A medical abortion is the use of medicines to end a
pregnancy. Medical care for a medical abortion is different from medical care
for a surgical abortion. This is because a medical abortion is like a
miscarriage (in this case, caused by medicines) that
takes place at home over 1 to 2 days and does not require your doctor to be
present. After a couple of weeks of bleeding, you then see your doctor for a
Care before a medical abortion
Before a medical
abortion, your doctor may:
Evaluate your medical history, including any
medicines you are taking.
Do a physical exam, including a
pelvic examination, to evaluate your health, how long
you have been pregnant, and location of the embryo or
ultrasound to confirm how far along and where the
pregnancy is. Not all doctors choose to do this step.
decision to have an abortion and your feelings about the
Discuss your plans for future pregnancies and birth
Explain how the medicines will work, possible side
effects (nausea, vomiting, and diarrhea are common), and when to call your
doctor. It is important for your doctor to know whether you:
Have access to a telephone, to call if you
Have transportation to a health care facility if
you need to be evaluated.
Will be able to return for a follow-up
Are prepared for the cramping pain and bleeding that
will occur as the uterine contents are passed.
Understand that a
surgical abortion will be needed if a medical abortion fails to complete the
In addition to the medicines used to cause an abortion,
your doctor will give you medicines to minimize side effects, with specific
instructions for their use. These medicines are used:
If you need to call your doctor about your symptoms during a medical abortion, be prepared to provide information about:
How heavy the bleeding is, compared with your
normal menstrual bleeding. The heaviest bleeding should stop 1 to 2 hours after
passing the pregnancy tissue.
The number and types of pads used in
1 hour and the total number of soaked pads used.
The presence and
size of blood clots.
Whether any pregnancy tissue has been
The severity of your cramping or pain.
Care after a medical abortion
Carefully follow all
of your doctor's instructions and review what-to-expect information after a
Follow these instructions:
Most women can return to normal activities in 1
to 2 days after the uterus has cleared. Avoid strenuous exercise for 1 to 2
Do not have sexual intercourse for 1 to 2 weeks or as
advised by your doctor.
Be sure to use birth control when you
start having sex again. And use condoms to prevent infection. For more information, see
Do not rinse the vagina with fluids (douche). This could increase your risk
of infections that can lead to
pelvic inflammatory disease.
Normal symptoms that most women will
experience after a medical abortion include:
Bleeding or spotting for up to 14 days.
Bleeding may last longer for pregnancies of more than 7
Cramping for the first 2 weeks. Some women may have
cramping (like menstrual cramps) for as long as 6 weeks.
for 2 to 3 weeks, often influenced by changes in pregnancy hormones. It's
normal to feel one or more emotions such as relief, guilt, sadness, and/or grief.
Call your doctor immediately if you have any of these symptoms
after an abortion:
Severe bleeding. Both medical and surgical
abortions usually cause bleeding that is different from a normal menstrual
period. Severe bleeding can mean:
Passing clots that are bigger than a golf
ball, lasting 2 or more hours.
Soaking more than 2 large sanitary
pads in an hour, for 2 hours in a row.
Bleeding heavily for 12
hours in a row.
Signs of infection in your whole body, such as
headache, muscle aches, dizziness, or a general feeling of illness. Severe
infection is possible without fever.
Severe pain in the belly
that is not relieved by pain medicine, rest, or heat
Hot flushes or a fever of
100.4°F (38°C) or higher that
lasts longer than 4 hours
Vomiting lasting more than 4 to 6
Sudden belly swelling or rapid heart
Vaginal discharge that has increased in amount or smells
Pain, swelling, or redness in the genital area
Call your doctor for an appointment
if you have had any of these symptoms after a recent abortion:
No bleeding. If bleeding does not occur, then
the medicines may not be working. A second dose of misoprostol may be needed.
Methotrexate and misoprostol may take up to 3 weeks to be
Bleeding (not spotting) for longer than 2
New, unexplained symptoms that may be caused by medicines
used in your treatment
No menstrual period within 6 weeks after the
Signs and symptoms of
depression. Hormonal changes after a pregnancy can
cause depression that requires treatment.
Complications that can occur include:
Tissue remaining in the uterus (retained
products of conception). Cramping belly pain and bleeding will occur again within
a week of the procedure.
Infection. Symptoms of fever of
100.4°F (38°C) or higher, pain,
and belly tenderness will usually start within 2 to 3 days of the
procedure. But you can have a serious infection without
Blood clots blocking the cervix (hematometra). If the uterus
doesn't contract to pass all of the tissue, the cervical opening can become
blocked. This prevents blood from leaving the uterus. The uterus will become
enlarged and tender. Belly pain, cramping, and nausea may be
Moderate to severe bleeding (hemorrhage). Bleeding may be
more than normal if:
Products of conception are retained in the
The uterus has not contracted toward its prepregnancy size
Uterine muscle rupture has occurred. In rare cases, a
uterine incision scar tears open when a medicine is used to induce
When a medical abortion fails, a surgical abortion must
be done as follow-up to prevent complications or development of a fetus with
Follow-up examination after a medical abortion
follow-up examination is done about 2 weeks after a medical abortion. The
examination may include:
How this information was developed to help you make better health decisions.