00:00Welcome to this educational presentation on Guidelines for Self-Managed Abortion, or SMA, with Misoprostol.
00:07This evidence-based guidance was carefully developed by the International Women's Health Coalition,
00:13drawing on established gold standard protocols from the World Health Organization and FIGO.
00:18This presentation serves as a comprehensive guide for all pregnant people seeking to self-manage their abortion.
00:25Our goal is to ensure you have the knowledge necessary to make this process safe, effective, and entirely private.
00:33Let's begin by reviewing how to prepare.
00:35Before beginning the process, it's crucial to gather your supplies and review a brief safety checklist.
00:41Your kit should include exactly 12 tablets of Misoprostol at 200 micrograms each.
00:47You will also need ibuprofen for pain relief, thick sanitary pads, and plenty of drinking water.
00:53There is one critical medical prerequisite.
00:55If you currently have an IUD in place, it must be removed by a healthcare professional before taking Misoprostol.
01:03Finally, while you can do this privately, having a trusted companion nearby is highly recommended for emotional and physical support,
01:10especially for pregnancies past the 12-week mark.
01:13Let's take a moment to discuss critical legal and safety information.
01:17Depending on where you live, there may be legal risks associated with self-managed abortion,
01:22so it is vital to be careful about what you say.
01:26Please understand that medical providers cannot physically tell the difference between an abortion induced with Misoprostol and a natural miscarriage.
01:34Furthermore, Misoprostol is not detectable in standard blood samples.
01:38Because hospital personnel in some regions may report suspected abortions to authorities,
01:43know that if you seek hospital care, you are not required to disclose that you took medication.
01:48You can simply state you are experiencing a miscarriage.
01:52Now let's look at the instructions for Protocol A, which is designed for pregnancies up to 12 weeks.
01:58Step 1 is your initial dose.
02:00Place 4 misoprostol tablets, totaling 800 micrograms, either under your tongue or tucked into your cheek.
02:09It is very important to hold them there for 30 minutes to allow the medication to absorb directly into your
02:15bloodstream.
02:16After 30 minutes have passed, swallow any remaining bits of the pills with a glass of water.
02:22Please note that bleeding and cramping are expected and may begin as quickly as 30 minutes after completing this first
02:29step.
02:29If the pregnancy does not pass after the first dose, you may need follow-up doses.
02:35Wait exactly 3 hours after taking step 1.
02:39For step 2, if the pregnancy has still not come out, place 4 more tablets under your tongue or in
02:46your cheek just as before, holding for 30 minutes.
02:49Wait another 3 hours.
02:51If you still have had no success, proceed to step 3 by taking the final 4 tablets in the exact
02:58same manner.
02:58Keep in mind that most pregnancies end within a few hours of starting the medication, and over 75% of
03:06abortions are successfully completed within the first 24 hours.
03:10For pregnancies between 13 and 24 weeks, protocol B must be followed.
03:16Please pay close attention as the dosage per round is lower here.
03:20Instead of 4, insert just 2 tablets, totaling 400 micrograms, under your tongue or in your cheek.
03:27You will repeat this 2-tablet dose every 3 hours continuously until both the fetus and the placenta come out.
03:35If the placenta does not pass within 30 minutes of the fetus exiting, you should take 1 extra dose of
03:422 tablets to help your body safely expel it.
03:45Knowing what to expect can help you feel much more comfortable and prepared.
03:49Normal symptoms during this process include bleeding that is notably heavier than a normal period, which is why thick pads
03:56are necessary, as well as the passing of blood clots and tissue.
04:00You may also experience strong cramping, nausea, vomiting, diarrhea, or chills.
04:05These are standard side effects of the medication.
04:08Signs of a successful abortion include seeing the embryo pass and a noticeable decrease in pregnancy symptoms, like nausea and
04:16breast tenderness, in the days following.
04:18To be absolutely certain, you can take a standard home pregnancy test 2 weeks after the abortion to confirm.
04:24While severe complications are rare, it is absolutely essential to know when to seek medical help.
04:30Go to a clinic or hospital immediately if you experience hemorrhage, which means soaking through more than 2 large pads
04:37per hour for 2 hours in a row.
04:40Seek care if you show signs of infection, such as chills and a fever lasting more than 24 hours after
04:46your last dose.
04:47Severe belly pain lasting more than 24 hours, or signs of shock, like steady bleeding accompanied by severe dizziness or
04:54lightheadedness, also require immediate medical attention.
04:58Finally, consult a doctor if very heavy bleeding suddenly starts 2 weeks or more after using the medication.
05:05This brings us to the end of our guide.
05:07This evidence-based protocol was developed by the International Women's Health Coalition, utilizing the latest guidance from the World Health
05:14Organization and FEGO, and was thoroughly reviewed by medical professional Dr. Suchitra Dalvi.
05:20We share this information to empower you, because everyone has the fundamental right to safe, private, and effective abortion care.
05:27Thank you for your time, and please ensure you have the support and resources you need to stay safe and
05:32healthy.
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