FAQs about Abortion Pills in UAE
Whether you are a person in need of an abortion, or just curious about our service, here are some frequently asked questions about abortion pills in UAE. Everything you need to know about how to use abortion pills, Every question has a simple answer and a more in-depth answer which refers to scientific articles.
General information about the Abortion Service
Is it difficult to do an abortion in UAE by yourself?
The Abortion pill in UAE is easy to administer & can be taken in the privacy of your home. Our team will walk you through the process in real time.
A medical abortion does not need to take place in a hospital or first aid clinic in order to be safe. Abortion pill is easy to administer and can be taken in the privacy of your home. The World Health Organization suggests that individuals can self-manage their abortions until 12 weeks without the support of a health-care provider.
Using Mifepristone and Misoprostol is no more complicated than using other medications. You will get step-by-step instructions about how to use the pills, what to expect, and when you need to see a licensed medical practitioner, should you experience any complications. If you have questions about any step of the process, you can contact our helpline. Our helpdesk staff will get back to you within 24 hours.
A medical abortion resembles a miscarriage and can occur safely at home. The process is very similar, and the effects are the same as those of a miscarriage. About 30% of all pregnancies end in a miscarriage, most of which do not happen in a hospital. Most people will deal with miscarriages by themselves and only seek medical attention in case of problems, such as prolonged, heavy bleeding or fever.
Medical abortion is highly safe and effective. Out of every 100 people who do medical abortion, 2 to 3 will seek further medical care. When you do medical abortion, please ensure that you are less than 12 weeks pregnant and live within 1 hour from a first aid facility.
Why is this abortion service needed?
A safe abortion service protects the life and health of individuals when they experience an unwanted pregnancy. This abortion service trusts pregnant people to make conscious and well-informed decisions about their bodies.
Abortion access is a human right, essential healthcare and medical abortion pills are listed as essential medicines by the WHO.
Is it legal?
In most countries there is no violation of customs regulations when you receive the medicines at your home address. Customs regulations allow individuals to receive prescribed medicines for personal use. It is not permitted to receive large quantities of medicines by mail for commercial use without an import and distribution license.
Mifepristone and Misoprostol are on the list of essential medicines of the WHO. Misoprostol is registered in most countries and can also be used to prevent stomach ulcers. Mifepristone is not registered in all countries but this should not be a problem because the medicines are for personal use only. Mifepristone can also be used as a morning-after pill, to treat breast cancer and some brain tumours. The possession of small quantities of Mifepristone or Misoprostol for personal use only is allowed in most countries.
Is an abortion with pills safe?
Medical abortion within the first trimester (12 weeks) is >98% effective. It entails a safe procedure with few risks of complications. These risks are the same as when a person has a natural miscarriage and can easily be treated by a doctor. Further medical care consists of vacuum aspiration or medication for a continuing pregnancy or an incomplete abortion.
Medical abortion is safer than childbirth and the use of antibiotics, penicillin or Viagra. In countries where childbirth is safe, 1 in every 15.000 women dies during childbirth. The risk of fatal anaphylaxis with penicillin has been estimated to be around 1 in 100 000. The mortality rate of people using drugs that treat erectile dysfunction, including Viagra, is approximately 4 in 100,000 users.
Mortality of medical abortion is less than 1 per 100,000.
Medical abortion with Mifepristone and Misoprostol is used in most European countries. In France alone, more than 2.000.000 abortions have been done with Mifepristone and Misoprostol since 1992 and no deaths have occurred. Mifepristone and Misoprostol are listed on the Core Model List of Essential Medicines of the World Health Organization.
Is it safe to do a consultation for an abortion over the internet?
A consultation over the internet is very similar to a face to face consultation. Our medical practitioners depend on the information that you give, as is also the case with an in-person consultation.
In the online consultation our medical practitioners ask you questions in order to get all the information needed to make sure that you can have a safe medical abortion.
There are only few reasons why you might not be able to take medication for an abortion. You should not use the medicines if:
- Someone is forcing you to end your pregnancy
- You are not sure about wanting to end your pregnancy
- You have an allergy to Mifepristone, Misoprostol, or prostaglandins
- You have one of the following diseases: Chronic adrenal failure, Hemorrhagic disorders or bleeding disorders/diseases, Inherited porphyries (it is highly unlikely that you have one of these diseases and do not know about it)
- You have an ectopic pregnancy (a pregnancy outside the womb)
- You cannot get to a hospital or first aid center within an hour
- You are alone. You should ask a partner, friend or another trusted person to stay with you while you use the medicines.
When you have an intrauterine device (IUD), if possible, we advise to have it removed before using the medicines.
If performed within the first 12 weeks, a medical abortion carries a very small risk of complications. This risk is the same as when a woman has a miscarriage and can be easily treated by a doctor or trained medical practitioner.
Further medical care consists of vacuum aspiration or medication for a continuing pregnancy or an incomplete abortion. Out of every 100 women that do medical abortions, 2 or 3 women have to go to a doctor, first aid center, or hospital to receive further medical care.
What is an abortion with pills?
An abortion with pills is a non-surgical termination of a pregnancy. The safest, most effective type of medical abortion requires the use of two different pills. These medicines, called Mifepristone and Misoprostol, provoke the spontaneous expulsion of the pregnancy from the uterus. Mifepristone blocks the hormone progesterone, which is required to sustain a pregnancy. Without this hormone, the attachment of a fertilized egg to the uterine wall is disrupted, and the uterus contracts. Misoprostol enhances contractions and helps to expel the products of conception from the uterus.
Medical abortion with Mifepristone and Misoprostol is highly effective and safe. The effects include cramping and prolonged menstrual-like bleeding. Common side effects are nausea, vomiting and diarrhea. The World Health Organizations suggests that individuals can self-manage their abortions until 12 weeks of pregnancy.
Pregnancy
What are the human chorionic gonadotropin (hCG) levels during pregnancy?
HCG is a hormone produced by the placenta. If you are pregnant, it is detectable in your urine. Most people can expect their levels to return to a non-pregnant range about 4 – 6 weeks after an abortion.
More information:
The human chorionic gonadotropin (hCG) is a “chemical created by the trophoblast tissue, tissue typically found in early embryos and which will eventually be part of the placenta.” The hCG levels in weeks from last menstrual period:
3 weeks LMP: 5 – 50 mIU/ml
4 weeks LMP: 5 – 426 mIU/ml
5 weeks LMP: 18 – 7,340 mIU/ml
6 weeks LMP: 1,080 – 56,500 mIU/ml
7 – 8 weeks LMP: 7, 650 – 229,000 mIU/ml
9 – 12 weeks LMP: 25,700 – 288,000 mIU/ml
13 – 16 weeks LMP: 13,300 – 254,000 mIU/ml
17 – 24 weeks LMP: 4,060 – 165,400 mIU/ml
25 – 40 weeks LMP: 3,640 – 117,000 mIU/ml
These numbers are just an indication, every person’s level of hCG can rise differently. HCG can also be measured in ng/ml, which should be multiplied by 10 to get a number comparable with mIU/ml.
What if you are not pregnant but take the medicines anyway?
Your health will not be harmed if you are not pregnant but take the medicines anyway. However, you may still experience the common side effects of the medicines, including nausea, vomiting, diarrhea, or a low fever for up to 24 hours.
How do you know if and how long have you been pregnant?
Most individuals determine that they are pregnant if they are sexually active and have missed a period. Nausea, breast soreness and fatigue are also common symptoms in early pregnancy. Ultrasound or pregnancy tests are the only ways to immediately be sure that you are pregnant.
You can do a pregnancy test from the first day of your missed period. Before that, the level of hormones produced by the pregnancy is too low to show up on the test and the test might give you a false negative.
