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 service this is available up to 9 weeks of pregnancy (pregnancy due date calculator).

The first stage, taking the Mifepristone tablet, 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, the insertion of the vaginal tablet Misoprostol, happens on the gynaecology ward (Meavy Ward) at Derriford Hospital between 24 and 48 hours later.

Most women choose to go home from Meavy Ward soon after insertion of the vaginal tablet. However:

  1. You must live within 45 minutes’ drive of Derriford Hospital
  2. You must have an adult to accompany you to Meavy ward and to stay at home with you for 24 hours so they can bring you back to the hospital. This person will be essential in the unusual but serious event that you start bleeding very heavily.
Postive aspects
  • 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
Negative aspects

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 300 (0.3%).

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.

Bleeding
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.

Infection
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