Costs and Options for Medical Abortion After RU486 Use - Obstetrics and Gynecology

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After taking RU486 and misoprostol, if the embryo is still present, what are the surgical costs?


Hello, doctor.
Last week, my girlfriend was diagnosed with a five-week pregnancy at the obstetrics and gynecology clinic.
Due to financial reasons, we decided not to proceed with the pregnancy.
Following the doctor's advice at the clinic, she took RU486 for a medical abortion and also placed three doses of Misoprostol sublingually at home.
Afterward, she experienced heavy bleeding and severe pain.
We were aware that these symptoms could occur, so she endured it.
However, a week later, during a follow-up visit, the embryo was still present.
The doctor prescribed nine more doses of Misoprostol, but after taking six, there was no bleeding at all.

I would like to ask, in the worst-case scenario, if the doctor recommends a surgical procedure, it seems the clinic does not have the facilities for surgery and we would need to go to a larger hospital.
Would this cost be out-of-pocket? If it is billed separately, could you please provide an estimate of the costs involved, considering the presence of national health insurance and medical insurance?

Niming, 20~29 year old female. Ask Date: 2017/02/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology


Last week, my girlfriend was diagnosed with a five-week pregnancy at the obstetrics and gynecology clinic.
Due to financial reasons, we decided not to proceed with the pregnancy.
Following the doctor's recommendation at the clinic, she took RU486 for a medical abortion and then took three doses of Misoprostol sublingually at home.
After that, she experienced heavy bleeding and severe pain.
We were aware that these symptoms could occur, so she endured it.
However, a week later, during a follow-up visit, the embryo was still present.
The doctor prescribed nine more Misoprostol tablets, but after taking six, there was no bleeding at all.

I would like to ask, in the worst-case scenario, if the doctor recommends a surgical procedure, it seems that the clinic does not have the facilities for surgery, and we would need to go to a larger hospital.
Would the costs for this be out-of-pocket? If so, could you provide an estimate of the expenses considering the availability of National Health Insurance and medical insurance?
Answer: I am not aware of the cost situation.

Reply Date: 2017/02/23

More Info


When considering the costs and options for medical abortion after the use of RU486 (mifepristone), it is essential to understand both the medical and financial implications involved. RU486 is typically used in combination with another medication, misoprostol, to terminate an early pregnancy, usually within the first 10 weeks. However, as your girlfriend has experienced, there are instances where the medical abortion may not be successful, necessitating further medical intervention.

In your case, after taking RU486 and experiencing significant bleeding and pain, it appears that the embryo has not been expelled, which can happen in a percentage of cases. If the medical abortion fails, surgical intervention may be required to complete the abortion process. This is often done through a procedure known as suction curettage or dilation and curettage (D&C), which is performed in a hospital setting.

Regarding the costs associated with surgical abortion, it can vary significantly based on several factors, including the healthcare facility, geographic location, and whether or not you have health insurance. In many cases, if the procedure is deemed medically necessary, health insurance plans may cover a portion of the costs. However, it is crucial to check with your specific insurance provider to understand what is covered under your plan.

If your girlfriend is referred to a larger hospital for the surgical procedure, you may incur additional costs, especially if the facility does not accept your insurance or if there are out-of-pocket expenses. Generally, the cost of a surgical abortion can range from a few hundred to several thousand dollars, depending on the complexity of the case and the facility's pricing structure. In some instances, if you have health insurance, the out-of-pocket expense could be significantly reduced.

It is also important to consider that some clinics and hospitals may offer financial assistance or sliding scale fees based on income, which could help alleviate some of the financial burden. It would be beneficial to discuss these options with the healthcare provider or the billing department at the hospital.

In terms of managing the side effects of RU486 and the subsequent procedures, it is advisable to maintain open communication with the healthcare provider. They can offer guidance on pain management, potential side effects, and what to expect during recovery. It is also essential to follow up with the healthcare provider after the procedure to ensure that the abortion was successful and to monitor for any complications.

In summary, if surgical intervention is necessary after the use of RU486, it is crucial to discuss the financial implications with the healthcare provider and your insurance company. Understanding the costs involved and exploring available financial assistance options can help you make informed decisions during this challenging time. Always prioritize your girlfriend's health and well-being, and ensure that she receives the appropriate care and support throughout the process.

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