A medical abortion uses two medicines to end an unwanted pregnancy (commonly known as the Abortion Pill). The first tablet weakens the attachment of the pregnancy to the uterus. A second medication is then swallowed or put into the vagina 36 to 48 hrs, which makes the uterus cramp and causes bleeding to expel the pregnancy.
Medical abortions can be provided from as early as a pregnancy can be confirmed, up to 9 weeks. The length of a pregnancy is usually measured by the number of days that have passed since the first day of the woman's last menstrual period (abbreviated as LMP).
It can take anywhere from about 2-4 weeks from the time a woman takes the first medication until the medical abortion is completed.
The most common side effects of medical abortion are caused by the second pill. In addition to cramps and bleeding, early side effects may include: headache, nausea, vomiting, diarrhoea, fever, chills, or fatigue. It causes cramping pain and bleeding, usually within a few hours of using the tablets. Pain can range from mild, period-like pain to severe, disabling pain.
In about 7% of cases the medications do not work and the pregnancy 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 medications because the medications can cause birth defects in the pregnancy.
Although cramping and bleeding are expected as part of ending a pregnancy, rarely, serious and potentially threatening bleeding, infections or other problems can occur following a medical abortion. The use of this treatment is not risk free.
A medical abortion may be suitable for most pregnancies up to 9 weeks but there are certain conditions that may prevent women from choosing this method. These conditions are listed below:
- Women who wish to minimise participation in their abortion
- Women who are anxious to have the abortion over quickly
- Women that can't return for follow up visits
- Women who can't communicate easily with the provider due to language or comprehension barriers
- Women who are unable to access phone services or Emergency medical treatment
- Women who are unwilling to undergo a surgical abortion procedure should the medical method fail, or in case of an incomplete abortion, heavy bleeding
- Women younger than 18 years of age
The following medical conditions also make her unsuitable.
- Allergy to the medications in the abortion pills
- Severe anaemia
- Bleeding disorders
- Inherited porphyria (rare blood disorder)
- Long term anti-coagulant therapy (blood thinning agents) (Warfarin, Heparin)
- Chronic adrenal failure
- Corticosteroids therapy (eg. Prednisone, cortisone)
- Irritable bowel disease (chronic diarrhoea and Crohn's disease)
- Serious systemic illness (eg. Heart disease, severe liver disease, kidney failure, uncontrolled seizures)
- Serious pelvic infection
- Confirmed or suspected ectopic pregnancy (Pregnancy growing outside uterus)
- Presence of an intrauterine device. This must be removed before proceeding with abortion.
- Women who are breastfeeding may be eligible, provided the woman is prepared to stop breastfeeding from Day 1 (taking the first tablet) until Day 4 (24 hours after taking the four tablets).
Once a woman has decided to have a medical abortion, the following three steps will follow:
Step One - at the clinic (we have clinics in Brisbane and the Gold Coast)
- At the clinic, a medical history is taken and a clinical exam with ultra sound and lab tests are performed
- Counselling is completed and informed consent is obtained
- If eligible for medical abortion, the woman swallows the abortion pill
- Take home the second tablets
Step Two - at home
- This step takes place 36 to 48 hrs after step one.
- The woman uses the second tablets, which may be swallowed, placed between cheek and gum, or in the vagina.
Step Three - at the clinic
- This step takes place within about 2 weeks of step two (earlier if any concern)
- It is essential for women to return to the clinic to confirm that the abortion is complete.
- If there is an ongoing pregnancy, a suction abortion should be provided.
- If there is an incomplete abortion, the clinic doctor will discuss possible treatment options with the woman. These may include waiting and re-evaluating for complete abortion in a number of days or performing a suction procedure.