What is the Medical Abortion?

The Medical Abortion (also called the "Abortion Pill" or Non-Surgical Abortion) uses two medications, Mifepristone and Misoprostol, to end a pregnancy. These medications cause changes in the lining of the uterus and cause muscle contractions that expel the pregnancy tissue. Patients will have bleeding and cramping (sometimes heavy bleeding with sever cramping) like those that occur during an early miscarriage. Some patients may also experience nausea, vomiting, diarrhea, headaches, dizziness and fever, these side effects are not common for all patients and do not last long.

The Medical Abortion is recommended for early pregnancies only. It can be done as soon as the pregnancy is confirmed up to 49 days by ultrasound. The Medical Abortion does not work on pregnancies over 49 days or ectopic pregnancies. The Medical Abortion involves several steps and requires at least two office visits. The Medical Abortion is about 95% to 97% effective. For the percentage of patients in which abortion does not occur or is incomplete, a Surgical Abortion process is required to complete the process. Failure to expel all tissue can lead to problems and even death to the patient if an infection develops.

What happens on the first day for the Medical Abortion?

When the patient comes in for the first visit, a transvaginal ultrasound (A transducer with a sterile sheath is inserted vaginally) will be done in order to visually see the pregnancy. Once the gestation of the pregnancy has been determined to be less than 49 days the patient will be given paperwork. When the patient has completed the paperwork she will be brought to the laboratory for a check of vital signs and some basic blood work. The patient's blood type will be tested to see if they are RH-Negative. Any patient who is RH-Negative will be charged and additional fee for a Rhogam shot. Next the patient will be called up for payment, all payment is expected in full prior to the procedure. The patient will then be counseled about their medical history and given information about the procedure. Once counseling is complete the patient will be ready to see the Doctor. The Doctor will perform a pelvic exam, similar to the one dome for your annual exam, and then will administer the Mifepristone to the patient. Once the patient has taken this medication they must continue with the second part of medications to complete the procedure. Failure to do so could cause serious birth defects to the fetus. After the first pill has been taken the patient can experience some bleeding, cramping, nausea or diarrhea. The patient will be advised prior to leaving how to take the Misoprostol at home and what to expect. The patient should call the center if they have any concerns.

What happens two days later when the pills are taken at home?

The patient will be given several Misoprostol pills to take at home at a designated time. The center will have provided you with instructions, both verbal and in writing, of how to take these pills and when. The abortion process can occur at any time once you have ingested this second set of pills. Some patients have begun bleeding and cramping as early as four (4) hours after taking the Misoprostol pills, and for some patients the process has taken as long forty-eight (48) after taking the Misoprostol pills. Vaginal bleeding and uterine cramping are and expected part of the procedure. Some patients may want to use pain relievers, such as Ibuprofen, to help reduce some of the discomfort from the cramping. Misoprostol may also cause nausea, vomiting, and diarrhea in some patients. Anti-nausea medications can be used to help reduce these side effects.

What happens at the two week follow-up exam?

Two weeks later the patient is required to return for a follow-up exam to make sure that the procedure was successful and there is no evidence of retained tissue or blood. Upon coming back to the center the patient will give a urine sample. The patient will them be given another transvaginal ultrasound and will have another pelvic exam done. At this time it will be determined if the procedure was successful or if a surgical procedure is needed. The surgical procedure involves a quick cleaning of the uterus by suction (Dilation and Curettage) and can usually be done the same day. This surgical procedure cleaning will be done at no extra cost to the patient.

What can be expected after the Medical Abortion is complete?

Most patients can expect to get their first period 4-8 weeks after the completion of the Medical Abortion. Before that time the body is very fertile and ovulation is likely to occur within the first two or three weeks after the abortion. For this reason we encourage patients to use some form of birth control including a back up method such as condoms and spermicide. If a patient would like to get birth control with a physician at our facility we encourage them to make an appointment for an annual exam and pap smear.