- There could be a risk to the mother’s life to continue with the pregnancy.
- There could be a risk to the mother’s physical or mental health to continue with the pregnancy.
- There could be a significant risk that the baby could be born with a serious mental or physical abnormality.
- The pregnancy could be an unplanned one due to contraception failure or other reasons.
An MTP should be done only after consulting a physician. A physical exam is first given in order to determine eligibility for this type of medical abortion procedure. Certain conditions may render the patient ineligible for the procedure. These include ectopic pregnancy, ovarian mass, IUD (intrauterine device), corticosteroid use, adrenal failure, anaemia, bleeding disorders or use of blood thinners, asthma, liver or kidney problems, heart disease, or high blood pressure. Antibiotics are given to prevent any infection. A counselling session is also held with the physician explaining the physical and mental impact of undergoing an MTP. A pregnancy can be terminated either through a surgical procedure or non-surgically.
Non-surgical MTP is possible when the pregnancy is less than seven weeks (forty-nine days). In this procedure, two sets of tablets are prescribed by the doctor. The first pill blocks the action of certain hormones and breaks down the lining of the uterus. Forty-eight hours later the second set of tablets is taken which starts uterine contraction and helps expel the contents of the uterus. This takes place within the next few days. This is usually accompanied by heavy bleeding with clots. The bleeding may continue for the next seven to ten days. A follow up should be done with the gynaecologist to confirm that the abortion is complete and no residual contents remain within the uterus. “It is important to confirm that the abortion process is complete as it is not advisable to continue the pregnancy in case the tablets do not work. The tablets have the potential to cause serious birth defects in case the pregnancy continues” says Mumbai doctor Dr. Sangeeta Agrawal, an Obstetrician & Gynaecologist who trained in Mumbai and UK. In case there is an incomplete abortion there has to be a follow-up surgical procedure.
Side effects of non-surgical MTP may be cramping, nausea, vomiting, diarrhoea, heavy bleeding and infection.
Surgical MTP is usually done when MTP is required after seven weeks, in the second trimester or when non-surgical methods may not be appropriate according to the physician. This usually consists of vacuum or suction techniques. Surgical MTP may also be required in case of incomplete abortion due to non-surgical procedures.