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What to expect, how it works and the possible side effects of a early medication abortion
An early medication abortion can occur by using two medications, mifepristone and misoprostol to cause the pregnancy to miscarry.
Since its first use in 1988, mifepristone has been safely used by millions of women and pregnant people world-wide with approximately 95 to 98% experiencing a successful abortion.
An individual medication regimen will be discussed with you at your consultation appointment and this may vary for different patients.
You can expect to be at a health facility for approximately two hours on your initial visit where you will be assessed by a health worker and doctor and then take the first medication. You will be able to return to work or resume your normal daily activities until you begin the second dose of tablets 24-48 hours later. It is recommended you have a support person with you once you take the second lot of medications.
A tablet, mifepristone, blocks the action of progesterone, a hormone essential for pregnancy. This changes the lining of the uterus preventing the pregnancy from continuing. It opens the cervix and increases the sensitivity of the uterus to the second medication
The second medication misoprostol, also taken orally, is administered up to 48 hours after the first medication, causing the uterus to contract, assisting the expulsion of the pregnancy tissue.
These two medications will not prevent an ectopic pregnancy from growing. An ultrasound and a blood test are essential to exclude ectopic pregnancy prior to an early medication abortion.
These medications cause cramping, pain and bleeding, usually after one to six hours of taking the Misoprostol tablets. Pain can vary from mild period type pain to severe cramping and pain. For most people the pain can be managed by pain relieving medication.
Bleeding can vary from light spotting to a very heavy flow with blood clots and pregnancy tissue. The duration of the bleeding can also vary – most people will experience spotting for two to six weeks after the procedure, however, if there is stop/start bleeding a review by your medical practitioner is recommended.
Headaches, nausea or vomiting can occur along with chills and or flushes.
Continuing pregnancy: minimal bleeding and continuing pregnancy symptoms can mean the pregnancy is still present. This occurs in about 1% of early medication abortions and requires a follow up surgical termination.
Continuing pain and bleeding: for approximately 2% of patients having an early medication abortion, the tissue will not be completely expelled from the uterus and pain/bleeding can persist. A surgical procedure, known as a curette may be needed in these circumstances.
Future fertility: early medication abortion does not reduce the chance of becoming pregnant again. Fertility can return again as early as two weeks after an abortion and need to consider contraception as soon as the current pregnancy is over.
A low sensitivity urine pregnancy test after an early medication abortion checks that the abortion is successful. A blood test or an ultrasound may also be used to confirm the abortion is completed.
24 hours telephone support is available for patients who have an early medication abortion procedure. For more information, see the unplanned pregnancy page.