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To get rid of unwanted pregnancies, women in Armenia jumped off cabinets, inserted tubes into the uterus and drank various “medicines”. Now they often buy only “Cytotec” – a drug for the treatment and prevention of ulcerative lesions of the mucous membrane of the gastrointestinal tract, which can provoke a miscarriage, and try to do the same procedure yourself at home .
According to health experts, the 16 percent decrease in the number of medical abortions in Armenia since 2007 is due to women using Saitotec to perform abortions themselves, rather than going to medical institutions for the required surgical procedure.
According to a 2010 study among 5,922 women aged 16 to 40 by the RA Ministry of Health and the RA National Statistical Service, 29 percent of respondents’ pregnancies in the past five years were terminated by an abortion performed in a medical institution. Was.
For comparison: In 2005, 45 percent of respondents’ pregnancies were terminated this way.
Also, there was no increase in birth rate, sterility and use of contraceptives during the study period.
“So where is this ‘no abortions’? Either people no longer have sex, or these abortions are not registered,” says Garrick Herapetyan, a representative of the Armenian Office of the United Nations Population Fund. “The reason, probably, is pregnancy. contained in its medical termination.”
“Medical abortion,” as they are called, refers to the termination of pregnancy due to the drug Cytotec, produced by the American pharmaceutical company Pfizer, which, if taken incorrectly, can cause uterine contractions, bleeding, and miscarriage in pregnant women. It is possible. In the United States, Satotec is a prescription-only product; The drug is contraindicated for pregnant women.
As informed by the author of this article within the framework of a study conducted in several Yerevan pharmacies with the financial support of SCOOP for the MediaLab.am portal, an international network of journalists specializing in investigative journalism, Armenia There are no such restrictions in , and 0.2 mg Cyoteca tablets sold freely in pharmacies since 2007*. (According to official data, the import of this drug into the territory of the republic began at the end of 2009).
The indicated period roughly coincides with the period during which a 16 percent reduction in the number of officially registered abortions was recorded.
According to an obstetrician-gynecologist at a medical center in Vanadzor, the third largest city of the republic, most of the cases of “acute bleeding” she encountered were linked to attempts to terminate the pregnancy at home.
“In very rare cases, home abortion using medication and other means leads to a successful outcome,” says Dr. Smriti Agarwal. “We typically deal with women in a dangerous situation with bleeding from an incomplete abortion.”
This opinion is echoed by the doctors of the Yerevan clinic. “Satotok” is a very strong drug, but women do not know about it, they simply take it … That is why we have many fatal cases, ”said the head obstetrician-gynecologist of the perinatal department of Yerevan Arpin Soghoyan says “Kanakar-Zetun” Medical Center. … “Women are brought to hospitals with internal bleeding and we are fighting to save their lives.”
Often women listen to the advice of their neighbors about the use of Cytotec and do not go to the doctor to save money, says Razmik Abrahamian, chief obstetrician-gynecologist of the Ministry of Health: “Complications in such cases are possible, bleeding It can happen. Anything can happen.”
There is no official data on the number of deaths as a result of taking the drug “Cytotec” in the country. In 2007, the cause of death of a 37-year-old Yerevan woman named “Cytotec” was Armin Danielian, who took a drug to terminate the pregnancy.
However, there is little evidence that this risk has led to a decline in demand for Cytotec. According to the Ministry of Health, for the period from 2010 to 2011. The amount of imported drug in RA increased more than tenfold, amounting to 26 655 packages of 0.2 mg.
Fifteen Yerevan and ten regional pharmacies told MediaLab that the majority of buyers of the drug are women aged 16 to 40.
Women who have taken Cytotec to terminate their pregnancies often cite financial reasons as their reasons.
Surgical termination of pregnancy in a medical institution costs an average of 15 thousand to 20 thousand drams (35-50 dollars); Cytotec will cost 180-200 drums (40-50 cents) per 0.2 mg tablet. In a country where monthly incomes can be as low as $440, the difference is significant for many.
Other women taking the drug expressed a desire to avoid shame, which traditionally threatens women in Armenian society who give birth out of birth.
