Medical termination of pregnancy while breastfeeding. Will milk be preserved if a nursing mother has an abortion? Medical abortion: the essence of the method

Have an unplanned pregnancy and are you breastfeeding?

Medical abortion may be considered as one of the options for terminating a pregnancy. However, many patients are afraid to carry out interruptions because of this factor.

The choice of method for getting rid of an unwanted pregnancy while breastfeeding depends on many factors:

from the desire to continue breastfeeding,
on whether a caesarean section was performed during the last birth,
from the duration of pregnancy.

On average it takes 2-3 days. In the first hours after taking the first drug - blocking local action pregnancy hormone - progesterone, the concentration of this substance in the blood remains at its peak.

It was during the first day chemical compounds this means achieves its goal maximum value, they also pass into breast milk. At the stage of taking the second drug, which contains prostaglandins, which stimulate the contractility of the muscle fibers of the uterus, chemicals from this drug are released into breast milk through the blood.

Effect of pharmaceutical products. abortion for lactation

Pharmacological agents used to perform medical abortion in a clinic with all Required documents on their use for the purpose of terminating an unwanted pregnancy, penetrate into breast milk and, if ingested by the baby, can provoke allergies or other toxic lesions.

Taking these medications does not affect the amount of milk produced. After the removal of residual substances from the breakdown of drugs for medical abortion (4-5 days), the concentration of these drugs is negligible and cannot harm the child.

Feeding regimen for medical abortion

If a woman, together with a gynecologist, has chosen a pharmacological method of terminating pregnancy, then it is necessary to adjust breastfeeding.

After taking the first pills, you cannot breastfeed the baby, but at the same time, if a woman wants to maintain lactation at the same volume, she must regularly express milk. Expressed milk is not suitable for feeding a baby, but it is necessary to pump with the same frequency and regularity as if a child were doing it. With this mode of pumping, milk production will remain the same.

On the fifth day, after a miscarriage has occurred, which is confirmed by an ultrasound protocol, you can continue breastfeeding the baby. Mothers should know that if a child refuses to breastfeed, this may be caused by a change in his taste due to the very fact of pregnancy and subsequent miscarriage, or poor-quality pumping.

In most cases, breastfeeding is fully restored and continues. When breastfeeding is resumed, there is no need to do breast milk tests; its indicators remain normal.

Due to the temporary interruption of breastfeeding, and the inconvenience associated with it, the choice of terminating an unwanted pregnancy early in nursing mothers often opts for the vacuum method.

A woman who is breastfeeding cannot be completely protected from unwanted pregnancy. When making a decision to terminate, it is important to know whether abortion is possible with gw.

For infant The quality of mother's milk is of great importance. But it is influenced by many factors, including medications and surgical interventions. This is why it is so important to understand whether breastfeeding and abortion are compatible.

The female body recovers differently after childbirth. It may take several weeks to several months to resume normal sex life. Doctors usually recommend starting sex life 4-6 weeks after the baby is born.

Many women believe that breastfeeding itself protects against unwanted pregnancy. Therefore, when having intimacy with your partner, they don’t think about additional methods contraception. This often leads to fertilization.

Can lactation be a reliable method of contraception? Indeed, there is a so-called lactational amenorrhea method. It lies in the fact that hormonal background a woman's body does not allow her to become pregnant. However, it works under certain conditions, which not all women take into account:

The method works for the first 6 months after birth;
the child should take only breast milk, without supplementary feeding or formula feeding;
if you don’t have your period yet;
feeding during the day should be at least 10 times;
The break between feedings should not exceed 3 hours, including at night.

If at least one of the points is violated, the effectiveness of the lactation method is sharply reduced. This leads to unwanted pregnancy. Then the question arises, is it possible to have an abortion if you are breastfeeding?

Yes, you can. But keep in mind that it hurts both the mother and (indirectly) the baby. And perhaps, in a few years, when you have not one child, but already two (or three, if you now have a third in your belly), you will remember with horror: “Was I really going to terminate the pregnancy? What a blessing that I changed my mind..."

How to terminate a pregnancy

If a woman decides to terminate her pregnancy, it is important not to blame herself. Depression has never helped anyone cope with the problem. The quantity and quality of breastfeeding milk are affected not only by medical manipulations, but also the psycho-emotional state of the nursing mother.

