea and vomiting: Some women may experience nausea and vomiting after taking the medication.
3. Headache and fever: Headaches and fevers are also possible side effects.
4. Incomplete abortion: In rare cases, the medical abortion may not be complete, and a surgical procedure may be necessary to remove any remaining tissue.
5. Infection: Infection is a rare but potentially serious complication that can occur after a medical abortion.
6. Allergic reaction: Although rare, some women may have an allergic reaction to the medication.
7. Emotional side effects: Some women may experience emotional side effects such as sadness, anxiety, or guilt after the procedure.

It’s important to discuss any concerns or potential risks with a healthcare provider before undergoing a medical abortion. A healthcare provider can also provide guidance on how to manage any side effects that may occur.

Dilatation and Curettage (D&C)

D&C is a surgical procedure that involves dilating the cervix and removing the contents of the uterus using suction or scraping instruments. D&C is typically performed under local or general anesthesia.

Who is eligible for D&C?

D&C is recommended for people who:

• Are in the first or second trimester of pregnancy (up to 24 weeks)
• Cannot undergo medical abortion due to medical conditions or allergies
• Have an incomplete abortion or missed abortion
• Require a diagnostic procedure to investigate abnormal uterine bleeding or other conditions

How is D&C performed?

D&C is performed in a healthcare setting, usually in an outpatient clinic or hospital. The procedure typically involves the following steps:

1. Pre-operative Consultation: Before the procedure, the healthcare provider will conduct a physical exam and review the persons medical history. They will also perform an ultrasound to confirm the gestational age of the pregnancy.
   
2. Anesthesia Administration: Depending on the person’s preference and medical history, the healthcare provider will administer either local or general anesthesia.
   
3. Dilation of the Cervix: The healthcare provider will insert a series of rods or laminaria into the cervix to gradually dilate it.
   
4. Curettage: The healthcare provider will use suction or scraping instruments to remove the contents of the uterus. Follow-up: A follow-up visit is necessary to monitor the person’s health and ensure that the abortion was successful.
   

What are the risks and side effects of D&C?

Here are some of the potential risks and side effects associated with the procedure:

1. Bleeding: Some bleeding is normal after a D&C, but excessive bleeding can occur in rare cases.
2. Infection: Infection is a possible complication of any surgical procedure, including a D&C.
3. Perforation: There is a small risk of perforation or puncturing of the uterus during a D&C, which can cause damage to nearby organs.
4. Anesthesia complications: There is a small risk of complications related to anesthesia, such as an allergic reaction or breathing problems.
5. Scarring: In rare cases, scarring may occur inside the uterus after a D&C, which can cause fertility problems in the future.
6. Cramping and pain: Some women may experience cramping and pain after the procedure, which can be managed with pain medication.
7. Emotional side effects: Some women may experience emotional side effects such as sadness, anxiety, or guilt after the procedure.

It’s important to discuss any concerns or potential risks with a healthcare provider before undergoing a D&C. A healthcare provider can also provide guidance on how to manage any side effects that may occur.

Conclusion

Abortion care is an essential aspect of reproductive health care that needs to be accessible, safe, and legal. The WHO recommends two primary abortion procedures: medical abortion and D&C. Medical abortion involves taking medication to end a pregnancy, while D&C is a surgical procedure that involves dilating the cervix and removing the contents of the uterus.

Both procedures carry potential risks and side effects, and it is crucial to seek medical attention immediately if any complications arise. It is also essential to consult with a healthcare provider to determine the best abortion procedure based on the person’s medical history, gestational age of the pregnancy, and other factors.

In summary, safe abortion care services are crucial for promoting the health and well-being of people worldwide. By providing access to safe and legal abortion care services, we can prevent the negative consequences of unsafe abortions and ensure that everyone has the right to make informed choices about their reproductive health.