Medical Abortion (The Abortion Pill)
Mifeprex (RU-486 / Medical Abortion Pill)
Gestational Age – Within 10 Weeks of LMP1 Typical Cost - $400-$600
First, you'll be given one dose of mifepristone2, which will make it impossible for a fertilized egg to remain attached to the lining of your uterus. Originally, the dose was three tablets, but this was reduced to one tablet, taken orally.
The second medication, misoprostol3, causes uterine contractions and is taken two days later. The new guidelines allow it to be administered at home as four tablets you place in your cheek rather than swallowing, allowing them to dissolve for 30 minutes. The original guidelines, enforced by some states, required you to visit your doctor to take this second medication.
Misoprostol terminates pregnancy anywhere from six hours to one week later. You must be prepared for cramping and bleeding, which may continue for several days.
Your health care provider must assess your condition seven to 14 days after taking mifepristone. The FDA no longer specifies that this must be an in-person visit. If the pregnancy is still present, a surgical abortion must be performed.
Risks and Side Effects
- The procedure is unsuccessful <3.2% of the time prior to 57 days, 6.5 % from 57-63 days and 7.2% from 63-70 days gestation.3
- Major adverse events requiring going to the emergency room occur for about 3.7% (about 1 in 25) of the patients between 47-63 days and 4.6% (about 1 in 20) of the patients between 64-70 days gestation. 4
- Cramping, nausea, vomiting, diarrhea, heavy bleeding, infection and in rare cases, death.
- Not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease, use an intrauterine device (IUD), or are unable to return for the follow-up visit.
Abortion Pill Reversal
There is a 50% chance of continuing a healthy pregnancy if therapy is started within 72 hours of taking mifepristone. See Abortion Pill Reversal for details.
1 LMP – Last Menstrual Period
2 U.S. Food and Drug Administration (2016). “Mifeprex Medication Guide.” U.S. Department of Health. Retrieved from http://www.fda.gov/downloads/Drugs/DrugSafety/UCM088643.pdf
3 Mifeprex Label (2016), Table 4.
4 Winikoff B, Dzuba IG, Chong E, Goldberg AB, Lichtenberg ES, Ball C, et al. (2012). “Extending outpatient medical abortion services through 70 days of gestational age.” Obstet Gynecol, 120(5): 1070-6.
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