Early Medical Abortion
Early Medical Abortion (up to 9 weeks):
Information About Your Treatment
What is early medical abortion?
What happens?
Do I have to go to a treatment unit?
Can I bring anyone with me?
What do I need to bring with me?
What else must I do?
What happens after I take the first tablet?
What if I change my mind and don’t come to the second appointment?
On my second visit to the clinic, do I have to stay in the treatment unit after the misoprostol tablets have been inserted?
What happens next?
How long will I bleed for?
How likely am I to get side effects from the drugs?
Will my body return to normal?
Do I have to take time off work?
Why do I have to come back for a check-up?
How will I feel afterwards?
How safe is it?
Will I be given any more information?
What do I do if I can’t make the appointment or change my mind?
What is early medical abortion?
This procedure is also known as EMA and can be carried out up to 9 weeks gestation.
It involves taking medication to cause an early miscarriage. It does not involve any surgery and there is no anaesthetic involved.
What happens?
At the first appointment, a tablet (mifepristone) is swallowed which blocks the hormone that supports the pregnancy.
If your blood group is rhesus negative you will have an Anti-D Immunoglobulin injection.
At a second appointment tablets (misoprostol) are placed in the vagina causing the uterus to cramp and its lining to break down. You can place the tablets yourself or have a health professional place them. The pregnancy is lost in the bleeding that follows, as happens with a miscarriage.
Do I have to go to a treatment unit?
For this treatment you will need to visit the bpas treatment unit twice, either on the same day, or one to three days apart. You will also need to attend an appointment about one to two weeks later so that you can have a check-up.
Can I bring anyone with me?
Yes, but space is limited, so please try to bring only one friend or relative with you - but note that we do
not have facilities to accommodate them all day. However, if you are under 16 years of age a female adult may stay with you. Also, there are not usually any facilities for children, so you need to make alternative arrangements for child care during the time you will be at the clinic/treatment unit.
What do I need to bring with me?
You need very little but on each visit you must bring:
Any prescribed medicines or inhalers
Stick on sanitary towels
What else must I do?
If you are prescribed any medication between the consultation appointment and the treatment appointment, please advise the nurse on admission.
What happens after I take the first tablet?
You may leave the clinic soon after you have taken this tablet. If you vomit within two hours of taking the tablet, please inform the clinic as soon as possible, as the tablet may not have been absorbed.
Most women can carry on their usual lives at home or work but you may have some bleeding and period-like pains. It is unlikely that the abortion itself will happen after the first tablet. However, this can
happen occasionally and we will provide you with a phone number that you can call at any time if you have any questions or need advice.
What if I change my mind and don’t come to the second appointment?
We strongly recommend that you complete the treatment. However, if you decide not to come to your second appointment, please contact the clinic to cancel your appointment and go to see your GP to register for antenatal care.
You should be aware that studies done so far do not indicate that mifepristone is associated with any increased risk of fetal abnormality.
On my second visit to the clinic, do I have to stay in the treatment unit after the misoprostol tablets have been inserted?
No. You will leave the treatment unit soon after this if you are fit to be discharged.
This means you will miscarry in the privacy of your own home. It is advisable for you to have an adult to escort you home after being discharged.
It is important to note that you may start bleeding immediately, although it may also take up to several hours
before you start to bleed.
If you have a long journey home, we recommend that you have additional sanitary towels and pain killers as you may find that you require these.
What happens next?
At this stage, bleeding will start. It is likely to be heavier than your normal period and some women find the contractions painful. You will be offered pain medication to take home and given advice on how to use it.
The amount of bleeding at the time of the abortion varies but most women describe the bleeding as ‘much heavier than my period’ and it may include some large clots.
Usually you should then find that any pain starts going away and that the bleeding has slowed down.
You may want to stay in bed or lie down, but many women feel comfortable walking around, watching
television or reading. It’s up to you and how you feel.
You may use the toilet as often as you want and flush it as normal. You may feel sick. You may vomit or have diarrhoea.
How long will I bleed for?
You can then expect to bleed on and off for around 7-14 days although this could continue for around 3-5weeks.
If you experience continuous and heaving bleeding (to SOAK two or more pads each , for two hours in a row) contact the clinic, post treatment support line or go to A&E urgently.
If you have not started bleeding within 24 hours of your treatment, contact the clinic as the procedure may not have been effective.
How likely am I to get side effects from the drugs?
You may experience some of the following side effects. They are expressed in the number of cases per 100 women. Nausea 40 in 100
Vomiting 20 in 100
Diarrhoea 15 in 100
Headache 16 in 100
Dizziness 25 in 100
Flushes/sweats 25 in 100
Do I have to take time off work?
It is advisable not work on the second day of your treatment. After that, it all depends on how you feel.
Why do I have to come back for a check-up?
You will need to have a follow-up check to ensure the abortion was successful and you have recovered fully. Preferably this should be done at the bpas treatment unit 1-2 weeks after your treatment
You will receive a pregnancy test with instructions on how to use it. If you cannot return for a check up in person, do the test 3 weeks after the treatment. If the test is positive you must call the bpas treatment unit immediately. A positive test may mean the treatment has not worked.
How will I feel afterwards?
Every woman is different. It is a good idea to have someone with you afterwards because you might want to talk or have some support. Women experience different feelings and cope in different ways. Some like to take a couple of days off work, others prefer not to. It is advisable that you rest until you feel able to return to your normal routine.
Your breasts may become firm and a little tender, but this will only last a few days.
If you experience lasting pain, abdominal tenderness or a temperature you must see a doctor urgently as these could be symptoms of an infection.
How safe is it?
As with all clinical procedures there is a small risk of complications, which are approximately as follows:
Excessive bleeding happens in around 1 in every 1,000 abortions
Damage to the cervix happens in no more than 10 in every 1,000 abortions
Up to 1 in 10 women will get an infection after an abortion
In 1 in every 100 abortions the womb is not completely emptied of its contents and the woman may need further treatment.
1 to 14 out of every 1,000 medical abortions fail to end the pregnancy
There is no long term proven association between abortion and any future ectopic pregnancy or infertility. Abortion may be associated with a small increase in the risk of subsequent miscarriage or pre-term delivery.
Some women may experience short-term emotional distress after abortion. There is a slight increased risk of mental health disorders after abortion compared with childbirth, but no evidence that these problems are actually caused by the abortion. They are often a continuation of problems a woman has experienced before.
Will I be given any more information?
Yes. Our staff are there to help and can give you any extra information you want at any time. The nurses who have been looking after you will talk to you afterwards and give you the leaflet 'Caring for yourself after an abortion'
If you have any specific wishes about the disposal of your fetal tissue, it is important that you tell a member of staff before you start your treatment.
The bpas Post Treatment Support Line 0800 247 1122 can be called 24 hours a day in case you have any problems. You will also be provided with leaflets about contraception.
If this webpage hasn’t answered all your questions, please ring the treatment unit where you have the appointment. Our staff are used to dealing with all sorts of enquiries so do ask any questions you may have.
What do I do if I can’t make the appointment or change my mind?
No one will mind if you ring to cancel or rearrange your appointment. Do try to give us as much notice as possible so that we can offer the time to someone else.
Please call the clinic (you can find their phone number on your clinic leaflet) or Actionline on 08457 30 40 30 to rearrange or cancel appointments.