Mifepristone is a steroid used to terminate pregnancy. It inhibits the secretion of progesterone that is needed to maintain the pregnancy. It should only be used if the pregnancy is within 70 days (10 weeks). It is recommended that you do not use it if you are over 10 weeks pregnant. It can only be bought with a prescription. For a complete medical termination of the pregnancy, Mifepristone is used with Misoprostol. Mifepristone is taken as a tablet once. After 24-48 hours, Misoprostol is taken.
Information given here is based on the salt and content of the medicine. Effect and uses of medicine may vary from person to person. It is advicable to consult a Obstetrician before using this medicine.
Mifepristone is prescribed for terminating pregnancies, which are less than 70 days and also to induce labour in case of fetal death. It may also be given to treat high blood sugar level in patients with Cushing’s syndrome.
Mifepristone starts producing the required effects within 1-2 hours of administration.
It is advised that Mifepristone is used to terminate a pregnancy that is within 63-70 days. Use of this drug to control elevated blood sugar level should not be done if you are pregnant.
It is not habit forming.
It is recommended that you do not breastfeed your child if the administration of this drug is highly necessary.
Interaction with alcohol is still unknown. Consult your doctor before proceeding
Mifepristone may cause sleepiness. It is advised that you do not drive if you are experiencing this side-effect.
There is no reported impairment to the kidney functioning.
There is no reported impairment to the liver functioning.
For termination of pregnancy, it is a single dose therapy; it is not possible to miss a dose. If you are taking it for controlling blood sugar level and miss a dose, take it as soon as possible. But do not double dose.
If you overdose on Mifepristone, contact your physician right away.
There are no known alcohol interactions.
It is recommended that you avoid grapefruit juice while taking this medication. It may modify the effects of the drug.
Mifepristone severely interacts with the following drugs- dexamethasone, erythromycin, hydrocortisone, ketoconazole, simvastatin, pimozide, warfarin and ergotamine.
Things you need to know about the mtp act
In 1971, the increasing cases of maternal morbidity due to unsafe abortions, and the idea that abortions could be used as a method of population control motivated the government to enact the medical termination of pregnancy act. But what does the law really say? to what extent is abortion a reproductive right in india?
Here are the facts you need to know about the indian law on abortion:
1. Access to abortions is legal in india
medical termination of pregnancy has been legal in india under certain conditions since the passage of the act in 1971. India became one of the first few countries to actually legalise abortions beyond just life-threatening situations. Pretty cool, right?
However, a survey conducted in 2007 by the ministry of health and family welfare suggests that only 22.9% of men, and 28% of women were aware that medical abortions are possible and available! a large number of people still remain unaware that by law, they have the right to access abortions.
2. Although abortions are legal, there are certain conditions to be kept in mind…
While abortions are legal in india, the law as it stands today does not allow termination of pregnancy on the request of a woman. In india, abortions are legal up to 12 weeks with approval from one service provider and beyond 12 weeks to 20 weeks requires the approval of two service providers.
There are some other conditions listed in the act: you can get an abortion if the service provider is able to assess that there is a risk to the woman’s life, a threat to a women's physical and mental health (including contraceptive failure for married women), or risks the child if born to be “seriously handicapped”. Frankly, the conditions are pretty inclusive and whatever the situation, the service provider is your friend.
3. Medical abortions and surgical abortions? yes, there are two types!
Medical abortion is a common terminology for abortions induced by the use of pills. An abortion within the first 10 weeks of pregnancy in india can be legally performed using a combination of 2 pills. These pills are available in a combi-pack and are to be taken in the span of 3 days. Medical abortion is completely safe, non-invasive, non-surgical and - as you may have already guessed - a much preferred method of seeking abortion for majority women. These pills should be prescribed to you by a medical practitioner or an obgyn licensed to perform abortions as per the mtp act. Therefore, be quick and consult your ob-gyn! do not do the mistake of consuming these pills yourself as they can give rise to complications which may sometimes be really serious.
A surgical abortion on the other hand ends a pregnancy by removing the foetus and placenta from the uterus using either electric or manual vacuum aspiration. Although these terms sound very technical, advancements in technology have made these procedures completely safe! your doctor is your best guide so do consult them. Just make sure you get quality service in a safe environment from a trained doctor. 3 magic words - quality, safe and trained.
4. You don’t need parental or spousal consent if you’re an adult.
At times like these, you can thank the universe for being an adult! as an adult person and when it comes to seeking safe abortion access in india, you do not need anyone else’s permission. The act recognises the personhood of a woman and respects the rights of an adult person in india by maintaining confidentiality.
5. The mtp act is separate from the law on gender biased sex selection.
And there are 2 separate laws for these 2 unrelated issues! makes sense yet?
Safe abortion access is an issue of reproductive and sexual rights where a woman makes choices and decisions regarding her body and life. On the other hand, gender biased sex selection is an issue of deep rooted gender based discrimination against women and girls in the patriarchal indian society which needs to be targeted at it’s root. The first is regulated by the medical termination of pregnancy act, 1991 and the second by the pcpndt act, 1994.
We are not making this up! if you read the 2 laws, then you will find that mtp act has no mention of gender biased sex selection and pcpndt does not mention access to safe abortion anywhere. See?
