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The abortion pill after 9 weeks 
 
Click here to download The abortion pill after 9 weeks section from the bpas guide

The abortion pill is a medicine that ends a pregnancy. The medical name for the abortion pill is mifepristone. It works by blocking the hormone progesterone. Without progesterone, the lining of the uterus breaks down and the pregnancy cannot continue.

The abortion pill is followed by another medicine called misoprostol which makes the womb contract, causing cramping and bleeding similar to a miscarriage. 

This method can be used up to 23 weeks and 5 days of pregnancy at bpas.

First appointment
A healthcare professional will give you the abortion pill to swallow while you are in the clinic.

If your blood group is Rhesus-negative you will also have an Anti-D injection. You may then leave the clinic. Most women can carry on their usual lives at home or work but you may have some bleeding and period-like pains.

You may have nausea or vomiting. If you vomit within one and a half hours of taking the pill, please inform the clinic as soon as possible, as the tablet may not have been absorbed.

Second appointment
You will either return to the same bpas clinic or visit a different bpas clinic 1 or 2 days later. You will be admitted and tablets of misoprostol will be placed into your vagina. You may insert these tablets yourself or have a healthcare professional insert them for you.

A nurse will be in attendance and your progress will be monitored. You can rest in bed or be up and about as you wish. The misoprostol tablets will cause you to have cramps and bleeding. This usually starts about 2 hours after the misoprostol is placed, but may start sooner. You may need pain medicine, which we will provide.

The misoprostol will be repeated every 3 hours, until the abortion is complete. Many women will only require 1 or 2 doses of the misoprostol before the abortion happens, but it can take longer. You may need to stay overnight. If you have not completed the abortion after 5 doses of misoprostol then you will rest for 12 hours before starting again.

You may see large blood clots or the pregnancy at the time of the abortion. The nurse will try to make sure that you see very little, but sometimes this is not possible as events can be rapid.

Sometimes the placenta does not come out at the time of delivery. In this case, you may need more misoprostol or need to be taken to the operating theatre. On rare occasions you will need to be transferred to a local NHS hospital for further treatment.

It’s normal to have some bleeding or spotting for up to 4 weeks after the abortion. You should use sanitary pads as it makes it easier to keep track of your bleeding.

Side effects
For most women, medical abortion is like a miscarriage. It is normal for you to have bleeding and cramping. You might also:

 

  • feel dizzy
  • feel nauseous or have to vomit
  • have a headache
  • have diarrhoea
  • have temporary flushes or sweats

 

A nurse will be with you at all times and will give you medicine to help control any side effects or pain you might have.

Risks and complications of the abortion pill after 9 weeks
Significant, unavoidable or frequently occurring risks
These are usually easy to treat and rarely have any long-term health effects
Unpredictable time to complete the procedure
Side effects of drugs such as nausea, vomiting, diarrhoea, headache, dizziness, fever/chills (common)
Retained placenta  (1 in 60)
Infection (none reported to bpas in 2008 but may be up to  1 in 10)
Unpredictable, irregular or prolonged bleeding after the  abortion (variable)
Pain during the procedure (common)

These may require transfer to hospital or surgical procedures, and may have serious long-term health effects.
Psychological problems (variable)
Continuing pregnancy/failure to deliver (1 in 150)
Haemorrhage - very heavy bleeding (1 in 200)
Rupture of the uterus/womb (1 in 1000)
Death (less than 1 in 100,000)Extra procedures which may be necessary
Surgical abortion or uterine aspiration• Blood transfusion
Laparoscopy or laparotomy - operation to look inside the  abdomen
Hysterectomy - surgical removal of the womb (very rare)