Just last December, Uncle Doctor heard from a state hospital’s youth clinic that a 17-year-old teenager came to consult about having attempted a self-abortion but failed. The story is that she is now 13 weeks pregnant.
First, Uncle Doctor wants to know how you count the weeks of pregnancy. If you can remember your last period, start counting from the first day of your last period, which should be a full-day bleeding lasting 2-5 days, not just light bleeding for a day or two. Then count up to the current day to get the number of days and divide by 7 to get the number of weeks. Pregnancy is confirmed by a urine pregnancy test, which can be done 14 days after unprotected sex or 7 days after a missed period. However, to be sure of the gestational age, an ultrasound by a doctor is necessary.
Continuing the story, the teenager ordered abortion pills online at the end of November, 4 pills for 3,000 baht, with instructions to take 2 pills at a time, 12 hours apart. She took the pills as instructed, but there was no abdominal pain or bleeding. It was found that the order was made via a Line account named “24-hour youth clinic.”
Uncle Doctor sympathizes with this issue and wants to raise awareness. If analyzed, it would be the use of abortion pills not in accordance with the World Health Organization’s guidelines: 1) using only one type of pill, 2) incorrect dosage, 3) incorrect timing between doses, leading to a low chance of abortion. It might also be fake pills or ineffective medication. It’s difficult for teenagers to discern which websites provide genuine medication because there are so many. It’s a risk of losing money and feeling for those with unplanned pregnancies trying to help themselves by finding and buying pills, which may or may not work. To be sure, why not call a real doctor who handles unplanned pregnancies, or ask on the Love Care website or call 1663 for advice?
Safety from abortion and effective use of medication are things teenagers need to know and prioritize. Knowing what symptoms to expect and being prepared to face emergencies is crucial. Can you tell yourself that you are brave and confident? Is there someone who will be with you and take care of everything? Is the place where you will wait for the abortion far from the hospital? The travel time to the hospital should not exceed one hour, and when should you go to the hospital and with what symptoms?
Uncle Doctor wants to explain the symptoms of medication-induced abortion for teenagers to learn and understand:
The medication will take effect within 24 hours, often with side effects such as fever, chills, nausea, and vomiting. There will be increasing lower abdominal pain for several hours, much more painful than menstruation. Many cannot endure it and faint. Fresh blood will then flow from the vagina, with clear fluid like urine mixed in, which is amniotic fluid. If the bleeding increases or the pain is like a bowel movement, and you feel something coming out of the vagina, if unaware, you might think it’s a bowel movement and go to the bathroom, only to find the fetus has fallen out. Some may have slight bleeding.
For this teenager, 13 weeks pregnant, the fetus would be about 7 cm in size.
Heavy bleeding during labor before abortion can be dangerous. After abortion, the amount of bleeding depends on the placenta, but the pain will decrease as the uterus contracts periodically until the placenta is expelled, which sometimes comes out with the fetus.
However, if the placenta is stuck at the cervix, it will cause severe pain and increased bleeding, or even if the placenta remains and does not detach, it can cause significant bleeding. Observe the amount of bleeding carefully; if it’s less than 5 sanitary pads, it’s not much, and if you still feel okay, it’s safe. But if fresh blood flows continuously, and you feel dizzy, very tired, it’s very dangerous. This is a signal to urgently get help to go to the hospital. Some cases do not bleed much, but the placenta remains for several weeks, causing severe anemia and uterine infection.
How should teenagers choose to take care of themselves? Afraid of others knowing and taking care of themselves as Uncle Doctor described without anyone knowing is very risky. Even though Uncle Doctor explained the steps and tried to follow them, he still sees it as very risky because no one knows what will happen, and it cannot be guaranteed. If something goes wrong, it can be life-threatening.
Because….
If an abortion is performed at 3-4 months of pregnancy, the risk of death is 7.7 times higher compared to earlier gestational ages, and 31 times higher if the abortion is performed after 5 months. Death usually results from prolonged bleeding (some women bleed quickly and heavily like a faucet turned on), and delayed hospital visits lead to severe infections in the uterus and bloodstream, making timely treatment impossible.
There was an incident where a teenager 5 months pregnant bought abortion pills and stayed alone in a dormitory outside the city. The abortion was successful, but there was heavy bleeding and rapid blood flow due to retained placenta. Fortunately, she was conscious and called 1669, and the hospital’s emergency vehicle arrived in time before she went into shock. The World Health Organization has a standard that abortions after 3 months of pregnancy should be managed in a hospital for safety.
In conclusion, thinking before acting…
The pros and cons, risks and safety
Choose more safety, less risk is better.
With love and care
Dr. Ruangkit Sirikanchanakul, RSA Network Coordinator