Abortion By Pill

What is Medical Abortion?

In very early pregnancy, some women may choose medical abortion which is a non-invasive, non-surgical abortion option. Not every early pregnant patient is a candidate for these procedures and we have very strict criteria for choosing those patients who are offered these options. It is extremely important for women choosing medical abortion to come back within two weeks for follow up care.

There are two drugs that can be used to terminate an early pregnancy: Methotrexate or Mifeprestone (known in Europe as RU-486). Both drugs are used to end a pregnancy and then are followed by Cytotec which is a drug used to help the body expel the pregnancy material.

Mifeprestone ends a pregnancy by blocking the hormone progesterone in the pregnant woman. Without this hormone the uterine lining breaks down, the cervix softens and opens, and bleeding begins.

Methotrexate causes the cells of the developing pregnancy to stop dividing therefore disrupting the implantation process that is taking place in the weeks after pregnancy begins. Methotrexate is preferred to Mifeprestone if an ectopic pregnancy (a pregnancy located outside of the uterus) is suspected.

How long does a Medical Abortion take?

The length of time it will take to have a medical abortion will depend several factors:

• A medical abortion can take up to 3-4 weeks to complete
• Mifeprestone will usually work faster to cause an abortion than Methotrexate.
• Most women who take Mifeprestone will abort within 4 hours of taking the second drug Cytotec. About 95% will abort within a week of taking Cytotec.
• Of the women taking Methotrexate, about 80-85% of women will abort within two weeks..
• It is common to need a second dose of Cytotec to induce a complete abortion.
• Between 5% and 10% of women who attempt a medical abortion will need to return for D&C to complete the procedure. This means between 1 in 10 and 1 in 20 women will need to complete a medical abortion surgically.

What to expect:

A woman who is having a medical abortion should expect to experience heavy bleeding accompanied by cramping. The bleeding and cramping can range in severity from resembling normal menstrual bleeding and cramping to passing blood clots and substantial discomfort. Other common side effects are: headache, nausea, vomiting, diarrhea, fever, chills, or fatigue. After a woman completes the abortion, she can expect to bleed or spot for up to 3 more weeks.

When will I menstruate again?

Women who use medical abortions generally menstruate again within 4 to 6 weeks of their abortion. However, prolonged bleeding after an abortion may make a period indistinguishable from the post abortion bleeding and spotting. Some women also experience a longer or heavier period the first time the menstruate after their medical abortion.

Follow Up:

Medical abortion requires one or more follow-up visits to the clinic. This return visit is very important to be sure that the abortion has been completed. In addition, a woman should contact our clinic about any problems or concerns she has during the medical abortion.