Credits: Health and me
In 2023, medication abortion emerged as the most common form of abortion in the United States, reflecting both the convenience and accessibility it offers. With evolving policies, telemedicine provision, and the continued demand for privacy and safety, understanding when and how medical abortion is recommended has become more critical than ever. Abortion in the United States has long been a controversial topic, but the increasing patchwork of state laws has made medical abortion all the more difficult to monitor.
Unlike surgical abortions that take place in clinics, medical abortions tend to occur in private locations with pills prescribed or even ordered over the internet something that makes it difficult to collect data. Throw in the recent round of restrictions and court battles, and researchers, policymakers, and clinicians are left with a distressing void: we just don't know how many medical abortions are being performed, where they are being performed, or what this looks like for women's health.
Although surgical abortion continues as a necessary procedure for specific circumstances, the growth of medication abortion has revolutionized reproductive health care by providing a safe and non-invasive alternative for termination during early pregnancy. This change also highlights the need for proper information, safe access, and quality follow-up care to provide positive health outcomes.
Latest figures from the Guttmacher Institute bring to fore that in the majority of U.S. states with less stringent abortion laws, medication abortion had represented 63% of total procedures offered during 2023. In Wyoming, as an example, 95% abortions were medication-related, with 84% taking the same route in Montana.
Even telemedicine is coming into play: an estimated 10% of medication abortions were provided solely online in states where telemedicine bans did not exist, with some states up to 60%. These trends highlight the importance of preserving and continuing access to abortion pills as an essential part of reproductive health care.
Medical abortion is a non-surgical and non-invasive procedure to end an early pregnancy, usually between 4 and 9 weeks. It uses a two-drug combination: mifepristone, to block progesterone required for continuing the pregnancy, and then misoprostol, which causes uterine contractions to pass the pregnancy. Dr. Rupali Mishra, sonologist and physician at Dr Rupali's Abortion Centre, describes, "Medical abortion is advised if the pregnancy is ensured to be intrauterine and the patient is medically fit".
This involves factors such as severe anemia, bleeding disorders, chronic asthma, or allergies to drugs. She reiterates that availability of follow-up care, such as ultrasound scans to exclude retained products of conception (RPOC), is fundamental to the safe outcome.
Medical abortion is most effective in the early weeks of pregnancy. For pregnancies nine weeks or less, the procedure may frequently be carried out outside of hospital facilities by trained health-care practitioners like gynecologists, nurse-midwives, or certified midwives but outside of US that might be different like in India, No medical method abortions are carried outside the clinic and only at registered MTP centers, by qualified Gynecologist.
However, beyond nine weeks, there is no medical method of abortion that can be carried out in hospitals because risk is greater and complications may arise and only suction evacuation can take place. "Medical abortion is a convenient and non-invasive procedure, hence suitable for patients who value such factors," remarks Dr. Mishra.
The eligibility criteria too are medically oriented. The patient should not have ectopic pregnancy, severe chronic illnesses of heart, kidney, or liver function, or known contraindications to the medication. Written informed consent is legally mandatory in registered MTP centers to confirm understanding and safety of the patient.
After administration, patients can suffer from abdominal cramps, pain, and bleeding for 15–20 days. In most instances, there are no complications, but excessive bleeding, severe pain, or incomplete abortion can lead to a suction evacuation procedure. A follow-up ultrasound after about three weeks confirms the uterus is clear, marking the success of the procedure. Dr. Mishra states, "Even with high success rates, routine follow-up is critical to manage potential complications such as infection, prolonged bleeding, or retained tissue."
Safety Precautions and Possible Side Effects
Medical abortion is normally safe, but improper use or self-administration under unsupervised conditions can prove fatal. Heavy bleeding, incomplete abortion, infection, or, in exceptional cases, shock caused by undiagnosed ectopic pregnancy are serious side effects. Dr. Mishra cautions, "Selling abortion pills over the counter without a prescription is illegal and very risky. Medical supervision is a non-negotiable factor to avoid severe complications."