If you do an ultrasound, the doctor can tell you exactly how long you have been pregnant. A pregnancy test is not as accurate. The ultrasound, however, will only show the pregnancy from about a week after you missed your expected period.
You can make an approximate calculation of how long you have been pregnant by calculating from the first day of your last menstrual period (LMP) to the present.
What will happen if you do an abortion with pills after the first 12 weeks?
Medical abortion has been proven to be effective and safe up to 12 weeks of pregnancy.
If you have been pregnant for longer than 12 weeks and do a medical abortion, the medicines will still work and cause an abortion. However, the risk of complications increases and it is more likely that you will need to receive treatment from a medical professional afterwards (see the table below on complications to determine the exact amount of increased risk). Therefore, it is strongly advised that if you are taking the pills after 12 weeks, make sure you situate yourself close to a healthcare facility, such as in the waiting room of a hospital or in a nearby place very close to a hospital.
Medical abortion feels like having a miscarriage and there are no physically significant differences between having a medical abortion and spontaneous miscarriage. The symptoms and treatment are the same. If you live in a country where abortion is illegal and you need emergency care in a hospital, it is important to tell the doctors that you had a miscarriage because in some countries individuals can be prosecuted for having an abortion. Please be aware that you will lose a lot of tissue and blood, but also a fetus (the size depends on the duration of the pregnancy), which can be recognized as such; this can be quite distressing to see.
Medical abortion after 12 weeks of pregnancy is always a safer option than resorting to unsafe methods to induce an abortion, such as inserting sharp objects into the vagina, ingesting toxic chemicals such as bleach or causing trauma by punching the abdomen. You should never use these dangerous methods!
More information:
The longer the pregnancy is, the higher the risk of complications a medical abortion entails. According to the study by Hamoda et al. “Medical abortion at 64 to 91 days of gestation: a review of 483 consecutive cases” published in the American Journal of Obstetrics and Gynecology, the percentage of people who needed further medical care as per the length of pregnancy is as follows:
|
Length of pregnancy |
% who needed further medical care |
|
0- 49 days (0-7 weeks) |
<2 % |
|
40-63 days (7-9 weeks) |
2.5% |
|
64-70 days (9-10 weeks) |
2.7% |
|
71-77 days (10-11 weeks) |
3.3% |
|
77-84 days (11-12 weeks) |
5.1% |
|
85-91 days (12-13 weeks) |
8% |
The medical care for complications consists of medication, emergency curettage, and vacuum aspiration for a continuing pregnancy or an incomplete abortion.
For pregnancies from 64 to 93 days (9 to 13 weeks), 0,4 % of the women might need emergency curettage for bleeding.
Even for pregnancies longer than 13 weeks, only 8,1 % of the women need a surgical intervention because of continuing pregnancy or incomplete abortion.
If there is no access to legal safe abortion services or to an abortion help service like Dr. Ahmed Abortion Centre, it is likely that individuals will turn to a variety of dangerous methods to induce abortion. These methods are always more dangerous than medical abortion!
How many weeks into your pregnancy can you do an abortion with pills?
You can do a medical abortion at home until the 12th week of your pregnancy.
More information:
Medical abortion has been shown to be effective through the first trimester (12 weeks) and has been successfully used during the second trimester. The World Health Organization supports self-management of medical abortion until the 12th week. Medical abortion in the second trimester is considered highly effective and can be carried out safely in a health center or hospital.
What if you have a RH- bloodtype?
Usually individuals with RH-bloodtype who have a (surgical) abortion or miscarriage after 12 weeks or delivery are advised to have an injection with anti-D globuline. If the fetus has a positive blood-type and it is exchanged with the mother, they can produce antibodies that can potentially affect another fetus if they decide to have another baby.
However, research indicates that early medical abortion and first trimester (first 12 weeks) spontaneous abortions have no or very little exchange in blood between the pregnant person and the fetus, and that the pregnant individual does not make a significant amount of antibodies that could affect the next fetus.
We do not advise you to get an injection with anti-d globuline for a first trimester (12 weeks) medical abortion. But if you feel unsure, you should seek professional medical care shortly after having the medical abortion, say that you had a miscarriage and you are rhesus. Depending on your doctor, they might decide to give you anti-d globuline.
More information:
There is minimal evidence that administering Rh immune globulin for first trimester vaginal bleeding prevents maternal sensitization or development of hemolytic disease of the newborn. The practice of administering Rh immune globulin to Rh-negative women with a first trimester spontaneous abortion is based on fetomaternal hemorrhage in late pregnancy. Its use for first trimester bleeding is not evidence-based.
Precautions
Why should you be within 60 minutes of a hospital or first aid center when you do the abortion?
It is absolutely necessary to be within one hour of help, in case you lose too much blood. This is also the case when a person has a miscarriage or gives birth. It is not necessary for you to live in an urban area to do a medical abortion. Almost all areas with internet access will also have a basic first aid center nearby.
All hospitals and first aid centers have basic medical equipment and staff. This equipment and expertise is sufficient to care for individuals who have complications related to miscarriage or birth.
More information:
Medical abortions can be used safely in the most basic settings, as long as back-up medical care is available for treatment in case of complications and method failure. Since medical abortion mimics miscarriage, the techniques used in the treatment of both are similar. The availability of a full surgical abortion service is not a prerequisite for introducing medical abortion; however vacuum aspiration should be available if and as required. Vacuum aspiration can be done in settings where there is no electricity, using a manual vacuum aspirator.
Why shouldn’t you be alone when you do an abortion with pills, and what if no one is available to be with you?
You are strongly advised to use the medicines in the presence of someone who you trust. However, it is not necessarily unsafe either if you choose to do the medical abortion alone.
Just make sure you are near a phone or some way of contacting medical professionals. You should consider telling someone (a neighbor, a family member, or someone who is nearby) that you are not feeling well, and you are going to rest. You can ask them to check on you later in the day after you use the Misoprostol.
This way someone will know if you are experiencing complications and can help you, but they do not have to know that you have done a medical abortion. You can say that you think you have had a miscarriage.
What is an IUD?
An IUD is a form of contraceptive; a small coil of about 3 cm inserted by a doctor in the womb to prevent pregnancy. An individual who becomes pregnant with an IUD must have an ultrasound because when getting pregnant despite the IUD, the risk of an ectopic pregnancy is higher.
The IUD makes the uterus and cervix inhospitable for a fertilized egg and therefore if a pregnancy does occur, it is more likely that it will occur outside the uterus. If the ultrasound shows that pregnancy is in the uterus, if possible, we advise to have the IUD removed before doing the abortion.
When should you not use the medicines?
You should not use the medicines if:
- Someone is forcing you to end your pregnancy
- You are not sure about wanting to end your pregnancy
- You have an allergy to Mifepristone, Misoprostol, or prostaglandins
- You have one of the following diseases: Chronic adrenal failure, Hemorrhagic disorders or bleeding disorders/diseases, Inherited porphyries (it is highly unlikely that you have one of these diseases and do not know about it)
- You have an ectopic pregnancy (a pregnancy outside the womb)
- You cannot get to a hospital or first aid center within an hour
- You are alone. You should ask a partner, friend or another trusted person to stay with you while you use the medicines.
If you have an intrauterine device (IUD), if possible, we advise to remove it before using the medicines.
What is a contraindication, and how do you know if you have one?
Contraindications are conditions or situations that may prevent you from being able to safely use Mifepristone-Misoprostol. These are generally conditions that you will already know about yourself.
Online screening for these contraindications is very similar to a screening process during a face-to-face visit between a doctor and a patient: The doctor generally finds out about contraindications by asking the patient if they have any of these medical conditions.
You might not know whether or not you are allergic to one of the medicines, but allergic reactions to these medicines are uncommon (0,008%) and very mild (hives).
