Medical non-surgical Abortions

Mifepristone/Misoprostol Abortion
Since 2000 we have offered mifepristone (Mifeprex, formerly known as RU486 in Europe) medical abortions.  Mifepristone is an anti-progesterone drug. The placenta requires progesterone to remain attached to the uterus. When this drug is given, it blocks the progesterone temporarily, and the placenta detaches from the uterine lining. Without the attached placenta the fetus does not get food and oxygen, and thus, the fetus dies. The body realizes this, and with the help of the misoprostol 12-36 hours later, the body expels the dead fetus in a miscarry  (~98% success). A follow-up on Day 7-21 is required. We allow 18yo and older the option of a medical abortion.

Methotrexate/Misoprostol Abortion
From 1995 to 2003 we offered a methotrexate/misoprostol medical abortion. Methotrexate is an anti-cancer drug injected into the buttocks on Day 1 and then on Day 7 you would insert misoprostol tablets vaginally.  We no longer offer the methotrexate/misoprostol abortion because the newer mifepristone/misoprostol abortions are quicker, simpler, and more effective. Methotrexate stops ectopic (tubal) pregnancies and is used in hospitals for that purpose. Methotrexate is normally used for rheumatoid arthritis and cancer.

Frequently Asked Questions About Medical Abortions.

Abortion Pill (Mifepristone/Misoprostol), FDA plan	Abortion Pill (Mifepristone/Misoprostol), Alternative plan (what we offer)	Regular 'Surgical' Abortion (Vacuum Aspiration)
1. How Far Along In The Pregnancy Can I Be? Up to 7 weeks LMP (49 days from last menstrual period)  for best success (95-98%).	Up to nine weeks LMP (63 days from last menstrual period) is the upper limit.	Five weeks on up. Surgical abortion has a higher than 99% success rate. A surgical at less than 6 weeks may increase the chance of retainage (some tissue left) and you would have to come back for a re-suction.
2. How Long Does It Take? -3 visits to the clinic.  -Swallow mifepristone. -Insert misoprostol on Day 3 AT CLINIC by nurse.  -It usually takes several hours after the misoprostol for the miscarry to occur.  -Follow-up visit on Day 4-14 at clinic.	-Two visits. -Swallow mifepristone at clinic. -Insert misoprostol vaginally 12 to 36 hours later. -It usually takes several hours after the misoprostol for the miscarry to occur.  -Follow-up visit on Day 7-21 at clinic for a re-sonogram.	-One visit to the clinic. -The surgical abortion takes 15 minutes. -Follow-up visit at the clinic or your own doctor's office in 2½ - 3 weeks.
3. How Painful Is It? From mild to very strong cramping off and on throughout the miscarry usually lasting 7-10 hours. Pain medicine prescribed to you helps.	Same as FDA mifepristone plan.	From mild to very strong cramping for 5 minutes if awake. If asleep during abortion, then mild cramping to no memory of it at all. We charge nothing to give Twilight sleep.
4. How Much Will I Bleed? Heavy bleeding and passing clots is common during the miscarriage. Afterwards, lighter bleeding is common from 9-14 days or longer. One percent heavy bleeding will require care.	Same as FDA mifepristone plan.	Usually light bleeding from 1-7 days, but may continue off and on up to 2 weeks. Note: no cutting is involved. A cannula goes through the cervical opening and removes the pregnancy tissue.
5. How Much Does It Cost? $720, the cost of the surgical abortion plus the expense of 3 mifepristone pills.	$420.	$420 if less than 10 weeks. Up to $600 at 15 weeks.
6. Can The Abortion Fail? Success rate varies with the length of pregnancy and protocol used. When it fails, a surgical abortion is necessary. Usually only a 1.5% failure rate.	Same as FDA mifepristone plan. We will re-suction and remove any tissue retainage if necessary at no charge.	Over 99% successful. Less than 1% re-suction rate needed.
7. Is It Safe, And Can I Still Have Children Afterwards? -Both medications have been formally studied and used safely. Possible complications are rare. -Child-bearing ability is not affected.	Same as FDA mifepristone plan.	-Surgical abortion has been formally studied for over 25 years. For abortions less than 14 weeks, the complication rate is less than 1%, and is at least 10 times safer than childbirth. -Childbearing ability is not affected, barring rare complications, 1 in 10,000.
8. What Are The Advantages? -It may seem more natural, like a miscarriage.  -No shots, anesthesia, instruments, or vacuum aspiration machine, unless it fails.  -Being home instead of a clinic may seem more comforting and private. -Any support person can be there during the miscarriage.  -A physician is available before the medical abortion for emotional support or answering questions.	-Usually only 2 visits, Day 1 and second visit choosen from Day 7 thru 21. - No Support Person necessary so may be more private.	-It's quick, over in 10 minutes. -It's highly successful. -There's less bleeding than with medical abortion. -There's less time spent cramping than with the medical abortion. -Medical staff is present. -A counselor or physician is usually available before surgery for emotional support or answering questions. -It can be done farther along in the pregnancy than with medical abortion. -It's more predictable.
9. What Are The Disadvantages? -It takes 4 to 14 days to complete. -It is not predictable like surgical abortion.  -Bleeding can be very heavy the first two days then tapers off, but can bleed up until first period. Bleeding lasts longer than with surgical abortion. -If hemorrhage occurs, patient must come into clinic for immediate surgical suction evacuation. Might need to travel to a hospital for blood transfusion. -Cramping can be severe and usually lasts longer than with surgical abortion. -Three visits to clinic are necessary. The doctor or nurse will insert the vaginal misoprostol on Day 3 at clinic.  -Less successful than than surgical abortion, but more successful than methotrexate by 1-2%. -It cannot end a tubal pregnancy, but methotrexate could have.	-Same as FDA mifepristone plan EXCEPT only 2 visits.   Same heavy bleeding is to be expected.	-A doctor must insert instruments inside the uterus.  -Anesthetics and drugs to manage pain during the procedure may cause side effects (dry mouth, medicated/drunk feeling).  -There are possible complications, although in less than 1% of cases which is still better than for medical abortions. -The woman has less control over the abortion process and who is with her.  -The vacuum aspirator may seem noisy. -It can't be done as early in the pregnancy as with the medical abortion. -It cannot end a tubal pregnancy.

medical.htm, Oct2006, (c) Central Family Medicine dba Aid For Women, 2000-2006.