The Abortion Pill
The Abortion Pill…in the comfort and privacy of your own home
The Abortion Pill (RU-486 or Medication abortion) is a safe way to end a pregnancy in the earliest stages without a procedure. This is an option for you if you are 10 weeks pregnant or less. Many women choose this method because it feels more natural. They like being at home, having a friend or family member with them, not requiring a procedure or anesthesia and having more control over their medical care. The abortion pill is also a good option for young women under the age of 18 who have adult support, and have never had a pelvic exam. Because it does not involve surgery, it can be perceived as less invasive or distressing for young women.
While the Abortion Pill method is a private experience, it is not one to go through alone. Having a good support system is essential. Understanding what is ahead is important. We hope the following information will be helpful in making the choice on whether the Abortion Pill is the right method for you.
What is the Abortion Pill and how does it work?
Using a series of carefully prescribed pills, a medication abortion terminates a pregnancy in the privacy of your home and allows you to have loved ones around you.
The first pill you are given is called Mifeprex (Mifepristone) and is taken in our office. This pill stops the pregnancy from growing. The second set of medications and pain medication are given to you to take at home. These expel the pregnancy. Please understand that in some ways the Abortion Pill process is very uncomplicated, as there is no surgical procedure, no anesthesia, etc. But, taking these pills involves a greater level of participation from you. Factors such as your emotions, comfort level, family implications, time and place must be considered for a positive outcome.
Is it safe?
Available in Europe and other countries for more than two decades, the FDA approved use of Mifepristone (Mifeprex) or RU-486 in 2000 after testing it for both safety and effectiveness. Since the 1990′s, women have safely used Mifepristone (Mifeprex) to end their pregnancies. It is now used in more than 50 countries.
Is the Abortion Pill method right for you?
It’s important to understand the differences between Medication abortion and surgical abortion:
- The Abortion Pill method is more expensive than surgical abortion because of the cost of the medication
- The abortion takes place over time; you can choose to complete it in one day or two, whatever works best for your schedule
- A follow up visit and ultrasound is necessary to ensure that the abortion is complete (included in your original fee)
- You will expel the embryo at home
To help you make an informed choice about medication abortion, we urge you to read through this section before making your appointment. More importantly, share your concerns with someone. We’re here for you and are more than happy to have a conversation with you as you consider your options.
What to expect at your appointment
When you arrive, you will be welcomed by our staff and be asked to complete informed consent forms and a standard medical history. You will meet our medical team and speak privately with a reproductive health counselor. For your additional safety and comfort, we also:
- Do a urine pregnancy test and an ultrasound to make sure you are 10 weeks pregnant or less
- Sit with you to review your medical history, answer your questions and provide you with a complete explanation of everything involved in a Medication abortion
- Our counseling staff will give you an opportunity to talk about any emotional or spiritual concerns
- Our office is a safe place to express your feelings and fears and our staff is ready to listen and is happy to speak with your support person
- You will leave our office with your medications, including a pain medication, and all the information you will need
- The only way to ensure the Medication abortion has been completed is to return to us for a follow-up ultrasound.
- There is no charge for this visit and it is vital that you make and keep this appointment
How do you know if you are a good candidate for the Abortion Pill?
For you to have a successful abortion experience, we use specific guidelines to help determine if Medication abortion is a good option for you. All of our patients go through a careful screening process. You MUST:
- Be no more than 10 weeks or 70 days from your last normal period
- Be sure of your abortion decision
- Speak, read and understand English or have a translator who speaks, reads, and understands English
- Live within one hour of a hospital in case of emergency
- Have access to a phone and be able to receive phone calls from us
- Be able to swallow pills
- Have immediate and reliable access to a car and a driver in the event of an emergency on the day of your second medication
- Commit to return to us for a check-up in 14 days and possible multiple visits, if needed
- Agree to have a surgical abortion if the medication abortion fails
- If younger than 18 years old, you need parental consent and a parent/adult as your support person
If you think you would be in danger if a partner or family member discovers that you are having an abortion, we urge you to make alternate arrangements to get to a safe place, like a friend’s house, if you need to.
What are the risks?
This method has a slightly higher failure rate than surgical abortion and, if the pregnancy were to continue, the medication used can cause serious birth defects. You MUST be willing to consent to a surgical abortion if the medication abortion fails.
And, crucial to your health: It is only with a follow-up visit and a repeat ultrasound at one of our Centers that we are able to determine if the procedure has worked.
What are the possible and reasonably likely side effects of Mifepristone (Mifeprex)?
Bleeding and cramping are a normal part of the process. The bleeding can be heavier than a normal period and can last from 9-16 days. In some cases, women may have severe bleeding. If this occurs, you need to contact us immediately. Some women experience pain, nausea, headaches, vomiting or diarrhea.
Who should NOT take Mifepristone?
