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Are Abortion Pills Better Than Surgical Procedures?

Written by Neil Simmons

Friday, 17 August 2007

Using an abortion pill to terminate an unwanted pregnancy appears to be a safe method and does not affect the health of women who choose it, according to a large study by researchers at the National Institute of Child Health and Human Development. Medical termination of pregnancy posed no danger to future successful pregnancies and did not elevate the risk of having an ectopic pregnancy, miscarriage, preterm birth or low birth weight babies in future.

Pregnancy can be terminated by two methods; medical and surgical. In the medical option, three methods are available. A medical abortion is undertaken from the time a woman suspects and confirms pregnancy until nine weeks from the last menstrual period.

Some of the common drugs used for medical abortions are mifepristone and misoprostol. Misoprostol is a drug that can be used alone to terminate a pregnancy medically. Additionally methotrexate is used first followed by misoprostol or mifepristone followed by misoprostol is used as per the suggestion of the doctors.

Mifepristone is also known as "Mifeprex" or "RU-486." It works by blocking progesterone from acting on the uterus thus causing the lining to shed and stopping pregnancy from progressing further. On the other hand Misoprostol (Cyotec) causes cramping and bleeding by contracting the uterus.

The most commonly used medical method to terminate a pregnancy is a combination of mifepristone and misoprostol, background information in this study appearing in the August 16 issue of the New England Journal of Medicine revealed.

The researchers used data from Denmark's national registry and involved 12,000 women who had had an abortion in the first three months of pregnancy for for non-medical reasons. These abortions took place between 1999 and 2004. Among them 2,710 women had opted for a medical abortion, while 9,104 had undergone surgical abortion.

Researchers found that in future pregnancies, 2.4 percent of women who had undergone medical abortion experienced tubal or ectopic pregnancies as compared to 2.3 percent in the surgical abortion group. Some 12.2 percent of women in the medical abortion group had a miscarriage in their future pregnancies, while 12.7 percent for the surgical group experienced miscarriages.

They found no statistical difference in the number of adverse events in future pregnancies in both groups.

Previous studies have highlighted the safety of surgical abortions, which are thought to be 98 percent effective. However this is the first study to focus on the effectiveness and safety of medical abortions.

Mifepristone was approved by the Food and Drug Administration in 2000. The drug also called as RU-486 has been involved in considerable controversy. In the three years from 2003 to 2006 seven women died after consuming Mifepristone and misoprostol, or misoprostol alone. But 360,000 American women were able to safely use it by 2004, the background information in the NEJM article stresses.

An earlier study conducted in France and published in the American Journal of Epidemiology four years ago had found a three-fold increase in risk of ectopic pregnancy following a medical abortion. However this study found no such association.

"We were kind of concerned, and we wanted to either confirm or refute these previous findings," said study co-author Dr. Jun Zhang, a senior investigator and epidemiologist at the National Institute of Child Health and Human Development.

Reacting to the findings, Vanessa Cullins, vice president for medical affairs for Planned Parenthood Federation of America, said Mifepristone was generally safe for medical abortions. "The data from this study shows health care providers and women that medication abortion compares very well with surgical abortion for safety and effectiveness for women who want to plan healthy pregnancies in the future," she added.

Despite the drop in the number of abortions each year, doctors still perform about 1 million surgical abortion procedures annually. The so-called abortion pills offer an alternative to women to terminate an unwanted pregnancy. However no decision must be taken without consulting your doctor who is in the best position to advise you.


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