Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion
A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last period. A combination of prescription hormone medicines are used to help the body remove the fetus and placenta tissue. Your health care provider may give you the medicines after performing a physical exam and asking questions about your medical history.
Medicines used include mifepristone, methotrexate, misoprostol, prostaglandins, or a combination of these medicines. Your provider will prescribe the medicine, and you will take it at home.
After you take the medicine, your body will expel the pregnancy tissue. Most women have moderate to heavy bleeding and cramping for several hours. Your provider may prescribe medicine for pain and possible nausea to make you more comfortable during this process.
Why the Procedure Is Performed
Medical abortion might be considered when:
The woman may not wish to be pregnant (elective abortion).
The developing baby has a birth defect or genetic problem.
The pregnancy is harmful to the woman's health (therapeutic abortion).
The pregnancy resulted after a traumatic event such as rape or incest.
Risks of medical abortion include:
Pregnancy tissue not passing completely from body, making surgery necessary
Before the Procedure
The decision to end a pregnancy is very personal. To help weigh your choices, discuss your feelings with a counselor, health care provider, or a family member or friend.
Tests done before this procedure:
Pelvic examination is done to confirm the pregnancy and estimate how many weeks pregnant you are.
An HCG blood test may be done to confirm the pregnancy.
A blood test is done to check your blood type. Based on the test result, you may need a special shot to prevent problems if you get pregnant in the future. The shot is called Rho(D) Immune Globulin (RhoGAM and other brands).
Vaginal or abdominal ultrasound may be done to determine the exact age of the fetus and its location in the womb.
After the Procedure
Follow-up with your health care provider is essential to ensure the process was completed and all the tissue was expelled. The medicine may not work in a very small number of women. If this happens, another dose of the medicine or a surgical abortion procedure may need to be done to complete the process.
Physical recovery usually occurs within a few days, depending on the stage of the pregnancy. Expect some vaginal bleeding and mild cramping for a few days.
A warm bath, a heating pad set on low, or a hot water bottle filled with warm water placed on the abdomen may help relieve discomfort. Rest as needed. Do not do any vigorous activity for a few days. Light housework is fine. Avoid sexual intercourse for 2 to 3 weeks. A normal menstrual period should occur in about 4 to 6 weeks.
You can get pregnant before your next period. Be sure to make arrangements to prevent pregnancy, especially during the first month after the abortion.
Medical and surgical abortions are safe and effective. They rarely have serious complications. It is rare for a medical abortion to affect a woman's fertility or her ability to bear children in the future.
American College of Obstetricians and Gynecologists. Clinical management guidelines of obstetrician-gynecologists. Medical management of first-trimester abortion. Obstet Gynecol. 2014;123:676-92. Practice Bulletin No. 143.
American College of Obstetricians and Gynecologists. Clinical management guidelines of obstetrician-gynecologists. Medical management of abortion. Obstet Gynecol. 2005 Oct;106(4):871-82. Reaffirmed 2009.
Annas GJ, Elias S. Legal and ethical issues in obstetric practice. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 54.
Jensen JT, Mishell Jr DR. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 13.
Simpson JL, Jauniaux ERM. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 26.
Cynthia D. White, MD, Fellow American College of Obstetricians and Gynecologists, Group Health Cooperative, Bellevue, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.