Termination of pregnancy is carried out in two main ways:

medical abortion– non-contact method, which is based on the influence of chemicals;
instrumental abortion - can be performed by curettage or using the vacuum method.

The choice of method depends on the specific case. All details must be discussed with your doctor. The specialist will recommend a regimen in which you can perform a medical abortion and maintain lactation.

Medical abortion and breastfeeding

Medical abortion for breastfeeding involves the use of several types medicines. A woman should be prepared for the fact that she will have to give up breastfeeding for a certain time. The period depends on the regimen chosen by the doctor.

Information about the effect of drugs on milk and the child’s body is not enough to talk about absolute harm or complete harmlessness of the procedure. Abstaining from breastfeeding during an abortion is a reasonable precaution. After all, with a baby it’s always better to be on the safe side.

If a woman chooses medicinal method, she can breastfeed, but not immediately, but when the drug is completely removed from the body.

Medical termination of pregnancy involves stopping breastfeeding for 3-14 days. Therefore, the timing depends on what medicine is used. Perhaps the doctor will take into account your circumstances and prescribe a remedy that is eliminated from the body faster. For example: when using Mifepristone, it is enough to stop breastfeeding for three days. Pencrofton, Mifolian and some other medications require abstinence from breastfeeding for 14 days.

Ideally, at this time, the child is switched to bottle milk, which the mother has expressed in advance (it can be stored in the refrigerator or frozen). Or, if there was no opportunity to express, the baby will “last” for several days on artificial formula.

Reception chemical substance occurs only in a clinic under the supervision of a specialist. Drug manufacturers indicate different durations of abortion. On average, the procedure takes 1.5-3 days.

During this time active substance enters the woman’s bloodstream and disperses throughout the body. It passes into breast milk in minimal quantities. Soon the medicine is eliminated from the body.

Medical abortion is performed at the earliest stage, up to the 49th day of pregnancy. After taking the medication, the patient must undergo an ultrasound scan within two weeks. Diagnostics will confirm the release of the fertilized egg and prevent the development of complications.

Surgical abortion and breastfeeding

Instrumental termination of pregnancy also affects the ability to maintain breastfeeding. We are talking about the use of anesthesia. The specialist can choose the anesthesia that is most suitable for the patient.

On early stages worked well during pregnancy vacuum method, which is often called a mini-abortion. Obstetricians and gynecologists tend to perform the vacuum procedure. Such an abortion has less negative consequences and in most cases does not require cessation of lactation.

It is carried out under local anesthesia. Most likely, the procedure will require interruption of breastfeeding for only a few hours. For example, Lidocaine and Propofol pass into milk, but in minimal quantities. After them, it is better to pause breastfeeding for several hours and during this time express a couple of times.

Be sure to ask your doctor what kind of anesthesia was used and whether it is allowed for breastfeeding!

When can breastfeeding be resumed? surgical intervention and application general anesthesia? It all depends on what kind of anesthesia was used. Nitrous oxide and other inhalational anesthetics are safe for your baby. But, for example, Fentanyl is harmful during breastfeeding; it penetrates into milk and is excreted for several days.

What to do if GW had to be suspended

In some cases, a pause in breastfeeding during an abortion will range from three to 14 days.

To prevent mother’s milk from disappearing, it must be expressed and poured out regularly (at least once every three hours) all this time.

Be prepared for the fact that after an abortion there will be less milk. After all, pregnancy hormones are present in the body before and immediately after an abortion, which “inhibit” lactation. In addition, termination of pregnancy is a hormonal explosion that cannot but affect milk production. But if you do everything correctly (immediately after the operation, express, and then put the baby to the breast more often, do not skip night feedings, etc.), then lactation will inevitably be restored.

If a woman cannot breastfeed her child, she must take care of his nutrition. If breastfeeding is interrupted for several hours, it is enough to express milk before the procedure. The child will be able to get enough of it until the mother returns home. But what should you feed your child if the period of abstinence lasts several days or weeks?

Modern doctors insist that babies should not be accustomed to objects that imitate female breast, more precisely, a nipple. These include pacifiers and pacifiers. If the child's age allows, it is better to feed him with a spoon or drinking bowl. This way he won’t get weaned from his mother’s breast.

Drinking formula from a bottle is much easier than sucking milk from the breast. And if the child is still unaccustomed to natural feeding, you can use special ones. At correct use they will allow you to transfer the baby from the bottle to the mother's breast. When lactation is fully restored, the pads can be removed.