A 20-year-old young woman from a small town told eurasianet.org that a friend advised her to use Cytotec to terminate a post-marriage pregnancy at home. An immediate hysterectomy (removal of the uterus) operation had to be performed to stop the bleeding that started as a result and to save the woman’s life.
The whole city learned of the incident, says this young woman, who wishes to remain anonymous, who can no longer have children and whose future, in her own words, is now “destroyed”.
Looking for ways to stop this use of “Cytotec”, most experts turn to the authorities. They point to the need to conduct an official study of the situation with abortion at home and demand that the drug be used only by prescription, and pregnancy should be terminated only in medical institutions.
The abortion drug used for abortion is Mifepristone (Mifegyne®). Also known as the “abortion pill” and with the abbreviation “RU 486”, mifepristone is a synthetic steroid with antiprogestinal activity.
Did you know that…
- Mifepristone is used not only for medicinal termination of pregnancy but also in the following conditions:
- dilation of the cervix in preparation for surgical abortion;
- To induce labor in the event of intrauterine fetal death.
- In any case, the anti-progestin action of mifepristone occurs through interaction with progesterone receptors: mifepristone binds to them, thus competing with progesterone and hindering its activity.
- Progesterone plays an important role in the early stages of serious dancing, because:
- This makes the endometrium suitable to welcome the embryo and allow its development;
- promotes relaxation of the myometrium during pregnancy;
- It increases the nutritional capacity of the blood vessels present in the uterus and is used to nourish the fetus.
- The above mechanism is lost by the use of mifepristone, thus it
- The growth of the embryonic sac is blocked and its detachment is determined “en block”.
- please pay attention
- The abortion pill based on mifepristone should not be confused with the morning-after pill, which, instead, represents an emergency contraceptive method.
- prostaglandin analogs
Prostaglandin analogs are usually given 36 to 48 hours after taking mifepristone. Most commonly misoprostol is used, but gemprost may also be used in the context of medicinal abortion. Misoprostol is given orally in pill form; Whereas gemprost is administered vaginally as an ova.
The function of prostaglandins is to induce uterine contractions favoring the expulsion of the embryo, sac and amniotic fluid and early placenta.
how to do this
How is a medicated abortion performed?
As mentioned, medicinal abortion must take place in hospitals, or in any case in authorized clinics and requires the administration of drugs whose use is reserved only within the above mentioned health facilities. Naturally, the administration of drugs necessary for the execution of a medicinal abortion should be carried out by specialized medical personnel.
In any case, the following are the main stages of the treatment in question:
Having ruled out the presence of any contraindications, we proceed with the administration of the abortion pill based on mifepristone. The medicine is in tablet form and hence has to be taken orally. The administered dose is 200-600 mg.
After a period ranging from 36 to 48 hours, it is possible to proceed with the administration of prostaglandins that allow the expulsion of the embryo sac to stimulate uterine contractions. The prostaglandins most commonly used in the context of medicinal abortion are:
Misoprostol (Misone®), is available in tablet form to be taken orally. The commonly used dosage is 400 micrograms.
Gemeprost (Cervidil®) is available as a vaginal suppository. The dosage used corresponds to 1 gram of the active ingredient.
After the administration of both the medicines, the health workers will have to provide all the necessary support to the woman.
The outcome of a medicated abortion is checked through an ultrasound which should be done 14 days after the treatment.
The studies conducted and the data collected so far have shown that medicinal abortion is effective in 95.5% of cases.
However, in the unusual event that the expulsion of the embryo sac does not occur completely, it is necessary to resort to scraping.
What are the side effects of drug abortion?
The side effects of drug abortion are closely related to the drugs administered to the patient.
However, the most common side effects of a drug abortion procedure are:
- abdominal pain of varying intensity (this is caused by contraction of the uterus and, for this reason, is considered normal);
- nausea and vomiting;
- vaginal bleeding that may continue for several days after treatment ends;
- Gastrointestinal cramps
- Other possible side effects of greater severity, which may actually be considered complications of treatment, include:
- pelvic inflammatory disease.