More information:
Individuals usually know if they have contraindications, like hemorrhagic disorders, or chronic adrenal failure; if they are undergoing long-term corticosteroid therapy; or if they have an allergy to mifepristone, misoprostol, or another type of prostaglandin. Generally allergic reactions to these drugs are uncommon. In a study that accounted for 80,000 women who have used Mifepristone-Misoprostol, 6 women (0.008%) had mild allergic reactions (hives) after they took mifepristone. All of the women received treatment with an oral antihistamine and took the misoprostol with no further problems.
Contraindications to Mifepristone-Misoprostol, aside from gestational age, are uncommon. These are based on medical history, and therefore usually already known by the person.
What painkillers can you use?
Non-steroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen and Diclofenac are the most effective painkillers for gynecologic pain management. If you cannot obtain those, Paracetamol (with codeine, if available) or Tylenol (acetaminophen) can be used and/or combined with NSAID.
Please read the package instructions of your painkillers carefully to know the maximum doses that you can take.
For some people, pain like uterine cramps may be intense, and not for others. It is difficult to know how strong the pain might be for you. As a precaution, we suggest that you take painkillers with food, approximately 1h before the Misoprostol. You can take another dose of painkillers 4 hours after the first one.
Do NOT use anti-spasmodics. As the misoprostol makes your uterus contract in order to push out the pregnancy, anti-spasmodics might interfere with the abortion process by relaxing the uterus.
What is an ectopic pregnancy and how do you know if you have one?
An ectopic pregnancy is a pregnancy that grows outside the womb, usually in a fallopian tube. It is a life-threatening situation because if the pregnancy grows too large, it can cause the tube to burst. An ectopic pregnancy must always be treated with an operation or medicines: A medical abortion does not affect a pregnancy outside the womb!
You can make sure that your pregnancy is inside the womb by having an ultrasound. If you use Mifepristone and Misoprostol to end a pregnancy and you do not do an ultrasound first, there is always a chance that you could have an undetected ectopic pregnancy.
If you do not pass tissue and blood after taking the Misoprostol, this might indicate an ectopic pregnancy. Some signs that you may have an ectopic pregnancy which has burst are sudden or ongoing severe pain, feeling light-headed or fainting, or pain in your shoulders.
If you have these emergency symptoms, you should seek medical help immediately. Ectopic pregnancies are treated everywhere, even in places where abortion is severely restricted.
More information:
A pregnant person who is experiencing any of the following symptoms, may have an ectopic pregnancy: abdominal or pelvic pain, cramping on one side of the pelvis, small amounts of unusual vaginal bleeding, breast soreness, nausea, or lower back pain.
A higher risk on ectopic pregnancy includes a history of: getting pregnant while using an IUD, having had an ectopic pregnancy in the past, scarring from past infections or surgery of the female organs, scarring after a ruptured appendix, STI .
An ectopic pregnancy occurs when a fertilized egg does not implant and grow in the uterus as usual, but instead implants and begins to grow elsewhere, usually in the fallopian tube. The fallopian tube is a tiny passage that the fertilized egg passes through as it goes from the ovary to the uterus. If the pregnancy continues, the embryo will grow and become too large for the fallopian tube, causing the fallopian tube to burst. Ectopic pregnancies cannot be carried to term and if left untreated, there is a risk of heavy internal bleeding due to rupturing of the fallopian tube, which can be life-threatening.
A medical abortion using Mifepristone-Misoprostol does not cause ectopic pregnancy, but it does not treat an ectopic pregnancy either. If an ectopic pregnancy goes untreated, the embryo can continue to develop outside the uterus even after taking Mifepristone and Misoprostol. There is no evidence to suggest that medical abortion treatment leads to unusual complications for women with ectopic pregnancies.
Medical abortion
How to end a pregnancy with misoprostol alone?
If you don’t have access to both pills, Mifepristone and Misoprostol, you can have an abortion with Misoprostol alone. Misoprostol alone is 94% effective. You will need 12 tablets with 200 mcg of Misoprostol each.
To have an abortion up to 12 weeks of pregnancy with Misoprostol only, the medicines should be taken as follows:
1st – put 4 pills of Misoprostol (200 mcg) under your tongue and keep the tablets there for at least 30 minutes. You can swallow your saliva, but avoid eating or drinking while the tablets are dissolving. After 30 minutes, the remains of the pills can be swallowed*.
2nd – 3 hours later, put 4 pills of Misoprostol (200 mcg) under your tongue. After 30 minutes, the remains of the pills can be swallowed*.
3rd – 3 hours later, put 4 pills of Misoprostol (200 mcg) under your tongue. After 30 minutes, the remains of the pills can be swallowed*.
You have to spit out any remaining bits of the pills when you used the medicines called oxaprost or arthotec as they contain diclofenac and can be harmful for your health if you take too much.
It is important to use the second and third doses of misoprostol even if you are already bleeding and think the abortion already occurred. These doses will help make sure the process is complete and make it less likely that you will need any sort of medical attention.
We strongly advise you to use Misoprostol under your tongue. This way, no remains of the pills can be found in the event that you need to go to a hospital. There are no blood tests that can show that you have taken Misoprostol, so there will be no way to prove that you tried to do an abortion.
Are there other ways to use Misoprostol?
The Misoprostol tablets can be used in one of these three ways: under the tongue, vaginally or buccally (in the space between gum and cheek). All methods are equally effective in causing an abortion. However, ALL the misoprostol must be used in the same way. Do not take Misoprostol under the tongue and vaginally during the same abortion.
We strongly advise you to use Misoprostol under your tongue. This way, no remains of the pills can be found in the event that you need to go to a hospital. There are no blood tests that can show that you have taken Mifepristone or Misoprostol, so there will be no way to prove that you tried to do an abortion.
In countries where individuals can be prosecuted for having an abortion, it is not necessary to tell the medical staff that you tried to induce an abortion. You can say that you had a spontaneous miscarriage. The medical practitioner CANNOT see the difference. The treatment is also the same as for a miscarriage. The treatment is curettage, also known as vacuum aspiration, during which a doctor will remove remaining tissue from the womb. Doctors have the obligation to help in all cases.
If you prefer to take the tablets through the vagina, you should use your fingers to put the Misoprostol tablets in as deep as possible, in the back where the womb starts. If you have a complication and you live in a place where hospital staff might report you to the police, check your vagina carefully with your fingers to determine whether all of the tablets have dissolved properly. Remove any undissolved pieces of tablets and then go to the hospital immediately. The pills generally take four days to dissolve completely.
What if you take the Mifepristone and then decide not to take the Misoprostol?
If, for some reason, you take the Mifepristone and then decide that you will not take the Misoprostol part of the medical abortion regimen, be aware no reversal regimen exists. Below a few possible scenarios that might take place:
- You might experience a complete abortion without ever taking Misoprostol.
- You might experience a missed abortion, which means that the fetus is no longer viable, but the products of pregnancy (blood, tissue) do not leave your body. This has to be treated with a vacuum aspiration.
- It is also possible that your pregnancy might continue. If you decide you want to keep the pregnancy at this point, it is unlikely that the Mifepristone will cause later fetal malformations.
More information:
Research suggests that a fetus that has been exposed to Mifepristone alone and is not aborted will continue to develop normally.
Why do you only need 4 tablets of Misoprostol after taking Mifepristone?
Why do we also recommend taking one extra dose of 2 Misoprostol 3-4 hours after the first dose?
Scientific research has shown that an abortion with the combination of Mifepristone and Misoprostol is safe and effective for home use up to 12 weeks of pregnancy.
