Women's Health

A medical abortion is the use of medicines to end a pregnancy. Medical care for a medical abortion is different from medical care for a surgical abortion. This is because a medical abortion is like a miscarriage (in this case, caused by medicines) that takes place at home over 1 to 2 days and does not require your doctor to be present. After a couple of weeks of bleeding, you then see your doctor for a follow-up examination.

Care before a medical abortion

Before a medical abortion, your doctor will:

• Evaluate your medical history, including any medicines you are taking.
• Do a physical exam, including a pelvic examination, to evaluate your health, how long you have been pregnant, and location of the embryo or fetus.
• Perform an ultrasound to confirm how far along and where the pregnancy is. Not all doctors choose to do this step.
• Discuss your decision to have an abortion and your feelings about the decision.
• Discuss your plans for future pregnancies and birth control use.
• Explain how the medicines will work, possible side effects (nausea, vomiting, and diarrhea are common), and when to call your doctor. It is important for your doctor to know whether you:
  • Have access to a telephone, to call if you have problems.
  • Have transportation to a health care facility if you need to be evaluated.
  • Will be able to return for a follow-up appointment.
  • Are prepared for the cramping pain and bleeding that will occur as the uterine contents are passed.
  • Understand that a surgical abortion will be needed if a medical abortion fails to complete the process.

In addition to the medicines used to cause an abortion, your doctor will give you medicines to minimize side effects, with specific instructions for their use. These medicines are used:

• For cramping pain caused by uterine contractions.
• To prevent nausea or vomiting.
• To prevent infection.

All women who have Rh-negative blood type will be given Rh immunoglobulin to prevent Rh sensitization after an abortion.

If you need to call your doctor about your symptoms during a medical abortion, be prepared to provide information about:

• How heavy the bleeding is, compared with your normal menstrual bleeding. The heaviest bleeding should stop 1 to 2 hours after passing the pregnancy tissue.
• The number and types of pads used in 1 hour and the total number of soaked pads used.
• The presence and size of blood clots.
• Whether any pregnancy tissue has been passed.
• The severity of your cramping or pain.

Care after a medical abortion

Carefully follow all of your doctor's instructions and review what-to-expect information after a medical abortion.

Follow these instructions:

• Most women can return to normal activities in 1 to 2 days after the uterus has cleared. Avoid strenuous exercise for 1 to 2 weeks.
• Do not have sexual intercourse for 1 to 2 weeks or as advised by your doctor.
• Be sure to use birth control when you start having sex again. And use condoms to prevent infection. For immediately effective birth control, you can use a barrier method (such as a diaphragm, cervical cap, or condom). A copper intrauterine device (IUD) is effective immediately after it is placed in the uterus. If you start hormone birth control pills, patches, or injections right after the procedure, be sure to use a backup method until the hormone medicine becomes effective. For more information, see the topic Birth Control.
• Do not rinse the vagina with fluids (douche). This could increase your risk of infections that can lead to pelvic inflammatory disease.