Medical abortion is a procedure that uses various medications to end an established pregnancy. A medical abortion is done either in a doctor's office or at home. Medical abortion doesn't require anesthesia or surgery, but it can only be done early in pregnancy.
Pursuing a medical abortion is a major decision with emotional and psychological consequences. If you're considering medical abortion, make sure you understand what the procedure entails, the side effects, and possible risks and complications.
Why it's done
A woman's reasons for pursuing medical abortion are highly personal. You may have mixed feelings about being pregnant. You may have financial problems that preclude having a baby. Or you may not be capable of parenting due to mental health problems or other issues. For many of these circumstances there are alternatives, such as adoption. In addition, you may have a serious medical problem that poses a risk to you or the baby during pregnancy.
Some women prefer medical abortion over other types of abortion because some methods of medical abortion may be done at home, providing privacy and some degree of control.
Potential risks of medical abortion include:
If you decide to continue the pregnancy after beginning to take the medications used in medical abortion, your baby may be at risk of birth defects.
Medical abortion hasn't been shown to affect future pregnancies unless complications develop.
Medical abortion may not be an option if you:
Women who want to end a pregnancy but can't have a medical abortion may want to consider surgical abortion instead.
How you prepare
If you're considering medical abortion, you'll meet with your health care provider to discuss the procedure. Your health care provider will likely:
Proceeding with a medical abortion is a big decision. Talking with your partner, family or friends may help. Your health care provider or a counselor can answer any questions you might have, help you weigh alternatives and consider the impact the procedure may have on your future.
Keep in mind that no health care provider is required to perform an abortion and that in some states there are certain legal requirements and waiting periods before proceeding with an abortion.
What you can expect
Medical abortion doesn't require surgery or anesthesia. The procedure can be done in a health care provider's office or clinic. Sometimes a medical abortion can be done at home, but you'll still need to make multiple visits to your health care provider to assess the effectiveness of the treatment and identify potential complications.
During the procedure
The medications used in a medical abortion cause vaginal bleeding and abdominal cramping. They may also cause:
You may be given medications to manage pain after the medical abortion. You may also be given antibiotics. A 2009 study showed a significant drop in the rate of serious infection after a medical abortion when women took misoprostol orally — instead of vaginally — along with antibiotics.
Your health care provider will explain how much pain, bleeding and passing tissue to expect depending on the length of your pregnancy. You may not be able to go about your normal daily routine during this time but it's unlikely that you'll need bed rest. Make sure you have plenty of absorbent sanitary pads.
Signs that may require medical attention after a medical abortion include:
If you have a medical abortion in a health care provider's office or clinic, you'll have a pelvic exam before you're given subsequent doses of misoprostol to see if the fetus has been expelled. The frequency and strength of your uterine contractions also will be monitored. While the most discomfort may last one to two hours, spotting before and bleeding after could last two weeks.
If you undergo a medical abortion at home, you'll need to have access to a health care provider who can answer questions by phone. You'll also need to be able to identify complications.
After the procedure
After a medical abortion, you'll have a follow-up visit with your health care provider to make sure you're healing properly. Your health care provider will evaluate your uterine size, bleeding and any signs of infection. You'll likely be asked if you still feel pregnant, if you saw the expulsion of the gestational sac or fetus, how much bleeding you experienced, and whether you're still bleeding. If your health care provider suspects an incomplete abortion or ongoing pregnancy, you may need an ultrasound and possible follow-up treatment.
Normal menstruation usually starts four to six weeks after a medical abortion. Keep in mind that pregnancy is possible shortly after an abortion, even before menstruation begins. To reduce the risk of infection, don't have vaginal intercourse or use tampons for two weeks following a medical abortion.
After a medical abortion, you'll likely experience a range of emotions — such as relief, loss, sadness and anger. These feelings are normal. Consider talking to a counselor about your feelings.
Last Updated: 2010-02-10
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