A patient takes an abortion pill. Bleeding follows. She assumes the medication has worked. But what if the pregnancy is ectopic? What if the abortion is incomplete? What if the patient was never assessed before taking the medication?

These are not theoretical concerns. Dr. Komal Chavan described seeing patients repeatedly present after consuming abortion pills over the counter, sometimes with incomplete abortion and, in some cases, serious complications requiring admission. The gap, she said, was not necessarily the medication itself but the absence of assessment before it was taken.

"Just taking the pill is not just the abortion."

That distinction shaped the discussion between Dr. Komal Chavan and Dr. Archana Baser. Abortion pills have made reproductive choices easier for women, but the medication cannot be treated like an ordinary pill or a contraceptive.

The assessment comes first

Dr. Chavan emphasized that every patient needs to be assessed for eligibility before taking an abortion pill. Counselling is equally important because the experience can vary, and patients need to understand the effects and possible side effects of the medication. Follow-up, too, cannot be overlooked. "It is not like a single-day procedure."

Patients need to know what to expect, recognize warning signs or serious complications, and have access to emergency care if required. As Dr. Baser highlighted during the discussion, establishing whether the pregnancy is intrauterine or extrauterine is an important part of this assessment.

When bleeding creates false reassurance

One of the more striking concerns discussed was how patients interpret bleeding after taking the medication. A patient may see bleeding and assume that "something has worked," without understanding that too little bleeding may indicate an incomplete abortion, while excessive bleeding can be a warning sign.

And the consequences of bypassing assessment can extend far beyond the initial episode. Dr. Chavan described patients requiring repeated blood transfusions, developing infection or sepsis, or having retained products. "MTP is supposed to be a very simple and a safe procedure. And let's not complicate it by...bypassing certain things."