The Abortion Pill: Medical Abortion
This method of abortion is available 5 weeks up to 9 weeks + 3 days of pregnancy (9 weeks + 3 days since last period).
Over half of all abortions taking place in England and Wales are medical abortions which involve taking medications to end the pregnancy. As a medical abortion is non-invasive and does not require any anaesthetics, it has a much lower risk of serious complications.
What is the abortion pill?
The medical abortion commonly referred to as the abortion pill, is an early abortion method. It actually involves taking two sets of pills (Mifepristone and Misoprostol). These medications cause the passing of the pregnancy which resembles a miscarriage.
The first tablet: Mifepristone
Mifepristone stops the hormone progesterone – the hormone necessary to maintain a pregnancy. Without this hormone, the pregnancy is unable to continue. After taking Mifepristone, most women can carry on with everyday life. There's normally no side effect, however, some women experience some spotting and in rare occasions, can cause the pregnancy to pass.
Once the Mifepristone has been taken, if you change your mind about continuing with the pregnancy, we cannot guarantee a healthy pregnancy.
The second tablet: Misoprostol
Misoprostol will be taken by mouth between 6 -72 hours after the Mifepristone. Four tablets called Misoprostol are placed in the upper gums, this causes the uterus to contract and expel the pregnancy, like in a miscarriage.
The success rate of the treatment changes depending on the length of the interval in between taking Mifepristone and Misoprostol.
What to expect with the abortion pill(s). How much bleeding will there be?
A medical abortion is very similar to an early miscarriage. It is normal to experience heavy bleeding, passing clots and cramping. For your comfort, we advise you to be close to toilet facilities at this stage.
For most women, heavy bleeding usually starts within 1-2 hours of taking Misoprostol. In rare cases, it can start as quickly as 15 or 20 mins, or it can take up to 2 days to start.
If the bleeding doesn’t start within 24 hours of taking the Misoprostol, please contact our aftercare line.
Once the pregnancy has passed, the bleeding should be lighter and become like a heavy period for a further 2 to 10 days and may come and go over a period of 2-4 weeks. Bleeding isn’t anything to be concerned about unless you find you are changing your pad more than twice an hour for two hours. The menstrual period can take up to 4-6 weeks to return to normal but can be affected by the method of contraception you are on.
Bleeding may be accompanied by heavy cramping for 2-5 hours. Paracetamol, Ibuprofen and heat packs/hot water bottles are often enough to manage the pain. It is important not to take aspirin as this will cause more bleeding.
We advise that you wear a sanitary pad to your 2nd stage appointment in case the bleeding starts quickly. Please do not wear tampons to avoid the risk of infection.
Eating and Drinking
You can eat and drink as normal before your appointment if you are having a medical abortion. It is advisable to have something to eat as you will be taking some antibiotics and these will go down better if you have something in your stomach. Please note that this advice may be different if you scan over the 9 weeks + 3 days limit and are rebooked into a surgical appointment. Find out more about surgical abortion.
Should I take any time off work?
If you are having a medical abortion, there is no requirement for you to take time off work. Depending on the abortion method that you choose, the type of anaesthetic and how many weeks it has been since your last period, you may be able to go back home on the same day or stay overnight.
Read more about our travel advice
Once you are home, how you will be feeling will vary from woman to woman. You may feel fine to return to work straight away or feel like it would be best to take days off work. You know your own body and will know what’s best for you and your health.
Please don’t hesitate to speak to one of our nurses if you are worried about anything after your treatment. Our specialist nurses are on the other end of the phone if you’re worried about anything at any point.
What are the side effects and complications with the medical abortion?
Not everyone experiences side effects from Misoprostol but it’s important that you’re aware of any risks and side effects:
These are not pleasant but they aren’t anything to worry about and shouldn’t last more than 24 hours. Medical abortion can also worsen symptoms of migraines and asthma in some people.
