There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

Premature labor is also known as preterm labor. This is the term given when the body gets ready for an early delivery in the pregnancy. Labor is considered to be premature if it starts almost three weeks prior to the due date. Premature labor usually leads to early birth, but now this can be delayed with medical help. It is better that the baby grows inside you because there are fewer chances of problems after birth. 

Risk of Preterm Labor:
Some of the things, which can increase the risk of a preterm labor are:
- Being underweight or overweight before pregnancy
- Poor prenatal care
- Use of alcohol and drugs during pregnancy
- Smoking
- Health conditions, such as preeclampsia, infections, diabetes, high blood pressure and clotting disorders
- Pregnant with a bay with birth defects
- Getting pregnant through vitro fertilization
- Pregnant with multiples like twins and triplets
- Becoming pregnant soon after having a baby

Symptoms of preterm labor:
Warning signs should be heeded to stop the stop premature labor, as acting quickly can help. Consult your doctor or midwife immediately in case you have the following:
1. Backache, especially in the lower back. Back ache can be a constant feature or might keep coming in intervals, but does not change with a change in position.
2. Contractions that take place in each 10 minutes.
3. A leaking feeling in the vagina or fluid leakage from the vagina.
4. Cramps in the lower abdomen very similar to menstrual cramps. These usually give a feeling of gas pains and come with a diarrhea.
5. Symptoms of flu like vomiting, nausea and diarrhea. Must to see a doctor if the liquids cannot be tolerated for more than 8 hours. 
6. The pressure in the vagina or pelvis increases.
7. Vaginal discharge increases.
8. There might be light bleeding from the vagina.

Ways to check for contractions
To spot and early labor one must be sure to check for the contractions. Contractions can be checked by the following:
1. When the fingertips are placed on the abdomen and the uterus feels too soft or tight then these are contractions.
2. Contractions if felt, should be timed and the starting time of these should be noted.
3. Contractions should be stopped by changing the position and drinking some water or by walking around.
4. Doctor or midwife should be contacted if the contractions occur every 10 minutes and the symptoms worsen.
5. Sometime women might experience false labor also known as Braxton Hicks contractions. These are not so strong, are erratic and stop on moving around.

Preterm Labor: What You Should Know

What is menopause?
Menopause is that phase in the life of a woman when she can no longer reproduce. It involves the loss of fertility and the cessation of the menstrual cycle. The woman will stop bleeding every month and the ovaries stop producing eggs that can be fertilized. Menopause normally sets on after the age of 40 and bleeding may permanently stop by the age of 50.

Post menopausal bleeding
You are known to reach menopause when you have not been bleeding for 1 entire year. Even a small amount of spotting should not have taken place. Post-menopausal bleeding is when bleeding occurs after a year of attaining menopause. It can be a serious health disorder and requires medical attention without any further delay.

Reasons behind post menopausal bleeding

Polyps that are mostly non-cancerous, unwanted growths on the cervical canal, uterus or ovaries are known to cause post-menopausal bleeding.
Thinning of the endometrium that lines the uterus can cause unexpected bleeding. It can be due to the rapidly receding levels of estrogen in the blood. It is also known as endometrial atrophy.
Endometrial hyperplasia is a condition that leads to the thickening of the inner lining of uterus (endometrium). It also leads to the growth of abnormal and malignant cells.
Endometrial cancer
Other health conditions such as reaction to hormone therapy, infections of the blood or reproductive organs, certain medications and blood-thinning drugs
Cancer of the ovaries, uterus or cervix
How it can be treated?

For diagnosis, you can undergo blood tests, ultrasounds, sonography and biopsy.
Hysterectomy is done to remove the uterus and cervix can be conducted for a complete cure. It also removes the ovaries, fallopian tubes and other lymph nodes.
Chemotherapy and other radiation therapies may be done for those who are in an advanced stage of endometrial cancer.
Medications such hormone regulators must be taken to prevent complications.

Post Menopausal Bleeding - Is it Normal?

Are you pregnant and planning on having a natural childbirth? There are several things to keep in mind when considering a natural childbirth. Natural birth involves no interventions and drugs and you need to prepare well for it. Here are some important tips you should follow, if you want to have a natural childbirth:

Choose a birth environment of your choice: You should choose a safe place for giving birth. Many women feel more secure at home and prefer it as the place for giving birth, while some choose a hospital.
Choose a care provider you trust: It is important for you to choose a trustworthy care provider, who will make you feel at ease and will pay respect to your wishes. In the case of giving birth in a hospital, you can opt for hiring a doula.
Prepare your body: It is important to prepare your body physically before natural childbirth. Pregnancy is quite exhausting and makes you want to refrain from activities, but you should walk for some time every day to keep fit. Keeping your body in good shape will help you with stamina during delivery.
Ice Game: You can play the ice game with your partner. It is a game designed to give you a glimpse of how to handle labor pain. This is more of an assessment, meant for giving you an idea about coping with pain of contractions. This method is also ideal for learning to deal with pain.
Educate yourself: It is important for you to read a lot about pregnancy. You should read from the Internet and also from books and stories related to natural childbirth.
Be positive: It is very important for you to maintain a positive state of mind, prior to your natural childbirth. You need to be determined and strong and reiterate to yourself that you are strong and will be able to cope with the process.
Coping strategies: Learn about various coping strategies. Keeping your jaw relaxed, horse lips, and low moaning are some strategies you can try.
Avoid cervical checks: Try avoiding cervical checks as much as possible, as they are not always a progressive measure. You do not have to be too much focused on dilation numbers.
Prepare your partner: Your partner also has to play an important role during your childbirth. You should make him learn all the major facts regarding natural childbirth and let him know about your expectations and hopes for labor.
Change positions during labor: You should try different positions during labor, and not think of being silly.
It is also important for you to get rid of preconceived ideas of natural childbirth from your mind. The process is different in different women, and you must embrace it.

