First Trimester Abortion
Young women need to know that abortion rights and abortion access are not presents bestowed or retracted by powerful men (or women)—Presidents, Supreme Court justices, legislators—but freedoms won, as freedom always is, by people struggling on their own behalf - Katha Pollitt
image by: Women's eNews
HWN Suggests
Trimesters Still Key to U.S. Abortion Views
Americans' support for the legality of abortion varies sharply when they are asked to evaluate it on a trimester basis, which is consistent with the pattern Gallup has found for more than 20 years. Six in 10 U.S. adults think abortion should generally be legal in the first three months of pregnancy. However, support drops by about half, to 28%, for abortions conducted in the second three months, and by half again, to 13%, in the final three months.
Articles of Interest
Cochrane Library - Medical methods for first trimester abortion
Safe and effective medical abortion methods are available. Combined regimens (prostaglandin combined with mifepristone, letrozole, estradiol valerate, tamoxifen, or methotrexate) may be more effective than single agents (prostaglandin alone or mifepristone alone). In the combined regimen, the dose of mifepristone can probably be lowered to 200 mg without significantly decreasing effectiveness. Vaginal misoprostol is probably more effective than oral administration, and may have fewer side effects than sublingual or buccal. Some results are limited by the small numbers of participants on which they are based. Almost all studies were conducted in settings with good access to emergency services, which may limit the generalisability of these results.
Early Abortion Options
In the United States, abortion remains a safe way to end a pregnancy. There are two methods of abortion available to women in the first trimester of pregnancy (up to 14 weeks from the first day of the last period). A medication abortion (also called medical abortion or the abortion pill) involves taking medicines to end a pregnancy. An aspiration abortion (also called surgical or suction abortion, or a dilation and curettage (D&C)) is a procedure that uses medical instruments in the vagina and uterus to remove the pregnancy.
First trimester abortion guidelines and protocols
This document integrates protocols, guidelines and standards in a broad framework to ensure that no aspect of care is overlooked when providing comprehensive abortion care in the first trimester of pregnancy. T
First-trimester abortion in women with medical conditions
Some serious, complex medical problems pose a dramatically increased risk for adverse health events during pregnancy. Early abortion care and effective postabortion care for women with such medical problems will reduce pregnancy-associated morbidity and mortality. To date, no level A evidence supports clinical recommendations for care of women with medical conditions who are undergoing abortion. We offer guidance in this paper on the basis of clinical experience combined with known features of coexisting conditions and abortion care.
Medical methods for first trimester abortion
Surgical abortion by vacuum aspiration or dilatation and curettage has been the method of choice for early pregnancy termination since the 1960s. Medical abortion became an alternative method of first trimester pregnancy termination with the availability of prostaglandins in the early 1970s and anti‐progesterones in the 1980s. The most widely researched drugs are prostaglandins (PGs) alone, mifepristone alone, methotrexate alone, mifepristone with prostaglandins and methotrexate with prostaglandins.
Misoprostol Alone Safely Ends Pregnancies After 10 Weeks, Study Suggests
Most women who took abortion drugs were successful even at later gestation periods, researchers reported. Many used only misoprostol, not the usual two-drug combination.
Options for first-trimester abortions
The landscape of abortion care is shifting. Safe, effective methods are now inaccessible to many patients and providers. As this article is being written, there is an effort underway to revoke the FDA approval of mifepristone. This would result in resorting to alternative regimens (misoprostol only) that have higher failure rates and increasing morbidity for patients.
Why Are We Restricting the Abortion Pill to First-Trimester Pregnancies?
As the demise of Roe went from theoretical to impending to reality, safe self-managed abortion with pills became a popular public conversation subject, with guides to telehealth abortion services and instructions for safely terminating a pregnancy with pills popping up across the media landscape. It’s a major change from just a few years ago, when the idea that the abortion pill was something you might be able to take all on your own, with no supervision from a doctor, the way one might take ibuprofen, was relatively fringe.
