Early medical abortions are available up to 9 weeks of pregnancy. This is where drugs are used to induce an abortion.
Treatment
The Mifepristone tablet works by blocking the action of progesterone, a hormone needed to maintain the pregnancy. Mifepristone is taken orally and acting together with Misoprostol tablets will bring on an abortion. Misoprostal is a vaginal tablet that contains a hormone called prostaglandin. Prostaglandins occur naturally in the body and help the uterus to contract.
Many women around the world have used this treatment and it has been shown to have a very good safety record. However, every form of medical treatment carries some risks or side effects. With this treatment the main risks, though very small, are:
- Excessive vaginal bleeding
- Incomplete abortion
- Infection
- Allergic reactions
These are usually easily treated.
First visit
You will be given a Mifepristone tablet to swallow with a glass of water. It is important to keep in mind that taking the Mifepristone is the abortion. It begins a process which once started cannot be stopped or reversed.
After taking the tablet, we ask that you stay at the clinic a short while so that we can check that you are well enough to leave and have had no adverse reactions. Before you leave the clinic, you will be given your next appointment time and who to contact if you have any queries or problems.
Are there any side effects?
After taking the first tablet, you may experience the following:
- Bleeding and passing of clots
- Feeling faint or a little nauseous*
- Headaches and skin rashes may occur
- Slight dizziness or feeling feverish
- You may experience heavy cramp-like period pains
- Miscarriage may occur in rare cases before the second tablet
You must still attend the clinic for your planned second appointment. We cannot be sure you have passed the pregnancy sac, therefore, we need to continue with your treatment.
You may take pain relief that does not contain aspirin.
* If you vomit within 2 hours of taking the Mifepristone, please contact the clinic and speak to a nurse
Can I change my mind after the first treatment?
It is inadvisable for you to change your mind once the first tablet has been taken. If the pregnancy continues the baby may be born with abnormalities.
Second visit
After your first visit, you will be asked to return to the clinic (between 24 and 48 hours later, whichever is convenient for you). It is vital that you keep this appointment.
You will be taken to a room and any symptoms that you may have experienced since your first appointment will be discussed with you. If all has been well, your treatment will continue.
There is a waiting room for relatives and friends to stay whilst you are having treatment.
A nurse will insert Misoprostal tablets into your vagina. The Misoprostal helps your body expel the pregnancy so you will start to bleed and experience period-like pains. All women react differently to this treatment. Some have heavy bleeding and quite a lot of pain, while others have very little bleeding and mild pain. Most women experience between the two, however it is important to remember that this is not a completely pain-free procedure. You will be given pain relief prior to the insertion of the Misoprostal.
You may experience the following:
- Nausea or vomiting
- A feeling of light-headedness
- Feeling feverish
- High temperature
- Diarrhoea
You can leave the clinic after the treatment. You should take it easy for a couple of hours. After this time you may find that moving around will ease any discomfort.
The abortion usually takes place between 4 and 6 hours following the insertion of the tablets. In some cases the abortion can take place earlier or later.
Discharge from the clinic
You may bleed heavily following the second visit, usually for 2 – 3 days, and you may even pass some clots. This is quite normal. After this time, the bleeding will reduce but you could bleed on and off for 3 – 4 weeks following the procedure.
If you have any concerns, you can contact the clinic.
Post procedure
- You can take your normal painkillers (they must not contain aspirin) to relieve any discomfort. The nurse will discuss suitable pain relief with you before you leave the clinic.
- Ensure you take the antibiotics provided after the procedure as directed
- Your first period may occur 4-6 weeks later and it may be heavier than normal
- We advise that you avoid any heavy lifting or exercise for 2-3 weeks
To avoid the risk of infection:
- You should refrain from sexual intercourse for 3 weeks after the treatment
- Do not use bubble baths/salts for three weeks after the treatment
- Use sanitary towels instead of tampons until your next regular period
If you develop any unexpected symptoms or reactions that you are unsure about, please contact the clinic and discuss your symptoms with a nurse.
If you have had the Depo-Provera injection, you could bleed intermittently after the second tablet.
Driving
1st visit – you can drive before and after treatment
2nd visit – we recommend you arrange to be collected and have someone with you (or nearby) overnight.
Aftercare
It is advisable to carry out a pregnancy test 3-4 weeks later to confirm your treatment was successful. If the pregnancy test is positive, please contact the clinic for further advice.
This kind of medical abortion of pregnancy may not be suitable for you if any of the following apply:
- You have been on long term corticosteroid treatment
- You are on any anticoagulant (blood clotting) treatment
- You have had a bad reaction or are allergic to Mifepristone
- You have liver or kidney disease
- You have risk factors for heart disease (such as high blood pressure or high blood cholesterol levels
- You suffer from asthma
- You suffer from any other disease or illness and are taking other medication
- You have an IUD (coil) in place that may need to be removed prior to beginning treatment
- You are breast-feeding (we do not recommend use of Mifepristone in women who wish to continue breast-feeding because the drug will pass into breast milk-it takes around 26 days for the drug to clear from the body)
If any of these conditions apply, please inform the doctor/nurse who will discuss them with you further.
Contraception
You are still fertile and at risk of another pregnancy. It is therefore important that you use reliable contraception. You can start the combined or Progesterone-Only Pill immediately after the second visit. If you do start The Pill, your next ‘period-like’ bleed is likely to be sometime during your week break. Start your next packet as instructed. Remember to use an alternative method of contraception (eg. condoms) because antibiotics can make The Pill ineffective.
Long-acting reversible contraception (Depo-Provero/injection or Nexplanon/implant) can be given at your second appointment.
