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"All of my previous notions of an abortion procedure were dissipated. The women who worked with me soothed any anxiety I had, which empowered my decision even more."
—Aradia Client

Medical abortion (Abortion Pill)

We are in the process of changing our medication abortion protocols and procedures. Until this process is complete, we are unable to offer medication abortions at our clinic at this time. We continue to offer early surgical abortions up to 14 weeks. Please call us if you have any questions about this.

Mifepristone (RU-486 or Mifeprex), the drug used in a medical abortion, became available for use in the United States in 2000, after a protracted political struggle and after being widely used in Europe since the 1980's. Medical (non-surgical) abortions with Mifepristone have been safely used by more than 600,000 women in Europe and Asia. In 1988, France became the first country to approve the use of Mifepristone for early abortions. Aradia Women's Health Center has been using Mifepristone since September 2000.

In The Clinic
Steps To Take At Home
Follow Up
Emergency Contact Information
Making an Appointment
Please read our disclaimer

In The Clinic

Aradia Women's Health Center is here to help you choose an abortion method that is right for you. Your health care advocate, a woman who counsels and accompanies you throughout your visit, will discuss your decision to have an abortion and the method best suited to your needs. If you are interested in having a medical abortion, your advocate will discuss your health history with you to be sure the medical abortion is a safe option for you.

If you decide to have a medical abortion, a vaginal ultrasound will be done to be sure your pregnancy is between five and nine weeks, the time frame that is safe for you to have a medical abortion. The advocate will discuss the procedure with you in detail, so that you are comfortable following the at-home directions once you leave the clinic.

Following the discussion of the procedure, you will sign a consent form. Your advocate will also discuss with you the particular dosing regimen that Aradia uses. There are two different regimens that clinics can use for medical abortions. Both options are extremely safe, and research has shown that the regimen we use is more effective and has fewer side effects.

Once all the counseling is complete, your advocate will take your blood pressure, pulse and temperature. She will then do a finger stick to check your iron levels and the (+) or (-) of your blood type called your Rh factor.

Your advocate will then bring you to a procedure room. Here, the doctor will perform a pelvic exam to be sure your uterus feels consistent with your ultrasound. After this exam, the doctor will give you a tablet of Mifepristone to take orally in the clinic, which is the first step in the medical abortion procedure.

Mifepristone blocks the progesterone receptor, causing the pregnancy to detach from the lining of the uterus. It also helps the cervix to soften and the uterus to be more susceptible to the second medication. Mifepristone is effective only in early pregnancy. Bleeding is not uncommon after this first step.

While you are in the clinic, you will have the opportunity to discuss birth control options with your advocate, and you can begin birth control once the abortion is complete. Aradia also offers you the option of having a support person, friend or partner with you during this process.

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Steps To Take At Home

The second step of the medical abortion begins at home, 24-48 hours following the administration of Mifepristone at the clinic, when you will insert four tablets of a medication called Misoprostol into your vagina. Misoprostol is a prostaglandin that accelerates the passing of the pregnancy by stimulating uterine contractions and softening the cervix. On the day you choose to insert your Misoprostol, a staff woman will call you to answer any questions you may have and to offer further support.

To insert the Misoprostol:

  1. Wash your hands well with soapy water.
  2. Use your middle finger to push the four tablets high in the vagina near the cervix. Remain lying down for a half hour after the insertion, and then resume normal activity.

During the medical abortion process, and in order to prepare for the vaginal insertion of the Misoprostol, please eat only light non-greasy meals and drink plenty of fluids.

What to expect after inserting the Misoprostol

Cramping: Most women experience cramping one to five hours after inserting the Misoprostol. You should be prepared to have more bleeding and cramping than with your normal period. This cramping can be strong and painful for several hours but usually does not last for more than 24 hours. It is normal to have this intense cramping as the pregnancy tissue and large clots pass through the cervix. If you plan to use pain medication, you can take it when you insert the Misoprostol or wait until the cramping begins. You may take:

  1. Ibuprofen (Motrin©, Advil©): 800mg every six to eight hours
  2. Acetaminophen (Tylenol©): 1000mg every six to eight hours
  3. Vicodin: one to two pills every four to six hours

Other things to help relieve the cramping include: using a hot water bottle or heating pad on your abdomen and on your lower back, and lying on your back with your feet elevated.

