Questions about abortion

How Should an Abortion Be Performed?

There are different ways to provide, manage, and perform an abortion depending on the gestational age. The CNEGSR Guidelines establish that, prior to fourteen weeks of gestation, abortion may be carried out using medications or through aspiration. After this period, it recommends dilation and evacuation in a supervised clinical setting. With regard to instrumental curettage, the Guidelines state that, being an obsolete and unjustified method, it should be avoided, as it not only carries greater risks and complications for the user’s health, but is also more costly for the health system—as it requires a surgical setting and specialized anesthetic management.

The Guidelines specify that, during the first trimester of pregnancy, abortion can be safely self- managed in the following ways:

Type of Medication Regimen	Up to What Gestational Age Is It Recommended? [2]	Advantages of the Combined Regimen Compared to the Misoprostol-Only Regimen
Combined medication regimen (mifepristone + misoprostol) or medication regimen with misoprostol only	Up to ten weeks of pregnancy, it may be carried out on an outpatient basis (that is, fully self-managed). The user should be provided with guidance regarding warning signs and what to do should they occur. Abortion may be carried out on an outpatient basis up to twelve weeks of pregnancy when follow-up by a health care provider is available (it is recommended that mifepristone be taken at the health facility and misoprostol at home).	The combined regimen: – carries a lower risk of therapeutic failure (particularly at earlier gestational ages) – is less painful; and – is faster.

Type of Medication Regimen

Up to What Gestational Age Is It Recommended? [2]

Advantages of the Combined Regimen Compared to the Misoprostol-Only Regimen

Combined medication regimen (mifepristone +
misoprostol) or medication regimen with misoprostol only

Up to ten weeks of pregnancy, it may be carried out on an outpatient basis (that is, fully self-managed). The user should be provided with guidance regarding warning signs and what to do should they occur.

Abortion may be carried out on an outpatient basis up to twelve weeks of pregnancy when follow-up by a health care provider is available (it is recommended that mifepristone be taken at the health facility and misoprostol at home).

The combined regimen:

– carries a lower risk of therapeutic failure (particularly at earlier gestational ages)

– is less painful; and

– is faster.

For the management of abortion during the second trimester of pregnancy, the CNEGSR Guidelines recommend that care be provided in a health facility, under the supervision of available and trained health personnel.

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