Medication abortion is a common and safe two-step process used to end an early pregnancy. This method involves taking two medications, mifepristone and misoprostol, usually 24 to 48 hours apart. This article provides a clear breakdown of the physical experience and potential side effects that can be expected.
Addressing the Core Concern: Nausea and Gastrointestinal Issues
Gastrointestinal symptoms, including nausea, vomiting, and diarrhea, are common side effects of medication abortion. These symptoms are particularly noticeable after taking misoprostol, which triggers uterine contractions. Some nausea may also be related to existing pregnancy symptoms that have not yet subsided. The medication can cause a transient feeling of being unwell, sometimes accompanied by chills or a mild fever. Healthcare providers often offer anti-nausea medication preemptively to manage these digestive disturbances.
What to Expect: Cramping, Bleeding, and Timing
Severe cramping and heavy bleeding are expected signs that the medication is working. Mifepristone blocks progesterone, stopping the pregnancy from progressing. Misoprostol causes the uterus to contract and expel the pregnancy.
The main physical process typically begins within one to four hours after taking misoprostol. Expect pain comparable to very strong menstrual cramps or an early miscarriage, which is why pain management is important. The heaviest bleeding and passage of tissue usually occurs for a few hours, often lasting between three and five hours.
Bleeding will be significantly heavier than a typical menstrual period, often involving large blood clots. This heavy flow usually tapers off after the passage of tissue, transitioning into lighter bleeding or spotting that may continue for several days or even weeks. The intensity of the cramping and bleeding confirms that the medication has been effective.
Practical Strategies for Symptom Management
Taking proactive steps to manage discomfort makes the experience more tolerable. Healthcare providers generally recommend taking an over-the-counter pain reliever like ibuprofen about 30 minutes before taking misoprostol. Ibuprofen is preferred because it is effective for cramping pain, while aspirin is discouraged due to its blood-thinning properties.
Comfort measures are also effective for managing the pain of uterine contractions. Applying a heating pad or hot water bottle to the abdomen can help relax the muscles and ease the intensity of the cramps. Resting in a comfortable environment and ensuring you have support is advised for the day misoprostol is taken.
To combat nausea and vomiting, eat a light meal, such as toast or crackers, before taking misoprostol. Staying well-hydrated by drinking plenty of non-alcoholic beverages is also helpful, especially if vomiting or diarrhea occurs. Over-the-counter anti-nausea medications, like dimenhydrinate, can be used to treat severe gastrointestinal upset.
Recognizing Warning Signs and When to Seek Help
While the process involves intense but expected symptoms, it is important to be aware of warning signs that require medical attention. Excessively heavy bleeding is defined as soaking through two maximum-absorbency sanitary pads in one hour for two consecutive hours. Passing large blood clots bigger than a lemon is also a cause for concern.
Signs of a possible infection also warrant contacting a healthcare provider right away. These include a fever of 100.4°F (38°C) or higher lasting more than 24 hours after taking misoprostol, or severe abdominal pain not relieved by pain medication. Continuing symptoms of pregnancy, or no bleeding at all 24 hours after taking misoprostol, should also be reported.