Want Natural Delivery? 10 Things You Must Prepare for!

Miscarriage refers to the spontaneous loss of the fetus before one completes the 20th week of pregnancy, taking into account the period from the conception to gestation.  It usually happens in the first trimester of the pregnancy; that is within the seventh and the twelfth week of conception. Recurrent miscarriage is when one suffers from multiple miscarriages in a row.

Possible Causes:

Abnormally-shaped Uterus: Some miscarriages, particularly late ones, are thought to happen because the uterus (womb) has an abnormal shape.
Polycystic Ovary Syndrome (PCOS): Women with this condition have many small cysts in their ovaries.They also tend to have hormonal problems, including high levels of insulin and male hormone in the blood, which can lead to recurrent miscarriage.
Infection: Some serious infections can cause or increase the risk of single miscarriages. These include toxoplasmosis, rubella, listeria and genital infection. But it is not clear whether infection plays a role in recurrent miscarriage.
Diabetes and Thyroid Problems: Uncontrolled diabetes and untreated thyroid problems can cause miscarriage. But well-controlled diabetes and treated thyroid problems do not cause recurrent miscarriage.
Risk Factors:
Your risk of recurrent miscarriage is higher if:

you and your partner are older; the risk is highest if you are over 35 and your partner over 40; 
you are very overweight. Being very underweight may also increase your risk.
Each new pregnancy loss increases the risk of a further miscarriage. But even after three miscarriages, most couples will have a live baby next time.

Testing After Recurrent Miscarriage:

If you have had three miscarriages in a row, you should be offered tests to try to find the cause. This should happen whether or not you already have one or more children. Testing is not usually offered after one or two early miscarriages (up to 14 weeks) because these are often due to chance. But you might be offered tests after two early miscarriages if you are in your late 30s or 40s or if it has taken you a long time to conceive.
If you had a late (second trimester) miscarriage, where your baby died after 14 weeks of pregnancy, you should be offered tests after this loss.

You can opt for blood tests to check for sticky blood syndrome or APS. Tests would look for antibodies that would help treat the condition. Antibodies are chemicals produced by the body to combat infections.
Get an examination done should the doctor suspect chromosomal abnormalities and in case it is diagnosed, both of you can consult a clinical genetics specialist for genetics counseling.
Your doctor will recommend an ultrasound scan to trace any type of abnormality that may make a pregnancy futile, for instance, a short or a fragile cervix.
Your hopes:

It is natural to pin your hopes on testing as the answer to your problems. But there are three reasons why it may not be the answer you re looking for:

A cause may not be found; when this happens your miscarriages are called  unexplained 
Even if a cause is found, it may not be treatable;
Treatment may not lead to a successful pregnancy. This can happen if a pregnancy miscarries for a different reason than the one being treated.

Understanding Miscarriages

The tissue that lines the uterus is known as the endometrium. In some cases, it can grow outside the uterus. This is known as endometriosis. Endometriosis usually involves organs in the pelvic cavity such as the ovaries, fallopian tubes, bowel and lining of the pelvic cavity. In rare cases, it may involve the vagina, cervix and bladder as well.

Depending on the location and extent of endometrial tissue, it can be classified into four stages ranging from minimal to severe. Most cases of endometriosis fall into the minimal or mild category which involves mild scarring and superficial tissue implants. Moderate or severe endometriosis can cause cysts and severe scarring. Infertility is also commonly associated with severe endometriosis.

Pain in the pelvic area just before and during menstruation is one of the most characteristic symptoms of this disorder. This is because the overgrown endometrial tissue acts like normal endometrial tissue and is shed during menstruation. The only difference is that since there is no exit for this overgrown tissue, it is trapped in the pelvic cavity. The location of the implantation of endometrial tissue also plays a role in the amount of pain experienced. The deeper the implant, more the pain. Implants near areas with high nerve density are also more likely to be painful than implants in areas with low nerve density.  These implants may also release substances into the blood stream that can cause pain.

Other symptoms associated with this disorder are:
  Painful intercourse
  Painful urination
  Pain during bowel movements
  Infertility

These symptoms especially the pelvic pain can vary from month to month in terms of duration and intensity.

A few simple changes in your diet can help manage the symptoms associated with this disorder and in some cases, prevent it as well. Avoid processed food and foods that are high in sodium content. You should also avoid high-fat dairy and food that is rich in arachidonic acid. Instead, increase your consumption of carbs and green leafy vegetables. You could also add two tablespoons of walnut oil a day to your diet to help combat inflammation and the other effects of arachidonic acid.

Early stages of this disease can be treated with hormone therapy, but if it has progressed to the later stages, surgery may be needed. This surgery is performed laparoscopically and aims at removing all the implanted tissue from outside the uterus. However, in cases where the anatomy of the pelvic organs has been distorted by the implants, a hysterectomy may be required. This option, however, it usually considered only in cases where a woman does not have any plans of conceiving more children. 

Endometriosis - How It Is Affecting Your Life?

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