Considering a First Trimester Medical Abortion
Same Day Process
What is it?
There are two medicines which are taken together. Mifepristone acts by blocking the effects of progesterone, a hormone needed for pregnancy to continue. Misoprostol helps to expel the pregnancy. They are given in the clinic and then you go home.
How will I take the treatment?
- You will be given the Mifepristone tablet which you must take at the clinic.
- You will have the Misoprostol tablets vaginally while you are still in the clinic.
- You will then go home. You may want a support person with you.
- Have a good supply of maxi-pads to use at home.
- In about 90% of women, the pregnancy will be expelled within 24 hours.
- If expulsion has not occurred the day after the medicines are taken, you will be asked to come back the next day to have another dose of Misoprostol.
- You need to have a blood test after 1 week to check that the pregnancy has ended.
- You should see your referring doctor within 2 weeks for a final check to make sure that you are well and have no complications. This visit is free if you are seen within 14 days of taking the medication.
- If the medical treatment fails, a surgical abortion will be necessary.
You should recover quickly from your abortion but take things easy for a few days. You may feel emotional and extra counselling is available if needed.
What are the effects of the treatment?
You may notice nausea, diarrhoea and stomach cramps soon after having the medications. You are likely to start bleeding within 6 hours and the stomach cramps may be quite strong. A medical abortion is like having a miscarriage. In some cases the bleeding can be very heavy and a few women (about 1 in 300) may need a blood transfusion and/or have a surgical abortion to stop the bleeding.
You will be given a prescription for painkillers. Pain can be worse for women who have never been pregnant before or for women who normally have painful periods.
Some women have diarrhoea, sickness, headache, dizziness, hot flushes and chills from the medication. Occasionally there may be a skin rash. If you are concerned about any side effects, contact the abortion clinic.
Managing discomfort and pain with Early Medical Abortion
Same day process
Most women have strong cramping, like period pains, during a medical abortion.
The strongest cramping is usually when the pregnancy tissue is being passed.
You will have both the abortion medicines together. Bleeding usually starts about 5 hours later, although there may be cramps before this. Expulsion of the pregnancy may be soon after the bleeding starts or may be much later in the first 24 hours or beyond that time.
The cramps usually lessen after the pregnancy tissue has been passed.
If you have very severe, continuous, or increasing abdominal pain that is not helped by rest, a hot water bottle or medicine, phone the Family Planning 24 hour phone line.
Everyone experiences discomfort and pain differently. There are many ways to reduce your symptoms:
- Know what to do in case of emergency (contact Family Planning clinic or After Hours phone line), have a phone and transport available
- Be in a familiar, relaxing place
- Have supportive people with you
- Do activities that you enjoy (it is best to avoid strenuous exercise or stressful activities)
- Ring the Family Planning clinic or After Hours phone line if you have any worries, concerns or unexpected symptoms
- Ring the Family Planning clinic or After Hours phone line if you feel sick, vomit, or have diarrhoea or other symptoms. Treating these symptoms may help reduce discomfort and pain
Discomfort and pain may be reduced by:
- Taking deep, relaxing breaths
- Using a hot water bottle or heat pack
- Taking pain medicine
Common side effects from EMA medications
- Mifepristone: diarrhoea, nausea, vomiting, dizziness, pelvic cramps
- Misoprostol: diarrhoea, nausea, vomiting, dizziness, chills, fever, stomach cramps
- Ibuprofen: Upset stomach, heartburn, constipation, diarrhoea, dizziness, rash, blurred vision
Take after food, do not take if you have previously had a stomach ulcer.
- Codeine: constipation, nausea, vomiting, mild itching or rash, dizziness or drowsiness, change in thinking or reactions
Do not drink alcohol while taking codeine. Avoid driving or operating machinery until you know how codeine will affect you. Should not be used if you are breastfeeding.
- Tramadol: dizziness, spinning sensation, constipation, upset stomach, headache, drowsiness, feeling nervous or anxious, rarely seizures
Do not drink alcohol on this medication
- Ondansetron: diarrhoea, constipation, weakness, fever, headache, dizziness, drowsiness, rarely blurred vision or temporary loss of vision, change in thinking or reactions
Be careful if you drive or do anything that requires you to be alert.
Before your appointment
You can download and print our EMA Checklist.
What if I have problems with the ema?
Here is important information to read in case you have any problems following your early medical abortion.
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