Bleeding: Bleeding is a normal and expected part of a medical abortion. As the pregnancy is expelled from the body, you will experience bleeding. Women's bodies react differently, so it is difficult to predict the amount of bleeding you may have. Most women have heavy bleeding and intense cramping within one to five hours after insertion of the Misoprostol. Most women pass the pregnancy in 24 hours of inserting the Misoprostol, and will bleed between nine and 16 days; however, some women experience bleeding for up to 30 days. You may also see large blood clots and pregnancy tissue pass from the uterus. These are all expected during the medical abortion process.

Emotional Reactions/Fatigue: Because of sudden changes in body hormones after an abortion, and all your body is experiencing, you may feel tired or mildly depressed for several days. This is normal and also can be part of your emotional response after the abortion. It may help to talk with a close friend or you can schedule an appointment for post abortion counseling with us. One session is included in your fee. Please contact us if you experience ongoing problems or concerns.

Pregnancy Symptoms: Nausea is greatly decreased in two days; other symptoms, including breast tenderness, should be gone in one to two weeks.

What not to do:

  1. Due to the risk of infection of the uterus, and because it is extremely easy to become pregnant again following an abortion, do not have sexual intercourse until your abortion care is complete. Even after the care is over, it is easy to become pregnant before your next period, so plan to have a contraceptive method to use.
  2. Do not engage in strenuous exercise or heavy exertion for five days after Misoprostol insertion, as this may increase bleeding and cramping.
  3. Do not douche, swim, sit in a hot tub, or consume alcoholic beverages or recreational drugs.

What to do:

  1. Drink plenty of water.
  2. Use maxi pads and change them often to keep harmful bacteria from growing. If you want to use tampons, we recommend waiting until the bleeding begins to decrease.
  3. Rest often, especially the first 48 hours after inserting the Misoprostol.
  4. Monitor your temperature, bleeding and any other symptoms you may be experiencing. Your advocate will give you a symptom log at your appointment to keep track of your bleeding, cramping and other symptoms.
  5. Since bleeding can be very heavy, you may want to use protection for your bed, such as a plastic mattress cover or towels.
  6. Return to the clinic in one week for your follow-up appointment.
  7. Call the clinic if any unusual symptoms develop or if you have any questions.

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Follow Up

We require a follow-up visit around day 10 to determine if the abortion is complete. At that visit, we will perform a second ultrasound to ensure you are no longer pregnant. You will also have another pelvic exam to be sure your uterus is returning to its non-pregnant size and a blood is again drawn from your finger to test your iron levels again, as you will have experienced bleeding. The medical abortion is about 97 percent effective, but because every woman metabolizes medications differently we may still see a pregnancy at your follow-up visit. If so, we will discuss options with you, and you may repeat the second step of the procedure and return in another week. If at that time the abortion is not complete, we may recommend a surgical abortion to complete the procedure.

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Emergency Contact Information

Call Aradia Women's Health Center if you have:

  1. Excessive bleeding (soaking through more than two maxi pads each hour for two hours in a row and feeling lightheaded).
  2. Severe pain not helped by rest, medication and/or heat to the abdomen and lower back.
  3. Fever greater than 100.5 degrees.
  4. Excessive vomiting (continuous for two hours or more).

You can call us during our office hours at 206-323-9388. If you have a medical emergency when Aradia Women's Health Center is closed (after hours or weekends) call 206-726-2632.

Please leave your name and telephone number only with the answering service and an Aradia Health Care Advocate, who has 24 hour access to a physician, will return your call. If your call is not returned within 20 minutes, please call back and leave another message. We want to hear from you if you believe you are experiencing problems.

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