For pregnancies up to 10 weeks gestation, research shows that taking 1 tablet of Mifepristone (200 mg) and 4 tablets of Misoprostol (200 mcg each) under the tongue 24 hours later, is a safe and effective way to take the medication, without the repeated doses of Misoprostol. Recent research on telemedical abortion, however, also indicates that even in early pregnancies of less than 10 weeks, an extra dose of 2 Misoprostol, used 3 to 4 hours after the first dose results in less ongoing pregnancies and less incomplete abortions.
Dr. Ahmed Abortion Centre follows the World Health Organisation Guidelines on Safe Medical Abortion. Most packages contain 1 tablet of Mifepristone and up to 8 tablets of Misoprostol 200 mcg for women who are expected to be less than 10 weeks pregnant when they do the abortion with pills. This way, the second dose of Misoprostol is part of the standard regimen. An extra dose of 2 Misoprostol 200 mcg can also be used for treatment of heavy bleeding or incomplete abortion.
Individuals who are longer than 10 weeks pregnant will receive 1 tablet of Mifepristone (200 mg) and 12 tablets of Misoprostol (200mcg) which should be used in repeated doses. In this case, the person will receive an email with detailed information on how to use the extra tablets of Misoprostol.
In some countries, Misoprostol is available only in tablets of 400 mcg. When these pills are used for medical abortion, the dosage of Misoprostol used should be halved.
Can you eat or drink while taking the medicines?
You should not drink any alcohol or use drugs prior to, during, and after using the medicines, as it can affect your judgment. You can eat food and drink liquids as you normally would. However, as some women experience nausea from the misoprostol, you may want to eat lightly.
What happens if you do not use Misoprostol in time after mifepristone?
Dr. Ahmed Abortion Centre advises you to use Misoprostol 24 hours after swallowing the Mifepristone tablet. However, it can also be used later, up to 72 hours after swallowing Mifepristone.
The World Health Organization advises on a regimen that starts with Mifepristone 200mg and is followed 1-2 days later by 800 mcg of Misoprostol. The minimum recommended interval between use of mifepristone and misoprostol is 8 hours.
More information:
Research has shown that for women with pregnancies of 8 weeks or less, Misoprostol works with the same efficacy whether it is taken at 12 hours, 24 hours, 48 hours, or as much as 72 hours after Mifepristone. Though we instruct women to take Misoprostol 24 hours after Mifepristone and strongly encourage women to follow all the instructions for proper use, if a woman takes it slightly earlier or later, this does not affect the outcome of the medical abortion.
How to end a pregnancy with Mifepristone and Misoprostol pills?
To end a pregnancy up to 12 weeks of pregnancy, the medicines should be taken as follow:
First, you should swallow one tablet of Mifepristone (200 mg).
24 hours later, put 4 tablets of Misoprostol (200 mcg each) under your tongue and keep them there for 30 minutes, until the tablets are dissolved. You can swallow your saliva. After 30 minutes, swallow any remains of the tablets.
We strongly advise you to use Misoprostol under your tongue. This way, no remains of the pills can be found in the event that you need to go to a hospital. There are no blood tests that can show that you have taken Misoprostol, so there will be no way to prove that you tried to do an abortion.
If you have less bleeding than expected and are concerned the medication has not worked, 3 hours after using the Misoprostol, put 2 tablets of Misoprostol (200 mcg each) under your tongue. Keep them there for 30 minutes, until the tablets are dissolved. After 30 minutes, swallow any remains of the tablets.
If you still have not started bleeding and you have more misoprostol tablets, you can continue taking 2 more tablets of Misoprostol (200 mcg each) under your tongue, keep them there for 30 minutes, until the tablets are dissolved. After 30 minutes, swallow any remains of the tablets.
You can repeat this up to maximum 5 doses of Misoprostol (dose = 2 x 200 msg) in total until you are sure that abortion has completed.
If you use Misoprostol 400mcg, instead of Misoprostol 200mcg, the number of Misoprostol pills needed per dose should be halved.
Can you use Mifepristone and/or Misoprostol if you are still breastfeeding?
Mifepristone and misoprostol pass into breast milk but the amounts are very small and should not cause adverse effects to the breastfed infant. You can continue to breastfeed without interruption following mifepristone and misoprostol, there is no need to discard any breast milk.
More information:
As a precaution, infants exposed to mifepristone or misoprostol via breastmilk should be monitored for nausea, vomiting and poor feeding.
Is it safe to have an abortion with pills if you've already had one in the past?
Individuals can be fertile for about 40 years. They may need more than one abortion for several reasons because, for example, their method of contraception fails, or they don’t have access to contraception at all.
Having one or more than one safe abortion, has similar risks on woman’s health or ability to have children later on than having a spontaneous miscarriage.
In fact, as spontaneous miscarriage usually happens unexpectedly and away from medical aid, it can involve more risks than a planned medical abortion.
The abortion process
What are the symptoms of an allergic reaction to the medication?
An allergic reaction can cause different symptoms, from mild to severe.
A mild local reaction can be experienced as itching, small blisters or pain in or around your mouth. This will disappear by itself sometime after the medicines are dissolved.
In a mild general allergic reaction, you can get tingling hands, nose congestion and swollen eyes, a rash, and itching of your skin. It is best not to continue taking Misoprostol if you have this reaction. You can use a medicine called antihistamines (for example promethazine and clemastine) to treat these symptoms.
In very rare cases of a severe allergic reaction, you can start feeling pressure on your chest, dizziness, swelling of the face and shortage of breath. If you have these symptoms, go to a hospital or medical center immediately.
What is a successful abortion and how do you know if you’ve had one?
A medical abortion is successful when the pregnancy stops developing and there is no need for additional medical care.
A medical abortion is successful when the pregnancy stops developing and there is no need for additional medical care. Research has shown that 99.5 % of the women who do a medical abortion in the first 9 weeks of pregnancy with Mifepristone and Misoprostol will have an abortion that ends the pregnancy. Only 3% of women will need additional medical care. In 97% of abortions, women’s bodies will eliminate all the remains naturally and without any other medical intervention. It is important that you understand that an abortion is a process. It takes time for the uterus to empty and for the abortion to be complete. It is normal for the bleeding and clotting to continue for 1-3 weeks longer; every individual’s body is different.
If you have extreme pain, prolonged heavy bleeding, abnormal vaginal discharge, or fever, it might be a sign that you have a complication and should seek medical attention. You should have an ultrasound after taking the medicines if you have any doubts about whether the abortion has been successful.
Many women can tell when the abortion is successful. They feel the symptoms of pregnancy (nausea, tender breasts, need to urinate) going away or are aware that the embryo passed. By having an ultrasound, you can learn whether the medicines have worked and if your pregnancy has ended within a few days after the abortion. An early ultrasound will tell you if the pregnancy has ended, but it is best to wait for an ultrasound for 10 days after using Mifepristone, as only 23% of abortions are fully complete after 7 days.
The urine home pregnancy test can be done only 3 weeks after taking the medicines, because before 3 weeks, the pregnancy hormones are still in your body and the test might show an unreliable, falsely positive result. Your body might need several days or weeks (until your next menstrual period) to expel the tissue and blood completely. The ultrasound will show what is still in the uterus. Some medical professionals will recommend a vacuum aspiration, but if you have no pain, fever, or signs of infection, it is better to wait and let your body empty naturally. A surgical treatment is an invasive procedure that involves risks.
More information:
Research has shown that women often correctly assess whether their medical abortions are complete or not, especially with protocols that include Mifepristone. Research comparing clinical follow up and self-assessment of outcome after medical abortion has found that self-assessment was non-inferior to routine follow-up and could therefore save resources.
What are the side effects of the medicines?
The medical abortion normally causes side effects such as pain and cramping, as well as bleeding accompanied by the passage of blood clots and tissue. Nausea, vomiting, diarrhea, headache, dizziness, and hot flashes or fever may also occur.
