The combination of mifepristone and misoprostol is the most effective regime (WHO, 2014)
safe2choose provides both regimes for medical abortion: mifepristone and misoprostol or misoprostol alone. However, we know that the combination of mifepristone and misoprostol should be the preferred choice. Why? 98 women in 100 will complete an abortion using the combination of mifepristone and misoprostol. 95 in 100 women will complete an abortion using misoprostol alone.
Abortion pills are safe if you are in general good health, no more than 10 weeks pregnant and not allergic to the medicines
You should not use the abortion pills on your own (or at all) if you (“be alert” symbol”):
Are more than 10 weeks pregnant (Want to know how far you are in the pregnancy? Click here)
Are allergic to mifepristone or misoprostol.
Have serious health problems, including blood-clotting problems.
Believe or know that the pregnancy is growing outside the womb (ectopic pregnancy).
Other health issues to think about:
(symbol) If you are breastfeeding a baby, you can use the abortion pills. However, the misoprostol pills may cause diarrhea in the baby. To avoid this, breastfeed the baby, take the abortion pills and wait 4 hours before you breast-feed again.
(symbol) If you are living with HIV, you can use the abortion pills as long as you´re not getting sicker, you´re on anti-retroviral medicines and your health is otherwise good.
(symbol) If you have anemia, you can use the abortion pills. However, If you´re very anemic (have weak blood) and have heavy bleeding after using the abortion pills, you could be in a dangerous situation. Find a health center where you could get help if you need it and plan in advance for unexpected situations.
If you have an intrauterine contraceptive device in the womb, you must get it removed before you take the abortion pills
If you have an intrauterine contraceptive device in the womb (e.g. the coil, a progesterone IUD), you must get it removed before you take the abortion pills.
It is a good idea to have a partner or friend near you when using abortion pills
Once you take misoprostol, you may have several hours of painful cramping and you may bleed more heavily than a normal period. Having your husband, partner or friend with you makes you feel there is someone who can help you through the abortion. They can give you water, make tea for you, make food, rub your back, or treat you with kindness any way that helps you.
Also, in the rare event that you might need urgent medical care, your support person can help make sure you get the care you need.
Some medicines may have the same name but they are junk: watch out!
In some countries, you can buy the best two kinds of abortion pills – mifepristone and misoprostol – in chemist shops or pharmacies. But, in others, you can only buy misoprostol. Watch out! Some medicines may have the same name but they are “junk”. Medicines are called “junk” when they don’t have the active ingredient that makes them work.
Order the abortion pills here or get information about which medicines are good quality from a trusted village worker, friend or midwife.
You will experience cramping and bleeding when you start using the abortion pills
These are the main side effects. Cramping and bleeding are good because it shows the medicines are working. But, how much cramping and bleeding will you have?
- For some women, cramping is very strong —much more painful than menstrual cramps (if you have menstrual cramps).
- For some women, bleeding is much heavier than a menstrual period. You might have blood clots the size of lemons in the first few hours after taking misoprostol.
- For other women, cramping is mild and bleeding is like a normal menstrual period.
We want you to be prepared!
- Do not be alarmed if you have heavy bleeding and bad pain. If you’re prepared to accept heavy bleeding and bad pain for several hours, you’ll be relieved if the pain and bleeding aren’t as bad as you expected.
- If you experience bad cramping ibuprofen is a good medicine to cope with pain. You can buy ibuprofen 200 mg strength over the counter (without a prescription) in most countries. Take 4 pills every 6 hours. This should make your cramping better.
(“Be alert” symbol)
- If you soak 2 large pads (made of cloth or disposables) per hour for 2 hours in a row, this is very heavy bleeding. You should seek medical help if you bleed this much. Soaking means that the large pad is completely soaked with blood, front-to-back, side-to-side, and through-and-through.
- If you have extreme pain that does not get better even after you take ibuprofen, seek medical help. This kind of extreme pain may mean that you could have an ectopic pregnancy which was not detected before the abortion and that is breaking out of the tube. Your life could be at risk!
- You may have fever, nausea and vomiting the day you take misoprostol. You should feel better and better the day after using abortion pills, not sick. If you feel very sick any day after you use misoprostol, you should seek urgent medical care.