Medical Abortion

Aftercare Instructions for the Medical Abortion

At South Avenue Women’s Services, we provide careful and effective Rochester, NY medical abortion care.

Early Medical Abortion Overview

Early abortion takes place within the first nine weeks of pregnancy (or 63 days), counting from the first day of the last menstrual period.

Abortion is a serious decision for you. You must be aware that you have the option of keeping the pregnancy, either to keep the baby or adopt it out. Your choice of abortion includes surgical abortion, or abortion performed as a minor surgical procedure with suction, in addition to medical abortion.

First, you must decide what you wish to do about the pregnancy. We strongly recommend that you consult with your partner, your closest relatives or friends, or your counselor or spiritual advisor as appropriate.

What Happens at My Appointment?

When you come in for an appointment, we will perform a vaginal ultrasound exam. This exam involves placing a probe or wand into the vagina, which is not painful. The ultrasound exam determines the age of the pregnancy accurately.

We will counsel you about your options, and about medical abortion. If you wish to proceed, you must read and sign the consent form.

We will then give you the mifepristone (Mifeprex) pill in the dose of 200 milligrams to swallow. Mifepristone at this dosage has very few side effects.

  • Mifepristone works by counteracting the hormone progesterone, which is essential for maintaining an early pregnancy. The FDA (the Federal Drug Administration) approves Mifepristone for this purpose.

We will then give you an envelope with four small tablets of the second medication, misoprostol. Misoprostol belongs to a class of drugs called prostaglandins, which cause the uterus to cramp and the cervix to dilate. Possible side effects of misoprostol are nausea, vomiting, diarrhea, and fever. The FDA has approved Misoprostol for the treatment of ulcers.

What Takes Place Following My Appointment?

Use the misoprostol from 24 to 72 hours after taking the mifepristone pill. Misoprostol pills must be placed in the vagina. Here are the instructions:

  • 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. Put them all in, one right after the other.
  • Stay lying down on your back for at least 30 minutes.
  • Cramping and bleeding usually start soon after inserting the misoprostol pills. The cramping and bleeding may last from one to ten hours.

Things to Remember After You Take Misoprostol Pills

You should strongly consider taking prescription pain medication during the abortion process. We will provide you with a prescription for Tylenol #3 or Vicodin. We recommend that you take two tablets of the pain medication by mouth at the same time that you insert the four misoprostol pills in the vagina. You may then take two more tablets of pain medication every four hours as needed. Do not drive or operate machinery while taking the pain medication.

  • Do not use other pain medications such as ibuprofen (Motrin, Advil), Aleve, or aspirin as these might counter-act the misoprostol.
  • Drink plenty of fluids to prevent faintness or dizziness. You may eat lightly.
  • If you get up from lying down, get up slowly and use support.
  • We recommend that you insert the four misoprostol tablets when you have no other obligations such as childcare, work, or social events. If possible, you should send your children to stay with a relative or friend for the day.
  • It is best if your partner, or a close friend or relative, who can help you during the cramping and bleeding phase of the process, accompanies you.
  • You may use sanitary pads. You should not use tampons.
  • There is no sexual intercourse during this process.
  • You may pass blood clots. You may also pass what appears to be a small glob of tissue. Flush anything that you pass down the toilet.
    Eventually the heavy bleeding and cramping will diminish. You should then rest.
    Light bleeding will continue for 9 to 16 days on average, after a medical abortion.
  • You must come in for a follow-up ultrasound exam within a few days of the medical abortion. Ultrasound is the best way to make sure that the process is complete. We will schedule the follow-up exam at the first visit.
  • We will help you with a plan for birth control at your follow-up visit.

There are several risks to the medical abortion procedure.

Heavy bleeding is the most important problem, 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.

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. In most of these situations, we will recommend that you use another dose of four misoprostol tablets in the vagina. The other option is to have a surgical suction D & C.

Infection is rare after medical abortion, but if you have fever, foul-smelling discharge, or pain in the lower abdomen or pelvis after the abortion, you should notify us promptly.

If you have any other problems, or experience anything that is frightening or seems to be abnormal, you should not hesitate to call us. Our number is 585-271-3850.