Medication Abortion: Common Concerns and Experiences

Regarding the issue of medication-induced abortion?

Hello Doctor, I discovered that my period was over a week late at the beginning of December and confirmed my pregnancy through a gynecological examination.
Due to practical reasons, I had to undergo a medical abortion.
Since I was only about four weeks along, I chose the medication abortion method.
On the morning of December 21, I took one RU486 pill in the clinic, and on December 23, I took three oral pills at home.
The abdominal pain was not severe, and I started bleeding about an hour later, but the amount of bleeding was not significant.
On the morning of December 24, I returned for a follow-up ultrasound, which showed that the embryo had moved down but had not been expelled successfully.
Therefore, the doctor immediately arranged for vaginal medication, warning that it would be more painful.
I took one painkiller at that time and went home in the afternoon.
The doctor mentioned that the medication would take effect quickly, and I could expect to expel the gauze from the vagina around 3-4 PM.
However, I did not feel any discomfort or pain, and after removing the gauze, there was no heavy bleeding.
Could it be that these medications did not work for me? Thank you!

Niming, 20~29 year old female. Ask Date: 2016/12/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, I'm sorry that I cannot provide a diagnosis based on what you've described.
It is recommended to check if the medication is effective and to return to your original obstetrician-gynecologist for further evaluation.
Wishing you good health.

Reply Date: 2016/12/24

More Info

Medication abortion, also known as medical abortion, is a safe and effective method for terminating an early pregnancy, typically within the first 10 weeks. It involves the use of two medications: mifepristone (commonly known as RU-486) and misoprostol. Understanding the process and potential experiences can help alleviate concerns and clarify what to expect.

In your case, you took mifepristone in the clinic and then misoprostol at home. Mifepristone works by blocking the hormone progesterone, which is necessary for the pregnancy to continue. After taking mifepristone, you typically wait 24 to 48 hours before taking misoprostol, which causes the uterus to contract and expel the pregnancy.
It’s important to note that the effectiveness of medication abortion can vary. In most cases, the process leads to a complete abortion, but there are instances where the body does not expel the pregnancy entirely, which may require further medical intervention. This seems to be the case for you, as indicated by the ultrasound showing that the embryo had moved down but had not been expelled.

Regarding your experience, it’s not uncommon for some women to have minimal pain and bleeding during the process. The absence of severe pain or heavy bleeding does not necessarily mean that the medications were ineffective. Some women experience varying degrees of symptoms, and the amount of bleeding can differ significantly from person to person.
After taking the misoprostol, many women report cramping and bleeding, but this can range from mild to severe. The fact that you did not experience significant discomfort or heavy bleeding could be due to several factors, including the timing of the medications, your body’s response, or the specific circumstances of your pregnancy.

If the ultrasound indicated that the pregnancy had not been fully expelled, it is crucial to follow up with your healthcare provider. They may recommend additional treatment options, which could include further doses of misoprostol or a surgical procedure to ensure that the uterus is clear of any remaining tissue.
It is also essential to monitor for any signs of complications, such as heavy bleeding (soaking through two or more pads in an hour for two consecutive hours), severe pain, fever, or foul-smelling discharge. If you experience any of these symptoms, you should seek medical attention immediately.

In summary, while your experience may differ from what is typically expected, it does not necessarily indicate that the medications were ineffective. The best course of action is to maintain open communication with your healthcare provider, follow their recommendations for follow-up care, and address any concerns you may have regarding the process. Remember, every individual’s experience with medication abortion can vary, and your healthcare provider is there to support you through this process.

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Hello, it generally does not have an impact. Wishing you good health.