Knowing the distinction between surgical and medical abortion enables proper patient decision-making. Surgical abortion is instant and appropriate for later gestation or incomplete medical abortion, whereas medication abortion is non-surgical and appropriate for early pregnancy. Both need follow-up for completion assurance and checking for complications.
Telemedicine has revolutionized access to medication abortion, especially in states with less-restrictive laws. Virtual consultations with trained providers enable patients to get prescriptions and instructions without face-to-face visits, providing greater privacy and ease. However, according to Isabel DoCampo of the Guttmacher Institute, legal safeguards and access need to keep evolving in order to provide safe provision across states.
Medical abortion is safe, effective and becoming increasingly prevalent for the ending of early pregnancy if under qualified medical care.
Eligibility, procedure, and follow-up must be explained to patients so that safety and health can be assured. As reproductive health policy continues to change, maintaining access to safe abortion care—including medication and telemedicine—remains paramount. Open dialogue with objective medical professionals, coupled with adequate support and counseling, continues to be imperative for enabling individuals to make responsible decisions regarding their reproductive well-being.
Disclaimer: This article is provided for informational purposes and is not medical or legal advice. Readers are urged to seek advice from qualified healthcare providers for medical advice and to consult state or federal authoritative resources for updates on the laws of abortion in the United States.
Credits: Canva
A doctor has cautioned that certain people may need to cut back on their favourite fruits if they are taking specific heart or blood pressure medicines. Ignoring this advice could lead to a serious but preventable health issue. Speaking during a past appearance on ITV’s This Morning, as reported by the Mirror, GP Dr Chris Steele explained that some prescribed drugs can react poorly with everyday foods. Eating these foods in large amounts may interfere with how the medication works and, in some cases, cause dangerous side effects.
He drew attention to two common fruits that many households keep on hand. The doctor warned that anyone taking medicines known as ACE inhibitors should avoid bananas and oranges. During the interview, he said: “Bananas are high in potassium, which is not suitable for certain medications. People taking ACE inhibitors such as captopril, enalapril, fosinopril, and others should try not to eat bananas or oranges.”
ACE inhibitors are used to lower blood pressure and treat heart failure by relaxing and widening blood vessels, allowing blood to circulate more easily. They are often prescribed as a first-line treatment for high blood pressure, heart failure, and some kidney conditions, though regular monitoring is needed to watch for possible side effects.
High blood pressure, also known as hypertension, occurs when blood pushes too forcefully against artery walls. Over time, this can damage blood vessels as well as vital organs such as the heart, brain, and kidneys. The condition often has no obvious symptoms, but it can increase the risk of heart attacks, strokes, kidney failure, vision problems, and aneurysms. Constant pressure makes the heart work harder, which may eventually lead to heart failure or thickening of the heart muscle, according to the Mayo Clinic.
Hypertension is usually linked to lifestyle factors like a high-salt diet, excess weight, lack of physical activity, and smoking. Age, genetics, and underlying health problems such as kidney disease also play a role. The condition develops when pressure inside the arteries rises, sometimes due to stress, hormonal changes, or long-term poor eating habits.
Bananas, along with oranges and some salt substitutes, contain high levels of potassium. When combined with ACE inhibitors, these foods can cause potassium levels in the blood to rise too much. Mild increases may lead to symptoms such as stomach pain, diarrhoea, nausea, or vomiting. However, many people do not notice any symptoms until potassium levels become dangerously high, which can increase the risk of chest pain, heart palpitations, and an irregular, rapid, or fluttering heartbeat.
Patients are advised to inform their GP if they are taking potassium supplements or diuretics alongside blood pressure medication. Those on ACE inhibitors should avoid eating large quantities of foods that are high in potassium.
The NHS advises people in the UK to aim for five portions of fruit and vegetables each day. Since all fruits contain some potassium, no option is completely risk-free when eaten in excess. That said, some fruits are much lower in potassium than bananas and oranges. These include apples, berries, grapes, pineapples, and pears.
