Medical Abortion


Medical Abortion

Medical abortion has been more widely available in India since 2012 and is a non-surgical abortion option, available to most women up to 63 days gestation. Choosing between a medical or surgical abortion is very much dependent on your circumstances and personal preference.

For many women, the availability of medical abortion in Australia has meant greater privacy and less invasiveness in accessing a termination. The more recent introduction of medical abortion via teleconsultation has also made early termination more readily available to women living in rural and regional areas or without access to an abortion clinic.

Medical abortion is available once a pregnancy is detected via ultrasound (usually around 5 weeks) up to 9 weeks (63 days) gestation. The abortion is achieved using a combination of two medications which work together to terminate a pregnancy. 

  1. The first medication is administered by your doctor or taken by you at home. This medication is an anti-hormone, which acts by blocking the effects of progesterone – the hormone needed for a pregnancy to continue.
  2. 24 to 48 hours after taking the first medication, you take the second medication buccally (which means you place the tablets between the cheek and gum for 30 minutes before swallowing any remaining fragments with water).

The second medication opens the cervix and assists the uterus to expel the pregnancy. This should occur between 30 minutes to 24 hours after taking the second medication, but most women can expect to experience some vaginal bleeding, cramps and to pass some pregnancy tissue within 4 hours.

Before being prescribed the medication for medical abortion you must have an ultrasound to determine that you are no more than 9 weeks (63 days) pregnant and to exclude ectopic pregnancy (a pregnancy in fallopian tubes).

Almost all women are suitable for a medical abortion, although there are a few medical conditions that may mean you are not suitable. If you have a bleeding disorder or are on blood-thinning medications, if you have adrenal gland problems or are taking corticosteroid medications, such as prednisone, medical abortion is unsuitable for you. Your doctor will take a medical history to make sure that you are eligible for a medical abortion. You will also need to able access emergency medical care during the time you are having a medical abortion.

The risks of medical abortion

Medical abortion is a safe and effective method of terminating a pregnancy  up to 9 weeks’ gestation; however, like surgical abortion, a medical abortion carries some risks:

  1. An incomplete abortion is the most common complication (1-4%) and occurs when the pregnancy is not completely expelled from the uterus, causing cramping or heavy bleeding. A surgical procedure may be required if the bleeding or cramping is not settling.
  2. Ongoing pregnancy occurs in less than 1% of cases  A surgical abortion will usually be recommended.
  3. Infection is uncommon (less than 1%).
  4. Excessive bleeding severe enough to require a blood transfusion occurs in around 1 in 1,000 cases.2

What to expect after taking the second medication

Vaginal bleeding and cramping is normal and usually starts within a few hours of taking the second medication (misoprostol). The amount of bleeding and cramping varies from patient to patient.

  • Bleeding lasts on average 10 to 16 days3 and it is usual for bleeding to be heavier than a normal period for 2 to 3 days.
  • Side effects of the medication can also include nausea, vomiting, diarrhea and chills or fever but these are usually mild and short-lived.

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  • You are soaking more than 2 maxi pads per hour for more than 2 hours;
  • You have severe cramps or pain uncontrolled by pain medication;
  • You have fever, chills, severe pain or other side effects which continue more than 24 hours after taking misoprostol;
  • You have any concerns after taking the medication.

If bleeding does not occur, some patients may require a repeat dose of misoprostol or another method of termination may be suggested. You should contact your doctor as soon as possible if this occurs.

Why choose a medical abortion?

If your pregnancy is under 9 weeks’ gestation and you prefer not to undergo surgery, then a medical abortion is a good option.  Other reasons women choose medical abortion over surgical abortion include:

  • It requires no anesthetic;
  • The procedure is non-invasive;
  • There is greater privacy than with a surgical abortion;
  • As a non-surgical procedure, there are no surgical risks associated with medical abortion;
  • You are at home and can have the support of friends and/or family if you choose;
  • It can feel ‘more natural’, as it is similar to having a heavy period or miscarriage.

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