“Plan C” is a common term for medication abortion, which uses prescription medications to end an early pregnancy. This non-surgical method’s safety is supported by extensive medical data. Understanding the mechanism, success rates, and signs of complication is necessary for anyone considering it. This article provides factual information regarding the safety and efficacy of the established two-drug regimen.
Defining Medical Abortion and Its Components
Medication abortion relies on a combination of two drugs, mifepristone and misoprostol, to safely end a pregnancy. Mifepristone, the first medication taken, blocks the hormone progesterone. Since progesterone is required to maintain a pregnancy, blocking its action causes the pregnancy to stop developing.
Misoprostol, the second medication, is typically taken 24 to 48 hours later. It causes the uterus to contract and the cervix to soften, resulting in cramping and bleeding that expels the pregnancy tissue. This two-step regimen is the standard of care due to its high effectiveness. Medical guidelines generally approve this method for use up to 10 weeks of gestation (70 days from the last menstrual period).
Medical Safety and Efficacy Data
The safety profile of medication abortion is well-established, with serious complications occurring infrequently. The combination of mifepristone and misoprostol is highly effective, successfully ending the pregnancy for an estimated 95% to 98% of individuals in the first 10 weeks. The mortality rate associated with medication abortion is extremely low, estimated at approximately 0.31 deaths per 100,000 cases. This figure is notably lower than the risk of death associated with childbirth (17.6 deaths per 100,000 live births in the United States).
Severe complications, such as excessive hemorrhage or infection, are rare. Excessive bleeding requiring a blood transfusion occurs in less than 1 in 1,000 cases. The risk of developing a serious infection is also small, estimated to be between 1 and 2 in every 1,000 abortions.
Recognizing Expected Symptoms and Warning Signs
Individuals undergoing a medication abortion will experience a predictable sequence of symptoms. The most prominent expected symptoms are heavy vaginal bleeding and significant cramping, caused by the uterus contracting to expel the pregnancy. The heaviest bleeding typically occurs for a few hours after taking the misoprostol and often involves passing large blood clots. Lighter bleeding or spotting can continue intermittently for several weeks.
Other common side effects include nausea, vomiting, diarrhea, headache, and a temporary low-grade fever or chills. These symptoms are short-lived, often resolving within 24 hours of taking the misoprostol. Expected pain is stronger than typical menstrual cramps but can usually be managed effectively with over-the-counter pain relievers like ibuprofen.
Immediate medical attention is required if critical warning signs of complication appear. The most serious sign is excessive bleeding, defined as soaking two or more full-sized sanitary pads in one hour for two or more consecutive hours. Signs of infection include a fever of 100.4°F or higher lasting more than four hours after misoprostol, or a fever that begins days later. Severe abdominal or back pain not relieved by medication or foul-smelling vaginal discharge also warrant contacting a healthcare provider immediately.
Conditions That Rule Out Use
Certain pre-existing conditions must be ruled out, as they are contraindications for medication abortion. The most serious exclusion is a known or suspected ectopic pregnancy, where the fertilized egg has implanted outside the uterus. The regimen is ineffective for this condition, and using it could delay necessary emergency treatment for a life-threatening rupture.
Individuals with specific underlying health issues are also advised against this method. These conditions include chronic adrenal failure or certain inherited bleeding disorders, which can be worsened by the medications. People on long-term corticosteroid therapy also face increased risk because mifepristone can affect the action of these steroids. A known allergy to either mifepristone or misoprostol, or having an intrauterine device (IUD) in place that has not been removed, also rules out the medication regimen.