You should not use Mifepristone if your last menstrual period was more than 10 weeks or 70 days ago. Also, Mifepristone cannot safely be used if you:
- Have an ectopic (tubal) pregnancy
- Have an IUD in place (it must first be removed)
- Have problems with your adrenal glands
- Have been treated with certain steroid medications over a long period of time
- Have bleeding problems or are taking blood thinning medications
- Have had a negative reaction to Mifepristone (Mifeprex), Misoprostol (Cytotec) or a similar drug
- Cannot return for necessary visits, including your 2-week follow-up
- Cannot easily get to emergency medical help, should you need it, in the 2 weeks after you take Mifeprex
Note: Women who are breastfeeding should discontinue breastfeeding while taking these medications.
I’m interested, but what else should I consider when making this decision?
Responsibilities at home and work…think about your schedule. Are you available to come in for both appointments and can you stay home for at least one full day immediately after you take your second medication, Misoprostol? While you can choose to use the Misoprostol anywhere from 6-48 hours after the Mifeprex, you will still need some time to recover at home.
Because your abortion will occur at home, it’s important to have a support person there with you… someone who knows you are having an abortion and is supportive, and who can drive you to our Center or the hospital in the event of an emergency. Think about what you would like your support person to do for you during your abortion experience.
- Will he or she be able to remain calm throughout this procedure or in case of an emergency? Will they be able to handle the sight of blood, the expulsion of the embryo? How will they react if they see you in pain?
- Where will your children or other family members be when you are going through this process? Do you want them to know? Will they support you?
- We recommended that women who are caring for small children or other relatives make arrangements to have someone watch them during the abortion process. Or, taking the Misoprostol at night might work best for you, while your children are sleeping and your support person is with you.
- If you have a roommate, will you have privacy in the bathroom? Do you want your roommate to know?
- It may be helpful to read over and share ideas from our Supporting a Loved One page
You will take the first set of pills at our Center, but the second medication will be taken at home. There are 2 different ways to take the second set of pills at home; your doctor will review with you what method is best for you. You will most likely pass or expel the pregnancy at home, which means you have to consider how you will react to seeing what looks like a lot of blood in the toilet (when mixed with water, it looks like there is much more blood than there actually is), blood clots and possibly the embryo. Most women don’t see the embryo. The embryo can be discharged in a blood clot making it difficult to see. If you do see the embryo, will you want to examine it to say goodbye or do you think you will want to flush it away without looking? Think about how you want this experience to be and be sure to give yourself the comforts and support systems you need to create a positive abortion experience. Consider surrounding yourself with items that make you feel good: videos, books, a bouquet of flowers, music.
Will the abortion pill prevent you from getting pregnant in the future?
Infections are the greatest threat to fertility, not abortion. Regardless of method, abortion is more than 10 times safer than childbirth. So, just like after surgical abortion, until your follow-up, nothing is to be placed into your vagina. And, just so you know, you can become pregnant again immediately after this pregnancy ends. If you do not wish to become pregnant, you must abstain from sex or use an effective method of birth control. We can help you select a method that is best for you.
What are some of the perceptions and misperceptions?
“It’s a miscarriage.”
Some women refer to their experience as a miscarriage rather than an abortion. That is a personal choice, but as our patient, we want to be sure you understand that you are ending a pregnancy by abortion. And, we want to make sure you have the emotional and moral support you need during this time.
“I can avoid doctors by having a Medication abortion.”
Some women do not like going to the doctor and think that the medication abortion is a way to avoid seeing a doctor. It is important to know that with any type of abortion, or with continuing a pregnancy, you will still need to see a doctor to have an initial health and pelvic exam, bloodwork and a vaginal ultrasound. Northland Family Planning also employs women doctors who understand your emotions and physical needs.
If you have ever been raped, sexually abused or taken advantage of sexually and did not get help with your feelings about this experience, please let us know. We can offer special support here and community referrals for help and support.
“My last abortion was a terrible experience so this will be a better method for me.”
First, let’s figure out what was okay and not okay about that experience. Perhaps you were further along into the pregnancy, a factor that affects the ease of the procedure. Maybe the physician or staff didn’t treat you as you wanted to be treated, leaving you feeling angry. If you felt pushed into the decision by someone and not allowed to explore your own feelings, this may have made the experience more difficult. Think about how you want this experience to be this time and give yourself the comforts and support systems you need to create a positive abortion experience.
IMPORTANT INFORMATION: BE WARY OF THOSE WHO PUT YOUR HEALTHCARE ‘ON SALE’! MIFEPRISTONE (MIFEPREX) IS THE ONLY DRUG APPROVED BY THE FDA FOR MEDICATION ABORTION: A different drug, Methetrexate, is being used by some providers for the medication abortion. It is much cheaper, takes longer to work and is less successful. Northland Family Planning uses only Mifepristone, ensuring you the very best and most up-to-date medical care.