APR is a procedure that involves attempting to counter the effects of the first pill in a medication abortion, also known as a chemical abortion. This first pill, mifepristone, blocks the hormone progesterone, which is necessary for maintaining a pregnancy. The second pill, misoprostol, is taken 24 to 48 hours later and causes the uterus to contract and expel the pregnancy.
In some cases, women who have taken the first pill regret their decision and want to continue their pregnancy. This is where the countering process comes in.
The process begins by calling the hotline to be connected to an on-call healthcare professional who will ask some basic questions to see if the procedure is possible. If so, they will be directed to a doctor or medical provider in the area to start treatment.
An ultrasound will be done as soon as possible to confirm heart rate, placement, and dating of the pregnancy. The doctor or medical provider will prescribe progesterone to counteract the effects of mifepristone and help support the pregnancy, given as a pill to be taken orally or vaginally or possibly by intramuscular injection. The treatment will usually continue through the first trimester of pregnancy.
Progesterone is the natural hormone in a woman’s body that is necessary to nurture and sustain a pregnancy. The first pill in the abortion pill regimen blocks progesterone’s actions. By giving extra progesterone, we hope to outnumber and outcompete the first abortion pill in order to counter the effects and provide an opportunity to save the pregnancy.
For some women progesterone may cause sleepiness, lack of energy, lightheadedness, dizziness, gastrointestinal discomfort, and headaches. Increased fluid intake might help relieve these symptoms.
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