Pharmacological inhibition of lactation after 16 to 20 week abortion: A randomized controlled trial
Awarded 2023
Uta Landy Complex Family Planning Scholars
Erin Fleurant, MD
Northwestern University

Approximately 10% of all terminations, whether elective or for fetal/maternal indications, take place in the second trimester of pregnancy. In situations after 16 weeks gestational age, post-procedure maternal lactation may occur, which is not only emotionally distressing to patients grieving a pregnancy loss, but also physically uncomfortable with painful breast engorgement as milk is produced. The American College of Obstetricians and Gynecologists state that management of lactation suppression with cabergoline, secondary to dopaminergic and prolactin inhibiting features, can be considered after term pregnancies and in select populations that choose or are unable to breastfeed (eg, transgender or HIV positive patients). However, this organization does not comment on pregnancies terminated in the second trimester. Recent research from the Society of Family Planning and Stanford (Henkel et al 2023) demonstrate improvement in breast symptoms with cabergoline after 18 weeks gestational age. However, this study had just 73 participants, with only 10 receiving cabergoline below 20 weeks gestation. The goal of this project would be to identify effectiveness of cabergoline at an earlier gestational age. We plan to conduct a randomized control trial to determine if administration of oral cabergoline for lactation inhibition after second trimester abortion decreased post procedural pain related to breast engorgement. Our expected population is pregnant individuals with gestational age ranges from 16w0d to 19w6d on the day of consent with a goal of 200 participants.