Safe Methods of Abor tion 245
Before using medicines for abortion
• Know the name and correct dose of medicine or medicines you
are using. Never use a medicine you are unsure of. If it is safe,
try to discuss using medicines for abortion with a health worker
you trust before using these medicines.
• Using medicines for abortion is most effective before 9 weeks
(63 days) of pregnancy. Start counting after the first day of
your last monthly bleeding. You can use medical abortion until
12 weeks of pregnancy, but the pills will be slightly less effective
and you may have more side effects, such as heavier bleeding,
painful cramping, or nausea.
➤ For complete
instructions on how
to take medicines
for abortion, see
IMPORTANT Make sure you are no more than one hour from a clinic where you can
get care for a miscarriage if you have heavy bleeding, especially if you are more than
9 weeks pregnant. Bleeding and cramping from a medical abortion are very similar to a
miscarriage and it is difficult for a doctor to know the difference.
Medicines used for abortion
Mifepristone is available in some countries where abortion is
legal. But in many countries it is not available. It is given in pill form,
Misoprostol is used for stomach ulcers, and is widely available in
many countries. It is often used alone to cause abortion, although
it is more effective when used with mifepristone (see page 508).
When misoprostol is used by itself, it is less effective and there are
more side effects, especially if used after 9 weeks.
➤ If you have no
access to safe abortion,
contact Women on Web,
They may be able to
What happens when you take the pills
Mifepristone and misoprostol together: usually cause the pregnancy to be pushed out in
4 to 6 hours. Painful (sometimes very painful) cramping and heavy bleeding with clots start
as soon as 30 minutes after taking the mifepristone. Bleeding is heavy in the first 4 to 6
hours after taking misoprostol. Bleeding lasts about 2 weeks but gets lighter after 1 week.
Misoprostol alone: usually causes the pregnancy to be expelled in about 4 to 12 hours.
The signs of pregnancy (see page 67), usually disappear after
48 hours. If you continue to feel pregnant, go to a clinic or hospital
to be checked. There is a small risk of birth defects if you go on to
have the baby.
Danger signs after medical abortion
• Heavy vaginal bleeding – soaking more than 2 large pads in 1 hour
for 2 hours in a row. Get to a clinic or hospital right away.
• Fever that begins a day after the last misoprostol dose and lasts
several days may be a sign of infection (although this is rare with
abortion using medicines). See a trained health provider.
➤ Also see
Abortion’, page 251.
Where Women Have No Doctor 2012