Medical Abortion

Medical abortion, also known as non-surgical abortion, is a way to terminate an early pregnancy. Medical abortion is provided by trained health care providers in the office or, for those who are eligible, via telehealth.

A medical abortion can be performed up to 10 weeks gestation (calculated from the first day of your last menstrual period).

In clinical practice, medical abortion is about 95 percent to 98 percent effective, meaning a patient will completely pass the pregnancy without the use of surgery the vast majority of the time.

Medications

The medications prescribed for medical abortion at the UCLA Medical Center are mifepristone (AKA Mifeprex or RU-486) and misoprostol (AKA Cytotec), as based on the best current medical evidence.

The first medication, mifepristone, also known as "Mifeprex" or "RU-486," blocks the action of the natural hormone progesterone on the uterus. This causes the lining of the uterus to shed, as it does during a period, and stops the growth of the pregnancy.

The second medication, misoprostol, also known as "Cytotec," causes the uterus to contract and initiates bleeding and cramping.

Telehealth Eligibility

For those who have regular periods that they keep track of using an app and/or calendar, know exactly when the first day of their last period was, and are located in California, medication abortion via telehealth may be an option. Once approved for the medication, they can be picked up at the office or mailed to your home.

How It Works

Medication abortion typically involves two to three appointments. The treatment includes giving the medication and then confirming that the pregnancy has been terminated. Sometimes more visits are necessary.

Step 1:  An initial visit with a medical provider, either in person or via telehealth
You will receive counseling and discuss your medical history. The provider will ask you detailed questions to make sure that you are a good candidate for the medication. An ultrasound may be done if recommended by the provider.

Step 2: Take the first medication, either at the office at your initial visit or at home after your telehealth appointment. Mifepristone blocks the action of the natural hormone progesterone on the uterus. This causes the lining of the uterus to shed, as it does during a period, and stops the growth of the pregnancy.           

Step 3: Take the misoprostol at home 6-72 hours after taking the mifepristone.
Misoprostol causes the uterus to contract and initiates bleeding and cramping.
These pills can be placed into the vagina, or placed in your mouth between your gums and cheek and allowed to dissolve.
You will receive detailed instructions on how and when to take the misoprostol

Step 4: Attend a follow-up appointment one week later to confirm the abortion is complete.
This is typically done via video visit, where you will discuss your bleeding with the provider. If you or the provider have any concerns about whether the abortion is complete, you will be scheduled for an in-person appointment.
If the abortion is not complete, additional medication or a surgical procedure may be recommended.

Step 5: Approximately four weeks after doing the medication abortion, take a urine pregnancy test at home.

Medical Abortion vs. Emergency Contraception

Medical abortion is NOT the same as emergency contraception, also referred to as the morning-after pill or Plan B. Emergency contraception prevents a pregnancy from forming and is taken within three days after having unprotected sex. Therefore, once pregnancy has occurred, the morning after pill is no longer effective. Medical abortion, on the other hand, is used to terminate an unwanted pregnancy.

Safety and Side Effects

Mifepristone has been studied for decades. Millions of patients in more than 20 countries, including the United States, have used mifepristone and misoprostol or similar medications to have an abortion. All studies have shown the method to be safe and effective; there have been no reports of any long-term risks. Heavy bleeding requiring blood transfusion is extremely rare, occurring in less than 0.5 percent of study patients. Short-term side effects of a medical abortion include:

• Strong cramps
• Bleeding
• Nausea
• Vomiting
• Fever and chills

There is no evidence of long-term risks with mifepristone when used for medical abortion and no long-term effects have been associated with misoprostol. There are no indications that any of the early abortion methods affect a future fertility (ability to get pregnant).

Little is known about the effect of mifepristone on a developing embryo. Misoprostol has been associated with birth defects when given in early pregnancy. Therefore, a woman should have a surgical abortion if a medical abortion fails.