Aftercare Instructions for Medical Abortion Procedures

What is a medical abortion?

Medical abortion is a non-surgical procedure in which the pregnant individual ingests abortifacient pharmaceutical drugs. Medical pregnancy termination became a safe alternative to the traditional surgical procedure in the early 1970s and was even more commonly used with the creation of the antiprogestogen Mifepristone in the 1980s.

This process is safe, effective and can be undertaken in the security of your own home. This is an accommodating option for patients commuting from Syracuse, Buffalo, Jamestown and other areas of Western New York. Our medical professionals have extensive experience with the medical alternative, and will thoroughly detail the pros, cons, and possible risks associated with this procedure.

We can ensure the credibility and reliability of the necessary procedural medications, as we have been using them for several years. Our caring staff will ensure that you receive all the necessary information for this procedure to guarantee that your experience goes as smoothly as possible. Please refer below for healing and recovery procedures.

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 is the medical abortion process?

Medical abortion is suitable for pregnancies up to nine weeks’ gestation. Ultrasound is essential for dating the pregnancy and for excluding the ectopic pregnancy.

  • After discussion, ultrasound, and signing a consent form, the woman takes a single 200 mg mifepristone pill by mouth, given to her by the clinician in the office. Mifepristone is an anti-hormone, which works by counteracting the effect of the hormone progesterone. It causes the pregnancy to die and detach from the wall of the uterus.
  • From 24 to 72 hours later, the woman inserts four little tablets of a different medication into her vagina. This medication is called misoprostol, and it has the effect of causing the uterus to contract and the cervix to dilate. If a woman is unable to insert the misoprostol tablets herself, then she may come into the office and we will do it for her.
  • Cramping and bleeding usually begin shortly after the insertion of the misoprostol. The uterus then expels the pregnancy.
  • The cramping and bleeding usually last between one and ten hours. During that time, it is advisable to take prescription pain medication. After the uterus has emptied itself, the cramping and bleeding subside. The process is over.

An essential part of the process is the follow-up ultrasound. This is performed a few days after the procedure, and is the only way to be completely sure that the abortion was successful.


What are the advantages of a medical abortion?

  • Medical abortion avoids the surgical procedure. Some women report that they have had a surgical abortion in the past, and found the procedure unpleasant. Medical abortion allows them to do it another way.
  • Medical abortion resembles a miscarriage, which occurs at home. Some women find this idea more natural and private, and appreciate the control that they have over the timing and setting of events.

During the cramping and bleeding phase of the medical abortion, it is best to “clear one’s schedule” of any obligations such as work, childcare, or social occasions. Women are advised to stay at home, take the pain medication, and have with them a trusted friend or relative who can help them.


What are the disadvantages of a medical abortion?

  • A medical abortion requires at least two visits to the office.
  • The cramping and bleeding may last several hours, and it requires a much higher level of patient participation than a surgical abortion. For example, the patient must insert the four little misoprostol pills into her vagina herself.
  • If something goes wrong, such as heavy bleeding, one is at home, away from medical care.
  • The woman may see the pregnancy after it passes; it is however just a small blob of blood and tissue at this stage.
  • Some women have side effects from the misoprostol such as nausea, vomiting, or diarrhea.
  • There is a small but significant risk of complications and failure.

What complications can occur during a medical abortion?

In general, complications have been uncommon with medical abortion. It has already proven itself to be quite effective and safe. The earlier the pregnancy is at the time of medical abortion, the lower the risk of complications.

There are three forms of failure that can occur with the medical method of abortion.

  • First, there can be heavy bleeding. This occurs one or two percent of the time. In one large study, four women out of 2000 required blood transfusions. In other studies, although some women had heavy bleeding, none required blood transfusions. The rule is: if the patient is soaking two pads an hour for more than two hours, she should seek medical attention. There are several ways to treat heavy bleeding, but if it is an emergency the treatment of heavy bleeding is to do a suction D & C-essentially the same procedure that the patient would have undergone had she chosen a surgical abortion in the first place.
  • The second type of failure is that the pregnancy stops growing but fails to pass, even after the self-administration of the misoprostol pills in the vagina. This occurs one or two percent of the time. This is not an emergency. The failure to pass will be suspected if the patient has no bleeding or only scant bleeding, and it will be detected at the follow-up ultrasound. Misoprostol pills can be placed in the vagina again in an effort to complete the abortion, or the patient may choose to have the pregnancy evacuated surgically.
  • The third type of failure is that the pregnancy continues to grow, even after the two medications have been used. This will be detected at the follow-up ultrasound of course. This occurs in one or two percent of cases. In this case, the patient should strongly consider having a surgical abortion, since the misoprostol has been known to cause deformities in babies exposed to it in early pregnancy.

Other complications are very rare. Allergic reactions to the medications are possible, but rare. Death as a result of medical abortion is exceedingly rare. A few cases have been reported in all the millions of women who have had this procedure.


Will a medical abortion effect future pregnancies?

Medical abortion has no known effect on future pregnancies. Many, many women have successfully conceived and delivered a normal baby later on after a medical abortion, at a time in their lives when they wanted a baby.