Medical (RU-486, Abortion Pill, Missed Period Pill)

A medical abortion, or the “abortion pill” is actually 5 pills, taken one or two days apart, and is a combination of two medications: mifepristone and misoprostol. Mifepristone is used to cause the death of the embryo and one to two days later, misoprostol is given to cause cramping that will expel the embryo. The process of expelling the embryo typically involves heavy bleeding and severe cramping or pain. These drugs are FDA approved for use in women in the first 10 weeks of pregnancy. This procedure is not available over the counter and requires a health care provider’s prescription and care. For safety this care should include an ultrasound before administration of the medication to determine pregnancy dating, viability and location (i.e. rule out ectopic pregnancy). After the medication is taken, a follow up visit is needed with a health care provider to ensure that the abortion is complete and there are no complications.

You may have heard of the “missed period pill” and asked yourself what it is. The “missed period pill” is comprised of the same medications as a medical abortion and is an abortifacient (causes an abortion).  

Surgical 

Dilation & Curattage (D&C) 

This procedure is performed from early pregnancy through approximately 12 weeks. This procedure may be performed in a doctor’s office without anesthesia or in a surgery center/operating room under general anesthesia. During this procedure the cervix is opened up using surgical instruments to dilate (or stretch open) the cervix. After the cervix is opened, all uterine contents are suctioned out. A loop-shaped tool called a curette may also be used to scrape out any remaining fetal parts or tissue. There is typically a small amount of bleeding and light cramping for a few hours to days after the procedure. 

Dilation & Evacuation (D&E) 

This procedure is performed at about 13 weeks and up, including into the third trimester. This procedure is usually performed in a surgery center or operating room under general anesthesia. During this procedure the cervix must be opened up further than with a D&C, to allow various surgical instruments to enter the uterus. This is sometimes done by inserting several small bundles made of seaweed into the cervix the day before the procedure, which expand to stretch open the cervix. The cervix can also be further opened by using surgical instruments during the procedure. Once the cervix is fully open, fetal parts are removed with a grasping tool (forceps). A loop-shaped tool called a curette, may also be used to scrape out any remaining tissue. There is typically a small amount of bleeding and moderate cramping for a few days after the procedure.

Abortion after Viability (24 weeks and greater)

This can be done by D&E or by inducing labor and allowing vaginal delivery. Digoxin and/or potassium chloride are injected into the amniotic fluid, the umbilical cord, or directly into the fetal heart to cause fetal death. If a surgical procedure is done, the procedure is the same as the second trimester D&E. All fetal parts are reassembled after removal from the uterus to make sure nothing is left behind to cause infection or bleeding. If labor induction is done it is similar to full term labor with a live fetus. Medications are administered to stimulate painful uterine contractions, which cause the cervix to open and allow the woman to actively push out the fetus. This may be done with no anesthesia or with regional anesthesia, such as an epidural.  

Whenever you take drugs or have a surgical procedure, there are possible side effects and risks, and abortion is no exception. Possible side effects include: heavy bleeding, fainting, fever, infection, tearing of the cervix, uterine perforation or hemorrhage (excessive bleeding), shock, and emotional side effects. Additional procedures may be needed if adverse side effects arise. 

These risks are real. They don’t just happen to people in other parts of the country or the world, they are happening to women in all communities, even yours. 

Resources:

Guttmacher institute. (2013, December). Facts on induced abortion in the United States. Retrieved from http://www.guttmacher.org/statecenter/spibs/spib_ARR.pdf Accessed March 18, 2021.

Fox, M. (2007). Cervical preparation for second trimester surgical abortion prior to 20 weeks. Contraception, 76(6), 486-95.

U.S. Food and Drug Administration, Postmarket Drug Safety Information for Patients and Providers/ (2011). Mifeprex (mifepreistone) information. Retrieved from website: http://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm111323.htm. Accessed March 18, 2021.

What are my rights? What should I do?

No one can force or pressure you to have an abortion. This is your decision and you will be the one most affected by the consequences. If you are feeling pressured, explain your needs and try to involve them in options counseling. We can help.

First you need to confirm that you are actually pregnant. We can offer you a free pregnancy test at Options. Next, we can perform an ultrasound. Ultrasounds will confirm three things; 

1. Viability: It’s important to know if it’s a viable pregnancy before you proceed. 

2. Location: This will rule out pregnancies that are in the fallopian tubes or outside the uterus. These cases can be life threatening and need medical intervention.   

3. Date: Dating your pregnancy will help you know what abortion procedure to research.