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MEDICATION ABORTION (THE ABORTION PILL)   

A medical abortion is one that is brought about by taking medications that will end a pregnancy.  Red River Women's Clinic offers medication abortion in the first 63 days (less than 9 weeks) of pregnancy.  Two medications are used as part of the medication abortion, mifepristone and misoprostol.

Mifepristone (the abortion pill or RU-486) is a medication that was developed and tested specifically as an abortion-inducing agent.  It was first licensed in France and China in 1988.  Since then it has been used safely by millions of women worldwide.  It was approved for use in the U.S. in September, 2000.

Mifepristone is taken in the form of a pill.  It works by blocking the hormone progesterone, which is necessary to sustain pregnancy.  Without this hormone, the lining of the uterus breaks down, the cervix (opening of the uterus) softens, and bleeding begins.

Misoprostol Within 24-48 hours after taking the mifepristone, a second drug, misoprostol, is taken.  Misoprostol tablets (which are placed in the cheek pouch between the cheek and gums) cause the uterus to contract and empty.  This ends the pregnancy.

It can take anywhere from about a day to 3-4 weeks from the time a woman takes the first medication until the medical abortion is completed.  The length of time depends in part on the medications taken and when the misoprostol is used.  The majority of women who take mifepristone will abort within four hours of using misoprostol.  About 95% of women will have a complete abortion within a week. 

Some women have vaginal bleeding after the first drug.  This bleeding may be light, or it may be like a heavy period.  After taking the misoprostol, cramping and bleeding usually begin within a few hours, although it may take longer.  The cramping and bleeding may be more than with a normal menstrual period. 

The most common side effects of medical abortion are caused by misoprostol.  In addition to cramps and bleeding, early side effects may include: headache, nausea, vomiting, diarrhea, fever, chills, or fatigue.  If a woman experiences flu-like symptoms or abdominal pain more than 24 hours after using misoprostol, she is advised to call the clinic. 

Most women have cramps for several hours, and many pass blood clots as they are aborting. Blood clots can be quite large, like a lemon or the palm of your hand.  This is to be expected.  Some women may see the grayish gestational sac.  However, the embryo will probably not be seen among the blood clots.  Cramps and bleeding usually begin to ease after the embryonic tissue has been passed, but bleeding may last for one to two weeks after medical abortion.

Possible Complications:  About 95-98% of women will have a successful medical abortion.  Complications are rare.  However, a small percentage of women (approximately 0.5-2%) will need a suction aspiration (similar to a surgical abortion) because of heavy or prolonged bleeding.  Rarely, in approximately 0.1-0.2% of cases, a blood transfusion might be required to treat very heavy bleeding. 

In about 1% of cases or fewer, the medications do not work and the embryo continues to grow. In these cases, a suction procedure (surgical abortion) must be done to empty the uterus and complete the abortion.  Deciding to continue the pregnancy to term is not an option after taking the first medication because the medications can cause birth defects in the pregnancy.

Medical abortion requires a follow-up visit to the clinic.  This return visit is very important to be sure that the abortion has been completed.  The follow up visit consists of a pregnancy test and a vaginal ultrasound.  The follow-up visit usually takes about one hour, and is FREE.

                             


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