Medical Abortion (sometimes known as RU-486, Plan C, Chemical Abortion, or Medication Abortion) is the purposeful ending of a pregnancy inup to 12 weeks gestation by taking a combination of two pills.

The first, mifepristone, blocks all nutrients to the pregnancy and therefore causes the death of the fetus. Then, 24-48 hours later, misoprostol is taken to induce contractions to expel the contents of the uterus.

Who Should Not Have a Medication Abortion?

According to the Mifeprex drug facts, patients who:

• have a confirmed or suspected ectopic pregnancy
• have a risk of hemorrhage
• chronic adrenal failure (including liver or kidney disease)
• have an IUD in place
• are taking blood thinners or certain steroid medications
• are taking any medications that may be contraindicated 

should not use medication abortion.

How Can I Avoid Complications with Abortion Pills?

While complications can never fully be eliminated, it is important to have a pre-abortion screening to make sure that:

• You are pregnant 
• Your period dating is accurate
• You do not have an ectopic pregnancy (ultrasound)
• You are not having a miscarriage (and therefore would be unnecessary to take the abortion pill)
• You do not have an STD  (raising your risk of Pelvic Inflammatory Disease)
• Know if you are RH negative or positive (your nurse can discuss this with you) as it could affect future pregnancies

Alpha Center provides pre-abortion screenings for free and believes that an informed decision is the best decision. Schedule your appointment today.

Can I take the abortion pill if I have an IUD?

No. You need to get your IUD removed before taking the abortion pill, and should contact your primary care provider or gynecologist.

How Safe is Medication Abortion Compared to Surgical Abortion?

Though both are considered relatively safe, medication abortions are associated with four times the risk of complications, such as hemorrhage and incomplete abortions, than surgical abortions.

Roughly 7% of women who undergo a medication abortion will need surgery to complete the abortion.

Prior to taking the abortion pill, make sure you know where your nearest Emergency Room is located. Make sure to tell the doctor that you took the abortion pill as this can affect your treatment. In Colorado, there are no legal consequences for abortion, and honesty is always best when it comes to medical care.

It is also recommended to have a follow-up appointment to ensure that the abortion is complete and doesn’t need further care. Surgical abortion is sometimes necessary to complete the abortion.

Rare Complications

In a review of Adverse Effects (AEs) Reports following the use of medication abortion from the FDA, 20 deaths occurred following the use of medication abortion from 2000-2019. 529 AEs were of life-threatening, 1957 were severe, 151 were Moderate and 3 were Mild.

Why Do I Need an Ultrasound?

During a pre-abortion screening appointment, if the pregnancy test comes back positive and the patient is eligible, our nurses will perform an ultrasound.

Ultrasound is important for a few reasons, the first being that according to ACOG, a due date determined without ultrasound is considered to be “sub-optimally dated” (Meaning, not reliable). The risk of an incomplete abortion and need for surgical intervention rises as pregnancy progresses.

Nearly 20% of women were not able to accurately state their when their last period was (LMP).

How Can I Avoid Risks?

As with any medication protocol and/or medical procedure, it is important to weigh the potential risks versus benefits associated with the medication.

Many of these risks can be mitigated (but not eliminated) by getting a pre-abortion screening, which Alpha Center provides at no cost to you. Request an Appointment here.

(Alpha Center does not provide or refer for abortions, which means we have no financial interest in your decision.)

Citations:

1. Niinimäki, Maarit MD1,2; Pouta, Anneli MD, PhD1; Bloigu, Aini3; Gissler, Mika BSc, PhD4,5; Hemminki, Elina MD, PhD4; Suhonen, Satu MD, PhD5; Heikinheimo, Oskari MD, PhD5. Immediate Complications After Medical Compared With Surgical Termination of Pregnancy. Obstetrics & Gynecology 114(4):p 795-804, October 2009. | DOI: 10.1097/AOG.0b013e3181b5ccf9
2. Methods for estimating the due date. Committee Opinion No. 700.American College of Obstetricians and Gynecologists. Obstet Gynecol 2017;129:e150–4.
3. Ganesa Wegienka and Donna Day Baird.A Comparison of Recalled Date of Last Menstrual Period with Prospectively Recorded Dates.Journal of Women’s Health.Apr 2005.248-252. http://doi.org/10.1089/jwh.2005.14.248
4. Mayo Clinic (2022, March 12). Ectopic Pregnancy. Retrieved September 25, 2023, from https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088#symptoms
5. ACOG (2022, June 1). The Rh Factor: How It Can Affect Your Pregnancy. American College of Obstetrics and Gynecology. Retrieved September 25, 2023, from https://www.acog.org/womens-health/faqs/the-rh-factor-how-it-can-affect-your-pregnancy
6. Bjartling C, Osser S, Persson K. The association between Mycoplasma genitalium and pelvic inflammatory disease after termination of pregnancy. BJOG 2010;117:361–364.
7. Mentula MJ, Niinimäki M, Suhonen S, Hemminki E, Gissler M, Heikinheimo O. Immediate adverse events after second trimester medical termination of pregnancy: results of a nationwide registry study. Hum Reprod. 2011 Apr;26(4):927-32. doi: 10.1093/humrep/der016. Epub 2011 Feb 11. PMID: 21317416.
8. Studnicki J, Longbons T, Harrison DJ, et al. A Post Hoc Exploratory Analysis: Induced Abortion Complications Mistaken for Miscarriage in the Emergency Room are a Risk Factor for Hospitalization. Health Services Research and Managerial Epidemiology. 2022;9. doi:10.1177/23333928221103107

Written by Kristen Long for Alpha Center. October 2023.