RU-486 (Mifepristone (Mifeprex) and Misoprostol)

Mifepristone is given orally during your first office visit. Mifepristone blocks progesterone from the uterine lining, causing the fetus to die. This alone may cause contractions to expel the fetus.
Misoprostol tablets are given orally or inserted vaginally during the second office visit which occurs 36 to 48 hours later.

You will return home where the misoprostol will start contractions and expel the fetus. This may occur within a few hours or in some cases up to two weeks after taking the misoprostol.

A physical exam is given two weeks later to ensure the abortion was complete and that there are no immediate complications.

Risks and Side Effects:

The procedure is unsuccessful approximately 8-10% of the time, thus requiring an additional surgical abortion procedure to complete the termination.

• Cramping
• Nausea
• Vomiting
• Diarrhea
• Heavy bleeding
• Infection

Not advised for women who have anemia, bleeding disorders, liver or kidney disease, seizure disorder, acute inflammatory bowel disease, or use an intrauterine device (IUD).

Fetal Development: Week 5-9

• Development of brain and spinal cord
• Heart begins to beat
• Hands and feet are forming
• Every essential organ has begun to form
• Bones begin to form, muscles can contract

Medical citation: http://www.americanpregnancy.org/unplannedpregnancy/medicalabortions.html


Fetal Development citation: http://www.mayoclinic.com/health/prenatal-care/PR00112

Suction Aspiration or Vacuum Aspiration

Patient will lie on her back with feet in stirrups and a speculum is inserted to open the vagina. A local anesthetic is administered to her cervix. Then, a tenaculum [a slender sharp pointed hook attached to a handle, and used mainly in surgery for seizing and holding parts]¹ is used to hold the cervix in place for the cervix to be dilated by cone shaped rods. When the cervix is wide enough, a cannula, which is a long plastic tube connected to a suction device, is inserted into the uterus to suction out the fetus and placenta.

The procedure usually lasts 10-15 minutes, but recovery may require staying at the clinic for a few hours.

You will return home where the misoprostol will start contractions and expel the fetus. This may occur within a few hours or in some cases up to two weeks after taking the misoprostol.

A physical exam is given two weeks later to ensure the abortion was complete and that there are no immediate complications.

Risks and Side Effects:

• Cramping
• Nausea
• Sweating
• Feeling faint

Less frequent side effects include:

• Possible heavy or prolong bleeding
• Blood clots
• Damage to the cervix
• Perforation of the uterus

Fetal Development: Week 9 – 13

• Genitals have formed
• Baby can make a fist
• Buds for baby teeth appear

Medical citation: http://americanpregnancy.org/unplannedpregnancy/surgicalabortions.html


Fetal Development citation: http://mayoclinic.com/health/fetal-development/PR00113

D&C: Dilation & Curettage (Within 12 – 15 Weeks)

Dilation and curettage is similar to suction aspiration, except that it uses a curette, a long, looped shaped knife that scrapes the lining, placenta and fetus away from the uterus. A cannula may be inserted for a final suctioning.

This procedure usually lasts 10 minutes with a possible stay of 5 hours.

D&E: Dilation & Evacuation (Within 15 – 21 Weeks)

In most cases, 24 hours prior to the actual procedure, the abortion provider will insert laminaria or a synthetic dilator inside the patient’s cervix. Cone-shaped rods of increasing size are used to continue the dilation process. The cannula is inserted to begin removing tissue away from the lining. Then using a curette, the lining is scraped to remove any residuals. If needed, forceps may be used to remove larger parts.

The procedure normally takes about 30 minutes and is usually performed in a hospital setting because of the greater risk for complications.

Risks and Side Effects

Nausea, bleeding and cramping may occur for two weeks following the procedure
Infection due to retained products of conception or infection caused by a STI or bacteria being introduced to the uterus can cause fever, pain, abdominal tenderness and possibly scar.

Although rare, the following are additional risks related to dilation and evacuation:

• Damage to uterine lining or cervix
• Perforation of the uterus
• Infection
• Blood clots

Fetal Development: Week 14 – 16

• Fingerprints have developed
• Baby begins sucking
• Patient can feel baby start to move (fluttering)

Fetal Development: Week 17 – 20

• Nails growing on fingers and toes
• Eyebrows and eyelashes grow in
• Patient feels baby’s movements more strongly

Medical citation: http://americanpregnancy.org/unplannedpregnancy/surgicalabortions.html


Fetal Development citation: http://mayoclinic.com/health/fetal-development/PR00114

Post-Abortion Syndrome (PAS) Definition: The stress reaction experienced after having an abortion. PAS is a sub-category of Post-Traumatic Stress Disorder.

PAS Symptoms (including percentage of women who experience them after having an abortion):

• Guilt
• Anger
• Remorse
• Depression
• Suicidal Thoughts
• Suicide Attempts
• Flashbacks to Abortion

Factors that will determine how severely a patient experiences PAS symptoms include:

• A crisis situation surrounding your pregnancy
• Urgency you feel when making the decision to have an abortion
• Absence of a support system
• Obligation to keep your pregnancy a secret
• Denial about recognizing and resolving your losses

Quiz: Rate Your Risk for Experiencing Post-Abortion Syndrome

• Are you single?
• Are you 18 or younger?
• Are you in your second or third trimester?
• Is having an abortion a difficult decision for you?
• Are you worried that your family/friends might find out that you are pregnant?
• Do you feel pressured by someone to have an abortion?
• Do you feel pressured by your circumstances to have an abortion?
• Do you feel rushed to have an abortion?
• Do you have any emotional or psychiatric problems?
• Have you had prior emotional or psychiatric problems?
• Do you have any unresolved trauma or grief?
• Have you been sexually assaulted or abused?
• Do you lack support from family or friends?
• Do you believe abortion is wrong?

If you answered “Yes” to two or more of the above questions, you are at HIGH RISK for experiencing PAS.

All information cited here was obtained from The Elliot Institute P.O. Box 7348 Springfield, IL 62791