Abortion

A medical abortion can be done up until 70 days, or 10 weeks, of pregnancy and involves taking pills to cause your body to pass the pregnancy.

Before the Abortion

Before having an abortion, an ultrasound examination may be necessary to confirm that the pregnancy is inside the uterus and not an ectopic pregnancy, a pregnancy that develops outside the uterus and can be life-threatening. Early in the pregnancy, an ultrasound probe placed into the vagina may need to be used to measure the pregnancy. You will then have a consultation with a healthcare provider, which can be done in-person at a clinic or via video consultation or telemedicine where those options are available. You will be counseled about how to take the medications and what to expect from the abortion process.

Medications

In the U.S. and in some countries where abortion is legal, two different medications are used in a medical abortion.

• Mifepristone, or RU-486, is a pill that works by stopping the pregnancy from continuing to develop. After taking mifepristone, you may notice a small amount of bleeding or light cramping, but most people don’t experience any symptoms. Within 48 hours after taking it, you will take misoprostol, a medication that causes the uterus to cramp and expel the pregnancy tissue.
• Misoprostol pills can be placed into the vagina or between the cheeks and gums to dissolve. This combination of mifepristone and misoprostol is highly effective. In geographic areas where mifepristone is not available, misoprostol can be used alone, although this method is slightly less effective.

The Process

Within a few hours after taking the misoprostol pills, you will have heavy bleeding and cramps. The bleeding may be as much as two sanitary pads an hour for 1-2 hours and may include clots as large as a golf ball or a lemon. A heating pad and pain medication, such as ibuprofen, can be used to relieve the cramps. The pregnancy at 10 weeks or less is very small and typically cannot be seen during the medical abortion process. After the pregnancy has passed, you will continue to have some bleeding and cramping for a few days and may have bleeding for up to 4 weeks. After a medical abortion, it’s important to confirm that the abortion is complete by doing an ultrasound or having blood tests.

Advantages

A medical abortion can be done in the privacy of your home and at a time that’s convenient for you. Some people may also have difficulty with pelvic exams or procedures, and neither of these is necessary for a medical abortion.

Risks

Medical abortion is safe and effective. As with any medication or procedure, there are some risks. During the process of passing the pregnancy, a small number of people may not pass all of the pregnancy tissue and may continue to bleed heavily. People who do experience continued heavy bleeding are encouraged to seek medical attention immediately. Despite taking the medication, few people may have a pregnancy that continues to develop. For this reason, following up to confirm that the abortion is completed is extremely important.

Having a medical abortion does not affect your ability to become pregnant in the future. If you don’t want to be pregnant after an abortion, you should start a birth control method as soon as possible as there’s a chance of becoming pregnant again as early as 1 week after an abortion.

Although it’s commonly called a surgical abortion, an abortion procedure does not require incisions or going to sleep with anesthesia. It’s quick, safe, and often done in a clinic or procedure room while you’re awake or have a small amount of anesthetic or pain medication. The abortion provider will do a pelvic exam, gently dilate the cervix (the opening of the uterus), and remove the pregnancy. A surgical abortion can be done at any point in the pregnancy within the legal limits of the state in which you live.

• If your pregnancy is 14 weeks or less, the provider will remove the pregnancy using a plastic catheter and a suction device.
• If your pregnancy is more than 14 weeks, the provider may use instruments in addition to the plastic catheter and suction device. You will experience cramping during the abortion process, but this will improve soon after the abortion is over. A surgical abortion is a shorter process than a medical abortion and you don’t have to return for testing to confirm that the abortion is complete.

Both medical and surgical abortions are extremely safe, and the risk of complications is extremely low. Having an abortion is much safer than continuing a pregnancy and going through the process of labor and delivery. Having an abortion does not change your ability to become pregnant in the future.