A mother of a baby should know that abortion while breastfeeding is a very real procedure. Its implementation will require preliminary consultation with a gynecologist and pediatrician. It is important to adjust yourself to the fact that a break in natural feeding does not mean stopping it.

Medicines are eliminated from the body over time. During this time, it is important for the mother to take care of rational nutrition child, about his psychological state and about maintaining lactation. After an abortion in mandatory you need to find it for yourself the best way contraception.

The first six months after the birth of a child, a woman’s body experiences difficult stage recovery after enormous stress during pregnancy and childbirth. At the same time, there is a myth among women that during breastfeeding a young mother cannot become pregnant. In fact, the lactation method of contraception cannot be called reliable, since in some women the first ovulation occurs as early as 6 weeks after birth.

Against the background of hormonal changes menstrual cycle long time may not be restored, which also does not allow a woman to fully control the likelihood of conception. As a result, unwanted pregnancy during breastfeeding is not uncommon.

Making a decision to continue pregnancy immediately after childbirth is not easy. In some cases, a woman is not yet ready for the birth of a second baby, and in others repeated births during this period are contraindicated for health reasons (for example, after caesarean section). This raises the question of having an abortion during breastfeeding. The safest and least traumatic method of abortion in modern gynecology is considered a medical abortion, but can it be performed while breastfeeding? Let's figure it out together with experienced specialists medical center Diana.

Which method of abortion should I choose while breastfeeding?

Many women categorically refuse medical abortion while breastfeeding, due to the risk of penetration pharmacological drugs into breast milk. In this case, the young mother chooses something that is more traumatic and dangerous to her health. surgical technique curettage to continue lactation. However, is such a risk justified? Gynecologists assure that this is not always the case.

The first thing that is important to understand is that medical abortion can be performed during breastfeeding, provided that the child’s feeding pattern is changed. Depending on the drug chosen for pharmacological abortion, the woman will have to stop breastfeeding for a period of 3 days to two weeks. During this time, breast milk should be expressed regularly and the baby should be fed formula. At the same time, of course, there is a risk of the baby further refusing to breastfeed, which is undesirable, because no formula can replace a baby’s mother’s milk.

However, this is not a reason to choose surgical method termination of pregnancy, because contrary to the misconception of many women, in this case you will also have to stop feeding for several days. This is due to the use of anesthetic drugs for surgical abortion. As a result, both methods will require the woman to temporarily interrupt breastfeeding, but medical abortion is accompanied by significantly lower risks for the woman’s body.

New research into the impact of medical abortion on breast milk quality

In any case, it is permissible only under the supervision of a specialist who will first carry out the entire range of necessary diagnostic measures. Moreover, if the patient is breastfeeding at the time of termination of pregnancy, the doctor will recommend a plan for temporarily stopping breastfeeding. It is important to understand that such a measure is only insurance against possible risks, since research into the effect of drugs for medical abortion on the quality of breast milk is still ongoing.

So, quite recently, regular research was carried out by famous world scientists on this topic. The experiment proved that only minimal doses of the drug used for pharmacological interruption pregnancy, can pass into breast milk. Maximum concentration chemical agent in a woman's milk was 1.5%, which is considered a negligible dose that cannot harm the baby.

Doctors conducting this study concluded that it is enough to stop breastfeeding for a period of 4 to 10 hours to completely eliminate the possibility of harmful effects chemicals for medical abortion on the baby's body. However, before completing all stages clinical assessment, these results cannot be considered reliable and final, and therefore you should listen to the feeding cessation plan that the doctor will select.

When contacting a doctor to terminate a pregnancy during breastfeeding, it is very important to inform the specialist about the fact of lactation and recent childbirth. Having knowledge and experience in this field, the doctor will choose the optimal drug and dosage in order to ensure guaranteed safety of the baby and increase the likelihood of continued breastfeeding.

Dear Colleagues!

