Pros and cons of both oral and vaginal abortion pill

Amongst the many controversies surrounding the methods of doing abortion, another issue raises its head, that of the safer choice of an abortion pill. Abortion pill can be administered in two ways, oral or/and vaginal and the debate here is of which is the safer option.

To understand the safety of either of the pill we must first grasp the basic facts about the abortion pill itself. The abortion pill or medical abortion involves the ingestion of mifepristone or RU 486 to end the pregnancy and a second drug called misoprostol to help the body expel the pregnancy tissue.

Although termed a safe and effective procedure there are certain side effects of this abortion pill which a patient should be aware of before taking the plunge. Heavy bleeding, headache, nausea, stomach cramps, diarrhea, vomiting are some of the more common side effects of the abortion pill and the rare ones include injury to the cervix or the fallopian tube which may affect future fertility.

RU 486 is given orally followed by misoprostol later. Misoprostol is given either orally or vaginally. Earlier the pill was administered vaginally only because it was more easily absorbed there. Although it was found that administering the pill vaginally lessened the side effects like nausea, vomiting and diarrhea and also increased the efficacy of abortion for women beyond 49 days gestation, it resulted in bacterial infections in many cases.

This infection was one of the more serious complications arising from the usage of the abortion pill as some deaths were also reported. When medical abortion was first started, there was almost no concern about the threat of infection as there was no use of instruments either in the cervix or the uterus unless the abortion remained incomplete and surgery had to be done. But gradually it became evident that serious infections could occur when the pill was given vaginally.

Both abortion pills were then started being administered orally only within 24 to 48 hours of the first one along with antibiotics and it was found that this cut down the risk of serious infection and possible death by almost 93%. Initially, antibiotics were given selectively to only those women whose tests showed that they had either of the two sexually transmitted diseases like gonorrhea or Chlamydia. But this changed to all women getting antibiotics as a rule without getting any testing done and it drastically brought down the rate of infection.

Oral ingestion of misoprostol means putting the tablet either under the lingua or in the space between the cheek and the gum where it should be left to dissolve by itself. Placing it between the cheek and the gum allows the drug to go directly in the bloodstream through the thin mucus membranes. The pill should not be swallowed. The pill should be allowed to dissolve for at least 30 minutes and can be swallowed only after this time frame.

Going by current surveys and medical opinion, it would appear that abortion pills taken orally are a safer bet than taken vaginally.