Medical abortion, often referred to as the abortion pill, provides a non-surgical option for ending an early pregnancy. This process typically involves taking two different medications: mifepristone, followed by misoprostol. While highly effective in completing a pregnancy, there are instances where the medication does not work as intended. This article explores the signs that indicate a medical abortion may not have been successful, the reasons why it might fail, and the subsequent medical steps available.
Recognizing a Failed Medical Abortion
After taking the abortion pill, individuals typically experience heavy bleeding and cramping, which signals success. It often includes passing blood clots and tissue. However, if these expected effects are minimal or absent, it could indicate the medical abortion was not successful.
Other signs include persistent pregnancy symptoms like nausea, breast tenderness, or fatigue. A positive pregnancy test several weeks later also confirms continued pregnancy. A follow-up appointment with a healthcare provider, often involving an ultrasound, is important to confirm the outcome.
Why Medical Abortions May Not Work
Medical abortions can fail for several reasons. One is an incomplete abortion, where pregnancy tissue remains in the uterus. This can cause continued bleeding, discomfort, and increased infection risk.
Another is an ongoing pregnancy, where the fetus continues to develop despite medication. Effectiveness is influenced by gestational age; success rates are highest in early pregnancies and decrease as pregnancy advances. Adhering to medication instructions, including dosage and timing, also plays a role.
Next Steps After a Failed Medical Abortion
Following a medical abortion, a follow-up appointment is scheduled within one to two weeks. During this visit, a healthcare provider conducts an ultrasound and assessment to confirm completeness. This identifies any remaining pregnancy tissue or continuing pregnancy.
If incomplete, options include observation, a second misoprostol dose, or a surgical procedure. For ongoing pregnancy or significant retained tissue, vacuum aspiration is often recommended. This common, safe surgical procedure gently removes pregnancy tissue from the uterus.
It involves inserting a thin tube through the cervix into the uterus, using gentle suction. Suction typically lasts one to three minutes, though the entire process may take longer. Healthcare providers also offer counseling to support informed decisions.
Understanding Continued Pregnancy Risks
If a pregnancy continues after exposure to abortion medication, there are health considerations for the pregnant person and fetus. For the pregnant person, risks include persistent bleeding, increased infection chance, or further medical interventions. Follow-up care is important to ensure uterine health.
Regarding fetal development, the medications have different profiles. Mifepristone is not known to cause birth defects; studies show a major malformation rate only slightly higher than the general population’s when pregnancy continues after exposure. Misoprostol exposure can be associated with certain congenital anomalies.
These include limb abnormalities (e.g., terminal transverse limb defects) or neurological issues like Mobius syndrome. While the risk is low, it is a recognized possibility, with some studies indicating an increased risk for specific anomalies. Given these risks, a comprehensive medical evaluation is important if pregnancy continues.