• Uncontrolled haemorrhage (prolonged heavy bleeding) – this is very rare but if you’re concerned about the level of bleeding you are experiencing, please don’t hesitate to call us
• Infection is rare. We will give you antibiotics to help prevent infection. Signs of infection include smelly vaginal discharge, fever lasting more than 24 hours, strange pain, and generally feeling unwell. If you experience these symptoms, please phone our aftercare line
• ‘Incomplete abortion’, where some of the pregnancy tissue remains in the uterus. If you have an incomplete abortion, we can arrange for a further dose of medication or a surgical appointment.
• Failed abortion – where the abortion drugs fail to work and the pregnancy continues
• Thrombosis (clots in the legs or lungs). This is a risk of being pregnant. This risk increases with a higher gestation
• Death: This is extremely rare after medical abortion and occurs in less than 1 in 10,000 abortions
Can the abortion pill(s) fail?
The failure rate of medical abortion is very low – 2 to 3 women in every 100. When a medical abortion fails this means taking more tablets or having a surgical procedure. In around 4% of these cases, further medical intervention is required.
If no bleeding (or very minimal) has occurred for 2 weeks with continued pregnancy symptoms, it is likely that the treatment has failed. Please call our aftercare line to speak to one of our nurses if you are worried about anything.
Most women experience no complications when having a medical abortion. Generally speaking, the sooner an abortion is carried out since your last period, the lower the risk. If you have an abortion in a safe, clinical setting like a Marie Stopes UK centre or clinic, you’re at a low risk of complications.
Am I eligible for medical abortion?
Not all women are suitable for this abortion method with Marie Stopes UK. But they may be able to have a surgical abortion or be referred to an NHS hospital in England and Wales.
You may not be able to have a medical abortion if you:
• Have a suspected ectopic pregnancy
• Have a history of heart disease, high blood pressure, liver or kidney disease
• Are taking long-term corticosteroids
• Have an IUD in place which will not be removed prior to treatment
• Adrenal failure
• Are taking anticoagulants or have any haemorrhagic disease or porphyria
• Have a poorly controlled inflammatory bowel disease
• Suffer from muscular dystrophies, myasthenia gravis, myotonic dystrophy or sickle cell disease
• Are currently taking the herbal remedy St. John’s Wort – (Hypericum Perforatum)
Our team will assess other factors that will need to be taken into consideration such as:
• Your Body Mass Index (BMI calculator) – we will ask you for your height and weight
• If you suffer from migraines
• If you suffer from asthma
Buying the abortion pill(s) online
In the UK, abortion pill(s) are only legal if taken on premises licensed by the Department of Health and registered with the Care Quality Commission (CQC) such as Marie Stopes UK clinics and centres.
Ordering the medication online without medical supervision can pose a serious risk to your health. We strongly recommend that you do NOT take the medical abortion pills without being supported by a trained professional.
Here are some of the factors you should bear in mind if you are considering ordering the abortion pill(s) online without being under clinical supervision:
• There may not be any guarantee that the drugs that are sent to you are safe and effective or that the drug is what it says it on the pack
• You would not receive a thorough medical pre-assessment to make sure that abortion is safe for you. This would include any contraindications with your personal medical history or current drugs you are taking, your blood type, gestation, Body Mass Index and more
• You would not be given the appropriate drugs, antibiotics or injections that you may need as part of your abortion treatment which could create easily avoidable medical complications
• You may not receive the appropriate and caring post-abortion support you would receive under medical supervision
• You may risk prosecution in your country
• Untreated complications can cause infertility or lead to death (in rare circumstances)
With our care and expertise, you can rest assured that we will support you every step of the way and make sure you receive the medical attention you need.
Why Choose Marie Stopes UK?
Marie Stopes UK will take a full medical history and may need you to have some tests done to ensure your safety during treatment. If you have serious medical issues, we may suggest it's safest to have your abortion done in a hospital setting.
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