Medication abortion - sometimes called abortion by pill, RU-486, the abortion pill, or the early option pill, is a process similar to miscarriage, induced by a combination of medications. It requires two visits to the Health Center, as well as a 24-hour period during which you will pass the pregnancy at your own home.
In order to be eligible for medication abortion - abortion by pill:
- You must have started your last period no more than 63 days before you begin the medication abortion process.
- You must be able to come to the health center for two required appointments.
- You must be able to clear your schedule for a 24 hour period after you take the second medication.
- You must have a support person who can be available to be with you for the 24 hour period. They should have access to a car in case of emergency.
- You and your support person must be available to us by telephone without confidentiality restrictions.
What to Expect at Your Appointment
When you call to schedule an appointment for an abortion procedure, please be aware that we will be reviewing a great deal of information with you, so give yourself about 10-15 minutes of private time to speak with us. We will need to determine how far you are into your pregnancy, as measured from the first day of your last normal period (LMP). We will also be reviewing your health history. During this time we will discuss which abortion procedure is right for you, medication or surgical.
Once you have made your abortion by pill appointment, please download, print, read, and complete the following set of forms: Instructions for your Medical Abortion Appointment
On the day of your surgical abortion, plan to be at the Health Center for approximately 2 hours. You will need to have several labs completed including a urine pregnancy test and blood tests for Rh typing. An ultrasound test will be done to confirm how far along you are in the pregnancy.
Afterwards, you will speak privately with a health care worker who will review your health history. At this time, we will discuss your options with you, answering any questions you may have. It is important that you understand the risks and complications associated with all three of the pregnancy options; and that you make a choice regarding your pregnancy of your own free will. Your health care worker will provide you with in-depth information regarding the abortion procedure and answer any questions or concerns you may have about the procedure or your decision to terminate the pregnancy.
Your health care worker will also help you examine the different methods of birth control and other related considerations as you determine which method of contraception is best for you. It is important to remember that all birth control methods try to prevent pregnancy, but not all try to prevent the transmission of sexually transmitted diseases. If you are sexually active and using a form of birth control, it is important to pick a method that you will remember to use as directed to reduce possible failure.
Following your counseling session, you will meet with our medical practitioner, who will review your medical history and do a brief physical exam. They will give you the first medication, Mifeprex, which you take by mouth in the office. You will be given our CFHC handout "CFHC Medical Abortion Home Care Instructions," which provides detailed instructions and what to expect.
Between 24 and 48 hours after you take the Mifeprex in the office, you will take four tablets of Misoprostol at your home, at a time you have agreed on with your practitioner. The pregnancy tissue is usually passed within six to eight hours from the time you take the Misoprostol, but it may take longer, which is why we ask you to clear your schedule for 24 hours.
CFHC staff are on-call 24-hours a day, 7 days/week to respond to medical emergencies, answer questions and provide support to those undergoing the medication abortion procedure at home. We urge those choosing this method to call us if they have any concerns about the process or their symptoms.
Abortion by Pill Follow-Up Care
If you had a medication abortion (an abortion by pill), it is essential that you return 14 days after your appointment to be sure that the procedure is complete. There is no cost for this visit. It is covered in your initial fee and takes about 30 minutes. We will be talking to you about how you are doing both emotionally and physically. It is important that you have a follow-up pregnancy test and a brief physical exam to ensure you are doing well.
Please select any of the following frequently asked questions about abortion by pill.
What happens at the first visit?
After you check in, you will have lab work done including blood tests for anemia and Rh typing and a urine pregnancy test. Next you will meet with a healthcare worker who will take your medical history. Your healthcare worker will spend time with you explaining the process you will go through with the medication abortion. They will go into detail about taking the medication and how to take care of yourself afterward. They will be able to answer any questions or concerns you may have. Your healthcare worker will also give you information regarding methods of birth control so that you can decide what method is right for you.
Following this session, you will meet with our medical practitioner. They will review your medical history and conduct a brief physical exam. They will also perform an ultrasound to determine how far along you are in your pregnancy. If you are no more than 9 weeks pregnant, They will give you the first medication, Mifeprex, which you take by mouth in the office.
What is in the first pill I will be taking?
Mifeprex is the brand name for mifepristone, a medication that ends pregnancy by blocking progesterone, the hormone that is needed for your pregnancy to grow. By taking Mifeprex, you are starting the abortion process, so it’s very important to be sure of your decision before you swallow the medication.
Are there any side effects to the first medication I take?
Although most have no side effects from Mifeprex, it can cause some nausea.
A very small percentage will pass the pregnancy without taking the second medication. For this reason, you must contact the Health Center if you have any bleeding between the time you take the Mifeprex and the time you are scheduled to take the second medication.
Who should not consider abortion by pill?
You cannot take Mifeprex at CFHC if:
- It has been more than 63 days since your last normal menstrual period
- You have an intrauterine device (IUD) in place
- You are diagnosed with an ectopic pregnancy (a pregnancy outside of the uterus)
- You have chronic adrenal failure
- You have a bleeding problems and/or you take blood-thinning medications
- You take certain steroid medicines
- You cannot clear your schedule for a 24 hour period
- You don't have a support person who is available to you during the 24 hours after you take the second medication, or
- You can't return for the required second visit to CFHC
What is the second medication, and what does it do?
The second medication is called Misoprostol. It causes cramping, bleeding, and passing of the pregnancy tissue.
Between 24 and 48 hours after you take the Mifeprex in the office, you will take four tablets of Misoprostol at your home at a time you have agreed on with your practitioner. Instead of swallowing these pills you will place them between your cheek and your gum, allowing them to stay there for 1/2 hour and dissolve.
Are there any side effects to the second medication I take?
This medication may cause nausea, vomiting, diarrhea, and dizziness. It can also cause a fever and shaking chills in the first 24-hours after you take it.
What will I experience after taking the second medication?
Typically, cramping and bleeding will begin within a couple of hours and can be quite heavy at times. However, because the experience varies from person to person, we can't tell you exactly how much or for how long you will bleed or how heavy your cramps will be. CFHC prescribes pain medication to help with the discomfort.
The pregnancy tissue is usually passed within six to eight hours from the time you take the Misoprostol, but it may take longer, which is why we ask you to clear your schedule for 24 hours. After you pass the pregnancy, cramping and bleeding subside. Lighter bleeding and cramping can continue for up to two weeks.
What are the risks of abortion by pill?
Studies show a 5-8% chance that a medication abortion will fail, either by failure of Mifeprex to end the pregnancy, or failure of Misoprostol to cause complete passage of the pregnancy tissue. It is not advisable to continue a pregnancy that has been exposed to these medications, as they can cause birth defects. If the abortion is incomplete, you will need to have a surgical abortion to reduce your risk of retained pregnancy tissue and infection.
Dangerous side effects rarely occur but may include:
- Hemorrhage -- bleeding that is excessive and uncontrolled can be fatal if untreated
- Infection in the uterus, which can potentially result in infertility or death
- Allergic reaction to one or more of the medications.
CFHC staff are on-call 24-hours a day, 7 days a week to respond to medical emergencies, answer questions and provide support to women undergoing the medication abortion procedure at home. We urge those choosing this method to call us if they have any concerns about the process or their symptoms.
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