Medical Abortion: What is it?
A medical abortion is one that is brought about by taking medications that will end a pregnancy. There are two medications that can be used to end early pregnancy: mifepristone or methotrexate. Mifepristone is also known as the abortion pill or RU486. Either Mifepristone or methotrexate is taken together with another medication, called misoprostol, to induce an abortion. After a medical abortion you should be able to resume your normal activities. Most women do not need to miss work to complete a medical abortion.
Medical Abortion compared to the Aspiration Procedure
Medical abortion is one of two non-surgical abortion methods. Another non-surgical abortion method is the Manual Vacuum Aspiration- a quick and gentle early abortion method that takes minutes to complete. The Manual Aspiration Procedure has some advantages over medical abortion. It is completed in one visit to the doctor’s office, it has a higher success rate, there is significantly less bleeding and cramping, and there is immediate recovery.
Medical Abortion and the Abortion Pill
Today, most medical abortion is completed with Mifepristone (Abortion Pill). This is the best medication for ending early pregnancy. It is 95-99% effective. It is convenient, because you can schedule a time to induce the miscarriage. Methotrexate has a higher failure rate, can only be used up to 7 weeks of pregnancy, and has a more unpredictable bleeding pattern. Since the FDA approval of mifepristone, methotrexate is mainly prescribed for ectopic pregnancies (or abnormal pregnancies that are in the tube, rather than in the uterus).
In some countries where mifepristone is not available, women use misoprostol, or Cytotec® for abortion. Cytotec® is much less effective than mifepristone. Cytotec® is about 80% successful at ending pregnancy. This is problematic, because Cytotec® causes birth defects. In addition, the bleeding is unpredictable.
Medical Abortion is a Three Step Process:
You take the first Abortion Pill (mifepristone) in the doctor’s office. The doctor determines if you are eligible for the Abortion Pill by doing an ultrasound, and making sure you are between 5-9 weeks pregnant.
You take the second set of medicines (misoprostol) at home, 24-72 hours after taking mifepristone. Within hours, most women experience strong period-like cramps and bleeding.
You return to the doctor’s office to make sure the medical abortion was successful.
When Is Medical Abortion Completed?
A medical abortion is best completed between 5 and 9 weeks from the first day of your last menstrual period. At your first medical visit the doctor will do an ultrasound to make sure you are eligible for a medical abortion. Methotrexate is only effective under 7 weeks of pregnancy.
How does a Medical Abortion Work?
Mifepristone is a pill. It works by blocking the hormone progesterone, which is necessary to sustain pregnancy. Without this hormone, the lining of the uterus breaks down, the cervix (opening of the uterus or womb) softens, and bleeding begins.
Mifepristone (the abortion pill or RU-486) is a medication that was first licensed in France and China in 1988. Since then it has been used safely by millions of women worldwide. It was approved for use in the U.S. in September, 2000.
Within a few days after taking either mifepristone a second drug, misoprostol, is taken. Misoprostol tablets cause the uterus to contract and empty. This ends the pregnancy.
Methotrexate has been used in the U.S. since 1953, when it was approved by the FDA to treat certain types of cancer. Since that time, medical researchers have discovered other important uses for the drug. One of these uses is to end unintended pregnancies. Although the FDA did not consider methotrexate for this specific purpose, clinicians may prescribe methotrexate for early abortion.
Mifepristone and methotrexate work in different ways. Generally Mifepristone is the first choice for medical abortion because it has a higher success rate, it is more predictable, and has a shorter bleeding pattern. Since the approval of Mifepristone, methotrexate is mainly used to end early ectopic pregnancies.