Aftercare Instructions for the Medical Abortion
At South Avenue Women’s Services, we provide careful, discreet, and effective medical abortion care for pregnancy up to nine weeks gestation. Our goal is always to provide you with the information and services you need to make the decision that is best for you.
What is medical abortion?
Medical abortion, sometimes referred to as early abortion, is a non-surgical procedure to terminate pregnancy within the first nine weeks (or 63 days), counting from the first day of the last menstrual period.
Medical abortion became a safe alternative to surgical pregnancy termination with the development of a drug called Mifeprex (mifepristone) in 1980.
The process is safe, effective, and can be completed in the comfort and privacy of your own home. This is an accommodating option for patients commuting to our Rochester practice from Syracuse, Buffalo, Jamestown, and other areas of Western New York.
*In September of 2000 the Federal Drug Administration (FDA) approved the use of the drug mifepristone (brand name Mifeprex®) for medical abortion in the USA. The FDA placed some rather severe restrictions on the use of mifepristone. Several excellent studies have shown that these restrictions are too severe and can safely be modified. The South Avenue OB Group conducted clinical trials with mifepristone for several years even before the FDA approval.
What happens at my medical abortion appointment?
When you come into our Rochester clinic for an appointment, you will be counseled about your options for pregnancy termination and be able to discuss and ask any questions about the medical abortion process. If you decide that medical abortion is right for you, you will need to read and sign a consent form. Once we have your informed consent, the process will begin:
- At the beginning of your appointment, the doctor will determine the age of your pregnancy by performing a vaginal ultrasound, during which a probe or wand is placed into the vagina. This exam is not painful.
- You will be given a 200mg dose of the mifepristone pill to take by mouth in the office. Mifepristone works by counteracting the hormone progesterone, which is essential for maintaining an early pregnancy. There are few, if any, side effects at this dosage.
- The doctor will give you an envelope containing the correct dosage of the second medication, four small tablets of misoprostol. You will use this medication to complete the medical abortion process in your home.
How do I complete the medical abortion process after my appointment?
You will use the misoprostol you are sent home with 24 to 72 hours after taking the mifepristone pill. Misoprostol belongs to a class of drugs called prostaglandins, which cause the uterus to cramp and the cervix to dilate. The FDA has approved misoprostol for the treatment of ulcers.
Misoprostol pills must be placed in the vagina. Follow these instructions for proper self-administration:
- Empty your bladder before you begin.
- Lie on your back with your knees up in the gynecological position. Use your fingers to push all four of the pills into the vagina as far as you can, one right after the other.
- Continue lying on your back for at least 30 minutes.
- Cramping and bleeding usually start soon after inserting the misoprostol pills. This may last from one to ten hours. We advise you to take prescription pain medication by mouth when you begin to administer the misoprostol. We will provide you with a prescription for Tylenol #3 or Vicodin during your appointment at South Avenue Women’s Services.
What are the advantages of a medical abortion?
Many women prefer medical abortion to the surgical procedure, as it allows them to conveniently complete the process at home. Some women also report that they have had a surgical abortion in the past and found the procedure unpleasant. Medical abortion is a safe, effective alternative.
Medical abortion can also be a more comfortable, private option for many women who wish to terminate a pregnancy. The misoprostol process works similarly to a miscarriage, inducing your body to terminate the pregnancy itself, which some women consider to be a more natural and comfortable experience. They also appreciate the control it gives them over the timing and setting of events.
What are the disadvantages of a medical abortion?
Medical abortion is a safe, FDA-approved method of pregnancy termination. However, like any medical procedure, it does have risks and drawbacks.
- A medical abortion requires at least two visits to the office, whereas a surgical abortion can be completed in one appointment.
- Cramping and bleeding may last several hours, requiring you to clear your schedule and stay at home during the process and for the early phase of recovery. We advise you to take pain medication and have a trusted partner, friend, or relative at home to help you.
- If complications do occur, you will not have immediate access to medical care.
- You may be unsettled by the visual of the terminated pregnancy when it passes, though it is no more than a small cluster of blood and tissue at this stage.
- Some women have side effects from the misoprostol such as nausea, vomiting, diarrhea, or fever.
- There is a small but significant risk of complications and failure.
What are the complications associated with medical abortion?
Heavy bleeding is the most serious risk of medical abortion, which may occur in one to two percent of cases. If you soak through two large sanitary pads per hour for more than two hours, or if you pass several clots bigger than a walnut, you should call our office at 585-271-3850.
In most cases of heavy bleeding, it will stop on its own, but if it continues, we will perform a suction surgical procedure or D & C.
Lack of Bleeding
In a few cases, there is no bleeding after inserting the misoprostol pills. This is not an emergency, but you should call the office at the first opportunity to discuss the situation. If you do not experience any bleeding or cramping following the insertion of the misoprostol, your pregnancy may not have fully evacuated.
In most of these situations, we will recommend that you use another dose of four misoprostol tablets. The other option is to have a surgical abortion procedure.
In one to two percent of cases, women remain pregnant even after both medications have been administered. If this happens to you, we will recommend that you strongly consider having a surgical abortion, since misoprostol has been known to cause deformities in babies exposed during early pregnancy.
Infection is rare after medical abortion, but if you have a fever, foul-smelling discharge, or pain in the lower abdomen or pelvis after the abortion, you should notify us promptly. An allergic reaction to either medication, although rare, is also possible.
Please note that death as a result of medical abortion is exceedingly rare. Only a few cases have been reported out of the millions of women who have had this procedure.
If you have any other problems, or experience anything that is frightening or seems to be abnormal, you should not hesitate to call the medical team at South Avenue Women’s Services. Our number is 585-271-3850. We are here for you during the entire abortion process, even after you’ve left the office.
Aftercare Instructions For Medical Abortion Procedures
Contact us online by completing a form for more information or call 585-271-3850 to make an appointment.