Medical Abortion (Abortion Pill)

Medical abortion is a way to end a pregnancy using medications without a surgical procedure. The protocol approved by the Food and Drug Administration allows this type of abortion up to 49 days after the last menstrual period. Only a licensed physician can perform a medical abortion. A medical abortion can only be used in early pregnancy, usually up to seven weeks. The gestational age must be determined before taking any abortion medications.

The Two Common Types of Medication used are:

RU-486 (AKA Mifeprex or Early Option Pill)

Morning After Pill (AKA Emergency Contraception)

Who should NOT have a medical abortion?

Some women should not be given medical abortion medications such as women who are too far along in their pregnancy or are allergic to certain medications, women with confirmed or suspected ectopic pregnancy, or women with an IUD in place. You should discuss with your doctor whether you have any medical condition that would make a medical abortion unsafe for you.

To have a medical abortion, you must:
• Have access to an emergency room.
• Have access to a telephone.
• Be able to attend all the visits; several visits may be required.
• Be able to follow the doctor’s instructions and understand what may occur with the procedure.

RU-486 (AKA Mifeprex or Early Option Pill)
(For use up to 7 weeks from LMP.)

RU-486 is a man made steroid designed to work against the pregnancy.

Mifepristone and methotrexate are two of the medicines used for a medical abortions. Milefistone is given a woman orally or vaginally. Methotrexate is usually given by injection, but may also be given by mouth. Methotrexate can cause serious birth defects if your pregnancy doesn’t end.

After receiving mifepristone or methotrexate, you may bleed and pass clots, tissue, and the unborn child within hours to days. The bleeding can last up to three weeks or more. Your doctor will tell you when you need to return to be checked. If you are still pregnant at that visit, you will be given a second drug (misoprostol), either by mouth or vaginally. Approximately two weeks later, you will return for an important follow-up visit. Your doctor will determine whether your pregnancy has completely ended. If you are still pregnant, a surgical procedure will be necessary.

Possible Side Effects and Risks:
• Strong cramping of the uterus or pelvic pain.
• Nausea or vomiting.
• Diarrhea.
• Warmth or chills.
• Headache.
• Dizziness.
• Fatigue.
• Inability to get pregnant due to infection or complication of an operation.
• Allergic reaction to the medications.
• Hemorrhage (heavy bleeding) possibly requiring treatment with an operation, a blood transfusion, or both.
• Incomplete removal of theunborn child, placenta, or contents of the uterus, requiring an operation.
• Rarely, death.

It is important that you fully communicate all health conditions to your doctor.

Morning After Pill (AKA Emergency Contraception)
Must be used within 72 hours of intercourse. There are two FDA approved emergency contraceptive drugs: Plan B and Ella.
Plan B (levonorgestrel) is the only FDA approved progestin-only emergency contraceptive. The morning after pill is not for routine use. Failure rates and side effects increase with repeated use.

Plan B works like a birth control pill. There are 3 ways a birth control pill can work:
1. Stop the release of an egg from the ovary.
2. Prevent the fertilization of an egg (the uniting of a sperm with the egg).
3. Prevent the already fertilized egg (embryo) from attaching to the uterus (womb). This causes an already fertilized egg to be expelled from the womb, causing an early abortion.

Possible Side Effects:
• Approximately 1 out of 4 women studied experience menstrual bleeding and nausea.
• Approximately 1 out of 5 women studied experience abdominal pain, fatigue, and headache.
Other side effects include:
• Changes in menstrual cycle
• Breast tenderness
• Dizziness
• Vomiting

Ella (ulipristal acetate) is in the class of progestins and supplied in a 30 mg tablet. It is not recommended for use as a routine contraceptive. The possibility of pregnancy should be excluded before Ella is prescribed. One tablet should be taken orally as soon as possible within 120 hours after unprotected intercourse or birth control failure (such as a broken condom).

Ella is a progestin hormone that prevents pregnancy be preventing the release of an egg (ovulation) and changing the womb and cervical mucus to make it more difficult for an egg to meet sperm (fertilization) or attach to the wall of the womb (implantation).

Some common drugs and compounds that may reduce the effectiveness of Ella are barbiturates, carbamazepine, phenytion, rifampin, and St. John’s Wort. It is unknown if the drug is excreted in breast milk.

Using this medication will not stop an existing pregnancy or protect you against sexually transmitted disease.

Most Common Side Effects:

  • Headache
  • Nausea
  • Abdominal Pain

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