Putting Women First

Medical abortion

What is medical abortion?

Medical abortion is a way to end pregnancy by taking medicines (tablets) by mouth without having surgery.  This can be performed up to 10 weeks of pregnancy and is like having a miscarriage.

The treatment

The treatment will consist of one Mifegyne® tablet. This acts by blocking the effects of progesterone, a hormone which is needed for pregnancy to continue.

Once you have swallowed the Mifegyne® tablet you will be asked to wait 24 hours then to place four tablets of Cytotec® (misoprostol) inside your mouth. This is a different type of hormone, a prostaglandin, that helps to expel the pregnancy. You will have the miscarriage at home.

Telemedicine or in-clinic

You can obtain medical abortion with us either by attending clinic or through a telehealth phone call. You can discuss your preferred option with us during your initial telephone discussion with our nurse. For women who choose to use telehealth, we still provide 24-hour support and advice from our specialised tea, 

Who can use this treatment?

Most women can choose medical abortion. However, it is not suitable:

  • If the first day of the last normal menstrual period was more than 70 days ago. The doctor can confirm the age of the pregnancy with an ultrasound scan.
  • If you have ever had a bad reaction or are allergic to the drugs used in a medication abortion: mifepristone (Mifegyne®) or misoprostol (Cytotec®).
  • If an intrauterine device (IUD) is in place. This must be removed before taking Mifegyne®.

In some other circumstances the treatment may also be unsuitable so the doctor must be advised, please let us know if any of the following apply to you. Then The Women’s Clinic team will discuss whether the treatment is suitable and what your options are.

  • If you have a medical condition such as a heart complaint, high blood pressure or diabetes.
  • If you suffer badly from asthma or are on long-term steroid treatment for any other reason.
  • If you are anaemic or have a bleeding disorder or are receiving anticoagulants.

The Women’s Clinic team will discuss whether the treatment is suitable and what your options are.

Some other precautions

  • The treatment is not suitable if you do not have a telephone or you live more than one hour from Emergency Hospital medical services. This is in case of heavy bleeding needing emergency treatment.
  • If you are breast-feeding you should stop for at least five hours after taking Mifegyne® and throw away the milk produced in that time.
  • If you are taking other medicines prescribed by your doctor you must tell us. Some medicines may interfere with the treatment.

What may you experience during a medical abortion?

  • After taking the tablets, bleeding should start within the next few hours and you will usually get stomach pain and cramps which may be quite strong. A medical abortion is like having a miscarriage. In some cases the bleeding can be very heavy and in a very small number of cases (about 1 in 300) it may be necessary to give a blood transfusion and/or perform a surgical abortion to stop the bleeding. This is why it is important that you have a phone and another adult to look after you during the abortion in case you need help in dealing with these complications.
  • We will give you painkillers to manage the pain. Pain can be worse if you have never been pregnant before or if you normally suffer from painful periods.
  • Other effects of the medicines can be diarrhoea, sickness, headache, dizziness, hot flushes and chills. Any concerns you have must be reported to The Women’s Clinic team.
  • In over 90% of cases the pregnancy will be expelled the same day after taking the tablets. If the medical treatment fails you can have a further dose of tablets the next day by returning to The Women’s Clinic. Should this still fail a surgical abortion will be necessary; this only happens in less than 5% of cases.
  • Many women ask if they will be able to see the embryo. The sac and the placenta surrounding the embryo can be seen clearly but the embryo at this stage is usually too small to be seen.
  • You should have a good supply of maxi-pads. The miscarriage will either occur into your pad, or into the toilet bowl if you decide to rest on the toilet during the heaviest part of the miscarriage. If you are bleeding very heavily (that is you soak more than two maxi pads per hour for 3 consecutive hours) you should seek help immediately. You will be given a number that you can call any time if you have any doubts or questions or need help during the process. However, in the case of immediate needs, such as severe bleeding you should ring 111.
  • A small number of women may develop an infection. This may cause a temperature, or pain, discharge or unusual bleeding. The Women’s Clinic should be consulted if this occurs so that antibiotics can be given, if needed.

Follow-up

  • We will call you the day after you have taken the misoprostol tablets to see if it sounds like you have miscarried. If you have we will organise for you to have a blood test a week later. This blood test is essential for us to be sure that you have miscarried.
  • The follow-up tests to confirm that the pregnancy has ended are essential. The clinic will make an effort to contact you if you do not attend for the tests. Bleeding and cramping are not proof that the abortion is complete.

What about contraception?

  • A plan for future contraception should be discussed with The Women’s Clinic staff.
  • It is possible to become pregnant again immediately after the abortion is complete. Contraception should be started immediately once you have miscarried.
  • Contraceptive implants can be inserted before the woman takes the second medication.
  • An IUD can be inserted a week after the medical abortion is complete.
  • You can resume sexual activity when you feel ready.

What to expect after going home

  • You may continue to bleed for up to 6 weeks. If the bleeding is heavy (more than two maxi-pads an hour for two hours) you should ring the clinic, the referring doctor or emergency hospital medical services.
  • You should recover quickly from the abortion but will be advised to take things easy for a few days and avoid strenuous exercise for two weeks.
  • If you feel that you would like to speak to someone after you have been through the abortion, we can arrange counselling appointments at no charge.
  • Your normal menstrual cycle may take up to eight weeks to re-establish.