Clearly, the above are just some of the side effects that can occur after administration of abortion medication and prostaglandin analogs. In addition, it should be noted that the type and intensity of side effects may vary according to the week of pregnancy during which the drugs are taken, according to each woman’s individual sensitivity to the drugs administered and even according to that conditions. The emotional and psychological experiences in which the patient finds himself.
please pay attention
Given the fragility of the situation and the emotional and psychological effects it can have on the woman, family, partner and the same health care staff, she should be provided with all necessary help and support before, during and after treatment. ,
when Medicinal abortion should not be practiced
Medicinal abortion should not be used in the following situations:
- in case of known allergy to any active ingredients or excipients contained in the drugs used for this type of treatment;
- In case of ectopic pregnancy (drug treatment for this condition involves the use of another type of medicine);
- in patients with hereditary porphyria;
- in patients suffering from coagulation disorders;
- in case of ongoing anticoagulant therapy;
- in patients with adrenal insufficiency;
- in patients with diabetes;
- in women with severe asthma;
- In the case of using an intrauterine coil (IUD).
- the protection
- Is Medicinal Abortion a Safe Procedure?
The evidence and data collected so far has shown that – if performed in authorized facilities and by competent and specialized doctors in accordance with the law – medicinal abortion can be considered a safer treatment and, undoubtedly, less than surgical abortion. considered aggressive. Clearly, as with any other type of medical treatment, side effects and complications cannot be excluded, however, are quite rare.
Medicinal Abortion Shutterstock
Also known as medical or chemical abortion, this treatment is considered the first choice method for terminating a pregnancy within the first few weeks of conception.
To be performed, pharmacological abortion requires the administration of an abortive drug—responsible for detachment of the embryo sac—and a prostaglandin analog, which induces contractions of the uterus favoring the expulsion of the embryo, sac, and amniotic. essential for. fluid, as well as the formation of the early placenta.
Throughout the article, the main features of medicinal abortion and the cases in which it can be used, possible side effects and contraindications for the implementation of this particular treatment will be analyzed.
Did you know that…
Medicinal abortion is also often referred to as “paradoxical”.
what is that
What is Medicinal Abortion?
Medicinal abortion is the termination of a pregnancy performed through the administration of a specific abortion drug, followed by the administration of a drug capable of inducing contraction of the uterus to favor expulsion of the fetus.
In Italy, medicinal abortion is a medical treatment that must be performed in authorized hospitals or clinics. As a result, the drugs used to carry it out are for hospital use only and must be prescribed and administered only by specialized medical personnel in the area.
Voluntary termination of pregnancy – by resorting to medicinal and non-medicinal abortion – in our country is permitted and regulated by Law 194. However, doctors opposing this type of practice can appeal for conscientious objection, refusing to prescribe and administer essential drugs. For interruption of pregnancy.
Despite this, the Court of Cassation has ruled out the possibility of raising a conscientious objection at the stage of embryo expulsion, during which the doctor – even if a conscientious objector – is required to provide assistance to the patient as it is a case of abortion surgery. Medical assistance provided after
Simplification, if a woman has already taken the necessary medicines for a medicamentous abortion or has already had a surgical abortion, the medical staff present at the time that the fetus and the material contained in the uterus is removed and the fetus is present In the later stages of removing the pouch, it is imperative to provide health care, even if it is a conscientious objection.
When can medicinal abortion be practiced?
Medicinal abortion can be used in cases in which termination of an intrauterine pregnancy is desired or necessary, provided that the treatment is carried out within 7-9 weeks and, more precisely, no later than the forty-ninth ( after the last menstrual period). 7 weeks after the first day) or the sixty-third (9 weeks) day.
In some cases, medicated abortion can also be used to medically terminate a pregnancy (medical abortion) beyond the third month of pregnancy.
Clearly, given the fragility of this medical procedure, the physician should inform the patient of all possible risks and, before proceeding with treatment, ensure that there are any contraindications to the use of the drug. or no restrictions. Used. to use.
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