Medical abortion while breastfeeding

This is an automatically translated article.

The article was professionally consulted by Specialist Doctor I Nguyen Thi Man - Department of Obstetrics and Gynecology - Vinmec Danang International General Hospital.
With the fetus under 9 weeks of age, there are two main methods of abortion applied: medical abortion and abortion. Medical abortion while breastfeeding has a certain effect on the quality of breast milk.

1. Is it safe to have a medical abortion while breastfeeding?

Many women are nursing children under 1 year old, the baby is still breastfed, but because they do not use safe contraception, they find out that they are pregnant. Many parents decide to terminate the pregnancy and choose to use abortion pills. Is this method safe for the nursing baby as well as the mother herself?
First of all, Women who are pregnant can breastfeed their big baby because the body continues to produce milk during pregnancy, pregnancy does not affect the quality of milk.
However, stimulation of the mammary glands during breastfeeding can cause mild uterine contractions, which are usually harmless, but can be problematic for those with a history of miscarriage or premature delivery. .
For women who have planned not to keep the pregnancy, this should be carefully considered. If you decide to choose a medical abortion, this method is quite safe for the fetus under 3 months of age, and you will not have medical problems.
Currently in the world there are many medical abortion regimens such as using Misoprostol alone, in combination with Methotrexate - Misoprostol... but the most common is still the combination regimen of Mifepristone and Misoprostol to terminate pregnancy.

Mifepristone and Misoprostol are not recommended for use in breastfeeding women because scientists have not studied the levels of the drugs in breast milk or the effects of these drugs on the baby.
Mifepristone is rapidly absorbed orally with a half-life of 18 hours, stays in the blood for 25-40 hours, the drug is metabolised in the liver, enters the enterohepatic cycle, metabolites are eliminated. through feces. Misoprostol is rapidly absorbed orally, peaking after 30 minutes and then rapidly decreasing within 2 hours; while the vaginal route, the drug is absorbed slowly, reaching a peak after 1.5 hours and then slowly decreasing after 4 hours.
Thus, if you are breastfeeding, you should not apply the medical abortion method. Women can stop breastfeeding to use abortion pills and after 5-7 days, when the drug is completely eliminated from the blood, they can breastfeed again.
However, stopping breastfeeding can potentially lead to loss of breast milk. Therefore, women who are breastfeeding and want to have an abortion should see a gynecologist as soon as possible so that the doctor can give the best treatment.

2. Safe abortion method for nursing mothers

When a mother is breastfeeding, if she finds out she is pregnant, doctors do not recommend abortion, but in case of force majeure, abortion is still applied. With the fetus under 9 weeks of age, there are two main methods of abortion applied: medical abortion and abortion. However, medical abortion is not good for nursing mothers, traditional method of abortion is still safer.
Based on the health of mother and child, the doctor will perform an abortion at an appropriate time. Then the mother needs to take some antibiotics to prevent infection. During this time, mothers also need to temporarily stop breastfeeding.

3. Use birth control to avoid unwanted pregnancy

After giving birth, having sex again can completely make the mother pregnant, for couples who do not want to get pregnant again, they should not be subjective, must definitely use contraception.
Some safe contraceptive methods that mothers after giving birth can refer to such as:
Condoms Using condoms is the most optimal contraceptive option for the period when the mother has just given birth and is breastfeeding. This method does not affect the mother and breast milk, is very safe and highly preventable.
After giving birth, when the uterus has recovered, the mother can refer to the method of IUD insertion, which can be effective for up to 5 years, this method also does not affect breast milk.
Contraceptive implant This is a new method of contraception today, there has not been much research and is considered to be quite optimal.
Emergency Contraceptive Pills Emergency contraceptives can affect the mother's health and milk nutrition. Therefore, nursing mothers should not take emergency abortion pills.
Thus, medical abortion while breastfeeding is not a safe method for mother's health and milk nutrition. If a nursing mother wants to have a safe abortion, go to a reputable obstetrician for advice and implementation.

Specialist I Nguyen Thi Man is former Head of Obstetrics Department - Tam Tri Da Nang General Hospital, Head of IUI unit (Intrauterine Insemination) - Hoan My Hospital - Da Nang. The doctor has more than 10 years of experience in diagnosing, consulting and treating in the field of Obstetrics and Gynecology such as:
Infertility examination and consultation, implementation of assisted reproductive techniques such as: Ovulation monitoring, intrauterine insemination (IUI) Examination, ultrasound, screening and treatment of gynecological diseases Laparoscopic surgery for ovarian cysts, ectopic pregnancy

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