Medical abortion involves two stages. The first is taking a tablet, Mifepristone, that ends the pregnancy. The second is a vaginal tablet, Misoprostol, that makes the womb contract causing the loss of the pregnancy similar to a miscarriage. In our
The first stage (taking the tablet, Mifepristone, by mouth) will be offered to you at your initial appointment with us provided that you are sure you wish to proceed and your scan shows a pregnancy of 5 weeks or more. Alternative dates can also be arranged.
The second stage (inserting tablets, Misoprostol, into the vagina) can now be done at home. We will give you these tablets to take home from your initial appointment to use 24 to 48 hours later. In order for it to be safe to do this:
- You must live within 45 minutes’ drive from Derriford Hospital (PL6 8DH) or any other major Accident & Emergency Department (A&E). You can find your nearest A&E here. A minor injuries unit is not suitable.
- You must have an adult to stay at home with you for 24 hours after the Misoprostol tablets. This person will be essential in the unusual but serious event that you start bleeding very heavily and need to be admitted to hospital.
For a home medical abortion most women choose to dispose of any tissue in the same way they dispose of sanitary towels but if you wish you will have the option to bring pregnancy tissue back to the hospital for sensitive disposal of your choice if that is your preferred option. If you know that you will wish to do this, then please could you let us know so that we can prepare paperwork.
- Many women feel more in control choosing this and it allows them to be in their home environment
- No need for a general anaesthetic or to be examined by a doctor if the procedure works well
Bleeding afterwards can last longer than with a surgical procedure. The risk of the tablets not working, and the pregnancy continuing or a piece of tissue being left behind is higher with this than with surgical.
After 8 weeks it may be possible to recognise the tissue that comes out and some women find this upsetting.
It is difficult to predict how long the bleeding or pain will go on for – we will give you pain relief to help manage this. Between 2 and 4 weeks can be normal.
Things to look out for after the procedure
Failed procedure (continuing pregnancy)
Sometimes the tablets don’t work and the pregnancy continues. The risk of this is 1 in 100 (1%) up to 9 weeks, and 3 in 100 (3%) between 9 and 10 weeks.
Symptoms that suggest the pregnancy is continuing are:
- Less than 4 days bleeding after the treatment
- Not seeing any blood clots or tissue coming away
If this happens we would like you to contact us within a week of taking the tablets.
Other possible symptoms of a continuing pregnancy include:
- Nausea or vomiting
- Tender breasts
- Tummy growing
- No period between 4-6 weeks after your treatment
We give all patients a “special” (less sensitive) pregnancy test to do at 2 weeks after the procedure. This test gives a negative result at higher pregnancy hormone levels, so is a more useful test soon after the procedure. If this is positive please contact us to arrange a rescan.
A “normal” (more sensitive) pregnancy test may remain positive for up to 4 weeks after a successful procedure as the pregnancy hormones take time to settle. If you have lost our special pregnancy test, please do a normal one at 4 weeks.
The most common side effect after a medical abortion is bleeding. This may continue for up to 4 weeks and be a normal part of the procedure. However, it can also be a sign of fetal tissue remaining inside, especially if it is associated with pain. If you are concerned please contact us.
We would expect you to have a period between 4 and 6 weeks after the procedure. This is usually separate from the bleeding that occurs immediately after the procedure.
We routinely give antibiotics to reduce the risk of infection after the procedure. However the following symptoms can suggest an infection and we recommend you contact our service, your GP, NHS 111 or nearest Emergency Department for review:
- Severe bleeding (more than 4 pads in 2 hours)
- Severe abdominal pain
- Offensive smelling vaginal discharge
- Feeling hot or feverish