A medical abortion is a type of abortion that involves taking a pill or receiving an injection of medication to terminate a pregnancy. This is done without any type of surgery or mechanical entry into the uterus. Medical abortions are performed up to six weeks into the pregnancy, or about nine weeks after a female’s last menstrual period. The procedure is more effective the earlier conducted. The amount of bleeding tends to be greater with a medical abortion than with a surgical procedure. Most women have cramping that lasts for several hours, but the symptoms tend to decrease once the embryonic tissue has been passed. The whole process can take anywhere from 4-6 days, and is confirmed with a doctor’s appointment.
A medical abortion is often preferred to a surgical abortion because it is less invasive, can be done early into a pregnancy, and normally happens in the comfort of the patient’s home. Some women find the process psychologically more difficult than surgical abortions because they are in charge of taking the medications in a pill form, instead of having the procedure done by a medical professional. A medical abortion is irreversible, meaning there is no way a pregnancy can continue after the medication is taken. If the fetus is not expelled, a surgical abortion is usually recommended to terminate the pregnancy. There do not seem to be any long-term complications with taking the medications.
The most common medications used by medical professionals to interfere with fetal development and implantation are methotrexate and mifepristone (RU-486). These medications are mixed with misoprostol, a drug that induces uterine contractions, to expel the contents of the uterus. Mifepristone is 96% effective, but cannot be used by women with an ectopic (tubal) pregnancy, severe anemia, an intrauterine device (IUD), or uncontrolled high blood pressure. When mifepristone cannot be used methotrexate is normally recommended by the health practitioner and is about 90% effective.
Mifepristone and Misoprostol
If a woman chooses to have a medical abortion, the first step will take place in a medical office. The first drug, usually mifepristone, is administered in the form of a pill or shot. Mifepristone affects the progestin receptors, blocking them from detecting progesterone and other similar hormones necessary to continue a pregnancy. Without progesterone, the inner lining of the uterus, called the endometrium, breaks down in a similar fashion to a female having her period. The lining can no longer support a pregnancy, and the fetus is expelled. The next step, taking misoprostol, is normally ingested (in pill form) two days after the initial dose of mifepristone. This contracts the uterine muscles allowing the fetus and endometrium to pass through the cervix and out of the uterus.
Methotrexate and Misoprostol
If a woman received methotrexate, usually by injection, she can expect to have a longer time period between first appointment and her follow up. Methotrexate tends to take longer to end a pregnancy, but is given to women with special medical needs or an ectopic pregnancy. This drug acts directly on the fetus, prohibiting the fetal cells from dividing. Misoprostol must be taken after this procedure as well to ensure a successful abortion.
The final step of a medical abortion takes place at the original medical office where the patient received her initial dose of mifepristone or methotrexate. Follow up care is very important! It is crucial to keep appointments with the medical professionals to confirm the abortion progressed successfully and to ensure no other health problems or complications arose during the process.
The most common side effect of medical abortions is vaginal bleeding, which rarely leads to serious complications. More possible side effects of the medications are stomach pain, cramping, dizziness, and heavy bleeding. Vomiting, diarrhea, chills, and a fever may accompany these symptoms as well. Call a doctor if you soak more than two sanitary napkins in an hour, bleed heavily for more than 12 hours, pass large blood clots, or run a temperature of 101 degrees Fahrenheit (38 degrees Celsius) or more. These could be signs of a complication that may require medical attention.
Last Updated May 2013.