The Pills: How They Work
1. The woman goes through a physical exam and pregnancy confirmation. The process cannot be done if it is more than 49 days from the start of her last menstrual period.
2. The woman takes Mifepristone (RU-486). Once the pill is taken, there is nothing that can stop the process. The pill begins working to block the body’s progesterone receptors in the uterus. Without progesterone, the pregnancy can’t continue. Progesterone makes the uterus lush and thick, the ideal environment for the developing baby.
3. There is a two-day waiting period after the first pill is given. I f the woman is still pregnant, she must return to take a second pill.
5. The woman takes a second pill, Misoprostol, a prostaglandin that causes the uterus to contract and empty. The woman will experience heavy bleeding in as little as a few hours or as long as a few days. The pill runs its course in about a week’s time.
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Inside Abortion By Melissa DeLoach Since the Federal Drug Administration approved the steroid hormone, RU-486, women are no longer required to visit an abortion clinic to end a pregnancy, said Mary Beth Walker, director of Harris School of Nursing’s learning center. RU-486, also known as mifepristone, is only one drug that when used with misoprostol, a prostaglandin, can end a pregnancy without surgery. Walker said a prostaglandin is a drug that causes
the uterus to contract and end the pregnancy. She said the regimen works only during the first seven weeks of pregnancy or 49 days after a woman’s last menstrual period. “It is an early option for women who want to terminate their pregnancy,” she said. According to the FDA, mifepristone, an antiprogesterone drug, is only distributed to physicians who can accurately determine the duration of a patient’s pregnancy. An antiprogesterone is a drug that shuts off the development of the hormone progesterone. Progesterone is essential for establishing and maintaining a pregnancy. Mifepristone stops the early pregnancy from growing, Walker said. An additional component involves a requirement that a physician must be able to detect ectopic or tubal pregnancies. The FDA defines an ectopic pregnancy as a condition when the fertilized egg grows in one of the fallopian tubes. The fallopian tubes connect the ovaries to the uterus. According to Planned Parenthood, the medical abortion is similar to an early miscarriage. Mifepristone and misoprostol are part of an approved treatment calling for at least three visits to a doctor’s office or clinic. Walker said the medicine is not administered until a woman is absolutely certain she wants to abort the pregnancy. “If you have the medicine in your mouth and change your mind, it is too late,” she said. “The likelihood of the pregnancy ending is high — as high as 95 percent.” During the first visit to a clinic, a woman must undergo a complete physical and have a pregnancy test. In addition, many variables like a woman’s health, how far along in the pregnancy she is and her feelings on abortion must be considered, Walker said. “The amount of counseling and guidance is (as) important to a woman one month pregnant as it is to someone nine months,” she said. “If a woman is ill and the pregnancy affects her health, RU-486 needs to be closely evaluated.” After the woman is screened, if approved, she is required to sign a patient consent form. At this time, the patient is given 600 milligrams of mifepristone in the form of three pills. According to Planned Parenthood, the drug works by binding to the progesterone receptors in the uterus and blocking the progesterone. Without progesterone, the lining of the uterus breaks down as it does in a normal menstrual cycle, and bleeding occurs. The patient must return to the physician two days later. If she is still pregnant, the FDA regimen requires that she take 400 micrograms of the misoprostol in the form of two pills. Misoprostol aids in the opening of the cervix. Walker said this leads to contractions that help dislodge and expel the early pregnancy. Once the medicine has been swallowed, the patient is required to return 14 days later to determine if the pregnancy has been terminated. A recent FDA study shows the combination of mifepristone and misoprostol stopped the continued growth of pregnancy from 92 to 95 percent. A surgical abortion, which is nearly 100 percent effective, takes 10 to 20 minutes. This type of abortion can be done as soon as a woman knows she is pregnant. If the pregnancy has not ended by drug treatment, doctors discuss options with the patient, including surgery to end the pregnancy. Walker said that although there is nothing written that prohibits stopping the abortion, once it has begun, patients are discouraged from ending the procedure. “Because the pregnancy is so small, a little alteration can cause disruption in the pregnancy,” she said. Walker said disruption can lead to birth defects and can even result in serious health issues if the patient chooses to stop the abortion. Supporters of non-surgical abortion said that even though the treatment takes longer than surgery, it provides greater privacy for women because they can heal outside of the doctor’s office. Melissa DeLoach |
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