- When is a termination of pregnancy possible with Mifegyne®?
- How does Mifegyne® work?
- How does a medical abortion work?
- What speaks against a medical abortion?
- What do women feel?
- Side effects of Mifegyne
- method comparison
Not every pregnancy is desired. By the end of the twelfth week after conception (14th week of pregnancy), women have time to deal with the new situation and to decide for or against a child. As long as a termination of pregnancy remains impunity (§ 218 StGB). Thereafter, a demolition is only allowed in exceptional cases. Legally prescribed is a pregnant women conflict counseling (§ 219 StGB).
In principle, there are two options for abortion: instrumental abortion (suction, usually with scraping) or the medical abortion with the abortion pill Mifegyne®.
Mifegyne® has been approved in France since 1988, followed by England and Sweden in 1991 and 1992. At the beginning of July 1999, Mifegyne® was also approved in Germany. Mifegyne® is also available in other countries such as Switzerland, Austria, Belgium, Holland, Denmark, Greece, Finland and Spain.
When is a termination of pregnancy possible with Mifegyne®?
The medical abortion is effective only in early pregnancy. It is allowed until the ninth week of pregnancy (ie until the 63rd day after the beginning of the last menstrual period). Before the demolition, a consultation and then three days waiting period are required by law.
Manufacturers may only deliver the product to approved clinics and medical practices. Mifegyne should only be taken under strict medical supervision. The conventional distribution channel through wholesalers and pharmacies is thus excluded.
Mifegyne® has the advantage over the suction method that no surgery (curettage) and no anesthesia are necessary.
How does Mifegyne® work?
Mifegyne® prevents the continuation of a possible pregnancy. The drug contains the active ingredient mifepristone, This artificial hormone is structurally similar to the natural hormone progesterone, which is important for the development and maintenance of pregnancy. MIfepriston inhibits the action of progesterone: The development of the embryo is stopped, the lining of the uterus dissolves and is - as in a menstrual period - repelled.
In addition, to increase the effect of Mifegyne®, small amounts of an artificial prostaglandin are administered. Prostaglandin is a vasodilator that triggers uterine contractions and thus almost certainly a miscarriage.
Mifegyne® must not be confused with the "morning after pill", which must be taken no later than 72 or 120 hours after unprotected sexual intercourse, depending on the preparation, and above all inhibits or delays ovulation. Thus, the "morning after pill" is not an abortion pill like Mifegyne®.
How does a medical abortion work?
Each abortion requires prior information, interviews and preliminary examinations. Women who have opted for the abortion pill must first seek advice, such as Pro Familia.
At the first appointment in the clinic or doctor's office it will be examined by ultrasound whether you are actually pregnant and how advanced the pregnancy is. If the amniotic sac is not visible on ultrasound, the pregnancy hormone HCG is determined by a blood test. In addition, it is clarified whether the medical abortion nothing prevents.
If this is not the case, take three tablets of Mifegyne® under medical supervision. You will then be told who to contact if any health problems arise. Then you can go home.
Sometimes on the following day the bleeding occurs, which indicates the demolition. Most women, however, feel nothing.
36 to 48 hours after taking the abortion pill, you must return to the clinic or doctor's office for the second time. There you will receive the prostaglandin (Cytotec®): It is taken until the 49th day of pregnancy (7th week) in tablet form. Later (50th to 63rd day, ie 8th to 9th week) the prostaglandin tablets are introduced vaginally. Then stay under medical supervision for about three hours. In most cases, the fruit is repelled during this time. On the other hand, every fourth woman will have more than 24 hours to stop. Therefore, if no bleeding has started after three hours, sometimes a second dose of prostaglandin is given.
After about 14 days, you must return to the clinic or doctor's office for follow-up. The doctor checks if the embryo has been completely rejected.
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Sheep, cola or crocodile manure - in human history there have been many ways to prevent unwanted pregnancy.However, there was no lack of fantasy in contraception questions - as the following more or less effective contraceptive attempts prove.
Image 2 of 9
Already in antiquity women should have used sponges for contraception. These were soaked with substances such as honey, resins or brine.
Picture 3 of 9
Sheep intestine condom
Beautifully thin and reasonably dense - sheep intestine was a popular raw material for this slip-on shed. Practical: the closure with bows.
