Name of the Procedure:

Medically Induced Abortion by Oral Ingestion of Medication (HCPCS S0199)

Summary

This procedure involves the administration of medication to terminate a pregnancy. The process includes taking prescribed pills orally and encompasses all associated medical services such as counseling, office visits, pregnancy confirmation, and ultrasounds.

Purpose

The procedure aims to medically terminate an early pregnancy. It is designed to induce a miscarriage safely and effectively without surgical intervention.

Indications

• Unwanted pregnancy within a certain early gestation period.
• Confirmed intrauterine pregnancy.

• Patient's informed decision to undergo a medication-based abortion.

  Preparation

• Counseling sessions to discuss the procedure, its effects, and alternatives.
• Confirmation of pregnancy through hCG tests.
• Ultrasound to confirm the duration of the pregnancy.
• Instructions on what to expect during the process.
• Taking any prescribed pre-medication as instructed by the healthcare provider.

Procedure Description

1. Counseling and Consent: Patient receives counseling and provides informed consent.
2. Medication Administration: Patient takes the first medication (usually mifepristone) orally at the clinic to block pregnancy hormones.
3. Second Medication: 24 to 48 hours later, the patient takes the second medication (misoprostol) at home to induce uterine contractions and expel the pregnancy.

4. Follow-Up: A follow-up visit, often involving an ultrasound, to ensure the abortion is complete.

   Tools: Oral medication (mifepristone and misoprostol). Anesthesia: None required.

Duration

• The initial office visit typically takes about 1-2 hours.

• The process of completing the abortion usually spans 1-3 days.

  Setting

• Outpatient clinic
• Possibly part of the process at home (for taking the second medication)

Personnel

• Obstetrician-gynecologist (OB-GYN)
• Nurse or medical assistant
• Counseling professional

Risks and Complications

• Common: Cramping, bleeding, nausea, vomiting, diarrhea.
• Rare: Excessive bleeding, incomplete abortion requiring surgical intervention, infection.

Benefits

• Non-surgical and less invasive.
• Can often be completed in the privacy of one's home.
• High effectiveness rate when taken within the appropriate gestational period.

Recovery

• Patients may experience bleeding and cramping for a few days.
• Follow-up visit to confirm the completion of the abortion.
• Patients are generally advised to avoid strenuous activity and refrain from inserting anything into the vagina until bleeding stops.

Alternatives

• Surgical abortion (e.g., Dilation and Curettage - D&C)

• Continuation of pregnancy with potential adoption or parenting.

  Patient Experience

• Expect cramping and bleeding similar to a heavy menstrual period.
• Pain management can include over-the-counter pain relievers like ibuprofen.
• Emotional support from counselors and possibly support groups.