Chapter 7: Learning a pregnant woman’s health history
Many women use plant medicines and
other remedies to regulate or bring on
their monthly bleeding, or prevent or
end a pregnancy. These remedies may be
safe, but ask the woman if she has ever
had a problem — such as pain, heavy
bleeding, or infection — after using any
plant or any kind of medicine.
If some person, or the woman herself,
does something to her body to end a
pregnancy, we call this an abortion.
Where abortion is legal and available, a
woman can have a safe abortion that will not usually
endanger her future pregnancies. There are 3 kinds of
abortion that can be safe:
• Vacuum aspiration. A health worker uses a machine or manual
vacuum aspiration (MVA) syringe to empty the womb (see Chapter 23).
If vacuum aspiration is done correctly, it is usually safe.
• D&C (dilation and curettage). A health worker empties the womb by
scraping it with a sterile instrument. A woman who has had more than
3 D&C abortions may have scar tissue on the womb that can make a later
pregnancy difficult. Get medical advice.
• Medication Abortion. The woman takes medicines that end the pregnancy
and empty the womb. The medicines that are known to be safe and effective
for this purpose are mifepristone followed 2 days later by misoprostol. See
page 485 to learn how these drugs can be used safely.
In places where abortion is illegal, a woman trying to end a pregnancy
may harm herself or turn to someone who does not give abortions safely.
Unsafe abortions can cause heavy bleeding, serious infection, infertility, or even
death. See Chapter 22 to learn how to help a woman after an unsafe abortion.
A woman who was sick, injured, or bled heavily after any kind of abortion may
have scars in her womb that could cause problems in this pregnancy or birth. It is
probably safest for her to give birth in or near a hospital or medical center.
A Book for Midwives (2010)