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Frequently Asked Questions

Q1 . How do I know if I am pregnant and how long I have been pregnant?

A: Most women determine that they are pregnant if they are sexually active and have missed a period. Nausea, breast soreness, and fatigue are also common symptoms in early pregnancy. Ultrasound or pregnancy tests are the only ways to confirm that a woman is pregnant. The pregnancy test can be done only after the first day that a woman missed her period, before that time the result is not reliable (the pregnancy test might be negative while the woman actually is pregnant).  If an ultrasound is performed, the doctor can tell a woman exactly how long she has been pregnant.

A woman can make a reasonable calculation of about how long she has been pregnant. She must figure out have a peek at these guys when the first day of her last menstrual period was, include that day and start counting up until today. The number of days is the time of pregnancy duration. If she wants to know the pregnancy duration in weeks she should divide the number of days by 7. There are many Apps online that can help one calculate pregnancy gestation. You can find a pregnancy calculator here

Q2. I have an unwanted pregnancy, what can I do?

A: If a woman has an unwanted pregnancy she can choose to keep the pregnancy and give the child up for adoption or she can keep the pregnancy and raise the child after birth or she can choose a safe abortion method. You can read more here on when the law allows for a safe abortion. A woman can call the Aunty Jane Hotline for more information on any of the above mentioned options on 0727 101919/ 0737 101919.

Q3: When can a woman not use misoprostol?

A:

1-    When she is alone. It is important to have someone close by when using misoprostol. this can be the partner, a friend or a relative who can help in case of complications.

2-    Woman should not use misoprostol for medical abortion if she is more than 12 weeks pregnant. A pregnancy of twelve weeks means 84 days (or three months) after the first day of the last menstrual period. A woman can make a reasonable calculation of how long she has been pregnant. She must figure out when the first day of her last menstrual period was, include that day and start counting up until today. If a woman thinks she has been pregnant for more than 12 weeks, or if the ultrasound shows she is more than 12 weeks, she should not do a medical abortion herself.

3-    A woman should not use misoprostol when she has a serious illness Most illnesses are no problem with medical abortion. Some serious illnesses, such as severe anaemia, can create problems because of the heavy blood loss involved. Serious illnesses are sometimes a reason for a legal abortion, even in countries with restrictive laws. If there is a risk of a sexually transmitted infection such as Chlamydia or Gonorrhea, arrange an examination with a doctor so that the infection can be treated properly.

Women with HIV can use Misoprostol safely, but they might be at slightly bigger risk of anemia or infection.  Therefore they should use antibiotics when using Misoprostol.

Misoprostol should also not be used when there is a possibility of an ectopic (or extra-uterine) pregnancy. Doctors treat women for this condition in all countries, even in countries where abortion is illegal. An ectopic pregnancy cannot be treated with Misoprostol.

4 – A woman should not use misoprostol if she got pregnant at a time when she had an intrauterine device (IUD)

5-    A woman should not use Misoprostol when she is far from the hospital and would need more than 2 hours to get to the hospital. That way, if complications occur, medical aid will be near.

6-    The woman should not use misoprostol if she is being forced or coerced to use them.

Q4:  Where can I get Misoprostol?

A: Misoprostol brand names are for example: Misoclear, Cytotec or Isovent. The pills should contain 200mcg Misoprostol in each tablet. Sometimes it is sold over the counter without a prescription. Sometimes a prescription is necessary. Misoprostol is used to prevent postpartum hemorrhage, treat post abortion care, to treat gastric ulcers and to treat arthritis.

Q5. What are the risks of using Misoprostol for abortion?

 A: If a woman uses Misoprostol for abortion there are chances of complications, she should seek medical advice as soon as possible if she experiences any of these symptoms:

1- Excessive bleeding that soaks more than 2 maxi sanitary pads per hour. Feeling dizzy or light-headed can be a sign of too much blood loss. This is dangerous and must be treated by a doctor.

2- Fever (more than 38 degrees Celsius) for more than 24 hours or if she has a fever of more than 39 degrees at any time. This could be a sign of an infection

3- Vaginal discharge that smells bad.

If a woman thinks she might have a complication she should go to a doctor immediately. Doctors have the obligation to help in all cases.

