What Is a Therapeutic Abortion?

What Is a Therapeutic Abortion?

It is medically necessary to execute a therapeutic abortion. If the risk to your health from continuing the pregnancy is too great, your doctor may advise a therapeutic abortion.

If the pregnancy is not viable or the fetus is not likely to survive without long-term difficulties, your doctor may also advise a therapeutic abortion.

The only distinction between an "elective" or "voluntary" abortion and a "therapeutic" abortion is this justification.

Regardless of the cause for care, the procedure for ending a pregnancy or treating a miscarriage is frequently the same.

Legislators increasingly employ terms like "elective abortion," "therapeutic abortion," and "spontaneous abortion" to define "acceptable" and "unacceptable" medical services.

These phrases are frequently used by insurance companies to specify the services they do and do not cover.

It's important to note that "medical necessity" is a highly subjective term.

On moral or legal grounds, pregnant women are routinely denied access to life-saving abortion care. This frequently leads to avoidable psychological, emotional, and physical problems, as well as, occasionally, death.

When is a medical abortion a viable option?
If continuing the pregnancy carries a greater risk than usual, your doctor may discuss the possibility of termination.

This might be connected to a current medical condition, like:
  • cancer
  • kidney disease
  • heart disease
Alternatively, it could be connected to a condition that manifests during pregnancy, like:
  • Premature membrane rupture (PROM), which can raise the risk of infection; placental abruption, which can raise the risk of hemorrhagic shock; and preeclampsia, which can raise the risk of organ damage.
If a fetal abnormality is detected during prenatal screening, they might also offer the choice. The risk of fetal death during pregnancy or soon after birth can be increased by several malformations.

These may consist of:
  • Anencephaly, in which the brain, skull, and scalp do not fully develop before birth, and hydrocephalus, in which the brain swells as a result of fluid accumulation in the skull
  • Meckel-Gruber syndrome, when numerous organs become abnormal
  • Low levels of amniotic fluid in Potters syndrome thanatophoric dysplasia, which causes short limbs and undeveloped lungs

Alternatives to therapeutic abortion are there?

The specifics of your pregnancy and where you live will affect your possibilities. The laws in your state might place restrictions on your ability to get care.

You might think about prolonging the pregnancy if it is high risk for you but not the fetus. As soon as the fetus is developed enough to survive outside the uterus, your doctor might advise starting labour inducement.

A pregnancy with a suspected fetal abnormality may also be carried to term. Fetal abnormalities can be fatal in certain cases, but not all of them. Discuss this with your doctor to see what it might signify for your pregnancy.

It is possible to have a stillbirth, postpartum death, or a shorter lifespan. Depending on how a person develops, they may develop problems that call for lifetime or long-term care.

Complications that cannot be treated are they possible?

Serious issues could arise if you continue with a pregnancy that puts your life or health in danger.

To be able to choose what is best for your situation, you must be aware of all the dangers and possible consequences.

Discuss your options for managing symptoms, reducing risks, and delivery with your provider if you decide against terminating the pregnancy. You can also think about writing or revising your medical advance directives.

In rare circumstances, carrying through with a pregnancy could lead to your or the fetus's demise. Finding possible sources of support may be beneficial.

Even though considering your end-of-life wishes may be challenging, doing so might help your loved ones feel less stressed if they need to know this information.

How are medical abortions carried out?
Medication abortions account for more than half of all abortions carried out in medical facilities in the US. Misoprostol is used alone in some procedures, while mifepristone is used in others.

Mifepristone and misoprostol are permitted by the Food and Drug Administration (FDA) to end pregnancies up to 10 weeks.

During the first trimester, the uterus can also be emptied by suction (vacuum) aspiration. Usually, a simple surgical procedure like this lasts between five and ten minutes.

Your cervix may need to be dilated first, though. To check that the uterus is empty, your surgeon may also scrape the lining with a tool known as a curette. A dilation and curettage (D and C) is what is used for this.

Dilation and evacuation (D and E), a surgical abortion procedure performed throughout the second and third trimesters. Aspiration and dilation are involved. Forceps are one of the additional tools used to assist in removing the pregnancy.

Prenatal screening for the first trimester is carried out between weeks 10 and 13 of pregnancy. The second trimester is screened between weeks 15 and 22 of pregnancy.

Many fetal defects aren't suspected or identified until the second trimester as a result.

Even though medicinal abortions are permitted up till week 15, doctors often advise surgical abortion.

What should you anticipate following a therapeutic abortion?

A healthcare practitioner can provide safe and efficient abortion services. Although they vary slightly depending on the technique utilized, side effects are normal and to be anticipated.

Termination of medical or pharmaceutical treatment might begin at a clinic and be completed at home. After taking misoprostol, a lot of people report any combination of the following side effects:
  • nausea
  • weakness
  • fever
  • dizziness
  • diarrhoea
  • chills
  • vomiting
  • headache

It's important to keep track of your symptoms when using medical termination. From days three to five, your symptoms may become more intense before progressively fading over the following few weeks.

You may be given sedation to make the surgical procedure more comfortable for you. Afterwards, you might have cramping or bleeding, but it will likely be far less severe than bleeding brought on by medical termination.

Probably the same day as your procedure, you'll go home. Many people believe they will be physically able to resume their regular activities the next day.
Afterwards, you might feel a range of feelings. These emotions could evolve. Do not forget that there is no "right" or "wrong" way to feel, and be kind to yourself as you proceed.
Post-traumatic stress disorder symptoms can appear in some persons and go away over time.

For a 30-year longitudinal study on the effects of pregnancy on mental health outcomes, which was published in 2008, researchers followed over 500 women until they turned 30.

They contend that miscarriage, which frequently happens early in pregnancy, may have a larger negative effect on mental health than other types of termination or loss.

To anticipate, comprehend, and contextualize the potential mental health impact, it is crucial to consider a person's physical, mental, and emotional health before pregnancy and termination. This is stated in a review of the literature from 2021.

Researchers discovered that people's moods typically significantly improved following termination compared to the preceding period.

Negative effects on mental health were less widespread; according to 1992 research, 10% of persons suffer from them. Negative effects typically take the form of severe or enduring depression or anxiety.

Researchers discovered that those with pre-existing mental health disorders had poor consequences more frequently. A quick onset of new symptoms was not linked to termination for medical reasons. Instead, pre-existing symptoms got worse.

Additional demographic factors that can affect a person's result include age at the time of conception and the number of prior pregnancies, as well as a wide range of social, cultural, and economic variables.

The bottom line

It might be difficult to decide whether to keep a pregnancy or end it. Your particular situation frequently affects the choice.

Talking about it with a significant other, close friend, or member of the family often proves to be beneficial. Getting in touch with a mental health expert could be helpful as well.

Your primary care physician or gynaecologist may be able to make a recommendation if you don't already have a therapist or counsellor. Your healthcare provider can also educate you on your alternatives and respond to any queries you might have.

Although your care team may give suggestions, the final decision is yours. Whatever happens, you deserve to be treated with respect, dignity, and support.