If you are considering an abortion, you should be fully informed about all aspects of an abortion.
Abortion is a procedure with risks to the mother. A woman should also consider that miscarriage, or natural loss of the pregnancy, is very common. According to the American College of Obstericians and Gynecologists (ACOG), an estimated 10-25% of all clinically recognized pregnancies will naturally end in a miscarriage1.
If you would like to speak to someone regarding abortion and alternatives, please contact us to make a medical consultation. We provide confidential services at no cost to you to ensure that you have all the information when making your decision to have an abortion.
There are 2 categories of abortions, medical and surgical.
There are two methods used for medical abortion in the United States: Methotrexate and Misoprostol (MTX) or Mifepristone (Mifeprex) and Misoprostol (RU486). RU486 is the more commonly method used for medical abortion in the United States than MTX.
Mifeprex is used in a regimen with another prescription medicine called misoprostol, to end an early pregnancy. Mifeprex blocks progesterone required to nourish the developing embryo.
Early pregnancy means it is 70 days (10 weeks) or less since your last menstrual period began. RU486 may be taken up to 70 days or 10 weeks after the last menstrual cycle. Mifeprex is not approved for ending pregnancies that are further along than 10 weeks.
Mifeprex and Misoprostol (RU486)
RU486 is the only FDA approved Medical Abortion used in the United States. Be aware of providers who prescribe other treatments which may lead to devastating results.
When you use Mifeprex on Day 1, you also need to take misoprostol 24 to 48 hours after you take Mifeprex, to end your pregnancy. The pregnancy is likely to be passed from your uterus within 2 to 24 hours after taking Mifeprex and misoprostol. When the pregnancy is passed from the uterus, you will have bleeding and cramping that will be heavier than your usual period. About 2 to 7 out of 100 women taking Mifeprex will need a surgical procedure because the pregnancy did not completely pass from the uterus or to stop bleeding.
Who should not take Mifeprex?
You should not take RU486 if you:
- Have a pregnancy that is more than 70 days (10 weeks).
- Are using an IUD (intrauterine device or system) serious complications can arise.
- If you have a pregnancy outside the uterus (ectopic pregnancy). Do not take RU486 without having an ultrasound first to rule out an ectopic pregnancy. Ectopic pregnancy undetected can be life threatening. Mifeprex cannot be used in cases of confirmed or suspected ectopic pregnancy as MIFEPREX is not effective for terminating those pregnancies
- Have problems with your adrenal glands.
- Take medicine to thin your blood.
- Have a bleeding problem.
- Have porphyria.
- Take certain steroid medicines.
- Are allergic to mifepristone, misoprostol or other prostaglandins.
What are the possible side effects of Mifeprex and misoprostol?
Most Common Side Effects
Mifeprex and misoprostol use can cause serious side effects. The most common side effects are:
Cramping and Bleeding. Cramping and vaginal bleeding are expected with RU486 treatment. This type of pain is greater than your typical menstrual period.
Bleeding or spotting can be expected for an average of 9 to16 days and may last for up to 30 days. You may see fetal tissue and blood clots as the pregnancy is aborted.
The other usual side effects of Mifeprex treatment include: nausea, weakness, fever/chills, vomiting, headache, diarrhea and dizziness.
In addition, there are severe reactions related to taking Mifeprex that you must be aware. These risks are not routinely mentioned:
Heavy Bleeding. Contact your healthcare provider right away if you bleed enough to soak through two thick full-size sanitary pads per hour for two consecutive hours or if you are concerned about heavy bleeding. In about 1 out of 100 women, bleeding can be so heavy that it requires a surgical procedure (surgical aspiration or D&C).
Abdominal Pain or “Feeling Sick.” If you have abdominal pain or discomfort, or you are “feeling sick,” including weakness, nausea, vomiting, or diarrhea, with or without fever, more than 24 hours after taking misoprostol, you should contact your healthcare provider without delay. These symptoms may be a sign of a serious infection or another problem (including an ectopic pregnancy, a pregnancy outside the womb).
Fever. In the days after treatment, if you have a fever of 100.4°F or higher that lasts for more than 4 hours, you should contact your healthcare provider right away. Fever may be a symptom of a serious infection or another problem. Serious infections have resulted in death for some women who have had medical abortions.
If you cannot reach your healthcare provider, go to the nearest hospital emergency room.
There is a possibility that you can still be pregnant after taking Mifeprex with misoprostol treatment. If you are still pregnant, you must seek immediate care for a surgical procedure to prevent life-threatening complications.
Methotrexate and Misoprostol (MTX)
MTX is a medical abortion procedure used up to the first 7 weeks (49 days of pregnancy). Methotrexate is generally prescribed in the treatment of arthritis and certain cancers. During the first office visit, methotrexate is given by injection or by mouth. Three to seven days later, misoprostol is given which leads to cramping and expulsion of the fetus. MTX treatment is not FDA approved and has proven to have a high failure rate, potentially requiring an additional surgical procedure to complete the abortion.
Common Side Effects
Common side effects experienced with the MTX abortion procedure include:
- Heavy bleeding
Methotrexate and Misoprostol is dangerous for women who have anemia, bleeding disorders, acute inflammatory bowel conditions, and those who have an IUD (intrauterine device).
