Early Abortion Pill (Medical Termination of Pregnancy)

In response to the current COVID 19 pandemic, the government has approved the use of pills by post for abortion treatment. This allows you to take both pills for a medical abortion up to 10 weeks in your own home, rather than attending a clinic. Click here for further information on “pills by post”.

‘What is the abortion pill?’

The abortion pill is a safe way to end an early pregnancy. It is a combination of two medications – mifepristone and misoprostol. You can have an early medical abortion (EMA) using an abortion pill up to 10 weeks of pregnancy.

Early Medical Abortion Pill Treatment

The first tablet is called Mifepristone and is taken orally (swallowed with water).  Mifepristone works by blocking the action of progesterone, a hormone needed to maintain the pregnancy.

The second stage of treatment is 4-6 Misoprostol tablets. 4 tablets should be either be inserted into the vagina or in the mouth against the gum (buccal). These contain a hormone called prostaglandin. Prostaglandins occur naturally in the body and help the uterus to contract. If there is no bleeding after four hours the 2 remaining tablets should be used.

Acting together the combination of Mifepristone and the Misoprostol will bring on an abortion.

EMA has a very good safety record, however, every form of medical treatment carries some risks or side effects. With this treatment, the main risks are:

• Excessive vaginal bleeding
• Incomplete abortion
• Infection
• Allergic reactions

Staged EMA

First visit

• You will be given a Mifepristone tablet to swallow with a glass of water.
• You will be given your next appointment time and a number to call if you are worried or have any questions.

Second visit

After your first visit, you will be asked to return to the clinic between 24 and 48 hours later. You must keep this appointment. There is a waiting room for your supporter whilst you are having treatment.

• Any symptoms that you may have experienced since your first appointment will be discussed with you by a nurse. If all has been well, your early abortion-pill treatment will continue.
• You will be given pain relief to be administered rectally.
• A nurse will insert Misoprostal pills either vaginally or buccally or you can choose to put them in place yourself. The Misoprostal helps your body to expel the pregnancy so you will start to bleed and have period-like pains.

Simultaneous EMA

One visit

We also offer simultaneous administration of early medical abortion.  This involves taking both parts of the early medical abortion medication at the same time, in one clinic visit.

• Your pregnancy should be dated at 9 + 0 weeks or under to have this type of abortion
• This involves an oral tablet (mifepristone) and four vaginal tablets (misoprostol)
• The vaginal tablets are preferably administered by a nurse to ensure correct insertion, however they can be self-administered if you feel confident to do so

Failure Rates

Failure rate of simultaneous and 6 hourly (EMA) is thought to be around 4 in 100 (compared to around 2 in 100 for staged EMA).

Potential Side Effects

All women react differently to this treatment. Some have heavy bleeding and quite a lot of pain, while others have very little bleeding and mild pain. Most women are in between the two, however, it is important to remember that this is not a completely pain-free procedure.

You may experience the following:

• Nausea or sickness
• A feeling of light-headedness
• Feeling feverish
• High temperature
• Diarrhoea

You can leave the clinic after the treatment. You should take it easy for a couple of hours. After this time you may find that moving around will ease any discomfort.

The abortion usually takes place between 4 and 6 hours following the insertion of the tablets however in some cases the abortion can take place earlier or later (up to 7 days later).

Discharge from the Clinic

You may bleed heavily following the second visit, usually for 2 – 3 days and you may even pass some clots. This is quite normal. After this time, the bleeding will reduce but you could bleed on and off for 3 – 4 weeks.

If you have any concerns about the side effects of your early abortion pill, you can always contact us.

Post procedure

You can take your normal painkillers (they must not contain aspirin) to relieve any discomfort. Do not take more than two in 4 hours.

Your first period may occur 4-6 weeks later and it may be heavier than normal.

We also advise that you avoid any heavy lifting or exercise for 2-3 weeks.

It is advisable to carry out a pregnancy test 4 weeks later to confirm your treatment was successful.  It the pregnancy test is positive, please contact the clinic for further advice.

Aftercare

It is advisable to carry out a pregnancy test 4 weeks later to confirm your treatment was successful. If the pregnancy test is positive, please contact the clinic for further advice.

This kind of medical abortion may not be suitable for you if any of the following apply:

• You have been on long term corticosteroid treatment
• You are on any anticoagulant (blood clotting) treatment
• You have had a bad reaction or are allergic to Mifepristone
• You have liver or kidney disease
• You have risk factors for heart disease (such as high blood pressure or high blood cholesterol levels
• You suffer from any other disease or illness and are taking other medication
• You have an IUD in place which may need to be removed prior to the beginning of treatment
• You are breast-feeding (we do not recommend use of Mifepristone in women who wish to continue breast-feeding because the drug will pass into breast milk- it takes around 26 days for the drug to clear the body)

If any of these conditions apply, please inform the doctor/nurse who will discuss them further with you.