Medication Abortion FAQ’s
Frequently asked questions about medication abortion (click to reveal answer):
A medication abortion ends pregnancy by using two different types of medication: mifepristone and misoprostol. It is like an induced miscarriage. Medication abortions are available at Women’s Health Clinic for people who are up to 9 weeks pregnant.
Step 1: After a health care provider determines that a medication abortion is safe and appropriate, a pregnant person will swallow one tablet of mifepristone, as prescribed. This blocks the hormone progesterone, a hormone needed to continue pregnancy. It makes the uterus contract, softens the cervix, and may cause bleeding. For a very small percentage of people, the pregnancy is passed at this stage.
Step 2: The health care provider will give the pregnant person a pack of 4 pills called misoprostol. It is important to keep these pills in a dark, dry, and cool place. After 24-48 hours of taking one tablet of mifepristone, the client will place 2 tablets of misoprostol into each cheek (4 tablets total). They will leave the pills in their cheeks for 30 minutes. After 30 minutes, any pills remaining in the mouth need to be swallowed. Some people experience nausea, chills, vomiting, fever, and diarrhea as side effects of misoprostol. If any of these last longer than 24 hours after taking misoprostol, call the Emergency On-Call number you were given at your appointment or proceed to the nearest emergency room.
Step 3: After taking the medication, cramps and bleeding will begin. The pregnancy is usually expelled between 30 minutes and 4 hours after taking the 4 pills of misoprostol. Expect heavy bleeding (usually heavier than a period), severe cramps, and passing clots. Some clots may be as big as a lemon. Cramps and bleeding will intensify as the pregnancy is being passed. After the pregnancy has passed, you can expect to feel a lot better. If you saturate 4 large pads in 2 hours, call the emergency number you were given at your appointment or proceed to the nearest emergency room. This might be too much bleeding.
Step 4: In the days following, the bleeding should slow down and the cramps should go away. If you are feeling feverish, sick, or if the bleeding continues or worsens, call the Emergency On-Call number you were given at your appointment or proceed to the nearest emergency room.
For some people, it is not safe to take the medications needed to have a medication abortion. If you have the following health concerns, a medication abortion is not a safe option for you:
- you are unable to access emergency medical care
- you have a known or suspected ectopic pregnancy
- you have a known or suspected bleeding disorder
- you are taking drugs that prevent or treat blood clots
- you suffer from a severe disease where it is necessary to take steroids (ie. asthma uncontrolled by treatment)
- you are taking medicines such as prednisone or cortisone, which reduce the activity of your immune system
- you have adrenal failure
- you have an allergy to either mifepristone and/or misoprostol or prostaglandins
- you have an IUD in place – this must be removed before the termination of the pregnancy process is started
- you have a pelvic infection
If you are currently breastfeeding, it is safe to have a medication abortion. However, breastfeeding after misoprostol may cause diarrhea in infants within 24 hours.
A medication abortion is usually completed within 48 hours. The pregnancy is usually passed between 30 minutes and 4 hours after taking the 2nd medication, misoprostol. Light bleeding may continue for up to 4 weeks.
You will need to take the 2nd set of pills (misoprostol) 24-48 hours after taking the 1st pill (mifepristone). The range gives you some choice for when you will have the heaviest cramps and bleeding. It is important to consider where and when you might take misoprostol for privacy and comfort, if those are of concern to you.
Yes. It is important to place the pills inside of your mouth, between your gums and cheek. Do not put these pills under your tongue or suck on them in the middle of your mouth.
People have a range of pain from moderate to severe period cramps and bleeding from moderate to a very heavy period. It is important to use large maxi pads when you take the medications. You can use a hot water bottle or heating pad, or take ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) to manage discomfort. Do not take ASA (Aspirin®) for pain – it may increase bleeding.
If you saturate more than 2 maxi pads per hour for more than 2 hours in a row, please call the Emergency On-Call number that was provided to you at your appointment or proceed to the emergency room.
You can use a hot water bottle or heating pad, or take ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) to manage discomfort. Do not take ASA (Aspirin®) for pain – it may increase bleeding.
Complications of medication abortion are very rare. They can include:
- Excessive bleeding – if you soak 4 large maxi pads within 2 hours, call the Emergency On-Call number you were given at your appointment or proceed to the nearest emergency room.
- Infection – if you experience fever or chills for more than 4 hours after taking the second set of pills or if fever or chills start more than 24 hours after taking misoprostol, call the Emergency On-Call number you were given at your appointment or proceed to the nearest emergency room.
- Birth defects if the pregnancy is not expelled and is continued to term. An aspiration abortion will be required if the medication abortion is not successful.
- Incomplete abortion – less than 4% of all people who have a medication abortion require a aspiration abortion (using suction) to end the pregnancy.
A medication abortion is successful about 96-98 times out of 100. Out of 100 people, 2-4 will need to have a second treatment with medication or a surgical procedure to ensure the pregnancy has ended.
No, the medication leaves your body within a couple of days and does not affect future pregnancies. You can become pregnant within days after having a medical abortion.
No, the medication leaves your body within a couple of days and does not affect future pregnancies.
Ovulation can occur within 8 days of taking mifepristone, so you could get pregnant right away. When to start your birth control depends on the type of birth control you have chosen:
- The birth control pill and the patch can be started on the day you take misoprostol.
- The vaginal ring can be inserted one week after taking misoprostol.
- The depo shot can be given at the follow-up appointment at Women’s Health Clinic, approximately one week after taking misoprostol.
- An IUD/IUS can be inserted during the follow-up appointment at Women’s Health Clinic, approximately one week after taking misoprostol.
- Condoms can help prevent pregnancy and the transmission of sexually transmitted infections.
- We recommend people avoid insertive sex (or inserting anything into their vagina) for a week after taking misoprostol.
There will be time during your appointment to discuss birth control options with the counsellor.