Medical Abortion

The most efficient and safest way to carry out the termination of an early pregnancy is with a medical (non-surgical) abortion. It offers a safe and effective alternative to the surgical process. The abortion pill procedure is highly recommended for women in their early weeks of pregnancy . The most well known and most frequently prescribed medication used to perform a medical abortion is RU 486 (Mifepristone, Mifeprex). This drug is commonly used in combination with Misoprostol (Cytotec) and the process is expected to terminate a pregnancy within the first 4 to 6 hours of administration of the Misoprostol tablets which are generally given 24 to 72 hours after taking the RU 486 tablets. The combined medications are generally not used for patients further than 9 weeks; however, recent studies indicate the abortion pill procedure can be safely and effectively used up to 14 weeks on an outpatient basis. The abortion pill procedure is up to 98 to 99% effective for terminating a pregnancy up to 9 weeks. The earlier in pregnancy the medical abortion is initiated, the higher the success rate. Only a small number of abortion clinics can offer medical abortion up to 24 weeks or beyond because very few physicians have the knowledge and experience required to perform this specialized procedure. RU 486 is also used to treat uterine cancer, uterine fibroids, and endometriosis. It is being further studied for the prevention and treatment of breast cancer.

In order to perform an abortion procedure as safely as possible, certain steps are taken to determine the safest method for each individual patient. This includes, but is not limited to obtaining the patient’s medical history, performing laboratory tests, a physical examination and ultrasound to verify the number of weeks of the pregnancy. After a full evaluation, the physician can then discuss with the patient the advantages and disadvantages of both the surgical and the medical abortion procedure.

Prophylactic medications may be offered after the surgical or medical abortion to ensure that there is minimal chance of infection following the procedure.

The RU 486 medical abortion works by blocking the progesterone hormone which is necessary for fetal growth and preventing uterine contractions. Low or no progesterone in early pregnancy may result in miscarriage. Prior to receiving the medication, informed consent must be obtained from the patient after she has been counseled by the physician. RU 486 is taken orally and Misoprostol (Cytotec) is either taken orally or inserted underneath the cervix (24 to 72 hours later) to help soften the cervix and initiate uterine contraction. This will result in uterine cramping and bleeding. The pregnancy is expected to be terminated within the first 4 to 6 hours, but may take 24 to 48 hours or possibly longer. The patient is expected to follow-up in the office one to two weeks later to ensure that the pregnancy has terminated successfully. In case of emergencies, patient may call the clinic or physician’s office for immediate evaluation.

During the medical abortion procedure, patients may experience the following symptoms:

•Nausea and Vomiting. This is generally mild in nature and expected to last for only a short period of time. If it persists, the patient is advised to seek further medical care.

• Dizziness and light headedness.

• Bleeding which can be moderate to heavy starting 4 to 6 hours after taking Misoprostol which decreases significantly after the pregnancy tissue has passed. Bleeding may last for 10 to 14 days. Some patients may bleed up to 30 days. If bleeding greater than two pads an hour for more than 2 hours occurs, the abortion clinic or physician should be contacted immediately.

• Women who usually have painful menstrual periods experience the most discomfort during the medical abortion procedure.

•Diarrhea, headache, fever and chills are also symptoms associated with the combination of the RU 486 and Misoprostol. These symptoms are normally mild, but if they persist for more than 24 hours, the patient should be immediately evaluated by her physician.

Antibiotics may be given to prevent a rare infection which has been known to lead to maternal death .

RU 486 Medical Abortion

The Medical Abortion Pill procedure is most commonly carried out with the use of RU 486 and Misoprostol. Another combination of medications used for the medical abortion procedure in early pregnancy is Methotrexate and Misoprostol. Prior to receiving the RU 486 medical abortion procedure, patients must be informed of the risks and benefits and provide consent. Since receiving FDA approval in 2000, the use of RU 486 has consistently increased each year. Today, 47% of patients who are 6 weeks or less are choosing to have their pregnancy terminated with the medical abortion process.