Medication Abortion

How Does Medication Abortion Work?
There are three steps. The First, your doctor will give you a dose of mifepristone (prescription drug) in tablet form. The Second step, you will take another medication called misoprostol in tablet form. The Third, you will return to your clinician for a follow-up visit.
Step One
Mifepristone- blocks the hormone proesterone. Without progresterone, the lining of the uterus breaks down, ending the pregnancy.
Step Two
Misoprostol- causes the uterus to contract and empty.
Step Three
Follow-up. Your clinician needs to make sure the abortion is complete. You will need an ultrasound or a blood test.

How Long Does it Take?
About 10 percent of women will have the abortion before they take misoprostol (the second medication). Most others will have it within four hours of taking misoprostol. For others, bleeding begins in 24 hours. The whole process can take about a week. It's important to remember that choosing medication abortion means that you will need to visit your clinician's office more than one time.

How Effective is it?
Medication abortion is from 92-95 percent effective. Misoprostol can cause serious birth defects. If the medication abortion does not work, a surgical abortion must be done.

What Do I Need To Do To Have a Medication Abortion?
During the first visit, you will need to:

• Have counseling
• Sign a consent form
• Give a medical history
• Have laboratory tests
• Have a physical exam - including an ultrasound

You will take the first medication at the clinic. You and your clinician will plan the next step according to what is best for you. You will probably take the second medication at home. After you take misoprostol, you will start to bleed heavily within hours or days. This is the abortion.

How Does it Feel?
For most women, medication abortion is like an early miscarriage. You might:
Feel strong cramps
Feel nauseous or vomit

Acetaminophen -- such as Tylenol® or Excedrin® -- can reduce most of these symptoms. Painkillers such as ibuprofen, (found in over the counter brands such as Motrin® or Advil®) can also reduce symptoms. You may see large blood clots or pieces of tissue at the time of the abortion. You may have some continued bleeding or spotting for up to four weeks after.

Call a clinician if you:

• Soak more than two maxi pads an hour, more than two hours in a row.
• Bleed heavily for more than 12 hours in a row.
• Pass clots larger than lemons for two hours or more.
• Run a temperature over 101.4°F for more than four hours.
• Feel strong nausea or throw up for more than four hours.
• Are in pain, even with painkillers
• Have an allergic reaction to the medicine.
• You may need a clinic visit. Rarely, women need surgical abortion or hospitalization.

Why Do some Women Prefer Medication Abortion?
No anesthesia or surgery.
Can be done early (as soon as pregnancy is known).
Less cramping than with surgery.
More control.
More "natural". (More like a miscarriage).
More privacy. (May have the abortion at home).

Who Can Choose Medication Abortion?
We can provide medication abortion if you are up to eight weeks pregnant. But you must agree to have a surgical abortion if the medical treatment fails. You also need access to a telephone, transportation, and backup medical care.
Medication abortion is not recommended if you:

• Are more than eight weeks pregnant
• Take anti-clotting medication or have blood-clotting disorders
• Have severe heart, liver, or kidney problems
• Have seizures more than once a week
• Take any medicine that should not be combined with mifepristone, or misoprostol
• Cannot return for follow-up visits
• Are unwilling or unable to have a surgical abortion if the medical abortion is incomplete
• Have an allergy to the medications

Will I need to Prepare for the Follow-up?
Yes. After you take the medicine and before your follow-up exam:
Do not take aspirin.
Do not drink alcoholic drinks.
Do not take anti-coagulant (anti-clotting) drugs.

What if I'm Still Pregnant after Taking the Medication?
Your clinician will help you decide. You may:
Wait two to six weeks and check again
Take more misoprostol
Need a surgical abortion

When Will I get my Period?
Abortion begins a new menstrual cycle. You should have a regular period in four to eight weeks.

When Can I Have Sex Again?
Don't have vaginal intercourse or insert anything into the vagina for one week after the abortion. You can get pregnant very soon after the abortion. Discuss birth control options with your clinician.