Medication Abortion

What is a medication abortion?

Medication abortion is a procedure that uses a combination of two drugs (Mifeprex, or mifepristone, and Cytotec, or misoprostol) to end a pregnancy. The first one (mifepristone) weakens the attachment of the pregnancy to the uterus. A second medication (misoprostol) is used six to 48 hours later, making the uterus cramp and causing bleeding to expel the pregnancy.

Medication abortions can be performed between five weeks and four days to nine weeks after the first day of the patient’s last period.

Patients often have stronger cramping and heavier bleeding than what they usually experience during a period. Bleeding and spotting usually last between nine and 16 days.

A return visit is needed to ensure the abortion is complete. A small number of patients (5 percent or so) will need a surgical abortion due to heavy bleeding or because the medication abortion did not effectively end the pregnancy.

What to expect during a medication abortion

We hope the following will prepare you for what to expect. You can also check out our Medication Abortion FAQs for additional information or read our comparison of Medication vs Surgical Abortion to decide which method is right for you.

Your first appointment (about 2 hours)

Reception area – When you check in for your appointment, the receptionist will notify our staff that you have arrived. The Comprehensive Women’s Health Center is integrated into the general clinic practice; patients are not identified in the reception area as desiring pregnancy termination and there are no signs advertising our clinic. This ensures the privacy and safety of our patients and staff.

Checking in – After completion of paperwork and payment is received, you’ll be brought to a private room to begin your consultation. Please note that all patients are initially brought back to the room by themselves. Your support person may come back with you after your initial medical history and options are reviewed. We typically allow a support person only for first-trimester procedures (up to 12w).

Meeting with the doctor – After your conversation with the health educator, you will meet the doctor. Our physicians are obstetrician-gynecologists with specialized training and interest in abortion provision and family planning. The doctor will review your medical history and discuss the abortion procedure, including possible risks and complications, and ask you to sign a consent form. They will also perform an ultrasound exam to determine your pregnancy’s gestation. At this time, they will give you the first medication, Mifeprex. You must take the Mifeprex while you are in the clinic.

Follow-up instructions – After you take the Mifeprex, you will be sent home with a copy of our aftercare instructions and four pills of Cytotec (misoprostol). The doctor will tell you how to place the four pills in your vagina or cheek. Six hours to three days after your first appointment, you will place four tablets of Cytotec (misoprostol) into your vagina or cheek. We will give you an instruction sheet detailing what to do and what to expect.

Your second appointment, seven to 14 days later (about 30 minutes)

It is extremely important that you come to the clinic for a second appointment. The medication you take for an abortion can cause severe birth defects if the pregnancy is not terminated, which happens for about 5 percent of patients. For this reason, you must return to the clinic to confirm that the abortion is complete. If it isn’t, we strongly recommend that you have a surgical abortion to complete the process.

Reception area – When you check in for your appointment, the receptionist will notify our staff that you have arrived. Once again, patients are not identified in the reception area as desiring pregnancy termination and there are no signs advertising our clinic.

Checking in – After completion of paperwork and payment is received, you’ll be brought to a private room to begin your consultation. Please note that all patients are initially brought back to the room by themselves. Your support person may come back with you after your initial medical history and options are reviewed. We typically allow a support person only for first-trimester procedures (up to 12w).

Meeting with the doctor – After your conversation with the health educator, you will see the doctor. The doctor will review your experience with the abortion process, and will perform an ultrasound exam to confirm the abortion is complete. At this time, they will review contraception options with you and, if appropriate, provide samples of your chosen method with an initial prescription.

Follow-up – Unless you are experiencing complications related to your abortion, you do not need to visit our office again after your second appointment. We recommend that you make an appointment to see your regular physician for an annual pap smear, physical/gynecologic exam, and birth control refill requests. You can always call us with any questions.