What Is Medical Abortion
Medical abortion is a procedure that uses medications to terminate a pregnancy from between 1 weeks to 28 weeks from the first day of your last period. Medical abortions have been safely provided to women in the South Africa, Botswana, Zimbabwe, Namibia and Lesotho for the last two decades and have recently been made available in SA. Medical abortion is not considered a safer option than surgical abortion as both options are considered to be extremely low risk, but it provides women with an additional choice.
The medical abortion process occurs in at least three stages over a 28 weeks period. During the initial visit to the clinic, the pregnancy must be confirmed with an ultrasound scan and the first medication is taken which halts the growth of the pregnancy and causes it to detach from the uterine wall. The second stage occurs in your home, 24 to 48 hours later, where you take a second medication which will cause your uterus to contract and encourage the pregnancy tissue to pass over the following 12 to 24 hours. This stage can be painful and the bleeding will be heavy but can usually be made tolerable with pain relief medications. You should plan to be in a quiet, private place, with easy access to a bathroom, for at least 6 hours, and possibly as long as 24 hours.
The third stage requires a tele-consult with clinic nursing staff after 21 days where we will confirm that the medical abortion has been completed successfully.
What should I expect during the abortion process at home?
You will need to allow at least 6 hours where you can rest comfortably in a quiet location with easy access to a bathroom. You must have the support of a responsible adult who you can call upon to assist you if required and you must be within 1 hour of a public hospital.
Misoprostol causes cramping pain and bleeding, usually within one to six hours of using the tablets. Pain can range from mild, period-like pain to severe, disabling pain. For most women the pain can usually be made tolerable with pain relievers such as paracetamol and ibuprofen.
It is important to commence taking pain relief tablets shortly before taking the Misoprostol and at regular intervals for it to have the best effect. A heat pack, or abdominal or back massage, can also help to ease the pain.
The Misoprostol causes your uterus to contract and this will encourage the pregnancy tissue to be expelled. This stage will cause cramping and heavy bleeding typically lasting around 6 hours, but sometimes up to 24 hours.
Intermittent bleeding may continue for up to 3 to 4 weeks and a follow-up tele-consult with the clinic is essential to verify that the medical abortion is complete. We will provide you with a special low-sensitivity urine pregnancy test that you must keep until we call you 3 weeks after your initial appointment. If this test is negative then there is nothing more to do. If the test is positive, or if you are still experiencing heavy bleeding, then you must return to the clinic for an ultrasound scan and possibly a surgical procedure. There is approximately a 1 in 20 chance that a procedure will be required and there is no additional cost for this service.