MEDICAL TERMINATION PREGNANCY

Medical abortion involves taking a combination of tablets to bring on a miscarriage. The tablets are prescribed as a pack. Your doctor may also prescribe additional tablets to minimise side effects (such as pain and nausea). Your doctor or nurse will discuss how to take the tablets – including the timing.

During and after the procedure, you will have the option of telephone contact with the clinic or a 24 hour help line in case you have any questions or concerns.

What to expect during and after a medication abortion

To take the first tablet (mifepristone) at an agreed time. This tablet (mifepristone) usually does not cause any side effects. You can continue with your normal activities.

After taking the second tablets (misoprostol) you may experience nausea, vomiting, diarrhoea, dizziness, headaches and fever for a short time.

36 to 48 hours later, take a second dose of tablets (misoprostol), which softens the cervix and helps the uterus push out the pregnancy experience cramping and bleeding similar to a miscarriage between one and 24 hours after the second medication.

Vaginal bleeding and abdominal (tummy) pain and cramping usually start 1 – 4 hours after taking the second tablets. Bleeding is usually heavier than a period and there may be large clots. Pain and cramping are generally much stronger than period pain.

After 2 – 6 hours the bleeding usually settles to the level of a normal period and continues like that of a normal period for another 3 – 7 days. The bleeding becomes lighter and usually settles after a total of 2 weeks. A small number of people may experience unpredictable, irregular or prolonged bleeding that can last for up to 5 weeks.

You organise a pregnancy hormone blood test 7 days after you have taken your first tablet, to check that the hormone level has dropped and you are no longer pregnant.

Around two weeks after taking the tablets you will have a follow-up appointment to make sure the pregnancy has ended and check for complications. You will also have the opportunity to review your contraception.

Complications of a medical abortion:

Complications are uncommon after a medical abortion, but may include:

Allergic Reactions to the medications such as Itchy Rash or difficulty in breathing-Contact clinic immediately or   Go to   Emergency Department of closest hospital.

Incomplete Abortion : Small pieces of tissue left in the uterus (womb) may cause prolonged or heavy bleeding, requiring a minor surgical follow-up procedure to clear the lining of the uterus (around 1 in 20 – 1 in 33 cases). This procedure is done under general anaesthetic. This will be checked when coming for follow up or following continuous bleeding.

The medical abortion does not work and the pregnancy continues (around 1 in 125 cases). The abortion tablets can be repeated if the pregnancy is not more than 9 weeks otherwise a surgical abortion may be required.

Haemorrhage – very heavy bleeding. ( Need of using 2 pads in an hr and next hour) Contact centre Immediately or Go to ED. In rare cases a blood transfusion is needed.

Infection requiring antibiotic treatment (symptoms include persistent pain, an unusual vaginal discharge, fever and feeling generally unwell). Contact centre Immediately.

Contact our Centre doctor or nurse if you experience:

• Heavy bleeding or bleeding that is not settling
• Pelvic pain that is not settling
• An unusual or smelly vaginal discharge
• Unexplained fever and feeling generally unwell.

Recommendations after a medical abortion:

After taking the medical abortion tablets it is recommended you:

Use pain medication such as ibuprofen or paracetamol to help manage the cramps (Contact centre for stronger medication if needed)

Massage your abdomen and use heat packs, Rest and take time off work or study.

To lessen the risk of infection during the two weeks after having the procedure, you should not:

• Insert anything into the vagina (including tampons and menstrual cups – which should not be used until your next period)
• Have vaginal sex
• Perform any strenuous activity, including sport or heavy physical work, until the bleeding is no longer heavy
• Go swimming or have a bath (you can shower).

Follow-up after a medication abortion:

We will organise a pregnancy hormone blood test 7 days after you have taken your first tablet, to check that the hormone level has dropped and you are no longer pregnant.

Around two weeks after taking the tablets you will have a follow-up appointment to make sure the pregnancy has ended and check for complications. You will have the opportunity to review your contraception.

If you have any questions or concerns, you can telephone our clinic or a 24 hour help line.