Medical (non-surgical) Abortion: First Trimester – Up to 7 Weeks after last menstrual period (LMP)

Nearly 1 in 4 abortions in the U.S. are now done by with this procedure.1 Doctors in some states (including Iowa) can give an abortion pill from a distance in what is called a telemedicine or webcam abortion. The abortion pill goes by many names, including medication abortion, RU-486, Mifeprex (Mifepristone) and misoprostol.

The abortion pill is approved by the U.S. Food and Drug Administration for use in women up to the 49th day after her last menstrual period.2  Some abortion doctors have been known to give the pill to a woman who is past the FDA’s approved 49-day-limit.3

In order to make sure you’re safe during this process, it is recommended for a doctor or other qualified medical professional (registered nurse or sonographer) to do an ultrasound to make sure the pregnancy is viable (uterine, non-ectopic pregnancy) and within the seven weeks, the FDA requires. Since a medical abortion will not end a life-threatening ectopic pregnancy4, your life could be in danger if you do not confirm with an ultrasound that you are pregnant.5

Her Health Women’s Center offers free first-trimester limited ultrasound services. Call us at 712-224-2000 to schedule a free, limited first-trimester ultrasound.

If you choose to use a medication abortion to end your pregnancy, you will need to make three separate visits to the doctor’s office:

  1. On your first visit, a physical exam is first given in order to determine eligibility for this type of medical abortion procedure. You are not eligible if you have any of the following: ectopic pregnancy, ovarian mass, IUD, corticosteroid use, adrenal failure, anemia, bleeding disorders or use of blood thinners, asthma, liver or kidney problems, heart disease, or high blood pressure. You will be given antibiotics to prevent infection and three pills (Mifepristone) to begin the process of ending your pregnancy. Mifepristone blocks progesterone from the uterine lining, causing the lining to break down, preventing the ability to continue a pregnancy.Note: If you change your mind after the first visit, call 1-877-558-0333 for help. In some cases, the effects of Mifepristone can be reversed.
  2. If your embryo has not been expelled from your body, you will be given Misoprostol tablets, orally or inserted vaginally, about 36 to 72 hours after taking the Mifepristone. Misoprostol causes contractions to complete the abortion and expel the fetus. This process may take a few hours or as long as a few days.
  3. One to two weeks later, you will make a third visit to check whether your pregnancy has been ended by the abortion and see if there are any complications.

The side effects and risks of Mifepristone and Misoprostol include the following:

  1. The procedure is unsuccessful approximately 8-10% of the time with the potential of requiring an additional surgical abortion procedure to complete the termination.
  2. Cramping, nausea, vomiting, diarrhea, heavy bleeding, infection
  3. Not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease, or use an intrauterine device (IUD).

Footnotes

  1. “Fact Sheet: Induced Abortion in the United States,” The Guttmacher Institute, last modified July 2014,http://www.guttmacher.org/pubs/fb_induced_abortion.html.
  2. “Medication Guide: Mifeprex,” The U.S. Food and Drug Administration, last modified April 22, 2011,http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088643.pdf.
  3. Graham Lee Brewer, “Oklahoma Abortion Doctor Facing Felony Charges Loses State Medical License,” The Oklahoman, Dec. 30, 2014.
  4. “Mifeprex: Prescribing Information,” Danco Laboratories, last modified April 22,2009,http://www.earlyoptionpill.com/userfiles/file/Mifeprex%20Labeling%204-22-09_Final_doc.pdf. See also “$15 Million Lawsuit Filed In Case Of Local Woman Who Died After Abortion,” The Chattanoogan, Aug. 14, 2002.
  5. An ectopic pregnancy is a potentially life-threatening condition where an embryo implants outside of a mother’s uterus, often in her fallopian tube. This condition can only be detected through an ultrasound.
  6. Medication Abortion-Facts and information for healthcare professionals,http://www.medicationabortion.com
  7. Planned Parenthood, http://www.plannedparenthood.com