Watermelon is generally classed as low to moderate in potassium, making it a suitable choice for people following a low-potassium diet. One standard serving of diced watermelon contains roughly 170 to 180 mg of potassium, which is far lower than levels found in fruits like cantaloupe.
According to the NHS, adults aged 19 to 64 need about 3,500 mg of potassium each day, which can usually be met through a balanced diet. A doctor can help address individual concerns and offer guidance based on personal health needs.
Credits: AI Generated
Heart stents have saved countless lives and remain one of the most effective treatments for blocked coronary arteries. By improving blood flow to the heart, they help relieve chest pain and lower the risk of serious events such as heart attacks. Today, stent placement is a routine, minimally invasive procedure performed on millions of patients each year. Yet as more people live longer with stents, an important question is gaining attention: how well do these devices hold up over time inside a constantly moving, living artery?
Stents are widely used to treat blocked or narrowed arteries, particularly in people with severe or advanced coronary artery disease. By restoring blood flow, they help ease chest pain, known as angina, which occurs when the heart muscle does not receive enough oxygen and nutrients because of reduced circulation.
Each year, millions of patients undergo stent procedures, making it one of the most commonly performed minimally invasive treatments worldwide. While stents have transformed heart care, it is still important to understand their limitations, especially as newer and more advanced technologies continue to emerge.
Before looking at how stents behave over time, it helps to understand the environment in which they are placed. We got in touch with Dr. Tamil Selvan Muthusamy, Primary Investigator in the MY-IVL Study of Elixir Medical’s Device and Consultant Cardiologist at Cardiac Vascular Sentral Kuala Lumpur (CVSKL), who told us, that coronary arteries, which supply blood to the heart, are living, flexible structures. They bend, twist, stretch, and move constantly with every heartbeat to manage changing blood flow and pressure.
These arteries travel along the surface of the heart, wrapping around its curves from base to tip, delivering oxygen-rich blood to every heart muscle cell. As the heart contracts and relaxes, the arteries shift side to side, stretch lengthwise, and twist repeatedly. Blood flow within them also changes throughout the heartbeat, moving more slowly during contraction and faster during relaxation. This constant motion creates friction and stress along the artery lining, known as the endothelium.
Under healthy conditions, this stress helps maintain vessel function. However, when blood flow is disrupted, small areas of damage can occur, allowing plaques to form, harden, and eventually block the artery.
A stent is a tiny metal mesh tube mounted on a deflated balloon catheter and guided through the arteries to the site of blockage. Once the balloon is inflated, the stent expands, pushing the plaque aside. The balloon is then removed, leaving the stent in place to keep the artery open, much like internal scaffolding.
Over the past two decades, research has shown that stents can behave like rigid cages inside arteries. Dr Selvan Muthusamy told us that depending on their length and position, they may restrict the artery’s natural ability to bend, twist, stretch, and pulse with each heartbeat. This stiffness can damage the delicate inner lining of the artery and increase stress on the vessel wall by limiting its natural movement.
When these mechanical changes alter normal blood flow patterns, they can trigger inflammation or excessive tissue growth inside the stent. This process, known as restenosis, is one of the main reasons stents fail over time. Long-term studies suggest that stents have an annual failure rate of around 2 to 3 percent. For patients, this may show up as the return of chest pain and, in some cases, can lead to a heart attack.
As explained by Dr Selvan Muthusamy, the challenge lies in matching rigid implants with arteries that are meant to move continuously. When this balance is disrupted, long-term complications become more likely.
Healthy habits play a major role in protecting stents and overall heart health. Patients are advised to stop smoking, follow a heart-friendly diet low in salt and unhealthy fats, and stay physically active, such as walking for at least 30 minutes a day.
