If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

What is a medical abortion?

A medical abortion uses 2 different medications, taken 1 to 2 days apart, to end a pregnancy and make the uterus push out the tissue (like a miscarriage).

Can I get a medical abortion?

If your pregnancy is 9 weeks (63 days) or less, counting from the first day of your last normal menstrual period, you may be able to have a medical abortion instead of a procedural abortion (also called a surgical abortion or a “D&C”, which stands for dilation and curettage).

What happens during a medical abortion?

• First you will have an ultrasound to make sure you are no more than 9 weeks (63 days) pregnant. You will also have blood work to check your blood type and pregnancy hormone level.
• If you are less than 9 weeks (63 days) pregnant, you will meet with a nurse to talk about the procedure in detail.
• You will then meet with a doctor, who will take your medical history and give you a prescription for Mifegymiso.
• The prescription for Mifegymiso can be filled at any pharmacy. Mifegymiso is free for any person with a Nova Scotia health card. The package will have 2 medications: mifepristone (1 tablet) and misoprostol (4 tablets).
• You may have very painful cramping.
• You may have heavy bleeding (soaking 1 to 2 large pads every hour) for several hours.
• 1 to 2 weeks after the treatment, you must have a blood test to check if the pregnancy has ended.

What are the possible risks?

Possible side effects include:

• nausea (feeling sick to your stomach)
• vomiting (throwing up)
• diarrhea (loose, watery poop)
• fever
• chills
• headaches
• fatigue (feeling tired)

These side effects may be intense (very strong). If you are not sure that you can manage these symptoms at home, you may wish to choose a procedural abortion instead. Talk about your concerns with your health care provider when making this decision.

Instructions:

Day 1: Mifepristone

• You will swallow 1 mifepristone tablet with water.
• Once you take this medication there is no way to reverse the effects.
• This pill will end the pregnancy.
• Most people do not feel any different after taking this tablet. A small number of people start bleeding and cramping because the pregnancy tissue has started to empty from the uterus.

Day 2 or 3: Misoprostol

Misoprostol softens the cervix and tells your body to push out the tissue (like a miscarriage). There are 2 ways to take the misoprostol tablets: vaginally and orally (by mouth). Both methods will cause heavy bleeding and strong cramping.

• You will need several large maxi pads to help manage the heavy bleeding that will start once you take the medication.
• Do not use tampons or menstrual cups during this procedure.
• Choose a time to take the tablets when you can rest for at least 3 to 4 hours.
• Your health care provider may have given you a prescription. If not, take an over the counter pain medication, like ibuprofen (Advil ®, Midol®) or acetaminophen (Tylenol®) before taking the misoprostol.
• A hot water bottle or heating pad may also help with pain.
• Within 1 to 4 hours of taking the misoprostol, you will start to have cramping, bleeding, and pass clots and pregnancy tissue. This is normal. It means that the pregnancy tissue has started to empty from the uterus. The bleeding may be very heavy, and you may pass clots as small as quarters, or as big as lemons.
• The bleeding and cramping may go on for several hours until the pregnancy tissue passes. After that, you may have lighter bleeding off and on for up to 6 weeks.

1. Vaginally

• • • This method is recommended because it causes less nausea.
    • 24 to 48 hours (1 to 2 days) hours after you take the mifepristone tablet, place all 4 misoprostol tablets in your vagina. Insert (put) them as high up as possible, like you would insert a tampon or menstrual cup.

2. Orally (by mouth)

• • • 24 to 48 hours (1 to 2 days) after you take the mifepristone tablet, place all 4 misoprostol tablets in your mouth at the same time. Do not swallow these tablets. Place 2 tablets between your cheek and gums on each side. Leave them there for 30 minutes. After 30 minutes, drink some water to swallow any pieces that are left.

Day 7 to 14

• You must go for a blood test to check if your pregnancy has ended.
• A nurse will contact you to confirm the pregnancy has ending. No other treatment or appointments are needed.
• There is a 2% to 5% failure rate with these medications. If the medications have not worked, we recommend that you return for a uterine aspiration procedure (D&C) as the medications can cause birth defects (harm to the pregnancy).

FOR MORE INFORMATION

Nova Scotia Women’s Choice Clinic
Tel: 1-833-352-0719
Hours: Monday to Friday: 8 a.m. to 3 p.m.
(Callers may also leave a message at any time and a nurse will return the call during these hours.)

Nova Scotia Health
http://www.nshealth.ca/abortion