A fever that starts soon after Misoprostol administration and lasts less than 24 hours and is less than 100.4 F/ 38,5 C is a common side effect. If the fever lasts longer than 24 hours or is higher than 100.4 F/38,5 C, you should seek medical attention.
An allergic reaction to the medication can cause hives (itchy welts or bumps on the skin.) Please refer to the question “What are the symptoms of allergic reaction?”
If your side effects are extreme, you may have a complication. Please refer to the question “How do you know if you have a complication and what should you do?” if you think you might be experiencing abnormal side effects.
More information:
Most women will experience pain and cramping during the medical abortion after using the Misoprostol. In the majority of the scientific studies on the topic, most women describe the pain as only a little bit worse than the pain they experience during a menstrual period.
Some women will experience nausea, vomiting, or diarrhea, but it is thought that this is an effect of early pregnancy as much as it is due to Mifepristone or Misoprostol.
Usually these side effects go away by themselves and do not require medical attention. Headache, mild dizziness, fever and hot flashes are symptoms that also should go away by themselves.
After taking Mifepristone: When bleeding will start and how long it will last?
How long do you bleed after Misoprostol? Does Mifepristone alone cause bleeding? Learn when bleeding will start and what to expect after taking abortion pills.
When will bleeding start after taking Mifepristone and Misoprostol?
Mifepristone alone usually does not cause any side effects before taking Misoprostol, although some women may experience light bleeding or nausea.
After taking Misoprostol, you should expect bleeding and cramps. Bleeding usually starts within four hours of taking the pills, but it sometimes starts later.
For some people, the bleeding and cramping and other side effects like nausea, vomiting, diarrhea, headache, dizziness, and hot flashes or fever may occur shortly after taking Misoprostol.
Bleeding is often the first sign that the abortion has begun. If the abortion continues, bleeding and cramps become more severe. Bleeding is often heavier than a normal menstruation, and it is normal to have clots. The longer the pregnancy has developed, the heavier the cramps and the bleeding will be.
If the abortion is complete, the bleeding and the cramps diminish. The moment of abortion can be noticed with a peak of heavier blood loss and more pain and cramps.
How long do you bleed after taking abortion pills?
You will continue to bleed lightly from one to three weeks after the abortion, but times may vary. Your normal menstrual period usually returns after four to six weeks.
The heaviest bleeding typically occurs 2-5 hours after using Misoprostol and usually slows down within 24 hours. The most intense cramping and bleeding generally lasts for 3-5 hours, but these times may vary.
Some women bleed heavily for up to 48 hours and may pass clots days or even weeks after taking Misoprostol. This is common and not dangerous, unless you soak through more than two maxi pads per hour for 2 hours or more, or when you pass clots bigger than an orange.
It is normal for your body to take time to empty the uterus completely. Every individual body is different.
What if you don’t bleed after taking Misoprostol?
If you do not start bleeding within 4 hours of taking Misoprostol, you can take another dose of Misoprostol.
If you still do not bleed within 24 hours and you are positive that you are pregnant, then you either have a continuing pregnancy or an ectopic pregnancy. In this situation, you should have an ultrasound.
If you experience complications such as fever, faintness, or extreme abdominal pain, then you should seek medical help immediately, because you could have a ruptured ectopic pregnancy.
If you have an ectopic pregnancy, the medical practitioner will treat it. This procedure is not considered an abortion and it is life-threatening if left untreated. If the ultrasound shows a continuing pregnancy, you can do the medical abortion again.
Can you see the “products” of the abortion (placenta, embryo, blood) and what should you do?
Most of the time you can see blood and tissue in the sanitary napkin or in the toilet. The (very small) embryo is usually passed within this blood and tissue in such a way that it can go unnoticed. However, it is possible that you might see the (very small) embryo.
Depending on the length of the pregnancy, a small pregnancy sac with some tissue around it may be visible. For instance, if you are only five to six weeks pregnant, a sac might be visible. At nine weeks, you might be able to find a sac in the blood and it is possible that you might see the embryo. Please be warned that later pregnancies of 8 or 9 weeks will pass an embryo that is approximately 2.5 cm. This can be distressing. Our helpdesk can offer resources and support if you’re concerned about this.
More information:
At 6 or 7 weeks gestation, the embryo measures approximately 1/4 to 1/2 inches, and at 9 weeks it measures about 1 inch. Frequently, the embryo expelled during a medical abortion is not explicitly visible because it is passed together with other pregnancy tissue and blood.
But women who experienced it, genuinely felt it was something that they could cope with at home. Many preferred their own choice of companions they could have in their own home, and being able to use their own toilet facilities. The World Health Organization suggests that self-management of medical abortion can be empowering as individuals may value the sense of control over the procedure and comfort of their own place.
Complications of medical abortion
How do you know if you have a continuing pregnancy?
Bleeding does not mean that you have had a successful abortion. If you still have symptoms of pregnancy such as sore breasts or nausea, you may have a continuing pregnancy.
A continuing pregnancy is a pregnancy that continues to develop even after the use of Mifepristone and Misoprostol. In this case, the abortion has failed completely and the woman remains pregnant.
Even if you bleed, you can still have a continuing pregnancy.
Pregnancy tests after abortion pills
You should have an ultrasound within a week or do a pregnancy test 3 weeks later to confirm that the pregnancy has ended. Most pregnancy tests that are done 3 weeks after the abortion are reliable.
It is necessary to wait 3 weeks after the abortion because the pregnancy hormones can remain in the body and can make the pregnancy test falsely positive.
If you have an ongoing pregnancy after you did a medical abortion, you can try to do a medical abortion again or have a surgical abortion.
What if I have a positive pregnancy test after abortion pills?
Although the risk is very low (less than 10/1000), Misoprostol can increase the risk of fetal malformations, when used during the first trimester of the pregnancy. If possible, we advise women with continuing pregnancies to undergo surgical or medical abortion to terminate the pregnancy.
Research shows that the risk of continuing pregnancies change as per the length of pregnancy during medical abortion.
|
Length of Pregnancy |
% of continuing pregnancies |
|
1-49 days |
0.1 % |
|
50-77 days |
0.5 % |
|
78-83 days |
3.1 % |
|
84-91 days |
5.1 % |
Order abortion pills from Dr. Ahmed Abortion Centre in UAE.
What is a curettage/vacuum aspiration and is it necessary after an abortion with pills?
Vacuum aspiration, curettage, is a surgical intervention to remove the contents of the uterus. This treatment might be necessary if there are complications after medical abortion or spontaneous miscarriage.
However, in some countries, doctors are accustomed to performing a surgical treatment even though it might not be needed for medical reasons.
You do NOT need a vacuum aspiration if the ultrasound shows that there are still some small remains in the uterus (incomplete abortion) or experience some bleeding after 3 weeks AND you do not have any complaints like pain, fever or heavy bleeding.
Small remains in the uterus can be treated with an extra dose of Misoprostol or you can just wait until your next menstruation; the uterus will most likely empty itself. Regular menstruation comes back 4 to 6 weeks after a medical abortion. After a normal menstruation you should not have any remaining tissue left in the uterus. However, in case you have severe complaints like high fever, persistent strong pain and increasing heavy bleeding, a surgical intervention called vacuum aspiration might be needed.
Some medical facilities still only do a procedure called D&C or sharp curettage: this should not be done! You can ask the doctor what kind of procedure will be used because they should perform a vacuum aspiration and not a sharp curettage or D&C (vacuum aspiration is less painful and has less risks and complications).
All procedures should be done under local or general anaesthesia!
Note: The word “curettage” might be used to signify “surgical evacuation of the uterus”, which can be done by vacuum aspiration or using a sharp curette.