As early as 6 weeks after birth, 15% of non-breastfeeding and 5% of breastfeeding women experience ovulation. The earliest ovulation was recorded at the 4th week after birth. Only complete exclusive breastfeeding (lactation amenorrhea method - LAM) reduces the likelihood of pregnancy in the first 6 months after birth (assuming no menstruation). The Pearl index in this case is 2 (for comparison: when using condoms it is 14, “mini-pill” is 5). If, after using MLA for 6 months after childbirth, a woman continues to have amenorrhea, and she continues to breastfeed before each complementary feeding, then it is possible to extend MLA to 9-12 months (Pearl index in these cases is 3-6). However, breastfeeding women do not always comply with the requirements of the MLA, which leads to unwanted pregnancy.
An analysis of Internet resources has shown that the issue of termination of pregnancy during lactation is not so rare. Due to the spread of medical abortion a common question is the possibility of continuing breastfeeding against the background of termination of pregnancy by this method. At the same time, there is unanimity in the answers to this question on the sites medical organizations No.

Question from a patient on the forum:

My baby is 10 months old! I want to have a medical abortion. Is it still possible sometimes to break the conditions and breastfeed the baby! How might this affect his health? Thank you in advance!
Answer 1:
When undergoing a medical abortion, breastfeeding should be stopped for 14 days after using Mifegin. We do not have any information about what will happen to the child if this rule is violated. If the rules for using the drug say that breastfeeding should be temporarily avoided, this is probably due to the fact that the drug will have an adverse effect on the child’s health.
Source:http://www.farm-abort.ru/faq/answer.php?id=2173
Answer 2:
When undergoing a medical abortion during lactation, breastfeeding must be abandoned (for at least 3 days).
Source:http://www.iampregnant.ru/question/4882
The “dispersion” of opinions on the part of practicing doctors is due to the fact that the instructions for drugs of different brands indicate different periods recommended for stopping breastfeeding - from 3 to 14 days, which is confirmed by the data of our study, which showed that only 13% of respondents were aware about the peculiarities of the pharmacokinetics of mifepristone and misoprostol in lactating women and the possibility of stopping breastfeeding for only 4-6 hours. Others would advise their patients to stop breastfeeding for 10-14 days. It is interesting to note that 23% of doctors would advise taking a break for 3 days (as indicated in the instructions for miropriston), without taking into account the 7 days of break recommended for the drug misoprostol (Fig. 1).

Rice. 1. The total number of votes received when answering a question posed during an interactive lecture " Recovery period: complications, treatment, prevention" by voting using remote controls in different regions (n=470) (data from G.B. Dicke, 2012)

In this regard, we conducted an analysis of the literature on this issue, the purpose of which was to determine the most optimal tactics when a mother breastfeeds a child during a medical abortion. Below are recommendations from the most authoritative sources.

Scientific researchVogelD. et al. (Switzerland, Germany, 2004):

The aim of the study was to compare the concentrations in milk and blood plasma after a single postpartum administration of 200 mg misoprostol and 250 mg methylergometrine for uterine contractions. It has been shown that the level of misoprostol in mother's milk increases to an average of 3.6 (7.6 ± 2.8) pg\mL within an hour (1.1 ± 0.2) and decreases very quickly, reaching almost zero values after 5 hours - 0.20 pg\mL (Fig. 2), while the half-life was half that of methylergometrine (1.1±0.3 hours; median 0.6 hours versus 2.33±0.3 hours ; median 1.9 hours; P≤.003, respectively). Milk/plasma concentration ratios for misoprostol were 3-fold lower than those for methylergometrine at 1 and 2 hours (P≤0.0001 and P≤0.0015, respectively).

Rice. 2. Concentration of misoprostol acid in milk after taking 200 mcg of misoprostol once orally, pg/ml
Source: Vogel D, Burkhardt T, Rentsch K et al. Misoprostol versus methylergometrine: pharmacokinetics in human milk. American Journal of Obstetrics and Gynecology, 2004, 191:2168-2173
http://www.geburtshilfe.usz.ch/Documents/LehreUndForschung/Publikationen/MisoprostolAJOG.pdf

RecommendationsICMA(UK, 2004):

There is some evidence that mifepristone is excreted in breast milk, but little evidence regarding the effect on adrenal function in infants, suggesting that the amount of mifepristone that enters the baby's body is unlikely to cause harm.
Since misoprostol levels decrease rapidly, it is recommended that misoprostol be taken immediately after feeding and the next feeding resumed after a four-hour break in the case of oral misoprostol and slightly later (6 hours) after vaginal administration.
However, if a woman is concerned that the drugs may be excreted in breast milk, she may not breastfeed for 24 hours after using mifepristone/misoprostol or misoprostol alone.
Literature:

1. Hill NC, Selinger M, Ferguson J et al. The placental transfer of mifepristone during the second trimester and its influence upon maternal and fetal steroid concentrations. British Journal of Obstetrics and Gynecology, 1990, 97:406-411. http://46.4.230.144/web/UpToDate.v19.2/contents/f36/20/37522.htm?/abstract/33&utdPopup=true
2. Vogel D, Burkhardt T, Rentsch K et al. Misoprostol versus methylergometrine: pharmacokinetics in human milk. American Journal of Obstetrics and Gynecology, 2004, 191:2168-2173.

