Medication for Unwanted Pregnancies and What to Expect

Medical abortion is a procedure that uses medication to end a pregnancy. A medical abortion doesn’t require surgery or anesthesia and can be started either in a medical office or at home with follow-up visits to your doctor. It’s safer and most effective during the first trimester of pregnancy.

Having a medical abortion is a major decision with emotional and psychological consequences. If you’re considering this procedure, make sure you understand what it entails, side effects, possible risks, complications and alternatives.

Why it’s done

The reasons for having a medical abortion are highly personal. You can choose medical abortion to complete an early miscarriage or end an unwanted pregnancy. You can also choose to have a medical abortion if you have a medical condition that makes continuing a pregnancy life-threatening.

 Risks

• Potential risks of medical abortion include:
• Incomplete abortion, which may need to be followed by surgical abortion
• An ongoing unwanted pregnancy if the procedure doesn’t work
• Heavy and prolonged bleeding
• Infection
• Fever
• Digestive system discomfort

You must be certain about your decision before beginning a medical abortion. If you decide to continue the pregnancy after taking medications used in medical abortion, your pregnancy may be at risk of major complications. Medical abortion hasn’t been shown to affect future pregnancies unless complications develop.

How to prepare

If you’re considering medical abortion, meet with your doctor to discuss the procedure. Your doctor will likely:

• Evaluate your medical history and overall health
• Confirm your pregnancy with a physical exam
• Do an ultrasound exam to date the pregnancy and confirm it’s not outside the uterus (ectopic pregnancy) and not a tumor that developed in the uterus (molar pregnancy)
• Do blood and urine tests
• Explain how the procedure works, the side effects, and possible risks and complications 

Having a medical abortion is a serious decision. If possible, talk with your partner, family, or friends. Talk with your doctor, a spiritual adviser, or a counselor to get answers to your questions, help you weigh alternatives and consider the impact the procedure may have on your future.

Keep in mind that no doctor is required to perform an elective abortion and that in some states there are certain legal requirements and waiting periods you must follow before having an elective abortion. If you’re having an abortion procedure for a miscarriage, there are no special legal requirements or waiting periods required.

Medication 

Oral mifepristone (Mifeprex) and oral misoprostol (Cytotec): This is the most common type of medical abortion. These medications are usually taken within seven weeks of the first day of your last period.

Mifepristone: blocks the hormone progesterone, causing the lining of the uterus to thin and preventing the embryo from staying implanted and growing. Misoprostol (my-so-PROS-tol), a different kind of medication, causes the uterus to contract and expel the embryo through the vagina.

If you choose this type of medical abortion, you’ll likely take the mifepristone in your doctor’s office or clinic. Then you will probably take the misoprostol at home, hours, or days later.

You’ll need to visit your doctor again about a week later to make sure the abortion is complete. This regimen is approved by the Food and Drug Administration (FDA).

Oral mifepristone and vaginal, buccal or sublingual misoprostol: This type of medical abortion uses the same medications as the previous method, but with a slowly dissolving misoprostol tablet placed in your vagina (vaginal route), in your mouth between your teeth and cheek (buccal route), or under your tongue (sublingual route).

The vaginal, buccal, or sublingual approach lessens side effects and may be more effective. These medications must be taken within nine weeks of the first day of your last period.

Methotrexate and vaginal misoprostol: Methotrexate (Otrexup, Rasuvo, others) is rarely used for elective, unwanted pregnancies, although it’s still used for pregnancies outside of the uterus (ectopic pregnancies). This type of medical abortion must be done within seven weeks of the first day of your last period, and it can take up to a month for methotrexate to complete the abortion. Methotrexate is given as a shot or vaginally and the misoprostol is later used at home.

Vaginal misoprostol alone: Vaginal misoprostol alone can be effective when used before nine weeks of gestation of the embryo. But vaginal misoprostol alone is less effective than other types of medical abortion.

If you are facing an unwanted pregnancy and seek assistance, reach out to us at M Doctor’s Hub.