Abortion, Prostaglandin-Induced

This is a medical (not surgical) procedure used to end a pregnancy by choice. Prostaglandins are hormone-like medicines used to start labor by making the womb (uterus) contract. It is best to take the prostaglandin pill with another medicine (mifepristone [RU-486] or methotrexate). These medicines should also be taken before 63 days of the pregnancy. Medical abortion does not appear to affect future pregnancies.

In a medical abortion:

  • You will not be given a drug to make you sleep (general anesthetic).

  • There is a high success rate (92% to 99%).

  • It does not involve going into the body (invasive) with instruments like a surgery does.

  • It can be done in the first 2 months of the pregnancy.

  • The prostaglandin pill can be taken at home by mouth (orally) or as a vaginal suppository.

It may take a couple of days or even weeks to complete the abortion. You need to keep taking the medicine. You will need to see your caregiver several times and will need a follow-up visit with an ultrasound. This is to be sure the abortion is complete. There may be heavy bleeding with the procedure.

REASONS FOR THIS PROCEDURE

  • Pregnancy is a threat to the life of the mother.

  • Mother has an inherited (genetic) condition which the baby (fetus) is at risk of developing or has developed (such as cystic fibrosis).

  • Pregnancy resulted from a rape or incest.

  • Concerns about an unplanned pregnancy.

  • Fetus has a chromosomal abnormality or birth defect.

  • Fear that the fetus has been harmed by medicines or other conditions.

YOU MAY BE ADVISED NOT TO DO THIS PROCEDURE IF:

  • You are allergic to the medicines.

  • You have a tubal (ectopic) pregnancy.

  • There is an IUD (a type of birth control) in the pregnant uterus.

  • You have a cyst or tumor in the area of the ovary.

  • You take steroid medicines.

  • You have a low blood count (anemia).

  • You take blood thinners.

  • You have medical problems such as liver, kidney, lung, and heart disease, high blood pressure, or convulsions.

RISKS AND COMPLICATIONS

  • If parts of the afterbirth (placenta) remain following birth of the fetus, they may need to be removed by scraping the inside of the uterus (D&C).

  • Increased bleeding.

  • If the procedure fails to work, surgery may be needed to remove the fetus and placenta (D&C).

PROCEDURE

  • An ultrasound is usually done before the procedure to calculate and confirm the age of the pregnancy.

  • Prostaglandin pills cause the uterus to contract.

  • The medicines are given orally, as a vaginal suppository, or as an injection. This is repeated every couple hours as needed until contractions of the uterus start and the abortion occurs.

  • Side effects from the drugs can include fever, chills, feeling sick to your stomach (nausea), throwing up (vomiting), diarrhea, facial flushing, and shortness of breath (bronchospasm).

  • An ultrasound is done after the abortion to make sure there is no more pregnancy tissue left in the uterus.

  • RhoGAM vaccine injection may be given if the patient is Rh negative and the partner is Rh positive or unknown.

HOME CARE INSTRUCTIONS

  • Your caregiver may order bed rest (only allowed to get up to go to the bathroom), or he or she may allow you to continue light activity.

  • Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver. Do not take aspirin. It can cause bleeding.

  • Keep track of the number of pads you use each day and how soaked they are. Write down this information.

  • Do not use tampons. Do not douche or have sexual intercourse for 2 weeks or until approved by your caregiver.

  • Birth control (contraception) can be started shortly after the procedure. If you wish to take birth control pills, start taking them either on the night you return from the procedure or the next day unless instructed otherwise. If you prefer an IUD, diaphragm, or cervical cap, the fitting can be made during your next appointment or as your caregiver suggests.

  • Usually, your next menstrual period begins 4 to 6 weeks after the procedure. If you take birth control pills, your first period will begin after you end the first cycle of pills.

  • Keep all of your caregiver's follow-up appointments.

SEEK IMMEDIATE MEDICAL CARE IF:

  • You get bad cramps in your stomach, back, or abdomen.

  • You get a temperature over 102° F (38.9° C) or as suggested by your caregiver (write your temperature down).

  • You pass large clots or tissue (save any tissue for your caregiver to inspect).

  • You bleed more or become lightheaded, weak, or faint.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.