Procedure, Effect, and Further Information on Medication Abortions
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- Medical abortions (aka, chemical abortions or medication abortions) are limited to the first nine weeks (in the UK, Australia, Ireland, and South Africa) or ten weeks (in the USA, Canada, and New Zealand) of pregnancy.
- The abortion pill is a combination of two medications:
- First, a single pill of 600mg mifepristone is taken (or 3x200mg pills). This medication causes the cervix to dilate and the uterine lining to loosen. The embryo dies in the process.
- Another pill (misoprostol) is taken 2-3 days later, causing contractions that bring about the expulsion of the embryo.
On this page, you will find more information about the process and effect of a medication abortion, including possible risks and repercussions.
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Abortion with Pills
In addition to surgical abortion methods, medication abortions are possible through pills. This is also referred to as chemical or hormonal abortion. Here, a pregnancy termination (removal of the embryo) is achieved by taking medication.
The word "pill" in this context is a colloquial term for the abortion pill.
Note: The active ingredient in the pill used for pregnancy terminations is neither the same as the contraceptive pill nor the morning-after pill (Plan B).
The abortion pill is a two-drug combination: The active ingredient of the first medication is mifepristone (mife). In addition, prostaglandin pills, such as Cytotec® with the active ingredient misoprostol (miso), are used to complete the abortion.
Prostaglandins are also sometimes used before surgical abortions via vacuum aspiration. In this case, the purpose of the drug is to soften the cervix in advance.
ℹ️ According to the Guttmacher Institute, the abortion pill was used in over 54% of US abortions in 2020. Mifeprex® is the most common abortion pill brand name. Other names for the abortion pill are Korlym, Mifegyne®, Mifegymiso®, and RU-486.
The abortion pill must be prescribed by a doctor and can only be used until the 9th week (Australia, UK, Ireland, South Africa) or 10th week (USA, New Zealand, Canada) of pregnancy, counting from your last menstrual period (LMP).
⏳Cut-off dates for abortions vary from state to state and country to country. Find out which limits apply to your area by going to Until When Can I Get an Abortion?
There is no minimum length of pregnancy for the utilization of the abortion pill, unless ultrasound requirements apply to your region. In that case, you would have to be at least six weeks along to receive the abortion pill.
Privately funded, the abortion pill usually costs $350 to $650 in the United States, around £500 in the United Kingdom, $250 in Australia, and R620-R1200 in South Africa (rates are not guaranteed). For more information, go to How Much Does An Abortion Cost?
For pricing of telemedicine abortions, go to Telemedicine Abortion Near Me.
ℹ️ The ten main steps of abortion can be found in the article Abortion Methods.
Before the Procedure
In some cases, the woman's blood type is determined. This is an advisable precautionary measure for two reasons:
If heavy bleeding during the abortion necessitates a blood transfusion.
If the woman is rhesus negative, she will need to receive a RhoGAM shot to avoid complications in future pregnancies.
Often, an ultrasound is ordered by the prescribing physician to determine the location and size of the embryo and to rule out a possible ectopic pregnancy.
Taking the abortion pill while experiencing an ectopic pregnancy would mask the symptoms. This may cause a dangerous delay in medical intervention.
Ultrasound is the most accurate tool for determining how far along you are in the pregnancy. Once you have passed the 9th week of pregnancy, the risk of complications with the use of the abortion pill increases drastically. Therefore, the abortion pill is not prescribed beyond the 9th or 10th week.
Medical Abortion Procedure
Initially, the pregnant woman takes one 600mg pill of mifepristone (or 3x200mg), as prescribed. Medical supervision for at least two hours after administration of the drug is advisable.
Two to three days later, another medication with the active ingredient misoprostol is taken according to the doctor's prescription.
Misoprostol is a synthetic prostaglandin that induces contractions. During an abortion, it causes the uterus to contract and bleed. Therefore, the woman should be closely monitored for the next six hours.
Within approximately two hours after the administration of misoprostol, bleeding sets in, and the embryo is expelled. If bleeding has not commenced within three hours, a second dose of four misoprostol tablets is administered.
After the Procedure
Seven to twenty-one days after the administration of misoprostol, a follow-up examination is recommended. Ultrasound or lab tests can determine whether the embryo and placental tissue with the chorionic villi have been completely expelled.
What is the Abortion Pill?
How the Abortion Pill Works
The abortion pill contains the active ingredient mifepristone. Mifepristone blocks the effects of the hormone progesterone, which is essential for maintaining a pregnancy.
Mifepristone makes the pregnant woman's body believe she is no longer pregnant.
Within approximately 48 hours, the cervix begins to dilate, and the mucus plug loosens.
