Medical abortion: Why the whole world chooses him
Olga Lukinskaya
We recently wrote about emergency contraceptive methods.: intrauterine devices and levonorgestrel preparations. We hope that our readers have already become accustomed to reliable methods of contraception, but the situations are different - and an unwanted pregnancy may still occur. The state is trying to reduce the prevalence of abortion by propaganda, and we tell what a medical abortion is and why it is preferable to the usual one.
According to WHO, of the 56 million abortions per year, 22 million worldwide are the so-called unsafe abortions, which are carried out by persons without proper qualifications or in inadequate conditions. These abortions lead to a huge number of complications - and as part of the fight against them, the World Health Organization is developing policies to educate and increase the availability of safe abortions, especially medical ones. The schemes are different, but more often it is the intake of mifepristone inside, and then the introduction of misoprostol into the vagina or under the tongue.
The effectiveness of medical abortion is proven and is 99%, and it involves less risk than a surgical one. In addition, this method is much more comfortable: although it is carried out under the supervision of a specialist, a woman does not experience drastic interference in her intimate sphere. She simply takes the pills at home and monitors the bleeding that has developed, visiting the doctor after a certain number of days. Any abortion, including medical abortion, is accompanied by certain risks - but they are much higher with surgical intervention.
It is important that the cost of medical abortion is much lower for the health care system (if we are talking about public medicine), and for the patient herself (if we are talking about a private clinic). A set of drugs and the services of a specialist watching the process are cheaper than the work of a surgeon, nurses and nurses, time in the operating room, and surgical materials. As stated in the book of Professor Radzinsky "Obstetric aggression", the difference in cost is thirteenfold.
Medical abortion is preferable to surgical in all respects: it is safer, easier and cheaper
It turns out that medical abortion is preferable to surgical in all respects: it is safer, simpler and cheaper. The paradox is that in Russia, according to various estimates, pharmacological accounts for about 4% of all abortions, whereas in Europe this figure reaches 80%, and even 90%. As Natalya Artikova writes on behalf of Russian obstetricians and gynecologists, “we are not able to do abortions” - we are talking about the inability to meet international standards, ensuring maximum safety at minimum cost.
It is noteworthy that the only surgical method that WHO refers to as recommended is vacuum aspiration, and Russian legislation proposes the use of medical abortion and vacuum aspiration. But in Russia, curettage (curettage) of the uterine cavity is most often used, an outdated and dangerous method. It happens that the problem is a lack of medical qualifications - surgery is simply used without need. According to a survey conducted in Russia, medical abortions are more often chosen by young women (under 30) - the authors explain this by openness to innovation. They make a decision together with a partner, consider health to be their priority and are willing to invest money in it: medical abortion is not covered by the CHI system, with the exception of certain regions, such as the Kemerovo region.
Discussions about the complete removal of abortions from the CHI system that were going on a couple of years ago ended in the insurance services that they still remained: lawmakers rightly feared that the bill would lead to an increase in the number of clandestine abortions with all their complications and abandonment of children. There were talks about banning mifepristone itself across the country - ostensibly its availability will lead to the fact that everyone will terminate the pregnancy without a doctor's supervision. But for such cases there is a system for selling prescription drugs. By the way, for the state budget it would be more effective to introduce medical abortions into the CHI system - this would reduce the number of surgical complications.
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