Medication abortion, often called the “abortion pill,” is a method for ending an early pregnancy. It involves taking specific medications to stop the pregnancy and cause the uterus to expel its contents. Understanding the typical course and recognizing signs of completion is important.
Understanding the Process
The medication abortion process involves taking two different medications: mifepristone and misoprostol. Mifepristone blocks progesterone, a hormone necessary for pregnancy to continue. Misoprostol, taken later, causes the uterus to contract and empty. These contractions lead to cramping and bleeding, similar to a heavy period.
Bleeding and cramping usually begin within one to four hours after taking misoprostol. The cramping can be strong, often feeling more intense than typical period pain. Heavy bleeding with blood clots is common. Passing tissue is a normal part of the process, and this phase typically lasts for several hours.
Some people experience side effects such as nausea, vomiting, diarrhea, headaches, or a low-grade fever and chills during this active phase. These symptoms are expected and indicate the medication is working to empty the uterus. The heaviest bleeding and cramping typically subside within several hours after the pregnancy tissue has passed.
Signs of Successful Completion
As the medication abortion progresses, symptoms should shift. A primary indicator of successful completion is a noticeable decrease in early pregnancy symptoms. Nausea and fatigue should diminish within a few days, while breast tenderness may take up to one or two weeks to fully resolve.
The intensity of bleeding and cramping should also reduce significantly after the active expulsion phase. Lighter bleeding or spotting can continue for several days to a few weeks, but it should consistently lighten over time. This reduction in symptoms signifies that the uterus has emptied and the abortion has been completed.
When to Seek Medical Attention
Certain symptoms warrant immediate medical attention. Very heavy bleeding is a concern if an individual soaks through two or more maxi pads in an hour for two consecutive hours. Passing large blood clots, especially those larger than a lemon, also requires prompt medical contact.
Persistent and severe abdominal pain that does not improve with pain medication can indicate a complication. A fever of 100.4°F (38°C) or higher, particularly if it develops more than 24 hours after taking misoprostol, suggests an infection. Foul-smelling vaginal discharge is another sign of potential infection.
If there is no bleeding within 24 hours of taking misoprostol, or if pregnancy symptoms like nausea and breast tenderness persist and do not lessen after the expected completion time, it could indicate an ongoing pregnancy or an incomplete abortion. In these situations, contact a healthcare provider without delay to assess the situation.
Confirming Success with a Healthcare Provider
To confirm the success of a medication abortion, a follow-up appointment with a healthcare provider is recommended. This appointment typically occurs within one to three weeks after taking the medication. During this visit, a healthcare professional can assess recovery and ensure the abortion is complete.
Common methods for confirmation include a physical examination, an ultrasound, or blood tests to measure hormone levels. An ultrasound confirms the uterus is empty. Blood tests, such as those measuring human chorionic gonadotropin (hCG) levels, show a decrease in pregnancy hormones, indicating the pregnancy has ended.
Home urine pregnancy tests may yield a positive result for several weeks after a successful abortion due to residual hormones in the body. Therefore, medical confirmation through a clinic is the most reliable way to confirm success.
If the Abortion is Incomplete
A medication abortion may not be fully successful, meaning some pregnancy tissue remains in the uterus. This is referred to as an incomplete abortion.
If an incomplete abortion is diagnosed, several approaches are available. Sometimes, remaining tissue may pass naturally over time without additional intervention. In other cases, a healthcare provider might recommend an additional dose of misoprostol to help the uterus expel the remaining tissue.
For situations where medication is not sufficient, a minor surgical procedure, such as a vacuum aspiration, may be performed to remove the remaining tissue. This procedure is generally quick and effective in completing the abortion. Healthcare providers will discuss the most suitable option based on individual circumstances and the amount of remaining tissue.