Dr Selvan Muthusamy said, “Managing weight, blood sugar, blood pressure, and cholesterol is equally important. Taking prescribed medications consistently, participating in cardiac rehabilitation, and attending regular follow-up appointments all help reduce strain on the arteries and lower the risk of complications.”
In recent years, newer technologies have also been developed to address some of the mechanical drawbacks of traditional stents. One such innovation is the bioadaptor implant. Unlike conventional stents that remain permanently fixed, the bioadaptor is designed to change over time. After about six months of healing, it unlocks within the vessel wall and becomes a dynamic scaffold. This allows the artery to regain flexibility, stretch, and natural pulsation. Studies have shown improved blood flow, healthier artery lining, and more than 50 percent better long-term outcomes compared to standard stents.
The most common cause of stent failure is restenosis, where tissue growth gradually narrows the artery again. Patients should pay close attention to symptoms such as chest pain or pressure, shortness of breath, unusual fatigue, a rapid heartbeat, nausea, sweating, or swelling in the legs. These signs may become more noticeable during physical activity.
Seeking medical help promptly when these symptoms appear is critical. Early detection can prevent more serious complications, including heart attacks, and allow doctors to intervene before the problem becomes life-threatening.
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High blood pressure is a serious health issue, but it usually causes no obvious symptoms until significant harm has already occurred. This makes it difficult for many patients to stay consistent with their medication. When you do not feel any immediate change after missing a pill, it becomes easier to forget doses or stop altogether.
Many people assume it is “not a big deal” to skip a dose now and then, or even to quit the medicine completely. In reality, blood pressure medication is often meant to be taken long term, sometimes for life, though certain medicines may need to be stopped or switched during pregnancy. In some cases, people may be able to gradually reduce or fully stop their medication if major lifestyle changes lead to a clear and lasting drop in blood pressure.
Blood pressure medicines, also called antihypertensives, lower high blood pressure in different ways. They may relax blood vessels, lessen how hard the heart has to work, or reduce the amount of fluid in the body. These effects help lower the risk of serious problems such as heart attacks and strokes.
According to Medline Plus, these drugs work by blocking hormones that tighten blood vessels, helping the kidneys flush out excess salt and water, slowing the heart rate, or stopping calcium from tightening the arteries, which allows blood to move more freely.
If you miss a dose, it is usually best to take it as soon as you remember, unless it is close to the time for your next dose. Skipping one dose is generally less risky than taking too much. To avoid forgetting, it helps to take your medication at the same time every day and link it to a daily habit. For example, morning pills can be taken with breakfast, while evening pills can be kept near your toothbrush.
Along with choosing a regular time, your doctor may also suggest a specific time of day. One large study found that taking blood pressure medicine at bedtime significantly lowered the risk of heart attack.
According to Health Central, it is understandable to think about stopping your medication once your blood pressure readings improve and you feel well. However, you should never stop taking these medicines, especially all at once, without speaking to your doctor first.
Stopping blood pressure medication suddenly can lead to withdrawal effects that vary in severity, including:
When high blood pressure is no longer treated, your readings may return to previous levels or rise very quickly and dangerously, leading to what doctors call a hypertensive crisis. This is defined as a blood pressure reading above 180/120. It is a medical emergency and raises the risk of:
The harm caused by a hypertensive crisis is not always reversible and can sometimes be life-threatening.
If you and your doctor decide that trying life without blood pressure medication is possible and something you want to explore, the safest approach is tapering. This means slowly reducing the dose over time rather than stopping suddenly.
Before doing this, you will need to regularly monitor your blood pressure at home while still on medication and share those readings with your doctor. If your numbers stay consistently at the lower end of the normal range while on treatment, such as around 115/80 mmHg or lower, your doctor may consider gradually reducing your dependence on medication.
Disclaimer: This information is meant for general awareness only and should not be treated as medical advice. Blood pressure medications affect each person differently, and stopping or changing your dose without proper medical guidance can be dangerous. Always speak to a qualified doctor or healthcare provider before starting, adjusting, or discontinuing any medication.
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