Abortion with pills

A medical abortion is commonly known as an 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).

The abortion pills generally refer to either using Mifepristone and Misoprostol in succession or using only Misoprostol.

Mifepristone

– Mifepristone is a medication that blocks the flow of progesterone, which is a hormone that supports the pregnancy. Without progesterone the pregnancy cannot grow. Mifepristone is only one half of what is commonly known as the abortion pill or medical abortion, it will not result in an abortion by itself.
– Mifepristone also softens the cervix (lower part of the uterus) which will intensify Misoprostol’s effect.

– Mifepristone alone is not enough to cause an abortion, Misoprostol is also needed.

– Mifepristone is primarily used for abortion or miscarriage, so depending on laws and restrictions in each country, it can sometimes be difficult to find.

Misoprostol

– Misoprostol is a medication which causes the uterus to move (or contract), and this helps to expel the pregnancy with cramping and bleeding.

– A medical abortion can be performed using Misoprostol without Mifepristone, but it is more effective to use both medications together.

– Misoprostol has other medical uses aside from abortion (induce labor, postpartum hemorrhage, ulcer, etc), so it is typically more widely available.

Mifepristone and Misoprostol are listed as essential medications according to the World Health Organization and they are intended for safe abortions.

To know how to have a safe and effective abortion using Misoprostol and Mifepristone click here. If you are using Misoprostol only click here.

Safety of abortion pills and Contraindications:

Medical abortion is safe for most people, but there are a few contraindications to using the abortion pills.

Mifepristone is NOT recommended if:

• You have been using long term steroids, such as prednisone or dexamethasone.
• You have a bleeding disorder such as Porphyria.
• You have chronic adrenal failure.

However, you can have an abortion with Misoprostol only.

BOTH mifepristone and misoprostol are NOT recommended if:

• You are using anticoagulants (blood thinners), such as Heparin and Warfarin.
• You are allergic to mifepristone, misoprostol or prostaglandins.

• You have an ectopic pregnancy (outside the uterus).

Using the abortion pills with an ectopic pregnancy will not harm you, but it will not terminate the pregnancy.
If you suspect or have an ectopic pregnancy, seek medical care.

Having an IUD (intra-uterine device) is not a contraindication to using the abortion pills, however:

• The risk of having an ectopic pregnancy with an IUD is increased.
• Cramping is likely to be more intense.
• It is safer to have the IUD removed prior to using the abortion pills.

If you are not sure if the abortion pills are safe for you, contact us! We can help you determine if this method is for you.

Remember this information is useful for an abortion with pills in pregnancies that are 13 weeks or less counted from the first day of your last menstrual period.
If you are more than 13 weeks pregnant, the process is different and requires special care, so please reach out to our team for the right guidance and available options.

What to expect during an abortion with pills

After using the abortion pills you will have symptoms similar to a menstrual period or a miscarriage.

If you are using Mifepristone, this medication does not usually cause any symptoms. Some people experience light bleeding. Even if you bleed, it’s very important to complete all the steps, including taking the misoprostol pills to complete the abortion.

After taking misoprostol, cramping and bleeding may start within 30 minutes or take up to 24 hours. Strong cramps are normal as the uterus contracts to remove the pregnancy.

Bleeding can be similar to or heavier than a period, with blood clots and tissue passing, varying in size depending how far along the pregnancy was. The duration of heavy bleeding and intensity of the cramps vary from person to person.

Misoprostol can cause temporary side effects such as diarrhea, nausea, vomiting, dizziness, stomachache,headache, fever and chills.

If you do not experience any of these it is perfectly normal. If you do, these will disappear in the next 24 hours or less.

Contact us to know how to manage side effects.

How to know if the abortion 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 medical abortion was successful. Pregnancy symptoms should improve over the next few weeks after using the pills, which indicates the abortion worked. Nausea and frequent urination typically stop within a few days, while symptoms like breast tenderness may last up to 10 days.

While it is not necessary, if you desire additional confirmation you may choose to do one of the following test:

– 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 4 to 5 weeks after using the abortion pills. If the process was successful, the test should be negative. Taking it sooner may give a false positive result.

– Blood test (quantitative hcg): This test requires a medical visit, and is most useful when the same blood test was also 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 a blood test, the pregnancy hormone should be absent approximately 4 to 5 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 you could be 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 24 hours have passed after you used the last dose of Misoprostol 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 afterwards, nor having any surgical intervention such as a D&C.

Fertility and menses after an abortion

Your menstrual cycle may return in approximately 4-6 weeks. Your fertility can return very quickly, which means you can get pregnant if you have unprotected sex very shortly after your abortion, within as little as two weeks.
If you wish to prevent an unwanted pregnancy, it is recommended that you start a contraceptive method right away. You can find more information at FindMyMethod.org