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Termination of first-trimester pregnancy is typically either done medically or via surgical methods. Although both methods are exceedingly safe, they both have their pros and cons. Approximately a million abortions were provided in the US in 2020, the overall rate has been steadily decreasing. Of note, first trimester abortions account for over 90% of all abortions. Surgical abortion is the most common method of abortion in the US however, the choice depends on the patient preferences, as well as clinician experience and legislative barriers to access.
Medical Abortion:
Medical abortion is the use of medications to terminate a pregnancy. The most common medications used for medical abortion are mifepristone and misoprostol. The procedure is usually performed in the first 10 weeks of pregnancy. Mifepristone is taken first and blocks the hormone progesterone, which is necessary for pregnancy to continue. Misoprostol is taken a 24-48 hours later and causes the uterus to contract and expel the pregnancy. This method is similar to a “miscarriage”. Medical abortion is exceedingly safe with an over 98% success rate and the rate of complications are exceedingly rare.
Benefits of Medical Abortion:
- Medical abortion is non-invasive and avoids surgical incisions or instruments as well as anesthesia. Thus, the risks from anesthesia are avoided.
- Medical abortion can be done at comfort of your home via telemedicine or in a private medical setting, making it more discreet than surgical abortion as well as providing women with a greater degree of control over the process, particularly avoiding travel issues that can rise due to ongoing legislative barriers.
- Medical abortion is usually less expensive than surgical abortion. This is because it does not require the use of surgical instruments or anesthesia and in most cases nothing more than a “telemedicine” visit.
- Since medical abortion does not involve surgical instruments, the risk of infection is lower than in surgical abortion and thus no antibiotics are needed routinely after the procedure.
- Patients undergoing medical abortion have reported that they felt more in control and that the procedure felt more natural. Furthermore, in studies more patients reported that if they had to get an abortion again, they’d choose a medical abortion compared to a surgical one. (63 vs 96%)
