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The Abortion Pill
This abortion procedure goes by many names, including medication abortion, RU-486, and Mifeprex/mifepristone. The U.S. Food and Drug Administration only approved this drug for use in women up to the 70th day after her last menstrual period; but it’s sometimes used off-label past 70 days—even against FDA guidelines. The FDA has determined REMS (Risk Evaluation and Mitigation Strategy) continues to be necessary to ensure safe use of Mifeprex. (REMS) is a strategy to manage a known or potential serious risk associated with a drug or biological product.
If a doctor recommends the abortion pill even though you’re more than 70 days (10 weeks) pregnant, it might be best to look for a medical professional who cares about your health and well-being enough to abide by FDA regulations.
This procedure usually requires three office visits:
- On the first visit, the woman is given pills to cause the death of the embryo (human being in early stages of development).
- 24 to 48 hours later, the woman is given a second drug (misoprostol) to induce labor at a location appropriate for the patient.
- Seven to 14 days later, the woman returns for an evaluation to determine if the procedure has been successfully completed.
Note: The abortion pill won’t work in the case of an ectopic pregnancy. This is a potentially life-threatening condition in which the embryo implants outside the uterus, usually in the fallopian tube. If an ectopic pregnancy is not diagnosed early, the tube may burst, causing internal bleeding and—in some cases—death.
First-Trimester Aspiration Abortion—Up to Twelve or Thirteen Weeks of Pregnancy
This surgical abortion is performed throughout the first trimester (though some abortion providers may use this technique up to 16 weeks of pregnancy). Depending upon the provider and the cost, varying methods of pain control are offered, ranging from local anesthetic to full general anesthesia. In the first trimester, local anesthesia is most commonly used, while IV (intravenous) sedation is used far less frequently.
Before the abortion can take place, the woman’s cervix must be opened so the instruments may pass through. The clinician does this either by inserting dilators (metal or water-absorbing) into the cervix, or by using a drug administered orally or vaginally. The degree of dilation required depends upon the stage of the pregnancy.
Once the woman’s cervix is dilated, the abortion provider uses either a manual vacuum aspirator or an electric suction instrument to remove the contents of the uterus, including the embryo or fetus (human being in first or second stage of development), placenta and other tissue.
The abortion provider passes the instrument through the cervix and into the uterus. Once inside, the instrument will suction out the uterine contents. After the uterus has been emptied, the clinician will remove the suction instrument and inspect the woman’s cervix for bleeding.
To ensure the abortion is complete and nothing has been left behind, the abortion provider may choose to use sharp curettage (a loop-shaped knife) and make a final pass with the suction instrument to ensure nothing has been left behind.
After the procedure the woman may be ushered into a recovery room. The amount of time spent in recovery varies. If complications from the procedure have occurred, the woman may notice immediately or up to about two weeks after.
Dilation and Evacuation (D&E)—About Thirteen Weeks and Onward
This surgical abortion is done during the second trimester of pregnancy. In this procedure, the cervix must be opened wider than a first trimester abortion. Dilating the cervix is done one or two days in advance of the abortion.
On the day of the abortion procedure, the dilators are removed. If the pregnancy is early enough in the second trimester, using suction to remove the pregnancy may be enough. This is sometimes called a suction D&E, and is similar to a first-trimester aspiration abortion.
As the pregnancy progresses to a further state of development, it becomes necessary to use forceps. The abortion provider will insert the forceps into the uterus and begin to extract the contents. The clinician keeps track of what has been removed so nothing is left inside that could cause infection.
Finally, a curette and/or suction instrument is used to remove any remaining tissue or blood clots to ensure the uterus is empty. After the procedure, the woman will most likely be taken to a recovery room. The length of time spent in recovery varies.
Second-Trimester Medication Abortion
The cervix may be softened either with the use of seaweed sticks called laminaria or medications at the start of the procedure. Once the cervix is prepared, various combinations of medications are administered, typically a mixture of mifepristone (taken orally) and misoprostol (either oral or vaginal). Mifepristone causes the amniotic sac (containing the pregnancy-related tissue) to detach from the uterus, while misoprostol induces labor to deliver the pregnancy, placenta and other pregnancy-related tissue.
Our center offers consultations and accurate information about all pregnancy options; however, we do not offer or refer for abortion services. The information on this website is intended for general education purposes only and should not be relied upon as a substitute for professional counseling and/or medical advice.
“Mifeprex: Prescribing Information,” Danco Laboratories, last modified April 22, 2009, http://www.earlyoptionpill.com/userfiles/file/Mifeprex%20Labeling%204-22-09_Final_doc.pdf
Maureen Paul et al., Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care (United Kingdom: Blackwell Publishing Ltd, 2009), 135-156.
 Ibid., 157-177.