Source: http://icma.org/en/icma/home
WHO recommendations (Geneva, 2007):

Mifepristone may pass into breast milk. When studying the effects of mifepristone on endocrine system the fetus showed an increase in the levels of adrenocorticotropic hormone and cortisol. Clinical significance these changes are not known.
It also passes into breast milk fairly quickly after use. a small amount of misoprostol, however, whether this affects the child’s condition or not is not known. The serum concentration of misoprostol decreases rapidly when taken orally, so it is recommended to take misoprostol orally immediately after breastfeeding, and the next feeding after 4 hours. When administered intravaginally, the serum concentration of misoprostol remains high longer, so feeding should be done after 6 hours or later. Unfortunately, the available data do not allow precise recommendations on the optimal timing of misoprostol administration during breastfeeding.
Source: Frequently Asked Questions About Medical Abortion. Based on the results of the international consensus conference on medical abortion in the first trimester of pregnancy, November 1-5, 2004. Belladio, Italy. - WHO, Geneva, 2007. - 33 p.
http://whqlibdoc.who.int/publications/2007/9241594845_rus.pdf

Misoprostol is rapidly metabolized in the mother's blood into misoprostolic acid, which is biologically active and is excreted in breast milk. There are no published reports of negative effects of misoprostol on infants of mothers taking misoprostol.
Source: Medication Guide by the U.S. Food and Drug Administration.LAB-0061-16.0 RevisedDecember 2010. ReferenceID: 2881258. http://www.accessdata.fda.gov/drugsatfda

Scientific researchSäävI., FialaC.ssoavt. (Sweden, 2010):

The levels of mifepristone in breast milk obtained from 12 women undergoing medical abortion were studied. Milk samples were collected during the first 7 days after administration of either 200 mg (n = 2) or 600 mg (n = 10) mifepristone. In addition, serum samples were collected on day 3 (n = 4). Mifepristone levels were determined by radioimmunoassay. The highest concentrations of mifepristone were found in the first sample within the first 12 hours after dosing, and ranged from undetectable (<0,013 мкмоль/л) до 0,913 мкмоль/л. После этого, отмечалось снижение концентрации мифепристона до неопределяемых значений в течение 7 дней. Самый низкий уровень мифепристона в молоке был получен после приема дозы 200 мг. Соотношение концентраций молоко:сыворотка колебалось от <0,013:1 до 0,042:1 на 3 день (n = 4). Расчетная относительная доза для ребенка (RID) составила 1,5 % на самом высоком уровне. Выводы: уровни мифепристона, определяемые в молоке, являются низкими, особенно при использовании дозы 200 мг. Грудное вскармливание может быть безопасно продолжено без перерывов во время медикаментозного аборта.

Pregnancy during breastfeeding is quite common. Every woman should soberly assess the situation and try to minimize the risk not only for her own body, but also for the baby. Any medical or surgical intervention naturally affects the quality and quantity of mother's milk. Abortion during breastfeeding is a complex procedure that must be approached with all responsibility. Is it possible to breastfeed a child after an abortion?

During the period of breastfeeding, a woman returns to her normal sex life. There are often cases when an unwanted pregnancy occurs during this period. A woman is faced with a serious problem: what to do if she cannot raise two children or has health problems?

According to medical research, the first ovulation can occur as early as 6 weeks after birth. Moreover, the likelihood is higher in women who do not breastfeed. However, science knows of cases where ovulation in nursing mothers occurred already 4 weeks after birth. It is believed that the period for 6 months after birth with full breastfeeding and no menstruation is safe from the point of view of unwanted pregnancy. Moreover, even the lactational amenorrhea method is only 98% effective.

