Planned Parenthood of Central North Carolina 1765 Dobbins Drive / Chapel Hill, NC 27514 Health Center Phone: (919) 942-7762 WHAT TO EXPECT WHEN HAVING A MEDICATION ABORTION If you are 9 weeks 0 days pregnant or less, you have the option of the medication abortion (abortion by pill). Before you receive the medications for the abortion, you will have a vaginal ultrasound (to date your pregnancy), an information session (that includes watching a video and a brief talk with one of our staff members), and lab work (that includes a check of your vital signs and a finger stick to test for blood type and anemia). You will then see the clinician to receive your medications. The entire visit typically takes between two and three hours. You must return to the health center in about two weeks to confirm that the pregnancy has ended. The first step in having a medication abortion is to take the medication Mifepristone. This is the medicine that stops the pregnancy from growing. Most women do not have side effects from the Mifepristone, but it is possible to have some nausea, spotting or mild cramping. If bleeding occurs before you take the second medication, you should still follow the following instructions. If you vomit after taking the Mifepristone, you do not need to take it again as long as the medicine was swallowed at least 15 minutes before. The second step in having a medication abortion is to take the medication Misoprostol. This is the medicine that causes the uterus to contract and to expel the pregnancy. You will take this medicine at home, 24-48 hours after you take the Mifepristone. Before you take the Misoprostol:
• Eat lightly and drink plenty of water. Eating rich, fried or spicy foods or not staying hydrated
• Plan ahead for your day so that you will be comfortable, have some privacy, and have someone
available in person or by phone to assist you if necessary.
• Fill the written prescriptions that we give you in case you want or need additional medicine for
• Make sure you have plenty of maxi pads and a heating pad on hand.
When you are ready to take the Misoprostol (buccal, or cheek, administration):
• You may want to take the Promethazine (Phenergan) first, about 30 minutes before the
Misoprostol, to prevent nausea and vomiting.
• You may also want to take Ibuprofen (Motrin) about 30 minutes before taking the Misoprostol to
help with the onset of cramping. (You can also use an over-the-counter medicine such as Advil, Aleve, or Naprosyn to help decrease the intensity of the cramping.)
• Place all four Misoprostol tablets between your cheek and gum and let them dissolve. They have
a chalky taste. After 30 minutes, swallow any remaining pill fragments or paste.
After you take the Misoprostol: Cramping and bleeding are expected, and they are both necessary to complete the abortion. Cramping: Cramps are a normal part of the process. Some women experience mild cramping, while others have extremely intense cramps. Most women have moderate cramps that gradually go away after passing the pregnancy. You will begin to have cramps within one to eight hours of taking the second medication. You may take Ibuprofen (Motrin), Tylenol, Percocet or Ultram every four to six hours to help with the cramps. You may combine certain types of pain medications as instructed by a clinician. Do not take aspirin. Things other than medication that can provide comfort include the following: putting a hot water bottle or heating pad on your abdomen; standing in the shower; sitting on the toilet; having someone rub your back. Once the pregnancy tissue has been passed, the cramping should get
better. If, after passing the pregnancy, you continue to have severe abdominal pain or cramps that are not helped by medication, call us.
Bleeding: Bleeding is a normal part of the process, but some women have more bleeding than others. Bleeding usually starts within one to eight hours after the cramps begin. You may have bleeding heavier than a period, and the heavy bleeding may last for several hours. You may also pass large blood clots, up to the size of a lemon, during the abortion. The pregnancy tissue itself is small and may not be noticed with the bleeding and clots. Occasionally, if the pregnancy has developed to about eight weeks, a recognizable embryo may be seen. If you soak through two or more maxi pads in an hour for two or more hours in a row, call us. Other Side Effects: Some women experience a mild fever and chills after taking Misoprostol. Acetaminophen (Tylenol) or ibuprofen (Motrin) should help. If you have a fever or chills 24 hours or more after taking the Misoprostol, call us. Some women experience other flu-like symptoms as part of the medication abortion process. These symptoms may include nausea, vomiting or diarrhea. If any of these symptoms are severe and not relieved by medication, call us.
After the abortion It is normal to have… Call us if you have…
Light to medium bleeding for a few days to several
Heavy bleeding that soaks more than two pads an
hour for two or more hours in a row, or passing clots for 2 or more hours that are larger than a lemon
Severe cramps or abdominal pain (after you pass the pregnancy) that is not helped by medicine, rest, or heating pad
Fever of 100.4°F or higher that lasts for more than four hours
Vomiting for more than four to six hours and not
You should start to feel better each day after the abortion. You may return to your normal activities as soon as you feel up to it. We recommend that you limit strenuous activity for a few days, and that you wait to have sex for one week after the abortion. Using pads makes it easier to check your bleeding, but it is fine to use tampons once your heavier bleeding lets up. If you plan to use birth control pills, the patch or the ring, you may start the day after you pass the pregnancy (or the next Sunday for easier tracking). We want you to call us first should you have any questions or concerns; however, if you see another healthcare provider, we recommend that you take this form with you. Remember that you should have a follow-up visit with us in about two weeks to confirm that your abortion is complete. At that time, we can also discuss your future birth control needs if we have not yet done so. You may schedule an appointment in advance or come during our walk-in hours. Please be aware that we are required to follow up with you by phone and mail if we do not see you back within the expected time frame.
How to reach us During regular business hours: (919) 942-7762
(our call center representative will consult with the doctor or clinician on site to assist you)
If/when you call us, we may ask you:
1) the telephone number of an open drug store near you; 2) your temperature within the last hour;
and 3) the number of pads you have used within the last hour.
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