Now that we understand that the two are separate from one another, let’s become advocates and stop this overlapping of the 2 issues and stigmatising safe abortion access. Because if we don’t then women may end up losing their lives for nothing.
Have a look at this document by the national health mission highlights areas of possible conflation between the two acts. It gives guidelines to stakeholders so that the pcpndt act and messaging against sex-selective abortion do not hinder access.
6. The law and how it relates to single unmarried women
The conditions mentioned in the mtp act also covers single unmarried adult women. Except for one clause reserved for married women which is abortion because of contraceptive failure. For all other reasons listed above, single women can access abortions. It is mostly because of the stigma associated with being a single woman that some service providers stigmatise abortions being sought by them, leading women to feeling humiliated or deterring them from accessing safe abortion services.
There are two methods by which abortion can be done:
Surgical or Medical Abortion for Unwanted Pregnancy
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
Advantages of Medical Abortion
Disadvantages of medical abortion
Advantages of Surgical Abortion
Disadvantages of surgical abortion
Related Tip: Why eating fish is essential for a healthy pregnancy??
The uterine fibroids are one of the most common gynecologic problems, with over 40-50% of women having them at some point in their life. The number and size of the fibroids, the age of onset, associated symptoms like dysfunctional bleeding and pelvic pain will determine the management of fibroid. The following is a series of management measures, starting from the most conservative to the most invasive.
1. Wait and watch: In women who are asymptomatic, it is best to watch them for the development of symptoms without any intervention. Also, in women nearing menopause, it is best to just watch the fibroids as they just shrink once menstruation ceases.
2. Medical therapy: In some women, menstrual cycles could be heavy or irregular and require hormonal replacement. They could also have occasional pain, and so may require painkillers.
3. Noninvasive procedure: MRI-guided focused ultrasound surgery is when the women are inside the MRI scanner and an ultrasonic transducer is used for treatment. The exact location of the fibroids are identified and sound waves are used to destroy the fibroid. Done on an outpatient basis, it is safe and effective.
4. Minimally invasive procedures: Uterine artery embolization is where the arterial supply is cut off to reduce fibroid growth. Myolysis is where laparoscopically heat or cold waves are used to lyse off the fibroids. Endometrial ablation is where the uterine lining is destroyed through high-intensity heat or cold waves.
5. Invasive procedures: Abdominal or Laparoscopic myomectomy is where the fibroids are removed through an abdominal incision or keyhole surgery. If fibroids are extensive and completed family, hysterectomy is the choice of treatment. Given their high incidence, fibroids require management based on symptoms, age, and other considerations as discussed and decided between the patient and the doctor.
Uterine fibroids, also known as leiomyoma or myoma, are benign growths on the uterus, occurring mostly during the years of childbearing. Few of the common symptoms of fibroids are leg pain or backache, constipation, difficulty in emptying the bladder, frequent urination, pain or pressure in the pelvic region, menstrual periods stretching over a week and excessive menstrual bleeding.
Certain genetic changes of the uterus which are different from the ones normally present in the muscle cells of the uterus can cause this disorder.
Substances which help the body maintain its tissues trigger fibroid growth as well.
Family history, excessive consumption of alcohol and red meat while going low on foods such as dairy products, fruits, green vegetables and vitamin D, obesity, usage of birth control pills and early onset of the menstruation cycle are other factors that may escalate the risks of one suffering from fibroids.
Be careful and take a closer look: Fibroids are fundamentally non-cancerous and they hardly interfere with pregnancy. Often, they do not exhibit notable symptoms and are prone to shrinkage after menopause. Hence giving them and yourself some time might be the best option.
Medications generally aim at the hormones controlling the menstrual cycle and treating symptoms such as pelvic pressure and excessive menstrual bleeding. However, they do not treat fibroids completely but work towards contracting them. They include-
Gonadotropin-releasing hormone (Gn-RH) agonists to block estrogen and progesterone production
Progestin-releasing intrauterine device (IUD) to alleviate severe bleeding caused due to fibroids
Tranexamic acid to ease excessive menstrual periods
Progestins or oral contraceptives to regulate menstrual bleeding
Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain associated with fibroids
Surgeries to Treat Fibroids:
Depending on symptoms and whether medical therapy has failed, the patient may have to undergo surgery. The following surgical procedures may be considered:
Hysterectomy: removing the uterus. This is only considered if the fibroids are very large, or if the patient is bleeding too much. Hysterectomies are sometimes an option to prevent fibroids coming back.
Endometrial ablation: removing the lining of the uterus. This procedure may be used if the patient's fibroids are near the inner surface of the uterus; it is considered an effective alternative to a hysterectomy.
UAE (Uterine artery embolization): this treatment cuts off the fibroid's blood supply, effectively shrinking the fibroid.
Mifepristone: It, also known as RU-486, reduces heavy menstrual bleeding and imporves fibroid-specific quality of life. It competitively binds and inhibitsprogesterone receptors.
Ulipristal acetate: It is a progesterone receptor modulator that acts as a postcoital contraceptive. As progesterone promotes the growth of uterine fibroids, blocking its receptor may reduce their size.