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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.

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 form of follow-up. This is very important to be sure that the abortion has been completed.  There are two options for follow-up:

  • 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.

CONFIDENTIALITY ISSUES: Please 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.

INSURANCE ISSUES: 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.

A form of follow-up is REQUIRED for the medication abortion process.


e-mail us at: info@RedRiverWomensClinic.com