Medication Abortion

Medication abortion provides people with a method of ending an early pregnancy that does not involve a procedure. Medication abortion involves 2 different medications and takes 1-3 days from start to end depending on the timing of medications.
The first pill in this process is known as Mifepristone. Mifepristone blocks the hormone progesterone, and results in the pregnancy detaching from the uterus.

After swallowing mifepristone, 4 misoprostol tablets are inserted into the cheeks (buccally) or into the vagina (vaginally) and left to dissolve. Misoprostol causes the uterus to contract and the cervix to open, expelling the pregnancy. In most cases, the abortion is completed within 24 hours of taking the misoprostol. Both vaginal and buccal administration of misoprostol are medically safe, and the route you take misoprostol by may vary depending on the gestational age of your pregnancy, location you are traveling from, and personal preference. If you have questions or concerns about what this means for your care, please call our office prior to your appointment.

Medication abortion induces what happens during a miscarriage. A miscarriage is also referred to as a spontaneous abortion.

During a medication abortion, it is common to experience bleeding, cramping/pain, and feeling sick. These symptoms usually start after taking misoprostol.

Bleeding can vary from person to person and may be moderate to heavy. Many people say this feels like a heavy menstrual period. Alongside bleeding, it is normal to pass clots of varying sizes. Bleeding is considered normal so long as it does not exceed 2 menstrual pads per hour, for more 2 or more hours.

Cramping occurs when the uterus contracts. Cramping can vary from moderate to severe. You can take pain medications as prescribed for your medication abortion. You can also use a heating pad, take a shower or hot bath, or have someone give you a backrub to help. In general, whatever you do for your normal menstrual cramps you can do to relieve cramping during this process.

It is normal to feel sick during a medication abortion. Nausea, vomiting, diarrhea, headache, backache, and fatigue are all normal side-effects. A slight fever or chills are also normal during this time. These symptoms should begin to improve by 24 hours after taking misoprostol.

Risks associated with medication abortion are similar to the risks associated with an in-clinic abortion procedure. For most people, a medication abortion is just as safe as an abortion procedure.

These risks include:

• Failed or incomplete abortion
• Hemorrhage (too much bleeding)
• Infection

Risk of hemorrhage or infection occur in less than 1% of people (fewer than 1 out of every 100) having medication abortions, with risks for serious infection occurring even less frequently. Serious infection or hemorrhage can have negative health impacts if left untreated. For this reason, Hope Clinic provides all patients with access to a 24-hour emergency line for concerns, as well as detailed guidelines for reasons to call us or seek immediate medical attention. This line is available on our instruction sheet.

Risks of incomplete or failed abortion vary depending on length of pregnancy and timing of misoprostol, but are generally considered to occur in 2-9 out of every 100 people (2%-9%) undergoing a medication abortion. In some cases, an incomplete passage of pregnancy tissue requires an in-clinic abortion procedure, also known as a dilation and curettage procedure, or D&C.

If you feel you may change your mind after taking mifepristone, do not take it. There is no evidence that a medication abortion can be successfully “reversed” once started.

It is possible for the medication abortion to fail. The recommended treatment for a failed medication abortion involves terminating the pregnancy through additional medications, or an in-clinic abortion procedure. Treatment options may depend on the gestational age of the pregnancy, your provider’s medical opinion, and your personal preferences.

The following is information from the medication manufacturer available in multiple languages.

English Materials:

• Patient Agreement Form
• Is Medication Abortion Right for You?
• Medication Guide
• What to Expect

Spanish Materials:

• Patient Agreement Form
• Is Medication Abortion Right for You?
• Medication Guide
• What to Expect

Chinese Materials:

• Patient Agreement Form
• Is Medication Abortion Right for You?
• Medication Guide
• What to Expect

Vietnamese Materials:

• Patient Agreement Form
• Is Medication Abortion Right for You?
• Medication Guide
• What to Expect