Q6. Can Misoprostol be used if I am HIV positive or have AIDS?

A: HIV positive women can use Misoprostol safely. HIV positive women may be at a bit higher risk of infection and anemia. Iron pills may be given for anemia. Antibiotics may be used to prevent infection.

Q7. I had an abortion but the pregnancy test is still positive. What should I do?

A: A woman should wait 3 weeks after the abortion to take a pregnancy test. Sometimes, pregnancy tests are still positive 3 or 4 weeks after the abortion, because the hormones are still in the blood.  In this case only an ultrasound can confirm whether a woman is still pregnant or not.

If the pregnancy symptoms haven’t disappeared a couple of days after an abortion it is possible that the woman is still pregnant. Blood loss does not mean that the abortion was successful; that is why it is so important to check for ongoing pregnancy by ultrasound or a pregnancy test.

Q8. What are the symptoms of an ongoing pregnancy and what can a woman do in this case?

A: If the pregnancy symptoms such as nausea, breast soreness, and fatigue don’t disappear after the medical abortion it is possible that she has an ongoing pregnancy. She can do an ultrasound or take a pregnancy test after 3-4 weeks. If a woman is not sure if the abortion occurred, because she still feels pregnant, she must not wait and should try to get an ultrasound to find out if she is still pregnant.

Q9. I used Misoprostol a few days ago and still am in a lot of pain. Is that normal?

A: No, this is not normal. If the treatment was successful, a woman should no longer suffer any pain, just some blood loss. If the abortion is incomplete, it can cause a lot of pain even days after a woman took misoprostol.

Q10: What can a woman do in case of an incomplete abortion?

A:  If woman has an incomplete abortion she should go and see a doctor who will help remove remaining tissue from the womb. Doctors have an obligation to help a woman in these circumstances. You can call Aunty Jane for referral on 0727 101919.

Q11: What is the treatment for an incomplete abortion/incomplete miscarriage?

 A: If the abortion was not complete, a woman might need an additional dose of Misoprostol, a curettage or a manual vacuum aspiration, during which a doctor will remove remaining tissue from the womb. Doctors have the obligation to help in all cases. The additional dose of Misoprostol for incomplete abortion is: 2 pills under the tongue and let them dissolve for at least 30 minutes.

Q12:  What are the symptoms of a pregnancy outside the womb and what is the treatment?

 A: If a pregnant woman experiences faintness or extreme abdominal pain, then she should get medical help immediately, because it might be a pregnancy outside the womb (ectopic pregnancy) that has ruptured. This is a life-threatening situation and the doctor will always help her.  The treatment is with a medicine called methrotrexate or surgical removal of the ectopic pregnancy and it is necessary to save the woman’s life.

Q13:. Can I get pregnant again immediately after using Misoprostol?

A: Yes. If a woman does not want to become pregnant right away, it is very important to start using contraceptives immediately. Condoms can be used immediately.The contraceptive pill and other hormonal contraceptive methods like the patch, ring, or shot can be started on the day a woman takes the Misoprostol. Before a woman gets again her normal period back, the hormonal contraceptives are less effective than usual, so she should use also a barrier method (like condoms). An IUD (coil) can be put in place as soon as 4-14 days after she takes the Misoprostol, even if there is still light bleeding. She can also wait to insert an IUD until her next regular period, but she will need to use another contraceptive method in the meantime if she does not want to risk becoming pregnant.

If a woman wishes to become pregnant again after doing a medical abortion, it is also better to wait until after the first normal menstruation, so she should use contraceptives until then. Although it can take several weeks  (usually 4-6 weeks) after the abortion before she gets her normal menstruation again, she could ovulate in the first week or two after abortion, which means she could get pregnant right away.

Q14. Will I have emotional problems after the abortion?

A: If a woman is not sure if an abortion is right for her, she should discuss it with a trusted friend or family member or counsellor. Most women do not need any psychological help after an abortion. Feelings of regret after abortion are rare. For some women to whom a continued pregnancy was a danger to their health or life the emotional response after abortion is relief. Transient feelings of guilt, sadness, or loss are common but most women overcome negative feelings that might affect them. It is normal to feel emotional after an abortion. While a woman may experience sadness or grief, these feelings usually go away after a few days. But in countries where the taboo and social stigma is big, it is more common for women to suffer feelings of guilt and shame. Some women feel bad about themselves because they don’t feel guilty about having an abortion, but think they should feel guilty. In general, understanding emotional pain can help to begin to let go of the grief, guilt, rage or shame. A woman that has an abortion is not a bad person because she had an abortion. She is also not alone in having had an abortion. Many women are surprised to learn that about 42 million women worldwide have abortions every year.