The preliminary stage of the placenta with the chorionic villi is already developing in the very first weeks of pregnancy. It is responsible for the exchange of nutrients and metabolic products between the maternal and child's circulation. Mifepristone causes the lining of the uterus with the chorionic villi to detach from the uterine wall. The embryo loses its footing and, thereby, its source of nourishment and dies.
In rare cases (3%), the first abortion pill works quickly, causing bleeding and cramping, resulting in the expulsion of the embryo and placental tissue.
However, in most cases, the first pill (mifepristone) alone does not lead to the embryo's expulsion. Therefore, the doctor also administers a prostaglandin two to three days later. This is a hormone that triggers contractions.
Abortion Pill Side Effects
Aside from vaginal bleeding, a medication abortion can have the following side effects:
- Abdominal pain/cramps
- Dizziness, chills, or hot flashes
- Nausea, vomiting, and diarrhea
- Heavy bleeding
Heavy bleeding may necessitate a curettage or a blood transfusion. For this reason, a medication abortion should only be performed under medical supervision and near an emergency room.
Your doctor will provide you with further information during your preliminary consultation.
Risks, Advantages, and Disadvantages
At first glance, a medical abortion seems more manageable and less stressful for the woman — after all, the alternative would be surgery. Nevertheless, several aspects should be considered:
Potential Physical Ramifications
Terminating one’s pregnancy via the abortion pill, using mifepristone and misoprostol, is physically demanding as it creates a hormonal deficit and is drawn out over several days.
- For further information on risk factors, go to Physical Effects of an Abortion.
Potential Emotional Consequences
Additionally, women often talk to us about their significant emotional strain:
- By taking the pill, the woman actively initiates the process of abortion.
- Some women still feel torn even after taking the first pill and struggle to decide whether they want to go through with the abortion. Then, the question arises of whether it is still possible to keep the baby. Sometimes it is too late to stop the abortion after taking mifepristone, but reversals are successful in many cases. For more information, go to Reversing an Abortion.
- Many women find it particularly hard to consciously experience the abortion unfolding over the course of several days.
To find out more, go to Anticipated Emotional Effects of an Abortion.
If you still feel unsure whether to have an abortion or have concerns about possible post-abortion repercussions, allow your gut instinct a voice in the decision-making process. Your thoughts and emotions matter! A decision as far-reaching as this also deserves the time you need and the outside support necessary for making a solid choice. Your life is too valuable for a quick fix.
Where Do I Go From Here?
Perhaps you are pregnant, and this situation is very stressful for you right now. Feeling the way you do is a normal response. Many women share the same reaction. Knowing more about your options may calm you down or create additional upheaval. All sorts of thoughts and feelings may come and go...
Don't keep your questions, concerns, and fears to yourself! We are here for you and would love to support you in discerning a way forward.
Take advantage of our digital counseling services and tests:
- ⚖️ Wondering whether to have an abortion or not? Take the Abortion Test!
- 🛤 Could an abortion affect me long-term?
- 🧑⚕️ (Suspecting a) pregnancy — How soon to see a doctor?
- 🤔 Could my symptoms be early signs of pregnancy?
Experiences with the abortion pill are unique and differ from woman to woman. While some women report a relatively complication-free procedure, with moderate pain and period-like bleeding, others describe the process as extremely taxing, physically and/or emotionally. Taking the abortion pill can result in severe pain and blood loss. The abortion may also be prolonged beyond the expected time frame. For more information on the abortion procedure, click here.
The abortion pill can only be obtained after a consultation with a medical provider. This sometimes requires an in-person office visit. Some women see it as an advantage to have the abortion procedure at home. Other women consider this a drawback and emotionally taxing.
A medical abortion usually takes hours and days to complete. Side effects may include heavy bleeding, pain, nausea, and faintness. The prescribing clinic should be available throughout the procedure to field questions. The abortion pill must only be taken within a 2-hour range of an emergency room, should surgical intervention become necessary. If remnants remain in the uterus, a D&C may be required.
For safety reasons, the abortion pill can only be used up to the 9th or 10th week of pregnancy. Vacuum aspirations can be performed until the 16th week of pregnancy (calculated from the last menstrual period — LMP). If a woman is unsure about her decision, the cut-off date can be a disadvantage by creating additional time pressure.
The abortion pill is available by prescription only. In the US, it is obtained directly from a clinic rather than a pharmacy.
Privately funded, the abortion pill costs $350 to $650 in the United States, £500 in the United Kingdom, $250 in Australia, and R620-R1200 in South Africa (rates not guaranteed). For more information on rates, click here.