According to World Health Organization, the sharp curette should not be used anymore for first trimester (12 weeks) abortions. As this wording might be confusing, we prefer not to use the word “curettage”, when it means “surgical evacuation of the uterus”, and only use this word when “the sharp curette is being used for treatment”. However some doctors still use the word “curettage” while they mean “vacuum aspiration”.
More information:
According to the World Health Organization, “if the person is feeling well, neither prolonged bleeding nor the presence of tissue in the uterus (as detected by ultrasound) is an indication for surgical intervention. Remaining products of conception will be expelled during subsequent vaginal bleeding. Surgical evacuation of the uterus may be carried out if the bleeding is too heavy or prolonged, causes anaemia, or if there is evidence of infection.”
If the results of an ultrasound reveal remains in the uterus but you feel well, it’s best to wait a few more weeks. If you start to observe signs of complications, you should go back to the doctor immediately. If you suspect a complication, please read “How do you know if you have a complication and what should you do?”
In case of diagnosed complications, a vacuum aspiration could be needed. Dilatation and curettage can only be used if vacuum aspiration is not available. Vacuum aspiration is a newer and much safer surgical method and you should always ask for it if you are given a choice between vacuum aspiration and sharp curettage.
How do you know if you have a post-abortion infection?
Infections following medical abortions are very rare. If you feel weakness, nausea, vomiting, diarrhea, fever that lasts more than 24 hours or is higher than 100.4 F/ 38 C, pain in your belly, if your belly feels sore or tender, if the bleeding increases or takes longer than expected or if you have vaginal discharge that smells bad, you might have an infection and you should seek medical care or assistance immediately. The infection should be treated with antibiotics.
A fever that starts soon after Misoprostol administration and lasts less than 24 hours and is less than 100.4 F/ 38 C is a common side effect. If the fever lasts longer than 24 hours or is more than 100.4 F/38 C, you should seek medical attention.
The risk of infection is greater when a woman gives birth than when she has a medical abortion.
More information:
The majority of medical abortion studies have reported no infections, although a few have mentioned isolated cases. Research has concluded that infection after medical abortion procedures is an infrequent event, occurring in <1% of over 46,400 cases. This is lower than the frequency of infection after surgical abortion or childbirth. Ten cases of infection were reported out of 80,000 women who had medical abortions using Mifepristone in the United States.
The most common type of infection reported after abortion is endometritis, which is an infection of the lining of the uterus, and genital tract. It may involve infection of reproductive organs and the urinary system. Clostridium sordellii sepsis is another type of post-abortion infection that is extremely rare.
Clostridium sordellii can also cause fatal infections in women who have just given birth. It is not an infection that only affects women having medical abortions. Clostridium sordellii specifically calls attention to the unusual and distinctive signs and symptoms associated with these infections — an absence of fever but the presence of refractory hypotension, hemoconcentration, effusions in multiple serous cavities, and dramatic leukocytosis.
What are the chances that the fetus will be malformed if you have an ongoing pregnancy?
If you have an ongoing pregnancy after using Misoprostol, the risk of having a baby with fetal malformations is increased. Exposure of fetuses to Misoprostol can lead to malformations, such as defects in the skull and abnormalities in the limbs and nervous system (called Mobius Syndrome). However, this risk is small: less than 10 in 1000.
This risk does not exist anymore when taking Misoprostol after the 12th week of pregnancy!
If possible, we advise women with ongoing pregnancies to undergo surgical or medical abortions to terminate the pregnancy in order to entirely avoid the risk of having a malformed fetus.
More information:
Research suggests that a fetus that has been exposed to Mifepristone alone and is not aborted will continue to develop normally.
Because of the restrictions around the distribution of Mifepristone, many people currently have to use Misoprostol alone, even though it is less effective. By making a more effective regimen available with both medicines, Dr. Ahmed Abortion Centre abortion help service makes the home medical abortion procedure safer and reduces the chance that pregnancies will continue and result in the births of malformed infants.
How do you know if you have an incomplete abortion?
An incomplete abortion is an abortion that has only been partially successful. The pregnancy has ended, no fetus will develop, but your body has only expelled part of the tissue and products of the pregnancy.
If you have prolonged bleeding, too much bleeding (much more than a regular menstrual period), pain in your belly that does not go away after a few days of taking the Misoprostol, pain that is unbearable, fever, continued bleeding after three weeks, or pain when pushing on your belly, you may have an incomplete abortion.
It is important to go to a hospital or a medical center to have an ultrasound if you have any of these symptoms. If the tissue and blood remain in the body, they can cause complications like heavy bleeding or an infection, which need to be treated. If there are no complication signs, often treatment with 2 extra tablets of Misoprostol in some cases is enough.
The treatment of an incomplete abortion is legal everywhere. In countries where women can be prosecuted for having an abortion, it is not necessary to tell the medical staff that you tried to induce an abortion; you can say that you had a spontaneous miscarriage.
There are no tests that can show that a woman has done a medical abortion. It is extremely important to treat the complications of incomplete abortion. The treatment consists of evacuating residual tissue by vacuum aspiration, and antibiotics, in case of infection.
Any clinic that can deal with complications of miscarriage can also help women with incomplete abortions because the symptoms are the same.
How do you know if you have complications and what should you do?
If performed in the first 12 weeks, a medical abortion carries a very small risk of complications. This risk is the same as when a woman has a miscarriage and can be easily treated by a doctor or trained medical practitioner. Out of every 100 women who do a medical abortion, 2 to 3 women will seek further medical care.
Please see the list below for possible complications, symptoms, and treatment:
Heavy bleeding (occurs in less than 1% of medical abortions)
Symptom: Bleeding that lasts for more than 2 hours and soaks more than 2 maxi sanitary pads per hour. Feeling dizzy or light-headed can be a sign of too much blood loss. This is a serious health risk and requires medical attention.
Treatment: Misoprostol and/or a vacuum aspiration (curettage.) When available, a woman should start taking 2 misoprostol under the tongue immediately at home before going to the hospital. Very rarely (less than 0.2%) a blood transfusion is needed.
Incomplete abortion
Symptoms: heavy or persistent bleeding and/or persistent severe pain.
Treatment: 2 tablets of misoprostol or/ and a vacuum aspiration
Infection
Symptom: If you have a fever (more than 38 degrees Celsius) for more than 24 hours, or you have a fever of more than 39 degrees, there might be an infection that needs treatment.
Treatment: antibiotics and/or vacuum aspiration.
If you think you might have a complication you should seek medical attention immediately. If you live in a place where abortion is illegal and you don’t have a doctor who you trust, you can still access medical care. You do not have to tell the medical staff that you tried to induce an abortion; you can tell them that you had a spontaneous miscarriage. Doctors have the obligation to help in all cases and know how to handle a miscarriage.
The symptoms of a miscarriage and an abortion with pills are exactly the same and the medical practitioner will not be able to see or test for any evidence of an abortion, as long as the pills have completely dissolved. If you took the Misoprostol under the tongue, as our protocol recommends, the pills should be spit out after 30 minutes, if not dissolved completely. If you took the pills vaginally, you must check with your finger to make sure that they are dissolved. Traces of the pills may be found in the vagina up to four days after inserting them.
Less than 1% of women experience ongoing pregnancy. This can be determined by a pregnancy test after 3 weeks or an ultrasound within a week. If the medical abortion treatment failed, there is a slight increase in the risk of birth defects such as deformities of the hands or feet,and/or problems with the nerves of the fetus. To treat an ongoing pregnancy, you must repeat a medical or surgical abortion.
Abortion After-Care
Do you require psychological counselling before or after you have had an abortion?
Most persons do not need any psychological help before or after an abortion.
