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Medication abortion (also called the abortion pill, MifeprexTm) is FDA approved for up to 70 days (10 weeks pregnant) after the start of your last menstrual period.
- The “pill” is actually a protocol that involves taking two drugs, mifepristone and misoprostol, which are taken in two separate doses on different days.
- It is not available through a pharmacy, but is only available by an authorized provider.
- The FDA strongly cautions against the use of mifepristone obtained over the Internet.3
- Because of complications, the FDA keeps close track.4
- The abortion pill is not the same as the emergency contraception.
- For women who change their minds after taking just the mifepristone, it may be possible to rescue the pregnancy. For more information, see: The Abortion Pill Reversal.
How it works – The first medication, mifepristone, blocks progesterone. Progesterone is a hormone that is necessary for the pregnancy to survive. Without progesterone, the embryo eventually dies over the next several days. The second medication, misoprostol, causes bleeding and cramping, expelling the embryo and uterine contents.
Side effects – Cramping and bleeding are expected. Bleeding lasts an average of 9 to 16 days. Other possible side effects include nausea, vomiting, diarrhea, fever, chills, weakness, dizziness and headache.
Complications – In 1% of women, bleeding is so heavy a surgical procedure called a D&C is required to stop the bleeding. Life-threatening infection has occurred in a small number of women who used the abortion pill protocol. Before taking any medication, you should discuss the risks with your doctor and know what to do if complications arise.
Follow-up – It is important to follow-up with your doctor 1 to 2 weeks after taking this medication regime to see if an abortion has occurred and to assess for complications.
Surgical abortions are done by opening the cervix and passing instruments into the uterus to suction, grasp, pull, and scrape the pregnancy out. The exact procedure is determined by the baby’s level of growth.
Aspiration/Suction23,24 – Up to 13 weeks LMP. Most early surgical abortions are performed using this method. Local anesthesia is typically offered to reduce pain. The abortion involves opening the cervix, passing a tube inside the uterus, and attaching it to suction device which pulls the embryo out.
Dilation and Evacuation25,26 (D&E) – 13 weeks LMP and up. Most second trimester abortions are performed using this method. Local anesthesia, oral, or intravenous pain medications and sedation are commonly used. Besides the need to open the cervix much wider, the main difference between this procedure and a first trimester abortion is the use of forceps to grasp fetal parts and remove the baby in pieces. D&E is associated with a much higher risk of complications compared to a first trimester surgical abortion.
D&E After Viability27-29 – 24 weeks LMP and up. This procedure typically takes 2–3 days and is associated with increased risk to the life and health of the mother. General anesthesia is usually recommended, if available. Drugs may be injected into the fetus or the amniotic fluid to stop the baby’s heart before starting the procedure. The cervix is opened wide, the amniotic sac is broken, and forceps are used to dismember the fetus. The “Intact D&E” pulls the fetus out legs first, then crushes the skull in order to remove the fetus in one piece.
Information taken from U.S. Food and Drug Administration (2016). “Mifeprex Medication Guide.” U.S. Department of Health. Retrieved from https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/mifeprex-mifepristone-information
23. Paul, M., Lichtenberg, E. S., Borgatta, L., Grimes, D. A., Stubblefield, P. G., & Creinin, M. D. (2009). First Trimester Aspiration Abortion. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 135-156).
24. Chichester, UK: Wiley-Blackwell. Planned Parenthood Federation of America Inc. (2014). In-Clinic Abortion Procedures : Planned Parenthood. Retrieved July 19, 2014.
25. Planned Parenthood Federation of America Inc. (2014). In-Clinic Abortion Procedures : Planned Parenthood. Retrieved October 28, 2015.
26. Paul, M., Lichtenberg, E. S., Borgatta, L., Grimes, D. A., Stubblefield, P. G., & Creinin, M. D. (2009). Dilation and Evacuation. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 157-74). Chichester, UK: Wiley-Blackwell.
27. Paul, M., Lichtenberg, E. S., Borgatta, L., Grimes, D. A., Stubblefield, P. G., & Creinin, M. D. (2009). Dilation and Evacuation. In Management of unintended and abnormal pregnancy: Comprehensive abortion care (pp. 157-74). Chichester, UK: Wiley-Blackwell.
28. American College of Obstetrics and Gynecology. (2013). Practice Bulletin: Second-Trimester Abortion (135).
29. Pasquini, L., et al. Intracardiac injection of potassium chloride as method for feticide: Experience from a single U.K. tertiary centre. Br J Obstet Gynaecol. 2008;115(4):528–31.
Do I need an ultrasound before abortion?
An abortion clinic may or may not offer an ultrasound before an abortion. However, if you are considering abortion, an ultrasound can provide important information, such as confirming a viable pregnancy (20-25% of pregnancies end in early miscarriage) and determining gestational age. Abortion costs in New Jersey and the type of abortion procedure that you receive vary depending on how far along you are; an ultrasound can help you determine what to expect. Reach out to us to learn about our free and confidential ultrasound services and schedule an appointment.
PRE-ABORTION CONSULTATION – NO COST TO YOU
At your appointment, you will be provided a lab-quality pregnancy test first. If positive, you will be offered a free ultrasound. An ultrasound can confirm a viable pregnancy and estimate how far along in pregnancy you are. If you are considering abortion, an ultrasound will provide important information that will tell you more about your options. Abortion costs vary depending on how far along you are and the abortion procedure that you receive. Speak with our staff today about our ultrasound services.