Abortion

Choices: Medical Abortion

Medical abortion, the use of medicines to end an early pregnancy, is up to 98% effective within the first 9 weeks of pregnancy.⁹ As a pregnancy progresses into the late first trimester, medicines are less likely to fully induce an abortion. When this happens, a follow-up surgical abortion becomes necessary to make sure that the uterus is completely clear of tissue.

• A typical treatment schedule for a medical abortion includes a first medical visit and medicine, followed a few days later by a second medical check and medicine (another common schedule allows the second medicine to be taken at home¹⁰). Moderate to heavy vaginal bleeding lasts about 14 days. About 2 weeks after the second medical visit, a follow-up examination is necessary to see if you are recovering well and to make sure the procedure worked.
• Medical care before and after a medical abortion includes physical examinations and lab tests, education about what to expect, self-care instructions, information on when to call your health professional, and birth control planning.

Medicines currently available in Canada for inducing abortion are:

• Misoprostol. This hormone softens and opens (dilates) the cervix and triggers uterine contractions. Misoprostol used alone may end a pregnancy but is much more effective when used with other medicines, such as methotrexate, in first-trimester abortions.¹¹
• Methotrexate and misoprostol. Methotrexate interferes with the placenta's growth; it is not as effective as mifepristone and takes longer to abort a pregnancy.⁹ Misoprostol is then used to start contractions to clear the uterus of all tissue. This is effective 95% to 99% of the time when completed before 7 weeks of pregnancy.⁹

See the section What to Think About for a comparison of medical abortion and surgical abortion.

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Author:	Healthwise Medical Writer	Last Updated: March 5, 2008
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine Lori A. Boardman, MD, ScM - Obstetrics and Gynecology Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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