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. f 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.
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 form of follow-up. This is very important to be
sure that the abortion has been completed. There are two options for
- Returning to
our clinic for a vaginal ultrasound. The follow-up visit usually
takes about one hour, and is FREE.
- The other
option is to complete a series of blood tests to make sure that the
pregnancy has successfully passed. This option costs money as it
requires a test at a lab outside of Red River Women's Clinic. If you
have insurance you can use your insurance to cover the test - but
will be responsible for any deductible or co-pays. If you do not
have insurance, or you don't want to use it - you can pay us
directly for the services as we get a discount from Sanford and will
charge you only $35 for the first test. To complete the second step
in this process - you will need to go to a clinic near your home and
have a second blood test done. If there is a Sanford clinic near you
- you can pre-pay our discounted fee.
be aware that anytime you have lab services at a clinic other than RRWC
- the results will appear in your medical chart at that clinic. If you
do not want your medical provider to know that you were pregnant, this
is not a good option for you as they may see the results & question you
about the pregnancy.
If your insurance is through a parent or a spouse that does not know you
are pregnant, you may not want to use that insurance. That person may
find out that you had the blood tests, and could ask you questions about
the charges on the insurance. You can always pay the discounted cash
price - even if you have insurance.
If you choose to
complete the blood test process - you can still come back to our clinic
for a check-up with a physician if you feel you need one. The check-up
at our clinic is included in your abortion fee - there are not
additional charges to be seen by us. If the medication abortion is not
complete - we will always provide a suction abortion at no additional
fee for you (If you are still within our gestation limits) - even if you
completed the blood tests.
Whichever method you
choose for follow-up, it is very important that you follow through. If
you do not return to our clinic for the check-up or do the blood tests -
we will send you a letter at your home. Just because you have bleeding
and cramping does not mean the pregnancy has passed.
form of follow-up is REQUIRED for the medication abortion process.