What is it?

A medical abortion uses drugs to empty the contents of the uterus. Medical abortions can be done only early in pregnancy. There are two types of medical abortions performed at the Bay Centre for Birth Control.

1) Mifepristone and misoprostol (the abortion pill)

Mifepristone is a drug that blocks progesterone, a hormone that is needed to keep the pregnancy going. It causes the pregnancy to detach from the uterus and be expelled. Mifepristone also causes the misoprostol to be more effective.

Misoprostol is a medication that when used after Mifepristone causes the cervix to soften and open up. The uterus then contracts (cramps) to push the pregnancy out.

Mifepristone is given as one pill that is taken by mouth at the clinic visit. The Misoprostol tablets are then taken 1-2 days later and are held in the pouch between your cheek and lower teeth for 30 minutes, and then the remainder is swallowed. This will be done at home. In 90% of cases, the uterus will be emptied within 24 hours. Pain medication is used to ease the pain of the cramps, which occur when the pregnancy tissue comes out of the uterus.

The drugs that induce medical abortions can cause birth defects. If the medical abortion is unsuccessful it may be recommended that a woman have a surgical abortion. A follow-up assessment is done one week after taking the Mifepristone to make sure that the abortion was successful. 

When is the procedure done?
Mifepristone and Misoprostol can be used for medical abortion at up to nine weeks of pregnancy. 

Advantages

• avoids surgery and the risk of damage to the uterus with surgical instruments
• can be done early before signs of pregnancy occur
• may feel less invasive than surgery, resembles a ‘natural miscarriage’ 
• may seem more private to some women since much of the procedure can occur at home

Disadvantages

• the cost associated with medication (may be covered by some drug plans/private insurance) 
• 2-5% chance that the medication will not be effective and a surgical procedure will be needed 
• Vaginal bleeding and cramping may be prolonged and heavy
• Medication side effects such as diarrhea, headaches, nausea, vomiting, or dizziness 
• The need for two or possibly more clinic visits, ultrasounds and blood draws 

2) Methotrexate and misoprostol (M&M)

When is the procedure done?
Methotrexate and misoprostol can be used for medical abortion at up to seven weeks of pregnancy.

Advantages

• avoids surgery and the risk of damage to the uterus with surgical instruments
• can be done early before signs of pregnancy occur
• may feel less invasive than surgery
• may seem more private to some women since much of the procedure can occur at home
• no cost for the medication

Disadvantages

• takes place over a week or more and involves several visits to the doctor
• sometimes causes heavy bleeding
• the drugs may have short-term side-effects including nausea, diarrhea, abdominal cramping or pain, vomiting, hot flashes
• with methotrexate, there is a 10 percent risk that the procedure will be incomplete and a surgical abortion will need to be done 
• uncertainty about when the abortion will occur 
• cramping may be severe and prolonged