Guide to a safe abortion
On this page, we will give information on one of the safe methods of abortion within the first trimester or the early second trimester of a pregnancy: the abortion with pills (medical abortion) and the vacuum aspiration abortion (in-clinic abortion).
It is up to the women to decide which abortion method is best for them according to their budget, availability, geographical location, gestational age, and personal choice.
A medical abortion is commonly known as abortion with pills. Some people also refer to this method as self-induced abortion, self-managed abortion or do-it-yourself (DIY) abortion.
If you use abortion pills you will experience bleeding and cramping. The symptoms are very similar to your menstrual period or as if you were having a miscarriage (natural abortion).
There are two methods to have an abortion with pills: using a combination of two different types of tablets or using only one type of pill.
Safety of abortion pills
Medical abortions are safe for the majority of women. There are only a few medical conditions that are contraindications for using the abortion pills.
Contraindications
If you have an IUD (intra-uterine device), it is not a contraindication to using the abortion pills, but it does require some precaution. A pregnancy that occurs with an IUD in place increases the risk that it is an ectopic pregnancy (pregnancy not inside the uterus). Whenever possible, the safest recommendation is to have the IUD removed prior to using the abortion pills.
If you are not sure if abortion pills are safe for you, contact us! We can help you determine if this method is for you.
Remember, safe2choose is trained to support women who will use abortion pills in the first 13 weeks of pregnancy. If your pregnancy is more advanced, we will do our best to refer you to a better-prepared local organization to support you.
What to expect during an abortion with pills
As previously mentioned, after using the abortion pills you will have symptoms similar to a menstrual period or a miscarriage.
Other temporary side effects are: fever, chills, diarrhea, nausea, vomiting, and headaches. If you do not experience any of these it is perfectly normal. If you do, these will disappear in the next 48 hours or less. Contact us to know how to manage these side effects.
How to know if the pills worked
If you used the medications according to the recommended instructions, and you had a bleeding as abundant as your menstrual period (or more) for several hours, it is very likely the abortion was successful. Your pregnancy symptoms (breast tenderness, nausea, fatigue), should gradually improve and then disappear around 5 days after using abortion pills, and this is another good indication that the pills were successful.
While it is not necessary, if you desire additional confirmation you may choose to do one of the following:
Urine test (urine hcg)
This is the simplest test that can be done for confirmation, as it can be done in the privacy of your own home. It is recommended to wait at least ~4 weeks after using the abortion pills. If the process was successful, the test should be negative after ~ 4 weeks.
Blood test (quantitative hcg)
This test requires a medical visit, and is most useful when the same blood test was done prior to using the abortion pills for comparison of the hormone levels. This test is not routinely performed, and thus, if you desire confirmation, the urine test as described above is more often recommended. If you do choose to do this test, the pregnancy hormone should be absent approximately 4 weeks after medication use if the process was successful.
Ultrasound
This requires a medical visit, and can be used to detect an ongoing pregnancy. Keep in mind that if the abortion pills worked, there may still be some blood and tissue visible on ultrasound for at least 2 weeks. Even if the pregnancy is gone, sometimes the ultrasound is performed too early and women are diagnosed with an "incomplete abortion" which could lead to unnecessary surgical procedures. If you choose to have an ultrasound, it is recommended to wait at least 2 weeks, unless you have symptoms of complications and need an ultrasound sooner.
If 48 hours have passed after you used the last pills and you have not bled or your bleeding is much less amount than your period, it is likely that the abortion was not successful. In most cases, it is possible to try again with abortion pills. Contact us if this is your case so we can support you.
Medical care after the abortion pills
If your symptoms are as expected and you do not have any warning signs, you do not need to get medical care. It is not necessary to get a pregnancy test or an ultrasound afterward, nor to have any surgical intervention.
Fertility and menses after an abortion
After an abortion (medical or in-clinic) your cycle will restart, as if you have had your menstrual period. You will ovulate again approximately 10 days afterward. This means that you can get pregnant again if you have sex.
Your next period can come back in approximately 4 to 6 weeks after using abortion pills.