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Medical abortion:

The Abortion pill from 10 weeks to 24 weeks

This method can be used at BPAS from 10 weeks, up to 23 weeks and 5 days of pregnancy.

VIDEO: The abortion pill after 10 weeks

What is the abortion pill?

The abortion pill is two medicines. Mifepristone is the first medicine which ends the pregnancy. It blocks the hormone progesterone, making the lining of the uterus break down so the pregnancy cannot continue. The second medicine, misoprostol, makes the womb contract causing cramping, bleeding and loss of the pregnancy like a miscarriage

First appointment

You will attend the clinic to be given a tablet of mifepristone to swallow. Mifepristone makes the uterus more sensitive to a medication called misoprostol, which is used to induce contractions (start labour).

You will go home and return to a clinic for the rest of your treatment on a different day. Contact us if you vomit within 1 hour of taking the pill.

If you are 22 weeks pregnant or more, it is necessary to administer an injection into your abdomen to stop the fetal heartbeat before the abortion takes place. This is called ‘feticide’ and more detail can be found here. If you are rhesus-negative you will also have an anti-D injection.

Second appointment

You will attend a BPAS clinic 1-2 days after you swallow mifepristone. You will be admitted to the clinic and misoprostol will be administered either vaginally or under your tongue, every few hours until all the fetus and placenta are passed. You will be awake throughout the process, but will be given oral and injectable painkillers as needed
and can use gas and air. The nurse or midwife looking after you will try to make the process as comfortable as possible.

On average it takes about 6 hours for the labour and delivery, but this can vary. In some cases, it may be quicker, but in others it may take over 24 hours and you will need to stay overnight in the clinic. In a minority of procedures, the placenta does not pass spontaneously, and it is necessary to perform an additional procedure, usually under
general anaesthetic, to remove it.

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

It is normal to have some light bleeding or spotting for up to 4 weeks after the abortion. Using sanitary pads make 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.

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 or midwife will always be with you and will give you medicine to help control any side effects or pain you might have.

Risks and complications

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 2013 but may be up to 1 in 400)
  • 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 1,000)

Extra procedures that 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 (2 in 100,000)

Death is very rarely linked to abortion treatment – less than 1 in 100,000’ for all abortions.