In a large number of countries in the world, abortion as a method of terminating a pregnancy, is unfortunately still a taboo subject. Despite the social and medical advancement in the world, abortion is still used as birth control and contraception. It is accompanied by many physical, emotional and psychological consequences for a woman in the reproductive period and therefore every woman should have the right to free choice, the right to a safe and legal abortion and full information about the procedure.
On average, about 41% (85 million) of the 208 million pregnancies annually in the world are unplanned, and half of them end up with abortion [1]. Modern methods of termination of pregnancy include traditional, surgical (instrumental) abortion and drug-induced (pharmacological) abortion.
The WHO recommended method for surgical interruption of pregnancy is a so-called vacuum aspiration (manual or electrical) at gestational age of 12-14 weeks. Dilatation and evacuation (D & E) or curettage is another method of surgical interruption of pregnancy that is recommended to be replaced by vacuum aspiration.
Medicaid abortion has been used in several European countries for several years and is a non-invasive method of terminating a pregnancy by using drugs according to a particular protocol depending on the gestational age of the pregnancy. In countries where both methods of termination of pregnancy are available, the woman decides on the type of abortion she chooses. In the Balkan countries, medical abortion is not yet an officially available method for terminating a pregnancy, and its available only surgical abortion that is actually an invasive method.
The most commonly used drugs for performing drug abortion are Mifepriston (commonly known as RU-486) and Misoprostol (Cytotec) and are administered in the first trimester of pregnancy (until the 9th or 12th week). In order to increase efficacy, it is recommended that a combination of both drugs be administered, or rather Mifepriston (orally) initiates the abortion first, and after two days Misoprostol is administered which causes contractions and helps the products to be thrown out of the conception by the uterus.
In many studies, it has been proven that medical abortion is a safe and effective method of terminating a pregnancy, with a reported success rate or efficiency of 95% [2]. Its advantages compared to the surgical are low cost and the possibility of performing at home if there is provided access to the appropriate healthcare facility in case of need.
Taking into account the efficacy and safety of medical and surgical abortion, as well as the complications they carry with them, the introduction of drug abortion in practice is the introduction of an appropriate alternative method for termination of unwanted pregnancy, and at the same time allows for greater choice in the adoption of one of the the hardest decisions in a woman’s life.
Safe Abortion: Technical and Policy Guidance for Health Systems. 2nd edition. Geneva: World Health Organization, 2012. ; b) Lohr Patricia A, Fjerstad Mary, DeSilva Upeka, Lyus Richard. Abortion BMJ 2014; 348 : f7553
American College of Obstetricians and Gynecologists (ACOG). Practice bulletin no. 143: medical management of first trimester abortion. Obstet Gynecol. 2014 Mar;123(3):676–92.
Image source: Photographer:BDS