Feelings of regret after abortion are rare. In fact, the most common emotional response after abortion is relief. Transient feelings of guilt, sadness, or loss are common, but most women can overcome negative feelings that might affect them. It is normal to feel emotional after an abortion. While you may experience sadness or grief, these feelings usually go away after a few days. However, in countries where taboos and social stigma are prevalent, it is more common for women to suffer feelings of guilt and shame.
If you are not sure if a medical abortion treatment is right for you, we encourage you to discuss it with a trusted friend.
It is advised to read the suggestions given below. You can also consider taking some time to focus on how your future would look if you keep the pregnancy.
How do individuals feel after an abortion?
Every individual is unique in how they feel after an abortion. Most people report feeling a sense of relief that they have made the best decision given their circumstances; this is the most common response. For some, however, abortion can raise a number of emotional responses including sadness, guilt, rage, shame, and regret. Some feel bad about themselves because they don’t feel guilty about having an abortion but think they should feel guilty. In general, understanding your emotional pain can help you to begin to let go of the grief, guilt, rage, or shame you may be feeling. It is important to acknowledge that you are hurting and to take good care of yourself if you are experiencing difficulties.
You are not a bad person because you had an abortion. You are also not alone in having chosen abortion. Many people are surprised to learn that about 56 million individuals worldwide have abortions each year.
What kinds of things might contribute to a woman feeling distress after an abortion?
Many factors could contribute to feelings of distress. Your hormones are changing back to their pre-pregnancy state. This chemical change can cause feelings of sadness and weepiness. Someone else may have pressured you into having an abortion, rather than letting you make the decision for yourself. You might not have much support from your friends or family; isolation and stigma are among major reasons why women may find themselves in distress after an abortion.
You might feel very divided inside about your decision to have an abortion. It may not have been clear to you that abortion was the right decision given your circumstances.
You may feel abandoned and alone. Maybe you were hoping the person who got you pregnant would want to have a baby with you. Maybe they were not willing to do that, contributing to your sadness.
Perhaps you are prone to feelings of low self-esteem and often feel bad about yourself.
Other parts of your life may be very stressful — school, your job, your children etc.
You might fear that you will never again be able to get pregnant. If this is a worry to you, be assured that a safe medical abortion does not cause infertility in the future.
Anytime you make a difficult decision, it is natural to worry “what if I had made a different choice?” and to agonize over the decision.
Abortion may bring up old experiences or feelings you have been repressing. For instance, if sexual abuse is a part of your past, you may find yourself re-living feelings related to your abuse. Feeling vulnerable about the pregnancy and abortion may trigger you to remember a time in the past when you felt frightened and vulnerable.
You may find it helpful and even empowering to know that you are not alone to experience an unwanted pregnancy and having an abortion. Each year 56 million individuals have abortions worldwide. Each person has a story and various reasons. Here you can read more about abortion facts.
Is it normal to feel depressed after an abortion?
In rare cases, women may become clinically depressed after having an abortion. If your feelings are overwhelming and do not seem to be resolving or you are suffering symptoms of depression, you should consult a professional.
There are some factors which are known to contribute to the risk of depression after abortion, including having a history of depression, anxiety or panic. Depression is a very serious illness. It is extremely important that you seek help from a professional such as a doctor, counsellor or therapist if you believe you are depressed.
What is “Post-abortion Syndrome”?
A general consensus has been reached in the medical and scientific communities that most women who have abortions experience little or no psychological harm. However, many people who are opposed to abortion claim that women who have had abortions will suffer from a type of post-traumatic stress disorder called “post-abortion syndrome”.
Reliable, unbiased studies have shown that, although psychological disturbances do occur after abortion, they are uncommon and generally mild and short-lived.
Most psychiatric experts doubt the existence of a so-called post-abortion syndrome and point out that abortion is not significantly different from any other stressful life experience that might cause trauma in some people.
What can I do to help myself heal after an abortion?
Different people have different feelings about and experiences with abortion. Psychological studies show that most people feel relief after an abortion and do not suffer for prolonged periods of time due to the abortions that they choose to have. These studies show that individuals can overcome negative feelings that might affect them.
After an abortion, there are concrete things you can do to help yourself come to terms with your decision. The following suggestions can help you accept and deal with your feelings, make your feelings of sadness go away and help you reach some “closure” to your abortion experience.
Allowing yourself to express any sadness and grief that you are feeling will help it to diminish; you won’t always feel this way.
Don’t be hard on yourself. Talk to yourself in ways that are affirmative: You are a good person. You are a moral person.
Remind yourself that you are brave – you made a difficult decision.
Remind yourself why you made the decision to have an abortion.
Remember you made the best decision you could under the circumstances.
Ask yourself, if you hope to have a planned pregnancy someday, how would it differ from the situation you have just been in?
Write your feelings down in a journal or special book which no one else will see.
Think about things you can do which will make you feel good. Write them down and try to do several of these each day.
Remind yourself of the future. Make a list of things you are looking forward to doing.
Consider creating an ‘end’ to your relationship with your pregnancy by writing a good-bye letter and keeping it in a safe place or burning it.
Practice relaxation exercises to help deal with stress.
Read about others’ experiences at the “I had an abortion” part of this website. This can be reassuring and make your own feelings clearer. You can find more resources on our website and consult other abortion stories websites.
When can you get pregnant again after having an abortion with pills?
Although your menstruation may not come for several weeks after your abortion, you can ovulate (be fertile) at any time after the abortion. This means you can get pregnant right away, even if you are still having some light bleeding. If you want to avoid becoming pregnant, it is very important to start using contraceptives immediately.
You can use condoms and other birth control methods right away. An IUD can be put in place as soon as the abortion procedure is determined successful, 4-14 days after you have taken the Misoprostol, even if there is still light bleeding. You can also wait to insert an IUD until your next regular period, but you will need to use another contraceptive method in the meantime if you do not want to risk becoming pregnant.
You can start hormonal contraceptive methods (pills, patch, ring, injection, and implant) immediately after the first pill of the medical abortion. Oral contraceptive pills can also be started 1 to 3 days after using the Misoprostol. If you start birth control pills more than 3 days after using the Misoprostol, it is recommended that you use a barrier method (condoms) during the first 9 days, until the pills reach their full level of protection.
If the medical abortion did not work and you are still pregnant, the hormones used in the birth control pills, patch, implant, ring, and injection are not dangerous to a developing fetus. Nevertheless, we recommend an ultrasound to confirm whether the abortion was successful or not.
Will you be able to get pregnant and have children after an abortion with pills?
A medical abortion and a spontaneous miscarriage have the same medical risks. As you are more prepared while having an abortion, you are in fact more focused on prevention and treatment of complications, when needed. A miscarriage usually happens unexpectedly and can occur in all circumstances.
You can become pregnant after having an abortion. In fact, if you do not want to become pregnant at this time, it is important to start using contraceptives as soon as you start having sexual relations again.
More information:
Research suggests that if a person who has never given birth has an early medical abortion using Mifepristone and Misoprostol, it will not cause problems during a future wanted pregnancy.
Induced medical abortion does not harm a person’s reproductive capacity. Premature birth, infertility, ectopic pregnancy, spontaneous abortion, and adverse pregnancy outcomes are not increased in frequency after medical abortion.
Does medical abortion increase the risk of breast cancer?
No, having an induced abortion does not increase a person’s chance of developing breast cancer.
More information:
The World Health Organization has concurred that no credible evidence supports a link between abortion and breast cancer.
How can you prevent a future unwanted pregnancy?
About 85% of sexually active people who do not use contraceptives become pregnant within a year. You can become pregnant while breastfeeding, from about 10 days after childbirth, and even during menstruation. Withdrawal of the penis prior to ejaculation and periodic abstinence does not prevent pregnancy or the spread of sexually transmitted diseases.
