As a medical abortion is a safe and non-invasive method to end an early pregnancy, usually possible to self-initiate at home. In this procedure, Mifepristone and Misoprostol pills are taken in a step-by-step format. While many countries have unrestricted access to pregnancy termination pills for an abortion, there are others with restrictions in place not just to access the medicines, but the procedure itself.
However, even in nations with restrictions on abortion, certain health emergencies, medical crises affecting the country as a whole, fetal abnormalities, and other scenarios are considered to bypass the limits. These allow an abortion irrespective of the applicable laws of when an abortion is not permitted.
In this blog, we will discuss exceptions in case of a medical abortion, which surpasses the restrictions due to health emergencies or risk to life.
1. Gestational Limits
Usually, a medical abortion is allowed up to 10 to 12 weeks of pregnancy, while a surgical abortion is allowed up to 20-24 weeks. Some countries disallow abortion completely, no matter the gestational age. While there are countries that permit medical abortion up to 6 weeks, 9 weeks, and others may not have any gestational limit at all for the use of MTP Kit medicines (Mifepristone and Misoprostol).
2. Exceptions to Relax Access to Abortion
Exceptions means abortion restriction relaxations, allowing people to seek an abortion during medical emergencies or crisis situations. These include grave injury to mental or physical health, pregnancies resulting from incest/coercion/abuse, fetal abnormalities or anomalies, or risk to the baby’s and mother’s life. There could be other exceptions applicable depending from a region to another.
3. Life-Threatening Emergencies: Unlimited Access
Imminent death risks to the pregnant person triggers abortion facilities and is considered an exception over and above all the abortion bans and laws. Some life of mother endangerment clauses includes septic miscarriage, ruptured ectopic pregnancy, pulmonary embolism, etc. Here, the hospitals are mandated to handle emergency abortions without delays, misinformation, or otherwise wait-times and formalities.
4. Abortion Allowed in Health Emergencies
Health emergencies are situations where humanitarian crises, disasters, pandemics, and other problems arise – and declared by the government. Such conditions affect not just a few people but a mass of population, triggering immediate changes in laws regarding abortion. In these circumstances, women who are otherwise not allowed to get an abortion, can do so either at healthcare facilities or by using telemedicine.
For instance, during COVID-19, women at many places were allowed to order abortion pills via telemedicine platforms. These regions otherwise had stricter laws related to abortion pill access. The focus here is to save the health and life of the pregnant person due to the susceptibility to the infection, health emergency, etc.
5. Fetal Anomaly Overrides
Abortion beyond 24 weeks is permitted in many countries if there is an incident of fetal anomaly. This is about a fetus found ridden with conditions that may cause problems to the child if it is born, leading to serious health debacles and handicaps, especially with short-life expectancy or existence in vegetable state. Certain anomalies of the fetus include severe heart defects, anencephaly, etc.
6. Judicial Interventions Past Limits
In conditions where abortion is sought past laws restricting the procedure, involvement of court is mostly required. At times, medical facilities can decide to provide abortion to the person or not past limits, if enabled to do so by the country’s government or judicial system.
If a teenager is pregnant, she may need parental or guardian consent to get an abortion. But if that’s not possible or available, the person can take permission from court to access pregnancy termination.
However, in any case, consent of the pregnant person is required along with undergoing of specific pre-assessment requirements, with data of all provided to the respective authorities to keep a record of the medical emergency.
7. Protocols for Late Medical Abortion
If the pregnancy is beyond the gestational limit for a medical abortion, use of abortion pills is not recommended by doctors. However, if the healthcare professional advises on the procedure for a pregnancy between 12 to 14 weeks, it is important to go through ultrasound scan, note the Rh status, blood tests to detect anemia and other issues, checking with health facilities to handle emergencies, and follow-up needs.