Mifeprex® / Mifepristone (“The Abortion Pill”) – 1st trimester medical
This drug is FDA (Food and Drug Administration) approved for use in women up to 49 days after their last menstrual period; however, it is commonly used “off label” up to 63 days and even beyond. The FDA-approved procedure usually requires three office visits. On the first visit, the woman is given pills to swallow (mifepristone) that cause the death of the embryo. Two days later, if the abortion has not occurred, she is given a second drug to swallow (misoprostol) which causes cramping that expels the baby. If she is beyond 8 weeks LMP, it is possible that she may see identifiable parts expelled. The last visit is to determine if the procedure has been completed.
- Bleeding: Vaginal bleeding lasts for an average of 9-16 days; 1 in 100 women bleed enough to require surgery (D&C) to stop the bleeding.
- Infection: According to the FDA, “Serious infection has resulted in death in a very small number of cases; in most of these cases misoprostol was used in the vagina.” The FDA recommends that anyone who “feels sick” with weakness, abdominal pain, nausea, vomiting or diarrhea, with or without fever, more than 24 hours after taking misoprostol should seek immediate medical attention. The FDA has not established the safety of off-label methods, which include using misoprostol in the cheek or vaginally, and many of the reported deaths were associated with these alternative methods.
- Undiagnosed ectopic (tubal) pregnancy: This abortion pill will not work in the case of an ectopic pregnancy where the embryo lodges outside the uterus (usually in the Fallopian tube). If not diagnosed early, there could be a risk of the tube bursting, internal hemorrhage, and death in some cases.
- Failed abortion: It doesn’t always work
- At 7 weeks from the LMP, anywhere from 3-8% of women will fail to abort, depending on the regimen used.
- When used beyond 7 weeks, the failure rate increases significantly.
- A surgical abortion is usually done to complete a failed medical abortion.
- Risk of fetal malformations: Research links the use of misoprostol during the first trimester with certain types of birth defects when the pregnancy continues after the regimen is used.
Methotrexate – 1st trimester medical
This drug is FDA-approved for treating certain cancers and rheumatoid arthritis, but is used off-label to treat ectopic pregnancies and to induce abortion. It works by stopping the grow of rapidly dividing cells. It is used up through 49 days of pregnancy and given orally or by injection. Three to seven days after methotrexate is taken, misoprostol (the second medication also used in “the abortion pill” method) is used vaginally.
Side effects of methotrexate include diarrhea, mouth ulcers, nausea, abdominal distress, fatigue, chills, fever, and dizziness. There is the risk of sever drug interactions with certain medications including ibuprofen and aspirin.
Misoprostol only – 1st trimester medical
This form of medical abortion uses only the second drug given in “the abortion pill” method. It is typically inserted vaginally, requires repeated doses, and has a significantly higher failure rate than “the abortion pill” method. It is associated with nausea, vomiting, diarrhea, and with potential birth defects in pregnancies that continue.
First Trimester Suction / Aspiration Abortion – 1st trimester surgical
This surgical abortion method is done throughout the first trimester. Varying degrees of pain control are offered ranging from local anesthetic (typically) to full general anesthesia (not usually available). For very early pregnancies (4-7 weeks LMP), after local anesthetic is given, a long, thin tube is inserted into the uterus which is then attached to a manual suction device, and the embryo is suctioned out.
Late in the first trimester, the cervix needs to be opened wider because the fetus is larger. The cervix may be softened the day before using medication placed in the vagina and/or slowly stretched open using thin bundles made of seaweed inserted into the cervix. The day of the procedure, the cervix may need further stretching using metal dilating rods. This can be painful, so local anesthesia is typically used. Next, the doctor inserts a stiff plastic tube into the uterus and applies suction by either an electric or manual vacuum device. The suction pulls the fetus’ body apart and out of the uterus. The doctor may also use a loop-shaped tool, called a curette, to scrape any remaining fetal parts out of the uterus.
For additional information on other abortion methods, please come in for a personal consultation.
Source: Before You Decide, Care Net. Used by permission.