You can prevent an unwanted pregnancy with:
Total Abstinence
Use of contraceptives
If you are sexually active and do not want to get pregnant, always use contraception.
Methods of Contraception:
No method of contraception gives 100% protection.
The latex condom is the only contraceptive method considered highly effective in reducing the risk of sexually transmitted infections (STIs). Birth control pills, implants and IUDs do not protect against sexually transmitted infections. When you start using contraceptives, please consider the possibility of a sexual health check including HIV. Be aware STIs do not always cause symptoms.
For the Woman
DIAPHRAGM is a rubber disk with a flexible rim that covers the cervix and must be used together with spermicide. It is available by prescription only and must be fitted for size by a health professional. The diaphragm protects for six hours and should be left in place for at least six hours after intercourse but not for longer than a total of 24 hours.
ORAL CONTRACEPTIVES protect against pregnancy by the combined actions of the hormones, estrogens and progestin. The hormones prevent ovulation. The pills have to be taken every day as directed and do not work after vomiting or diarrhea. Side effects of the pill can be nausea, headache, breast tenderness, weight gain, irregular bleeding, and depression.
DEPO-PROVERA is a hormonal contraceptive injected into a muscle on the arm or buttock every three months. In order to remain effective, the injection must be repeated every 3 months. Menstruation can become irregular and sometimes even absent.
IMPLANTS (such as Norplant or Implanon) are made up of small rubber rods, which are surgically implanted under the skin of the upper arm, where they release the contraceptive steroid, levonorgestrel. Their protection lasts from 3 to 5 years. Side effects include menstrual cycle changes, weight gain, breast tenderness and loss of bone mass.
COPPER-IUD is a T-shaped device inserted into the uterus by a health-care professional. The IUD can remain in place for 5- 10 years. IUD’s have one of the lowest failure rates of any contraceptive method. Sometimes the IUD can be expelled. Women should check each month after their period with their finger to ensure they can still feel the threads of the IUD. Other side effects can include abnormal bleeding and cramps, but this usually only occurs during and immediately after insertion.
HORMONAL-IUD is an IUD with a small hormonal (progestogen) sleeve. It is one of the most effective forms of birth control. Next, to the above-mentioned characteristics of an IUD, it can remain in place for 5 years but has no heavy bleeding side effects. As most women experience lighter periods and less bleeding (some stop completely having periods), it is used as a therapy as well for women with heavy cycle bleedings and for few women who experience hormonal side effects like acne and feeling depressed.
FEMALE STERILIZATION is done surgically. The tubes are ligated, preventing the egg-cells from encountering the sperm cells and preventing any future pregnancies. It is a permanent form of contraception.
FEMALE CONDOM is made of soft rubber and can be used only once. As a mechanical barrier method of contraception worn by women, it’s inserted easily into the vagina before sex and prevents direct vaginal contact with semen, infectious genital discharges, and genital lesions. It is shaped like a long tube or sheath, with one closed end and one open end, and at each end, there’s a flexible ring, helping to keep the female condom in place once it’s inserted. Condoms are the most effective method for reducing the risk of infection from the viruses that cause AIDS and other sexually transmitted infections (STI’s).
EMERGENCY CONTRACEPTION must be taken within 3 or 5 days after unprotected sex, depending on the type taken, however, the sooner used, the more effective. It prevents an unplanned pregnancy by delaying the ovulation. Most combination birth control pills (estrogens and progesterone) can also be used. Take one dose 100 µg ethinylestradiol (=2 to 4 birth control pills within 72 hours of unprotected sex (depending on the ethinylestradiol amount in each pill), and a second dose 12 hours later.
MORNING-AFTER copper IUD must be inserted within 5 days of unprotected intercourse. The IUD can remain for 5 to 10 years.
For the Man
CONDOMS are usually made from latex rubber and can be used only once. Some have spermicide added to kill sperm. They act as a mechanical barrier, preventing direct vaginal contact with semen, infectious genital discharges, and genital lesions. Condoms are the most effective method for reducing the risk of infection from the viruses that cause AIDS and other sexually transmitted infections (STI’s). It is important to put a condom on properly before intercourse.
MALE STERILIZATION also known as a vasectomy, is a quick operation performed under local anesthesia with possible minor post-surgical complications, such as bleeding or infection. The ability to get an erection and an ejaculation do not disappear. The sperm cells are just a very small part (1%) of the fluid and a man will not notice any difference in ejaculation. The body will absorb the sperm cells.
Different contraceptives as per their effectiveness:
|
|
Estimated Effectiveness |
|
Male Latex Condom |
82% |
|
Female Condom |
79% |
|
Diaphragm with Spermicide |
88% |
|
Oral Contraceptives |
91% |
|
Injection (Depo-Provera) |
94% |
|
Implant (Norplant, Implanon) |
Over 99% |
|
IUD (Intrauterine Device) |
Over 99% |
|
Surgical Sterilization |
Over 99% |
|
Emergency Contraceptives |
75% |
Do you need to have an ultrasound after doing an abortion with pills?
If you do not have symptoms of a complication, or doubts whether the pregnancy was terminated, it is not necessary to have an ultrasound after a medical abortion.
By having an ultrasound, you can determine whether the pregnancy has ended 3-10 days after the abortion, especially if you are unsure whether the abortion was successful. You can also have a home urine pregnancy test about 3-4 weeks after taking the medicines. If you take the home urine pregnancy test before waiting for 3 weeks, the result may show up as false positive, as there are still pregnancy hormones in your body.
Medical abortion, like miscarriage, is a process that takes place over time and the body might take several weeks to fully expel all the tissues and products from the uterus. This is completely normal.
Even if the pregnancy has ended, many women will still have tissues and blood inside the uterus for several weeks. If you do not have any symptoms of complications like strong pain in the belly, continuous fever, very strong bleeding, or foul-smelling vaginal discharge, there is no need for any surgical intervention, like vacuum aspiration, even if it is suggested. One can wait until after the next menstruation or take 2 tablets of Misoprostol under the tongue.
More information:
Research has shown that for an accurate diagnosis of incomplete abortion, the ultrasound has to be interpreted together with a clinical examination (signs of complications like excessive bleeding, severe and prolonged pain, fever and/or abnormal vaginal discharge), because the ultrasound results after medical abortion are very similar in complicated and uncomplicated abortions.
The surgical evacuation of the uterus (through curettage/ vacuum aspiration) in a clinically-well person is not indicated even if some remains of the abortion can be seen on ultrasound exam. Waiting until the next menstruation, as it is done in the case of miscarriage, is often sufficient for all cases, except for ongoing pregnancies.
Research shows that one week after the medical abortion, up to 77% of women with uncomplicated first-trimester medical abortions still had some remaining tissue and blood in the uterus.
Overall, only up to 3% of all first-trimester medical abortions have complications due to retained products of conception (incomplete abortion). Even if the results of the ultrasound show endometrial thickness or increased volume of the uterus this does not mean there is a complication or need for medical intervention.
When can you start having sexual relations again after having an abortion with pills?
It is best to wait 4-7 days after taking the Misoprostol to have sexual relations. Right after the abortion, the cervix might be slightly open, and there is a greater risk of infection if you have sexual relations during this time.
It is normal to have irregular light bleeding for up to two weeks after a medical abortion (sometimes even longer). You can have sexual relations even if you are still bleeding, although it seems best to wait until the bleeding reduces.
If you do not wish to become pregnant, it is important to use contraception every time you engage in sexual relations, or start hormonal contraception on the day you take Mifepristone (injection, implant) or the day after you used Misoprostol (oral contraceptive pill).
Although it may be several weeks after your abortion before you begin your menstruation again, you could ovulate in the first week or two after your abortion, which means you could get pregnant right away. If you do not want to become pregnant, it is very important to start using contraceptives immediately.