Abortion Pill Use In Case You Are Pregnant With Twins

 

Finding out that you are carrying twins, perhaps you are not ready for the pregnancy? It can leave a huge impact on life – caring for not just one with multiple babies – all the financial and other responsibilities that come with that. If you are considering a medical abortion, you may have several questions in mind. Is it safe? How many abortion pills do I need? Do I require a double dose? Plus, many other queries.

In this blog, we will try our best in breaking down everything about abortion pill use in case you are pregnant with twins.

What Exactly Is the Abortion Pill?

Let us understand more about different medicines that are part of the medical abortion process:

·       Mifepristone: This is the primary 200mg pill used first in the procedure. It blocks progesterone, which is a pregnancy hormone to keep implantation intact at the endometrium. However, after taking Mifepristone, the fetus and pregnancy tissues break away from the uterine lining, now allowing the pregnancy to go on.

·       Misoprostol: This prostaglandin medicine is taken 24 to 48 hours later. You will require at least 200mcg x 4 pills or more. Misoprostol makes the cervix soft and dilated. It also helps the uterus to contract and push out the pregnancy portions. It may cause some side effects such as nausea, abdominal cramps, pain, vomiting, headache, etc.

·       Abortion Process: The pills cause a natural miscarriage. But since you are in control of the experience, it is something you can personally monitor and manage. There is heavy vaginal bleeding to expel the pregnancy. Wear large sanitary napkins instead of inserting menstrual cups or tampons. Take pain meds to reduce abdominal discomfort. Stay hydrated and avoid alcohol.

·   Does It Work for Twins: Yes, the abortion pill is effective in terminating a twin pregnancy. However, you must administer the pills within the recommended gestational window (up to 11 – 12 weeks of conception). Make sure the pregnancy is within the uterus to take the medicines.

·       The "Double Dose" Myth: There is a common misconception that if one is pregnant with two embryos, they may have to take double the dose of usual abortion pill recommendation to terminate the pregnancy. However, they need to follow the standard dosage itself. This includes Mifepristone 200mg and Misoprostol 800mcg or more after 24 to 48 hours.

What to Expect: The Physical Experience

If you are carrying twins, you may think the medical process could be more intense. However, there is not much difference to expect compared to someone who is pregnant with just one embryo. This is because an abortion pill is taken in early pregnancy, where the fetus is not much developed and is quite small.

Moreover, the pills shed the endometrial lining to stop the pregnancy, and easily expel the pregnancy contents by causing uterine contractions. Here is a list of the major physical symptoms to expect:

·       Bleeding Volume: Since gestational tissues are of higher amount (slightly more), and the surface area of placenta is larger when it comes to twins, some women may pass larger clots and heavier bleeding in contrast to a singleton pregnancy.

·       Cramping Intensity: The uterus could be more distended because of multiple embryos. So, the abdominal cramps could be more pronounced. The uterus also must put some additional effort to empty itself. So, expect some moderate to intense cramping during the abortion.

·       Duration: It may take 4 to 24 hours for the uterus to completely empty. So, there is no great difference in the time taken to successfully have the pregnancy terminated as compared to if you are pregnant with a single fetus.

Medical Pregnancy in Twin Pregnancy Success Rates

Not just safe, but medical abortion has a success rate up to 98% when done correctly and as per doctor’s recommendation. Being pregnant with twins does not lower the chances of having a successful pregnancy termination. However, there are a few things to consider:

·       Follow-Up After 2 Weeks: After a couple of weeks of the abortion, a follow-up is necessary to check if all the pregnancy tissues have passed out or not. A simple ultrasound scan of the uterus and the whole abdomen can detect the needful. In very rare cases, if there is an incomplete abortion with leftover tissues in the uterus, a surgical termination could be considered.

·       Risk of an Ectopic Pregnancy: In rare scenarios, but especially if the twin pregnancy resulted through an IVF, a heterotopic pregnancy may happen. Here, one of the embryos attach in the uterus, but the other is in the fallopian tube. While the abortion pill can end an intrauterine pregnancy, it cannot do so for an implantation outside the uterus. So, before taking Mifepristone and Misoprostol pills, an ultrasound helps to check the pregnancy location.

·       Be Mindful About the Timing: Whether it is a single or more than one embryo, the abortion pill can be used only up to 11-12 weeks of pregnancy. Taking the pills as per the recommended intervals is also mandatory for positive effects. For instance, Mifepristone is taken first and Misoprostol is administered buccally, sublingually, or vaginally after 24 to 48 hours.

Frequently Asked Questions

Here are the common FAQs about medical abortion in twin pregnancy:

1.   Do I need to take a higher dose of the abortion pill if I am having twins?

You do not have to take a double or higher dose of abortion pills if you are pregnant with twins. Follow the dosage as asked by a healthcare professional.

2.   Is a medical abortion more painful with twins?

The cramping could be more intense because of larger placenta and more pregnancy tissues. However, this effect is manageable with over-the-counter pain relief medicines.

3.   Will there be more bleeding if I am carrying twins?

Larger clots are expected with heavier bleeding because of higher uterine volume. But any such difference should not hinder the success of the pregnancy termination.

4.   How do I know if the abortion was successful for both twins?

A follow-up ultrasound after a couple of weeks will confirm that all pregnancy sections have been expelled. Do not delay the consultation because confirming the abortion outcome is essential.

5.   Is the risk of complications higher with a twin medical abortion?

There is no additional risk of complications in case of getting a medical abortion for a twin pregnancy. There could be heavier bleeding and larger clots, but that does not escalate the risk of medical issues.