Drugs Q & A

Can A Baby Be Born Normal After Abortion Pill Fails?

A birth defect is something abnormal about your newborn baby’s body. Every four and a half minutes, a baby in the United States is born with a birth defect. Approximately 1 out of every 33 babies in the United States is born with a birth defect. A defect, which can affect almost any part of your baby’s body, can be:

•          Visibly obvious, like a missing arm or a birthmark.

•          Internal (inside the body), like a kidney that hasn’t formed right or a ventricular septal defect (a hole between the lower chambers of your baby’s heart).

•          A chemical imbalance, like phenylketonuria (a defect in a chemical reaction that results in developmental delay).

Your baby can be born with one birth defect such as a cleft lip (a gap in their upper lip) or multiple birth defects such as a cleft lip and cleft palate (a hole in the roof of their mouth) together, or even a cleft lip and cleft palate with defects of the brain, heart, and kidneys.

Your healthcare provider won’t be able to detect all birth defects right when your baby is born. Some defects, such as scoliosis, might not be apparent until your child is several months old. An abnormal kidney might take years to be discovered.

What is the abortion pill?

The abortion pill is a medication consisting of two medicines used for medical abortion. The first medicine ends the pregnancy and is named mifepristone. It works by blocking the hormone progesterone. Without progesterone, the lining of the uterus breaks down and the pregnancy cannot continue. The second medicine, misoprostol makes the womb contract, causing cramping, bleeding, and the loss of the pregnancy similar to a miscarriage.

This method can be used up to 24 weeks of pregnancy. What to expect depends on whether the pregnancy is less than or more than 10 weeks gestation. You can obtain these medications through doctors and clinics that provide abortion services, like Planned Parenthood. You should never buy them online or on the black market. The cost of the medication depends on location and additional tests or follow-ups that may be necessary. According to Planned Parenthood, abortion procedures can cost up to $800. However, this cost fluctuates depending on the area where you live.

How effective is the abortion pill?

The abortion pill is very effective. The effectiveness depends on how far along you are in your pregnancy when you take the medicine.

•          For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.

•          For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.

•          For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times. If you’re given an extra dose of medicine, it works about 99 out of 100 times.

•          For people who are 10-11 weeks pregnant, it works about 87 out of 100 times. If you’re given an extra dose of medicine, it works about 98 out of 100 times.

The abortion pill usually works, but if it doesn’t, you can take more medicine or have an in-clinic abortion to complete the abortion.

When can I take the abortion pill?

Depending on where you live, you may be able to get a medication abortion up to 77 days (11 weeks) after the first day of your last period. If it has been 78 days or more since the first day of your last period, you can have an in-clinic abortion to end your pregnancy.

Can A Baby Be Born Normal After Abortion Pill Fails

Can A Baby Be Born Normal After Abortion Pill Fails?

Yes, most of the time babies are born normal if a pregnancy progresses after a failed medical abortion. However,  studies have shown that abortion pill failure can lead to unusual congenital malformation of the skull in neonates, especially with misoprostol taken orally and/or vaginally in the first trimester to induce an abortion. Exposure to mifepristone alone has not been shown to cause fetal malformations.

A review of 71 cases of continuing pregnancy after failed early medical termination of pregnancy reported that in 8 of the cases (11.2%), malformation of the fetus or baby was reported.

A systematic review of four case-control studies with 4,899 cases of congenital anomalies and 5,742 controls showed an increased rate of misoprostol exposure in cases with anomalies. Misoprostol exposure was 25 times more likely in cases with Mӧbius sequence (a rare disorder characterized by congenital palsy of the 6th and 7th cranial nerves) and 12 times more likely in cases with terminal transverse limb defects.

In a cohort of 183 women exposed to misoprostol during the first 12 weeks of pregnancy, the major malformation rate was 5.5%; half of these were consistent with misoprostol malformation patterns. However, a prospective follow-up study comparing women who used misoprostol before 12 weeks of pregnancy to women who used antihistamines did not find a statistically significant difference in the rate of fetal malformations, although three malformations (2%) in the misoprostol group were consistent with misoprostol-related anomalies.

Although the rate of misoprostol exposure is higher in children born with characteristic defects such as Mӧbius sequence, the anomalies are so rare that the overall risk is low that a woman who takes misoprostol before 13 weeks gestation and carries a pregnancy to term will have a child born with a malformation related to misoprostol exposure. The risk of fetal malformation related to misoprostol exposure is less than 10 per 1,000 exposures.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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