Medication Abortion

A medication abortion is the use of pills to end a pregnancy. Most commonly, a medication abortion involves taking two medicines, mifepristone and misoprostol. 

The first pill taken in medication abortion is called Mifepristone. Mifepristone blocks the hormone progesterone, which is necessary for the growth of the pregnancy. Then, 6-72 hours after swallowing the first pill, you take a second medication, Misoprostol. Within a few hours of using Misoprostol, your uterus will begin to contract and expel the pregnancy. 

Heavy bleeding and cramping are normal at this time, and will typically last from 2 to 6 hours, but can last for a few days. We will provide you with pain medication for the cramping. Once you pass the pregnancy, the bleeding will lighten, and you may have period-like bleeding and spotting for 2-6 weeks. 

We will be in communication in one week to confirm the abortion is complete. We will provide you with written after-care instructions along with a 24-hour number where you can reach us if you have any questions or concerns.

Medication abortion is highly effective.

For pregnancies between 6 - 11 weeks from the most recent menstrual period, the mifepristone + misoprostol pill regimen produces complete abortion in about 95% of patients.

About 5% of patients may need to have a minor suction procedure or additional medication because of a continuing pregnancy, incomplete abortion, or persistent bleeding.

To estimate how far along the pregnancy is, use the Gestational Age Estimator.

Medication abortion is very safe. The Food and Drug Administration (FDA) approved mifepristone in 2000. Since then, nearly 5 million people in the United States have had a medication abortion.

Potentially serious risks are rare. They include heavy bleeding, pelvic infection, and delay in the detection of ectopic pregnancy (pregnancy in the tube, ovary, or abdomen). The rate of serious complication from medication abortion is 0.4%.

The risk of death is less than 1 in 100,000. The risk of death from continuing your pregnancy is up to 35 times greater than having an abortion.

Almost everyone having a medication abortion will have vaginal bleeding and abdominal cramping; that is the medications working as expected.

Many people also have other symptoms, such as nausea, vomiting, diarrhea, fatigue, headache, mild dizziness, back pain, chills, and mild fever. These side effects usually last only a few hours. We will provide medicine for pain and nausea in addition to the abortion pills.

Our current guidelines support using medication abortion up to 11 weeks, 0 days.

Medication abortion should NOT be used when people have any of the following conditions, all of which are rare:

• Signs that the pregnancy might be ectopic, which means that it is growing outside the uterus

• Failure of the adrenal glands

• Allergies to mifepristone or misoprostol

• Bleeding disorders, such as hemophilia

• Inherited porphyria, a genetic disease of the skin and nervous system

• Use of certain medications, including steroids or anticoagulants (blood thinners)

• Use of an IUD during the pregnancy. An IUD is a contraceptive device that is placed in a person’s uterus. Examples of IUDs include Paragard, Mirena, Skyla, Liletta, and Kyleena.

To estimate how far along your pregnancy is now, use the Gestational Age Estimator.

Some people choose medication abortion because they prefer completing the abortion in the comfort of their own home and setting the timing of their abortion around their work, childcare or life-demands. Many people have the impression that the medication abortion will be “easier” than the in-office procedure. This may be true for some, but it is important to note that it can be very crampy and take several hours to days to complete.

If you have regular menstrual periods about once a month, simply counting the number of days since the first day of your last menstrual period usually gives an accurate estimate of how far along the pregnancy is.

To use this method to estimate the length of the pregnancy, use the Gestational Age Estimator.

If you do not have regular, normal menstrual periods or do not remember the date your last period started, this method will not work well. In such cases, we’ll work with you to arrange for an ultrasound before your medication abortion.

Current guidelines support medication abortion without ultrasound. But not having an ultrasound does carry some risks:

If the pregnancy is much more than 11 weeks along, the chance of abortion failure increases, which could result in heavy bleeding and the need for a procedure to complete the abortion.

If the pregnancy is an ectopic pregnancy – i.e., it is growing outside the uterus, usually in the tube – the treatment will not work to end the pregnancy, and the detection of the condition may be delayed. Ectopic pregnancy is quite rare but it can be dangerous. It is usually treated with a surgical procedure or with medication.

If you can’t or don’t want to travel to our clinic in Whitefish, we can mail you the abortion pills to a Montana address through our medication abortion by mail option.

You could have a procedure abortion, in which the abortion provider uses suction (aspiration) or other methods to remove the pregnancy from the uterus. Procedure abortions must be done in a clinic. Like medication abortions, they are very safe and effective.

Or, you could decide not to have an abortion at all, and instead continue the pregnancy. Once you give birth, you could either raise the child yourself or place the child for adoption.