You can have an early medical abortion (EMA) up to 9 weeks of pregnancy.
Treatment
The Mifepristone tablet is swallowed and works by blocking the action of progesterone, a hormone needed to maintain the pregnancy.
Misoprostal is a tablet inserted into the vagina containing a hormone called prostaglandin. Prostaglandins occur naturally in the body and help the uterus to contract.
Acting together they will bring on an abortion.
EMA has a very good safety record, however, every form of medical treatment carries some risks or side effects.
With this treatment, the main risks are:
- Excessive vaginal bleeding
- Incomplete abortion
- Infection
- Allergic reactions
First visit
- You will be given a Mifepristone tablet to swallow with a glass of water.
- After taking the tablet, you need to stay at the clinic for a little while so that we can check that you are okay.
- You will be given your next appointment time and a number to call if you are worried or have any questions.
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 sick*
- Headaches and skin rashes
- Slight dizziness or feeling like you have a fever
- You may have heavy cramp-like period pains
- Miscarriage may sometimes happen before the second tablet
* If you are sick within 2 hours of taking the Mifepristone call the clinic straight away and speak to a nurse.
You must still come to the clinic for your second appointment to finish the abortion process.
You may take pain relief that does not contain aspirin.
Can I change my mind after the first treatment?
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 within 24 hours. You must keep this appointment.
There is a waiting room for relatives and friends whilst you are having treatment.
- 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.
- You will be given pain relief before the Misoprostal.
- A nurse will insert Misoprostal tablets into your vagina or you can choose to put them in place yourself. The Misoprostal helps your body to remove the pregnancy so you will start to bleed and have 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 are in between the two, however, it is important to remember that this is not a completely pain-free procedure.
You may experience the following:
- Nausea or sickness
- A feeling of light-headedness
- Feeling feverish
- High temperature
- Diarrhoea
4. 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.
Discharge from the clinic
You may bleed heavily, 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.
If you are worried you can always contact the clinic.
After the procedure
- You can take your normal painkillers (they must not contain aspirin) to relieve any discomfort- do not take more than 2 in 4 hours
- Do not do any heavy lifting or exercise for 2-3 weeks
- Your first period may happen 4-6 weeks later and it may be heavier than normal
To prevent an infection:
- It is important that you take the antibiotics given to you at the clinic
- Do not use bubble bath or bath salts for at least 3 weeks after the treatment
- Do not have sex for 3 weeks after the treatment
- Use sanitary towels instead of tampons until your next regular period
If you are unsure about any of your symptoms, please call the clinic and have a chat with a nurse.
If you have had the Depo-Provera injection, you could bleed on and off 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.
You should take a pregnancy test 3-4 weeks later to check your treatment was successful. If the pregnancy test is positive call the clinic straight away.
You may not be able to have this treatment if:
- 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 which may need to be removed prior to the beginning of treatment
- You are breast-feeding
If you have any of the above, please tell the doctor/nurse.
Contraception
You can still get pregnant again and you must use reliable contraception.
You can start the combined or progesterone-only Pill after the second visit.If you do start the Pill, your next ‘period-like’ bleed is likely to be sometime during your week break. Please 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.
