pregnancy

Abortion Pill

What is the abortion pill?

The abortion pill ( RU-486 ) is a pharmacological preparation based on mifepristone, a corticosteroid capable of inducing chemical abortion within the first 49 days of pregnancy.

First of all, we must point out that the abortion pill has nothing to do with the morning-after pill (emergency contraceptive method). While the latter is able to prevent pregnancy by stopping ovulation and obstructing the passage of sperm towards the uterus and tube, the abortion pill acts to interrupt the pregnancy.

To be marketed in our country, the abortion pill obtained the authorization from the Italian Drug Agency only in July 2009. From 10 December of the same year, with the publication in the Official Gazette, the abortion pill has definitively entered the list of drugs usable in Italy. In other European countries, the abortion pill has been used for decades.

Being an artificial means of birth control, the RU-486 abortion pill has been renamed a "pill of discord". The introduction of the abortion pill broke Italy in half. It is understandable how the use of a similar abortive method has rekindled even more the controversies concerning the eternal debate between Church, Ethics and Moral.

Theoretically, all healthy women who do not wish to become pregnant can resort to the abortion pill to facilitate the expulsion of the fruit of an unwanted conception. It must be stressed, however, that abortion is a practice that involves risks for the expectant mother; therefore, it cannot and must not be performed lightly.

Before proceeding with the discussion, let us pause for a moment to reflect: aborting means interrupting the life of a creature.

How is it assumed?

In Italy, the abortion pill is taken by mouth no later than the seventh week from the start of gestation (49 days).

The abortion pill must be taken to the hospital, under the supervision of a doctor. Pharmacological abortion requires adequate medical monitoring of a woman's physical and psychological condition.

To obtain maximum therapeutic efficacy, it is necessary to proceed in two steps:

  1. The active ingredient of the abortion pill is mifepristone, which is taken orally at a dose of 200-600 mg.
  2. After two days, the doctor gives the woman 400 mcg of misoprostol, a prostaglandinic analogue capable of intensifying the contractile activity of the myometrium, thus favoring the expulsion of embryonic tissues.

As an alternative to misoprostol it is possible to take gemeprost. Generally, the expulsion of the embryo occurs after a few hours after the administration of the prostaglandin.

How does it work?

The RU-486 abortion pill is composed of mifepristone, an antiprogestinic steroid hormone. It acts directly on progestin receptors, blocking the action of these hormones at the level of the uterus.

To understand...

Progesterone is a progestin hormone secreted by the corpus luteum and the placenta, which is essential to ensure the maintenance of pregnancy, once it has occurred.

The abortion pill prevents the development of the embryo according to a double modality:

  1. It blocks the action of progestin receptors on the mucosa and on the musculature of the uterus
  2. Promotes detachment and elimination of the uterine mucosa

After the administration of the pill and prostaglandin, the embryo is expelled just like during a menstruation.

What is the effectiveness?

The combination of abortion pill + misoprostol ensures maximum therapeutic efficacy in 92-99% of cases. It is considered possible that the intake of the only abortion pill (not combined with the prostaglandin drug) fails instead in 20% of cases.

The possibility - however remote - that the expulsion of the embryonic tissue does not take place requires a surgical abortion (dilation of the uterine cervix + curettage).

For whom is it indicated?

The main indication of the abortion pill is the voluntary interruption of an unwanted pregnancy no later than the first 49 days of gestation. In some European countries such as Great Britain and Sweden, the term for pharmacological abortion is postponed up to 63 days of gestation.

In addition to this circumstance, the abortion pill can be taken in the following cases:

  • Cervical dilation in preparation for surgical abortion (in the first trimester of gestation)
  • Induction of labor in the presence of intrauterine fetal death
  • Used in association with gemeprost for the termination of pregnancy between the 13th and 24th week of gestation

What happens next?

As analyzed, the intake of prostaglandin drugs after 48 hours from the oral administration of the abortion pill favors the expulsion of the embryonic tissues from the vagina.

In this circumstance, the woman observes an abundant uterine blood loss, always accompanied by cramping pain in the lower abdomen and / or lumbosacral level. The perceived pain is a consequence of the contractions to which the uterus is subjected to expel the embryonic tissue.

Besides the pain, the woman who has just had an abortion can complain of nausea, weakness, headache and dizziness. The duration of uterine bleeding generally varies from 14 to 17 days, although in some women blood loss continues for about 70 days.

Although quite rare, pelvic inflammatory disease and metritis are possible complications of pharmacological abortion.

The pain and other side effects of taking the abortion pill can be masked with analgesic drugs (eg ibuprofen), narcotics (eg codeine) and paracetamol.

After a week to ten days from the abortion, the woman is invited to go to the doctor for a gynecological check that verifies the absence of abortive material held in the uterus.

After abortion with the RU-486 pill women can experience anxiety and depression; therefore, family members are strongly recommended to take care of the patient.

Pharmacological abortion by taking the abortion pill RU-486 continues to be the first choice abortive method for terminating a pregnancy, especially between the 7th and 9th week of gestation.

Let us remember again that the RU-486 pill is NOT an urgent contraceptive method, but rather an abortion practice in all respects.

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