Medical Abortion Clinics Perform Abortions From 3 to 24 weeks

The medical abortion procedure using RU 486 (Mifeprex, Mifepristone) is widely accepted as the most common method for terminating pregnancy up to 7 weeks gestation. Numerous studies have shown that the abortion pill procedure can be performed on an outpatient basis up to 14 weeks. Medical abortions are now performed in a physician’s office or abortion clinic up to 24 weeks gestation and beyond if the pregnancy poses a threat to the mother’s life or if there is a genetic defect or severe fetal abnormality that is not compatible with life.

The combination of RU 486 and Cytotec (Misoprostol) has a 94 to 98 percent success rate for terminating pregnancy up to 9 weeks gestation. RU486 blocks the progesterone receptors in the uterus which are required to maintain the pregnancy. Absence of the progesterone receptors result in miscarriage. Cytotec is a prostaglandin which causes uterine contractions, increases intrauterine pressure and softens the cervix (opens the lower portion of the uterus) which leads to expulsion of the pregnancy tissue.

For patients up to 12 weeks pregnant, completion of the procedure normally takes 4 to 6 hours; although in some cases it may take as much as 3 or 4 days. Two or three doses of medication may be required before all of the pregnancy tissue passes. Therefore, patients must remain tolerant, determined, and maintain their composure throughout the abortion pill process.

The advantages of the medical abortion procedure include, but are not limited to the following: 1) Surgery is avoided in over 92 to 98 percent of the time and patients who are 6 weeks or less have a success rate of nearly 100 percent; 2) The patient maintains her privacy; 3) She maintains control of when and where her abortion is performed; and 4) The patient is able to choose who she wants to be with her when she goes through the abortion process.

There are very few complications and side effects associated with the medical abortion procedure. Some of the side effects include, but are not limited to the following: 1) fever and chills; 2) nausea and vomiting; 3) abdominal pain and uterine cramping; 4) diarrhea; and 5) heavy bleeding. Over 50 percent of patients do not require the use of pain medication. Over 90 percent of patients do not require narcotics for pain relief. A predictor of whether a patient may need narcotics to help reduce pain can be determined by the degree of menstrual cramping they normally have with their period. The greater the discomfort associated with a patient’s menses, the higher the chance she will require stronger medication.

Although rare, the complications that may occur with the use of the abortion pill procedure include the following: 1) Heavy bleeding which is measured as bleeding more than 2 pads an hour for 2 hours consecutively. This may require emergency surgery. There is a 2 to 3 out of a thousand chance that a blood transfusion may be required; 2) Retained products of conception which may be resolved by an additional dose of Misoprostol tablets. Alternatively, surgical suction aspiration may be performed; 3) Uterine infection which may be caused by retained pregnancy tissue and blood which normally responds to antibiotics and a surgical aspiration procedure; and 4) Sepsis may occur but only in extremely rare cases. Sepsis is caused by bacteria entering the blood stream and may cause maternal death. This rare bacteria (clostridia sordellii) has not only been associated with maternal death in women who have had medical abortion procedures, but even in women who have normal spontaneous deliveries at full term, spontaneous miscarriage and routine surgical abortion procedures. There is no direct evidence that the abortion pill causes sepsis.

In conclusion, women who are 14 weeks or less may have the abortion pill procedure performed on an outpatient basis. For women further than 14 weeks gestation, it is safer for the patient to undergo the abortion procedure in the physician’s office where complications such as heavy bleeding may be addressed immediately. Terminating pregnancy with the medical abortion process is highly safe, effective and efficient. Patients who do not wish to undergo the medical abortion process at home may choose an abortion facility that offers the Same Day Abortion Procedure. The Same Day process is performed in a medical facility or physician’s office and the patient remains there until the procedure is complete. A sonogram is performed to assure that the fetal tissue has passed. Patients greater than 14 weeks remain in the office until the abortion process is complete. This process may take up to 24 hours.