Medical Abortions

Disclaimer: Throughout this article, we will be using the term “female” to describe persons with biological female sex organs who can become pregnant. We understand that not every pregnant individual is female-identifying, but for the sake of simplicity and consistency, these are the terms we will be using. If you would like to learn more about gender identity, visit our Sexual Orientation Gender Identity article.

A medical abortion is a procedure that terminates a pregnancy through the use of medication, sometimes referred to as the “abortion pill,” and is usually administered within the first nine weeks of pregnancy. This type of abortion differs from a surgical (in-clinic) abortion because an in-clinic abortion will often use suction techniques to end a pregnancy. Medical clinics administer two kinds of medication for the medical abortion process: one mifepristone pill (also called Mifeprex) and four misoprostol tablets. Both are required to complete an abortion.

 

Eligibility for a Medical Abortion

A physical exam conducted by a healthcare professional will determine whether a person is eligible for a medical abortion. The doctor will check for certain conditions that would make a female ineligible, such as having an IUD, anemia, an ovarian mass, asthma, liver or kidney problems, high blood pressure, or another condition.¹ Normally, a female in the earliest stage of pregnancy, up to ten weeks (70 days) after the first day of their last menstrual period, will be eligible for a medical abortion.² The abortion pill is very effective in ending a pregnancy and is more successful the earlier it is taken. According to Planned Parenthood, for females who are eight weeks pregnant or less it is about 98% effective, 96% effective for eight to nine weeks pregnant, and about 91% effective for females nine to ten weeks into a pregnancy. ²

 

The Process

1. Mifepristone or Methotrexate

The first pill, mifepristone (also called RU-486), will be given orally by the female’s doctor at their office visit. Mifepristone blocks the hormone progesterone. If the body does not provide sufficient amounts of progesterone during pregnancy, the embryo cannot be implanted in the uterus which will effectively terminate the pregnancy. This medication must be followed by misoprostol.

In some cases, instead of mifepristone, a female will receive methotrexate, which is a drug that acts directly on the fetus. Methotrexate prohibits the fetal cells from dividing and is usually administered through injection. This medication is usually given to females who have an ectopic pregnancy or special medical needs. Methotrexate will often require a longer time period between the female’s first appointment and their follow up, and should be expected to take longer to end a pregnancy. Misoprostol still must be taken following the Methotrexate to ensure a successful abortion.³

2. Misoprostol

The doctor or nurse will instruct the female to take the second medication, misoprostol, usually about two days after taking the mifepristone. Before taking the four misoprostol pills, the female should swallow a drink of water to keep the mouth moist and place the pills between the cheeks and bottom gums (placing two pills on each side). The female should expect to hold the pill in their mouth for about 30 minutes until the medication dissolves. In many cases, the misoprostol will make the mouth feel dry and chalky but the female should not drink or eat anything within the 30 minute time span. Once the pills have dissolved the female may rinse her mouth with water and drink down all that is remaining of the pill.⁶ The female can usually expect to take this medication at home. The misoprostol tablets will cause contractions so that the body expels the fetus. This process can take anywhere from a few hours to a few days.⁴

 3. Follow up

It is strongly advised that females have a final examination to confirm that the abortion is complete. In the unlikely circumstance that it is not, more time may be needed or a surgical abortion should be scheduled.³

Possible Symptoms

Many people compare the symptoms of a medical abortion to a miscarriage. A female may experience heavy cramping and aches, very heavy bleeding with large clots, an upset stomach and vomiting, diarrhea, dizziness, tiredness, fever, and more.²

 

Commonly Asked Questions

What is the difference between a medical abortion and an emergency contraceptive?

One common misconception is that a medical abortion is the same as taking an emergency contraceptive, commonly known as the “morning-after pill”. This is inaccurate: an emergency contraceptive prevents a pregnancy from occurring and typically is only effective within the first five days after unprotected sex (meaning that it is ineffective if a female is already pregnant), while a medical abortion terminates an unwanted pregnancy and is effective up to ten weeks into the pregnancy.

Should I have a medical abortion or a surgical abortion?

There are pros and cons to choosing to have a medical or surgical abortion. Some of the pros of a medical abortion are that it can be administered in the earliest stages of pregnancy and can offer the potential of privacy during the abortion process. A surgical abortion, however, requires fewer office visits, more immediate termination of pregnancy, and less risk of an incomplete abortion.⁵ A healthcare professional can address any concerns or questions pregnant individuals may have during an appointment and recommend which abortion method would be the safest and most effective depending on the situation.

 

Concluding Remarks

The kind of abortion a female chooses to have is completely up to their personal preference and situation. It is important that the pregnant individual gets as much accurate and pertinent information as they need to make their decision, which is why it is imperative to meet with a specialized doctor or nurse that is trained to guide patients through this process.

Lastly, here at SexInfo, we prioritize mental health just as much as we do physical health. Similar to the way females can have varying physical symptoms after a medical abortion, there is a wide range of emotions they could feel after the pregnancy is terminated. Confidential helplines, such as All-Options or Option-Line, provide nonjudgmental emotional support after an abortion to anyone who may want to speak with someone about their experience.² Overall, when practiced correctly, medical abortions can be a safe, effective, and non-invasive way to terminate a pregnancy.

 

References

  1. "Medical Abortion Procedures: Types, Side Effects and Risks." American Pregnancy Association. N.p., 26 Apr. 2017. Web.
  2. Parenthood, Planned. "The Abortion Pill | Get the Facts About Medication Abortion." Planned Parenthood. N.p., n.d. Web.
  3. "Methotrexate (MTX) for Early Abortion." Abortion Is OK - A Call to Action. Feminist Women's 3. Health Center, n.d. Web. 19 Jan. 2019.
  4. "The Abortion Pill: Medical Abortion with Mifepristone and Misoprostol." Abortion Is OK - A Call to Action. Feminist Women's Health Center, n.d. Web. 19 Jan. 2019.
  5. "Medical Versus Surgical Abortion." UCSF Medical Center. N.p., n.d. Web.
  6. How to Use Abortion Pill. "Abortion Pills Instructions with Mifepristone & Misoprostol | HTU." How to Use Abortion Pill. N.p., n.d. Web. 07 Feb. 2019.

Last Updated: 07 February 2019.