Medication Abortion

If you are considering medication abortion, watch this short video.

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What Is the Abortion Pill?

The abortion pill is a medicine that ends an early pregnancy. In general, it can be used up to 63 days after the first day of a woman's last period.

The name for "the abortion pill" is mifepristone. It was called RU-486 when it was being developed.

How Effective Is the Abortion Pill?

You can feel confident in knowing that medication abortion with the abortion pill is very effective. It works about 97 out of every 100 times. You'll follow up with your health care provider after your abortion so you can be sure that it worked and that you are well.

Some of the medicines used in medication abortion may cause serious birth defects if the pregnancy continues. So, in the unlikely case that it doesn't work, you will need to have an aspiration abortion to end the pregnancy.

What Happens During a Medication Abortion?

It's common for women to be nervous about having a medication abortion — or any other medical procedure. But many of us feel better if we know what to expect. Your health care provider will talk with you and answer your questions. Here's a general idea of how it works and what to expect.

Before taking the abortion pill, you will need to

• discuss your options
• talk about your medical history
• have laboratory tests
• have a physical exam. This usually includes an ultrasound.
• read and sign papers

You will also be given a medication guide, instructions, and other information to take home with you, including a 24-hour-a-day, seven days a week telephone number you can call if you have any questions or concerns.

Medication abortion is a process that begins immediately after taking the abortion pill.

There are three steps:

STEP ONE — Mifepristone — The Abortion Pill

Your health care provider will give you the abortion pill at the clinic. You will also be given some antibiotics to start taking after the abortion pill.

The abortion pill works by blocking the hormone progesterone. Without progesterone, the lining of the uterus breaks down, and pregnancy cannot continue.

STEP TWO — Misoprostol

You will take a second medicine — misoprostol. It causes the uterus to empty.

You and your health care provider will plan the timing and place for the second step. You'll take the second medicine up to three days after taking the abortion pill. Your health care provider will give you instructions on how and when to take the second medicine.

The second medicine — misoprostol — will cause you to have cramps and bleed heavily. Some women may begin bleeding before taking the second medicine. But for most, the bleeding and cramping begin after taking it. It usually lasts a few hours. You may see large blood clots or tissue at the time of the abortion.

More than half of women abort within four or five hours after taking the second medicine. For others, it takes longer. But most women abort within a few days.

It's normal to have some bleeding or spotting for up to four weeks after the abortion. You may use pads or tampons. But using pads makes it easier to keep track of your bleeding.

STEP THREE — Follow-Up

You will need to follow up within two weeks. Follow-up is important to make sure your abortion is complete and that you are well. You will need an ultrasound or blood test.

In the unlikely event that you are still pregnant, your health care provider will discuss your options with you. It's likely you will need to have an aspiration abortion if the medication abortion did not end the pregnancy.

How Safe Is the Abortion Pill?

Most women can have a medication abortion safely. But all medical procedures have some risks, so safety is a concern.

Rare, but possible risks include

• an allergic reaction to either of the pills
• incomplete abortion — part of the pregnancy is left inside the uterus
• infection
• undetected ectopic pregnancy
• very heavy bleeding

Most often, these complications are simple to treat with medicine or other treatments.

In extremely rare cases, very serious complications may be fatal. The risk of death from medication abortion is much less than from a full-term pregnancy or childbirth.

Serious complications may have warning signs. Call your health care provider right away if at any time you have

• heavy bleeding from your vagina and are soaking through more than two maxi pads an hour, for two hours or more in a row
• clots for two hours or more that are larger than a lemon
• abdominal pain or discomfort that is not helped by medication, rest, a hot water bottle, or a heating pad
• a fever of 100.4°F or higher that lasts for more than four hours
• vomiting for more than four to six hours and you are not able to keep anything down
• an unpleasant smelling discharge from your vagina
• signs that you are still pregnant

You should start to feel better each day after the abortion. Feeling sick — having abdominal discomfort, diarrhea, nausea, vomiting, or weakness — more than 24 hours after taking misoprostol could be a sign of serious infection. Contact your health care provider right away if you have any of these symptoms. Do not wait until your scheduled follow-up.

You may need another visit with your provider. Rarely, women need vacuum aspiration or hospitalization. Take your medication guide with you if you need to visit an emergency room, a hospital, or a health care provider.

Why Do Women Choose the Abortion Pill?

• It can be done early — women can begin treatment as soon as they know they are pregnant.
• It's private — women may complete the process of abortion at home.
• There's usually no anesthesia.
• Many women feel it's more "natural" — they feel it is more like miscarriage.
• Women may feel more in control — many feel it is less invasive.

Nearly all women who have used the abortion pill would recommend the method to a friend.

What Can I Expect After Using the Abortion Pill?

Your health care provider will let you know what to do and what not to do after your abortion. Many of us feel shy about asking questions, but your provider is there to help you. Feel free to get answers to all of your questions. You might even find it helpful to make a list before you see your health care provider so you remember the questions you want to ask.

Your Emotional State After a Medication Abortion:

You may have a wide range of feelings after an abortion. Most women ultimately feel relief. Some women feel anger, regret, guilt, or sadness for a little while. Sudden shifts in hormones may make these feelings stronger.

Serious, long-term emotional problems after abortion are about as uncommon as they are after giving birth. You may be more likely to have emotional problems after abortion for certain reasons. Some of these reasons are

• having a history of emotional problems before your abortion
• having important people in your life who aren't supportive of your decision to have an abortion
• having to terminate a wanted pregnancy because your health or the health of your fetus is in danger

If you want to talk with someone after an abortion, abortion providers can talk with you or refer you to a licensed counselor or to nonjudgmental support groups.

Getting Your Period After a Medication Abortion:

Abortion begins a new menstrual cycle. You should have a regular period in 4 to 8 weeks.

Sex and Birth Control After a Medication Abortion:

Many health care providers recommend that you not have vaginal intercourse or insert anything except a tampon into your vagina for one week after the abortion.

You can get pregnant very soon after an abortion. So, birth control is an important and common concern for many women after abortion. Talk with your health care provider about getting a birth control method that's best for you.