Q15:  How do you know if you have an incomplete abortion?

A: It is an abortion that is partially successful. The products of conception have not been completely expelled, your body has only expelled part of the tissue and products of pregnancy. If you have prolonged bleeding more than the recommended two sanitary pads per hour for at most three hours with reduced bleeding, pain in your belly that does not go away after a few days of taking the Misoprostol, pain that is unbearable, fever, continued bleeding after three weeks, or pain when pushing on your belly, puss or weird, dark coloured and smelly discharge, you may have an incomplete abortion.

If you experience any of these symptoms, visit any level two hospital immediately;

Q16:. Will you be able to get pregnant and have children after a medical abortion?

A: A safely administered medical abortion does not affect your ability to conceive or bear a child in the future. The medication only works to expel the pregnancy and its products. It does not affect your hormones.  In fact, if you do not want to become pregnant at this time, it is important to start using contraceptives as soon as you start having sexual relations again. Three weeks after having an abortion, you should visit your gynaecologist to confirm that all is well..

Q17. I am more than 12 weeks pregnant. Can I use misoprostol for abortion?”

A: A woman should not do a medical abortion herself if she is more than 9 weeks (63 days from last menstrual period) pregnant. Misoprostol still works after 12 weeks of pregnancy but the chance of complications rapidly increases the more advanced the pregnancy is. 4% to 8% of women with second trimester pregnancies (after 12 weeks of pregnancy), who try to end their pregnancies with Misoprostol as described below, will experience severe bleeding. Therefore it is strongly advised that the pills are taken in the waiting room of a hospital. In that case, should you need urgent medical attention, you will be nearby.

Q18 . When can you start to have sexual relations again after having a medical abortion?

It is best to wait 4-7 days after taking the Misoprostol to have sexual relations. Right after the abortion, the cervix might be slightly open and the vagina or the vulva might be sensitive.  There is a greater risk of infection if you have sexual relations during this time thus there is need to take antibiotics. Chances of getting pregnant immediately are very high and you should review having a post abortion contraceptive plan.

 Q19:   When can a woman get pregnant?

 A:  A woman can get pregnant anytime during her menstrual cycle.  But some days are more likely than others.

10 days after birth

10 days after a safe abortion 85 % of sexually active women who do not use contraception will get pregnant within one year. There are days within the cycle that are referred as fertile days. On these days a woman is most likely to get pregnant if she has unprotected sex. The most fertile days are the ones around the ovulation day, which is normally 14 days after the 1st day of the last menstrual period, 3 days before ovulation and 4 days after ovulation. The rest of the days are known as safe days. On these days a woman is less likely to get pregnant but this is not 100% the case. There are women and girls who have gotten pregnant on their safe days.

Q20: Can I use breastfeeding as a form of contraception?

A: Breastfeeding can be used as a form of preventing pregnancy only if.

You are fully breastfeeding – this means you are not giving your baby any other liquid or solid food (at least eight times in a day) You are nearly fully breastfeeding – this means mainly breastfeeding your baby and infrequently giving your baby other liquids

Your baby is less than six months old

You periods have not resumed.

Q21: What if I become pregnant?

A: No method of contraception is 100%. If you think you could be pregnant, do a pregnancy test as soon as possible. If you are pregnant you need to think about what you want to do. You can choose to:

Continue with the pregnancy and keep the baby

End the pregnancy by having an SAFE abortion

Continue with the pregnancy and have the baby adopted.

Call Aunty Jane on 0727 101919 for support on the choice you make

Q22: Sexually transmitted infections

A:  Most methods of contraception do not protect you from sexually  transmitted infections. Male and female condoms, when used correctly and consistently, can help protect against sexually transmitted infections. One can also use condoms in addition to another method of contraception. This is called dual protection.