Types of termination of pregnancy

Today, termination of pregnancy is carried out in two main ways:

Surgical or instrumental method performed under general anesthesia. It consists of two main procedures: expansion and curettage. Average duration is about 40 minutes.
Vacuum or mini abortion. A gentler and faster procedure when breastfeeding. Duration about 10 minutes. The interruption occurs using special equipment - a vacuum apparatus.
Medications. A non-contact method based on the chemical action of certain substances. Medical abortion is the most gentle method of terminating an unwanted pregnancy. It is carried out in the early stages (up to 49 days) with the use of certain pharmaceuticals. The principle of such an interruption is as follows: the woman drinks a certain amount of medicine in the presence of a doctor, then the procedure is repeated after 48 hours, and then after another 3 hours. An ultrasound should be performed no more than 2 weeks later to prevent the development of complications. The abortifacient substance is mifeprex, or mifegin. You can find another name - RU 486. It is used as the main substance. In the final stage, misoprostol is used, which permanently terminates the pregnancy. During breastfeeding, a woman takes medications based on the same active chemicals.

In the first two cases, no effects on the quality of mother's milk are observed. However, contact methods have dire consequences for the female body. Often, surgical interventions lead to impaired reproductive function. Therefore, medical termination of pregnancy is considered the most gentle. Due to the fact that a woman takes certain medications, there is a risk of impairing the suitability of mother's milk. And yet, following a certain scheme, medical abortion during breastfeeding is quite possible.

Doctor about types of abortion: video

Feeding scheme

Instructions for use of drugs contain detailed information and recommendations. When using the medicine, you should refrain from breastfeeding for a period of 3 to 14 days. Most often the break is 2 weeks. After such a break, in most cases, lactation ceases.

In this case, the baby is transferred to artificial formula. When using a drug such as gemeprost, the active substance is eliminated from the body within 24 hours. Thus, it is absolutely safe for the baby’s health to resume feeding within a day after the procedure.

In the case of an instrumental method of abortion during breastfeeding, lactation can be resumed immediately after the anesthesia has stopped. However, in rare cases it is still necessary to take a short break. It all depends on the type of anesthesia with which the anesthesia was administered.

With a vacuum abortion, otherwise called a mini-abortion, there is no need to interrupt feeding.

Scientific research

An interesting fact is that the results of experiments conducted by world experts showed a very low concentration of active substances in human milk during medical abortion. The maximum content at the highest concentration is 1.5%.

A number of other European medical figures, after conducting large-scale research, came to a similar conclusion. They recommend interrupting feeding for 4 hours immediately after using the drug. Thus, drug research is not yet completed. And you should follow the recommendations of pharmaceutical manufacturers.

Consequences

The most negative consequences of medical abortion are not on the baby, but on the female body. The main problem is that the woman has not yet fully strengthened and recovered from childbirth. And any invasion in any case will have consequences, at least moral ones. It is extremely important to keep them to a minimum:

If you need to terminate your pregnancy, do not allow yourself doubts or regrets. Of course, this is a severe injury, but you have to think about the baby in your arms. Your depressive state will certainly affect your child’s emotional state. The nursing female body transmits all the information to the baby.
Depending on the individual, digestive system disorders (vomiting, nausea, diarrhea, stomach cramps and colic), as well as headaches, may occur.
Often, abortion is accompanied by strong contractions of the uterus, which are quite painful. Contractions may continue for some time after the procedure. In some cases, bleeding is observed. It should be noted that isolated cases of uterine rupture have been recorded.

Doctor about the consequences and contraindications of abortion: video

Be responsible!

Breastfeeding is an extremely important period for the baby's health. A woman must strictly monitor her diet. Any medications can have dire consequences. Therefore, in the case of a medical abortion, it is impossible to do without the strict presence of a medical specialist.

First, the doctor must find out whether this method of terminating a pregnancy during breastfeeding is suitable for your body.
Secondly, it is in the presence of a doctor that the active medication is used. And, naturally, minimal consequences can only occur if the rules of the recovery period are observed.

Whatever method of termination of pregnancy you choose, remember the need to prepare for a break from breastfeeding. So, before going for an instrumental abortion, express a sufficient amount of milk, which will feed the baby during your absence. When undergoing a medical abortion, consult with your doctor about which medications will be used to terminate the abortion, and after what time you can resume breastfeeding without endangering the baby’s health.