Two drugs are used to end an early pregnancy. Early pregnancy means a pregnancy that is ten weeks (70 days) or less since a woman’s last menstrual period began. [i]
The first drug (Mifepristone) blocks a hormone (progesterone) that is needed for pregnancy to continue. The second drug (Misoprostol) causes the uterus to contract. After using both drugs, the pregnancy is usually ended.
What You Must Do
Medical abortion requires more than one visit to your doctor. On the first visit, the doctor determines the length of your pregnancy. Before you can start the abortion process, you must read a special medication guide and discuss the benefits and risks of the first drug.
If you choose medical abortion, then you must sign a consent form saying that you understand the risks. At this first visit, you will be given the first drug to start your medical abortion.
You will be given the second drug to start contractions one or two days later. These tablets may be taken one of two ways: either put into your vagina, or put in your mouth between your cheek and gum. They may be taken at home or at the doctor’s office. Vaginal bleeding and uterine cramps are a normal part of this abortion procedure and occurs in almost all patients. You may also have nausea, vomiting, and diarrhea. Your doctor may give you additional medicine for these symptoms.
Your doctor will decide when you should return for your follow-up visit, usually in one to two weeks. The follow-up visit is important. Your doctor will check to see if your pregnancy has completely ended. If you are still pregnant, a surgical procedure may be necessary.
How Effective Is It?
For every 100 women having medical abortion using this method, 97 have completed abortions.[ii]
Who Should Not Use Medical Abortion drugs?
Do not start taking these drugs if you cannot return to your doctor for the follow-up visit. Do not take these drugs if you have:
- a confirmed or suspected pregnancy outside of the uterus (a tubal pregnancy);
- an undiagnosed mass in your lower abdomen;
- an IUD in place (must be removed before procedure);
- problems with your adrenal glands;
- current use of medicine to thin your blood;
- history of allergy to mifepristone or misoprostol or medicines that contain them;
- bleeding disorders or current treatment
- porphyrias (a rare inherited blood disorder)
Do not take these drugs from any doctor who is not a qualified dispenser of mifepristone. Under Federal law, mifepristone can only be provided by a doctor who has:
the ability to assess the duration of pregnancy accurately;
the ability to diagnose a pregnancy outside of the uterus;
the ability to provide surgical intervention in cases of severe bleeding or incomplete abortion, or have made plans to provide such care through others, and are able to assure patient access to medical facilities equipped to provide blood transfusions and resuscitation, if necessary.
Risks Associated With Medical Abortion
There are some risks and problems that can occur with medical abortion. Not all risks may apply to you. Talk with your doctor about what risks apply to you.
Vaginal bleeding and uterine cramping will occur in almost all patients. In some cases, bleeding can be very heavy. Most women feel that medical abortion is like a heavy, crampy period. You should expect bleeding or spotting for an average of nine to 16 days. Some women have bleeding for 30 days or more. In some cases, too much bleeding may require blood transfusions, treatment with medication, or surgery. Other risks related to medical abortion include infection, incomplete abortion, as well as need for emergency medical treatment. Common side effects include nausea, vomiting and diarrhea.
It is important to get medical care if you have more than the usual side effects and in the event of an emergency. Talk to your doctor about possible problems. Be sure to get your doctor’s phone number in case you have questions or need emergency care.
It is rare, but some women may have feelings of sadness, guilt, anger, trouble sleeping or doing daily activities after their abortion. These symptoms can also occur after the birth of a baby or after a miscarriage. Call your doctor or local community mental health, health department, or human services office for help if you have any of these symptoms that are strong or lasting.
As with any medical procedure, death is a risk. Death related to abortion occurs in less than one of every 100,000 abortions. [iii]
Risks and Complications associated with Pregnancy and Delivery
Most pregnancies are normal. Most women who have good care during pregnancy and delivery will give birth to a baby without problems. However, some women may have health conditions or pregnancy problems that may require special care or hospitalization during pregnancy. Just as there are risks with abortion, there are risks with continuing a pregnancy to full term.
Some of the pregnancy problems that may lead to hospitalization include a pregnancy growing outside uterus (tubal pregnancy), miscarriage, excessive vomiting during pregnancy, urinary tract infection, heavy bleeding or infection, diabetes, preeclampsia and eclampsia (causing swelling, high blood pressure and possible seizures), blood clots, premature labor, death of the fetus, newborn or maternal death.
Maternal death occurs approximately 17 times out of every 100,000 live births in the U.S.[iv]
Many services may be available to you if you choose to continue your pregnancy. You can contact your local health department, the Michigan Department of Health and Human Services, or your local county Department of Human Services to learn about help in your community.
If you would like information about adoption, contact your county Department of Human Services or a private adoption agency.
i FDA Approved Mifepristone Regimen March 30, 2016
ii Mifeprex (mifepristone) Prescribing information
iii M. Paul, E.S. Lichtenberg, L. Borgatta, D.A. Grimes, P.G. Stubblefield, M.D. Creinin; Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Wiley‐Blackwell, 2009, p. 225.
iv CDC Pregnancy Mortality Surveillance System, December 2016 https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pmss.html