What is forbidden during a Medical Abortion? Restrictions and regulations.

Between the first dose (Mifepristone) and 7 to 10 days after the second dose (Misoprostol), the patient is prohibited:

1. Performing a medical abortion beyond the recommended gestational age: Medical abortion is generally recommended for pregnancies within the first eleven weeks. Beyond this timeframe, the procedure may be less effective, and alternative options may be required.

2. Perform the procedure earlier than 4 weeks of pregnancy: the sensitivity of the uterus to the drugs does not appear before 4 weeks of pregnancy, the optimal gestational age for medical abortion is 5–6 weeks.

3. Deviating from the prescribed medication dosage: It is crucial to follow the instructions provided by your healthcare provider regarding the dosage and timing of the medication. Taking more or less than the prescribed amount can potentially compromise the procedure’s effectiveness.

4. Using additional medications or drugs without consulting a healthcare professional: Certain medications, such as NSAIDs or antibiotics, may interfere with the effectiveness of the abortion medication. You must inform your healthcare provider about any medications or supplements you are taking.

5. Engaging in sexual activity during the abortion process: Sexual activity during a medical abortion can introduce bacteria into the vagina, increasing the risk of infection. It is mostly recommended to abstain from sexual activity until the abortion process is complete, and your healthcare provider advises otherwise.

6. Ignoring the need for a follow-up appointment: It is essential to schedule a follow-up appointment with your healthcare provider after the abortion to ensure that the procedure is successful and to address any concerns or complications. They will provide further guidance on post-abortion care and contraception options.

7. Disregarding signs of complications: It is essential to be aware of warning signs or symptoms that may indicate complications during a medical abortion. Symptoms such as severe pain, excessive bleeding, persistent fever, or signs of infection should be promptly reported to your healthcare provider.

8. Neglecting emotional and psychological support: A medical abortion can have emotional and psychological effects on individuals. It is essential to seek help from loved ones, consider counseling services, or reach out to organizations that specialize in post-abortion care if needed.

9. Vaginal tampons use, but regular pads use is allowed.

10. Apply vaginal douching and baths;

11. Bathing, sauna, sauna, or swimming pool. It is allowed to take non-hot showers.
12. Doing hard physical work and engaging in physical exercise and sports;
13. Take non-steroidal anti-inflammatory drugs (NSAIDs) (e.g., Paracetamol, Diclofenac, Aspirin). Ibuprofen or Nimésulide can be taken as a pain reliever after taking Misoprostol.
14. Smoking during the MTP procedure is not entirely prohibited, but experts recommend reducing the number of cigarettes you smoke as much as possible. For more information, see the article Smoking and Alcohol in MTP.
15. We were drinking alcoholic drinks. Ethyl alcohol dilates blood vessels, increasing bleeding duration and intensity during MTP. Furthermore, taking alcohol reduces the general and local immunity, significantly expanding the abortion and Pyo-inflammatory complications risk. Read more in the article Smoking and alcohol in MTP.
16. Having sex (vaginal, classical) is discouraged for 2–3 weeks until the uterine mucosa is fully epithelialized. In addition, it is necessary to exclude the woman from having an orgasm during this period. Usually, when the bleeding stops completely, sex can be resumed. For more information, see “Sex after medical abortion.”
17. Personal and intimate hygiene practices should be carefully followed.

Author

Dr. Kopp Kallner. M.D. in Obstetrics & Gynecology, Columbia University Medical School.