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Medical Abortion

Options for Medical Abortion in Seattle from Aurora Medical Services include:
Mifepristone/Misoprostol

• Medical abortion involves using two medications to terminate the pregnancy.
The first medication, mifepristone, is given in the office. This stops the pregnancy from growing. The second medication, misoprostol, is taken by the woman at home and causes the body to expel the pregnancy.
• A second office visit is required to determine if the abortion is complete.
• About 2-4% of medical abortions fail. If this happens, additional doses of misoprostol
may be used or a surgical abortion may be required if the pregnancy does not pass completely.
• Women can expect significant bleeding and cramping that will continue for about
3-4 hours after taking the second medicine. Some women report minimal bleeding and cramping.
• Pain medication will be provided in case the woman should need it.
• It is important that another adult is available to the woman during the abortion process.

Who can use medical abortion?
• Women who are 9 weeks pregnant or less.
• Women who are in good health (without chronic illness).
• Women who are able to follow the treatment plan for medical abortion including
monitoring their own bleeding and communicating with the clinic as needed.
• Women who have transportation available to come into the clinic should the need arise.
• Women who agree to have a traditional abortion (suction procedure) if the medical
abortion fails.

Summary of Drugs Used for Medical Abortion:
Mifepristone: Mifepristone is an antiprogestin. It works by blocking progesterone,
which is needed to maintain and support a pregnancy in its early stages. Without progesterone, the pregnancy stops growing and the pregnancy detaches from the uterine wall. Possible side effects include abdominal pain or cramping, light bleeding, nausea, headache, weakness, and fatigue.
Misoprostol: Misoprostol is a prostaglandin, which causes the uterus to contract and
induces uterine bleeding, causing the expulsion of the pregnancy from the uterus. Possible side effects are abdominal pain and cramping, nausea, vomiting, diarrhea, dizziness, and hot flushes.

What can I expect during the medical abortion process?
• Women say the process is like having a miscarriage.
• Expect both heavy cramping and heavy bleeding with the medical abortion.
• Some women have very heavy bleeding accompanied by clots and heavy cramps.
• Both the heavy bleeding and heavy cramps are usually over within 3-4 hours of taking
the second medicine. Some women are lucky and have only mild bleeding and cramping.
• It is important that the woman has another adult nearby who is aware of her choice
for medical abortion and who can be a help to her during the process.
• Pain medicine will be provided should the woman need it.
• It is very important to return within 2 weeks after your abortion for a follow-up
appointment. At this appointment your healthcare provider can insure that your abortion has been complete.

What happens at a medical abortion appointment?
• At least two appointments are necessary for a medical abortion.
• At the first appointment, the following occurs:
– History, physical exam, blood tests, ultrasound exam to date pregnancy
– Information about the process and informed consent
– Instructions about how to use the drugs and how to contact the clinic for help,
if needed
– Instructions about how to care for yourself during and after the abortion
– The woman is given the mifipristone to take while at the clinic. This stops the
pregnancy from growing. Many women do not experience any bleeding or cramping before taking the next drug at home (misoprostol)
– The woman is given the second medicine (misoprostol) with instructions how to
take it sometime within the next 24-72 hours
– The woman is given pain medications for use with cramping during the abortion.
• At the second appointment, the following occurs:
– Review of how the process went for you
– Physical exam and ultrasound exam to insure that the abortion is complete.