Severe side effects related to medical abortions have led to life-threatening consequences. Contact your healthcare provider right away if you experience any of these major symptoms
American Pregnancy Organization
American College of Obstetrics and Gynecology
Care Net. Before You Decide Live. 2016
Suction Aspiration (Also called Manual Vacuum Aspiration):
This method is used up to the first 13 weeks of the first trimester of pregnancy. The cervix is stretched open with dilators (metal rods). A hollow plastic tube is inserted into the uterus. The fetus and the remaining contents of the uterus are removed using a handheld suction device.
Dilation and Curettage (D&C) with Vacuum Aspiration (Also called Suction Curettage):
This is a surgical procedure usually used in the first 12 weeks of pregnancy. The doctor normally opens the cervix with dilators (metal rods) and then empties the uterus with a hollow plastic instrument connected by tubing to a suction machine. After suctioning, the doctor may scrape the walls of the uterus with a curette, a loop-shaped knife, to ensure the fetus, placenta, and contents of the uterus have been completely removed.
Dilation and Evacuation (D&E):
This surgical procedure is generally performed from 13-24 weeks of pregnancy. However, Ohio Law prohibits abortion after 22 weeks of pregnancy. The doctor must first insert luminaria sticks into the cervix for 1-2 days to start the dilating process to enlarge the cervical opening so the baby can be pulled through the cervix. These dried seaweed sticks absorb moisture and expand, causing the cervix to enlarge. On the day of the procedure, the physician will use dilating rods to open the cervix and surgical instruments to extract the fetus. After 16 weeks LMP (Last Menstrual Period) surgical instruments are used to pull the baby through the cervix because the fetal parts are too large to go through the suction tubing.[i]
Dilation and Extraction (D&E After Viability):
This type of procedure is done after 24 weeks LMP and takes 2-3 days. D&E is the typical method of abortion during the second trimester. The D&E procedure is banned in some states, an abortion provider must cause fetal death or labor, adding unnecessary risk without any medical benefit to the patient[ii]. During the first two days, the cervix is dilated and medication is given for cramping. On the third day, the woman receives medication to start labor. After labor begins, the abortion doctor uses ultrasound to locate the positioning of the fetus. Using forceps, the fetus is delivered up to the head. Scissors are inserted into the skull to create an opening and a suction catheter is placed into the opening to remove the skull contents. The skull collapses and the fetus is removed.[iii]
Anesthesia for surgical abortion:
Three options are available for pain relief during a surgical abortion:
- Local anesthesia:A local anesthetic is injected into the cervix to cause a numbing effect before dilation.
- Local anesthesia with sedation: Along with a local anesthetic injected into the cervix, a medication is given to help the woman relax or become “sleepy” during the procedure.
- General anesthesia: Anesthetic medications are given intravenously to cause the woman to be “asleep”, completely unaware of her surroundings. (Reference 3)
[i] Before You Decide. Care Net 2016.
[ii] Guttmacher Institute: Evidence You Can Use: Later Term Abortions. Jan 2017.
[iii] Before You Decide. Care Net 2016
Infertility and life-threatening reproductive risks
Abortion can damage reproductive organs and cause long-term and sometimes permanent problems that can put future pregnancies at risk. Women who have abortions are more likely to experience ectopic pregnancies, infertility, hysterectomies, stillbirths, miscarriages, and premature births than women who have not had abortions.9
Reproductive complications and problems with subsequent deliveries
Pelvic Inflammatory Disease — Abortion puts women at risk of pelvic inflammatory disease (PID), a major direct cause of Pelvic Inflammatory Disease infertility. PID also increases risk of ectopic pregnancies. Studies have found that approximately one-fourth of women who have chlamydia at the time of their abortion and 5% of women who don’t have chlamydia will develop PID within four weeks afterwards.10
Placenta Previa — After abortion, there is a 7-to-15-fold increase in placenta previa in subsequent pregnancies, a life- Placenta Previa — threatening condition for the mother and baby that increases the risk of birth defects, stillbirth, and excessive bleeding during labor.11
Ectopic Pregnancy — Post-abortive women have a significantly increased risk of subsequent ectopic pregnancies, Ectopic Pregnancy — 12 which are life threatening and may result in reduced fertility.
Endometritis, a Major Cause of Death — Abortion can result in for endometritis, which can lead to hospitalization and infertility Endometritis, a Major Cause of Death —problems. It is a major cause of maternal death during pregnancy.13
Women who abort twice as likely to have pre-term or post-term deliveries. Women who abort twice as likely to have pre-term or post-term deliveries.14 Women who had one, two, or more previous induced abortions are, respectively, 1.89, 2.66, or 2.03 times more likely to have a subsequent pre-term delivery, compared to women who carry to term. Pre-term delivery increases the risk of neonatal death and handicaps. Women who had one, two, or more induced abortions are, respectively, 1.89, 2.61, and 2.23 times more likely to have a post-term delivery (over 42 weeks).
Death or disability of newborns in later pregnancies — Death or disability of newborns in later pregnancies — Cervical and uterine damage may increase the risk of premature delivery, Death or disability of newborns in later pregnancies — complications of labor, and abnormal development of the placenta in later pregnancies.15 These complications are the leading causes of disabilities among newborns
Elliot Institute: After Abortion.org & Fact Sheets, Outreach: www.TheUnChoice.com