Image 4 of 9
Paste from elephant dung
Magic pastes were already used by the Egyptians. Popular ingredient: elephant dung. Researchers suspect that due to the sticky consistency at least some mechanical protection could have existed.
Image 5 of 9
Pessary adjustment set with Uterector
Button pessaries were inserted into the uterus with the help of a rod until the middle of the last century. Every three to four months it was removed from the doctor and cleaned. Not only was this method unsafe, it was also painful, leading to some fatal infections.
Image 6 of 9
Contraceptive in ancient China: tadpoles fried in mercury, 16 in number, taken orally. Contraceptive effect, however, must be doubted.
Picture 7 of 9
With this "stubble" the urethra of the man should be closed. This should be used especially in the practice of coitus interruptus use to prevent any pleasure droplets at the outlet.
Picture 8 of 9
Forerunner of today's spiral
A good 100 years ago, Dr. Ing. Grafenberg in Berlin the first spiral. He combined silk thread with silver wire. In production, the spiral later went plastic. However, the first models often triggered inflammation, so the method did not spread.
Picture 9 of 9
Condom made from fish bubble
As well as the sheep intestine also fish bubbles were struck as a contraceptive over the penis.
What speaks against a medical abortion?
The abortion pill Mifegyne® must not be used if:
- the pregnancy was not confirmed by a doctor.
- the pregnancy has existed for more than 63 days (counting from the first day of the last menstruation).
- there is a specific suspicion of pregnancy outside the uterus (such as ectopic pregnancy).
- You can not tolerate prostaglandins.
- You are allergic to the active substance (mifepristone) or any other ingredient of Mifegyne®.
- You suffer from chronic adrenal insufficiency.
- You suffer from severe or poorly treated asthma.
- you have liver and kidney failure.
- You are malnourished.
If you have a blood clotting disorder, your doctor may advise against using Mifegyne®.
If you receive cortisone treatment, the dose of cortisone must be checked when using Mifegyne®.
If you have become pregnant, even though you are wearing a spiral, it must be removed before using the abortion pill.
What do women feel?
An abortion is for most women anyway a psychologically stressful situation, no matter which demolition method one chooses. Many women consider abortion with Mifegyne® to be at least a more physically gentle method than the instrumental demolition, which makes them more independent of the doctors and gives them more self-determination and responsibility. However, the medical demolition also has dark sides. Every woman should therefore be aware of the advantages and disadvantages of the medical abortion before deciding on it:
An advantage of medical abortion is that it can be done very early, at a time when the suction method is not yet in question. Anesthesia and instrumental intervention (with the risk of injury to the uterus) are usually not necessary.
However, the medical abortion takes longer than the instrumental intervention. The bleeding can last up to 12 days. And it takes a while until you can be sure that the pregnancy was completely stopped (follow-up 14 days after taking the abortion pill!).
Side effects of Mifegyne
- Bleeding: They almost always occur, making them the most common side effects. They can last up to 12 days and are comparable to a greater menstrual period. In rare cases, bleeding is severe, requiring curettage (scarring). Therefore, the medical method may only be used in medical practices and clinics equipped with the appropriate technique.
- Aftercare: Sclerotherapy may also be required if Mifegyne® and prostaglandin are not or not sufficiently effective.
- Abdominal pains
- Nausea, vomiting
- Circulation problems
|Medicinal (Mifegyne + prostaglandin)||Instrumental (suction, scraping)|
|time||Until the 63rd day (calculated from the 1st day of the last menstrual period)||From the 7thuntil the 14th week of pregnancy (calculated from the 1st day of the last menstrual period) *|
|duration||Several days: 1st day Mifegyne; 3rd day prostaglandin; a few hours later: expulsion (in some cases instrumental intervention is still necessary); Check-up after about 14 days||Only a few minutes; Check-up after four to six weeks|
|advantages||Early execution, no narcosis, no loss of control||Fast implementation, then hardly any physical discomfort|
|disadvantage||Bleeding, pain, incomplete abortion, time-consuming, treatment over several days, increased bleeding; possibly pain||From the 7th week possible, loss of control; possibly anesthesia; rare: injuries to the cervix and uterus; Infections with subsequent infertility|
* Applies to an abort without indication or a termination with a criminal indication (like rape). For termination for medical reasons (medical indication) there is no time limit.