The Abortion Pill

For generations, the medical profession has sought a safe and effective non-surgical method for terminating pregnancies. Historically, a multitude of herbs, drugs, and chemicals have been tried with limited success.

The Abortion Pill (also called Mifeprex, Mifepristone, or RU-486) provides women with a medical alternative to surgical abortion. Mifepristone, in conjunction with Cytotec was approved for use as an abortifacient by the United States Food and Drug Administration (FDA) on September 28, 2000. Mifepristone is an antiprogesterone drug that blocks receptors of progesterone, a key hormone in the establishment and maintenance of human pregnancy. Mifepristone induces spontaneous abortion when administered in early pregnancy and followed by a dose of misoprostol (Cytotec), a prostaglandin.

How the Abortion Pill Works
The Abortion Pill procedure involves the oral ingestion of mifepristone after ultrasound verification of a pregnancy nine weeks gestation or less. Twenty-four to thirty-six hours later, misoprostol is inserted into the cheeks, held in place for 30 minutes, and then swallowed with water. In most cases, a miscarriage occurs within 24 hours. If bleeding does not occur after 24 hours, the Misoprostol insertion is repeated. Usually bleeding is like a spontaneous miscarriage and spotting may occur for up to two weeks or longer. An ultrasound will be used to verify the successful termination of the pregnancy.

If the abortion does not occur with medication alone, a surgical abortion must be performed. This situation occurs in less than 8 percent of patients. The primary advantage of non-surgical abortion lies in the ability to end the pregnancy in the privacy of the patient's own home. Furthermore, the theoretical potential for surgical complications is lessened.

Side effects of mifepristone and misoprostol can include nausea, vomiting, diarrhea, heavy vaginal bleeding, headache, dizziness, backache and fatigue.

Occasionally, the cramping may become quite severe, particularly when the tissue is being expelled.

Medical abortion is limited to patients nine weeks pregnant or less, as verified by ultrasound. No sexual intercourse is allowed for two weeks after your abortion. The patient must agree to undergo a surgical abortion if the abortion is not completed medically.

Safety
As in surgical abortion, risks of hemorrhage do exist. In rare cases, the incomplete passage of tissue requires a surgical evacuation.

Serious infection can occur in about 1 per 1,000 women and death from infection occurs in less than 1 per 100,000 women. Therefore, if you develop a flu-like condition including sluggishness, weakness or muscle aches with or without fever, abdominal pain, nausea, vomiting or diarrhea more than 24 hours after taking misoprostol (Cytotec), it is essential that you call us immediately. As a means of helping to prevent the already low chance of infection, we will dispense a one-week supply of doxycycline, a more effective version of tetracycline. You will take one pill by mouth twice a day for one week, beginning at the end of your next meal and follow instructions regarding proper use of the drug. Please tell us if you may be allergic or have other abnormal reactions to this medication.

Efficacy & Acceptability
Approximately 750,000 women in the U.S. and millions worldwide have chosen the Abortion Pill. It is effective 92-95% of the time. This means that 5-8 women out of 100 will need a surgical procedure to terminate the pregnancy or to stop heavy bleeding. The most common side effects reported by women using mifepristone plus prostaglandin for early abortion are similar to those of a spontaneous miscarriage; uterine cramps, bleeding, nausea, and fatigue. Mifepristone is as safe as a surgical abortion. The medication abortion is a completely noninvasive procedure and does not require anesthesia.

Misoprostol (or Cytotec) is a prostaglandin known by the generic name of misoprostol. It had previously received FDA approval for use in the prevention of ulcers in high-risk patients taking non-steroidal, anti-inflammatory drugs.

Making Your Appointment
If you plan to use your private health insurance or HMO, please tell us at the time you make your appointment so that we may verify your insurance coverage before your scheduled surgery appointment.

If you have any health conditions, drug allergies, or if you take any regular medication (asthma inhaler, insulin, blood pressure medication), please inform us of this when you make your appointment.

In order to protect your confidentiality, we do not confirm appointments by phone. When you make your appointment, be sure to write down the date and time you have chosen.

Before You Arrive
If you would like to complete your registration forms before you arrive, they are available here for download.

NOTE: If you would like to complete your registration forms before you arrive, they are available here for download in Adobe Acrobat Reader. Please access www.adobe.com for a FREE download. Then you can download, print and complete the following two forms: Medical History | Demographics Information

Please eat and drink normally before you come for your appointment. A few patients will feel some nausea when they take the first pill. This may be less likely if you have a small amount of food in your stomach before you take it.

If you have an inhaler for asthma, please bring it with you, even if you rarely use it.

If you take any medications, please bring them with you.

Please do not bring children to the clinic. Plan to spend 1 to 2 hours with us in the clinic.

Please bring the full fee in the form of cash, Visa, MasterCard, Discover, money order, cashier’s check or traveler’s check. We do not accept personal checks. If you use a credit card, the person whose name is on the card must be present to sign for charges. If you are referred by your insurance company or HMO, please bring your insurance card, photo ID and referral (if required by your HMO).

The fee you pay at the time of surgery includes pregnancy testing, admitting, history and physical, ultrasound, lab work, MicRhoGAM (if required), medications required for the procedure, your follow-up visit, and any additional care as authorized by us.

The fee does not include pain medications.

About Your First Visit
When you arrive at the clinic, you will be asked to complete personal demographic and health information and consent forms. A lab technician will draw a sample of your blood to determine your Rh factor and iron level. Your vital signs will be taken. The clinician (a Physician Assistant or Nurse Practitioner) will review your medical history and perform a physical examination and transvaginal ultrasound. An admissions staff member will explain the procedure to you and assist you in completing additional paperwork.

You will take the first pill, mifepristone, in the clinic. We will give you the misoprostol, antibiotics and a prescription for pain medication to take home.

Though most women have no side effects after taking mifepristone, some possible side effects are nausea, headache, bleeding and cramping. Some women even pass the pregnancy with mifepristone alone, though this is rare.

When You Take Misoprostol (Day 2)
When to take the misoprostol is your choice, depending on work, school, childcare or other situations. Plan to be at home for at least 12 hours after taking misoprostol.

Expect to have bleeding, blood clots and cramping. Some other possible side effects of misoprostol are nausea, diarrhea and an elevated temperature. We will give you pain medication to help you through this time. You are free to go to work or school the day after you take misoprostol.

You will also be given an instruction sheet that will include our 24-hour emergency number to call with any questions or problems you may have after you leave our facility.

About Your Follow-Up Appointment
You will have your vital signs taken, a transvaginal ultrasound, and a physical exam and/or blood testing (if necessary). If you would like to start a birth control method, we can provide you with one at this time, if eligible.