Medical Abortion – Frequently asked questions
1. Will it hurt? The amount of pain women feel with a medical abortion varies a lot. Some women report that they felt nothing, or it was like a normal period. Other women are very uncomfortable and use the pain killers that are provided. It is hard to predict how you will feel. We will provide medications to reduce any pain that you may have.
2. Will this affect future pregnancies? No. The medications leave your body within days.
3. How much bleeding will I have? Usually, the bleeding is heavier than a normal period. Often there are clots. The bleeding starts off heavily, and then gets less and less, as a period does.
4. How long will I bleed? The length of time is different for everyone, but will be longer than a period. Once the bleeding starts, it can be as short as a week but can last much longer, most often from 5 to 20 days. It is not heavy all the time.
5. What is the failure rate? With the Mifepristone, 95% of women miscarry within the first week. 4% will have a delayed reaction and may require more medication or request surgery. 1% will require surgery for a continuing pregnancy. With methotrexate, 80% of women miscarry within the first week. Another 10% miscarry by the end of the second week. 4-5% of women will not have a continuing pregnancy but it may take up to a month to pass the tissue. 1-2% of women will require surgery for a continuing pregnancy.
6. What happens if this doesn’t work? If you wait 2 or more weeks, and you don’t lose the pregnancy, we will schedule you for a minor surgical procedure. We will make the appointment for you at a local clinic. This procedure is very safe. There is less than 1% chance of any complications.
7. Is this safe? There is a very small risk of infection or bleeding which would require treatment.
8. What are the short-term side effects? The side effects of the medical abortion don’t last long. Some women will have chills, headache, fever, nausea, vomiting or diarrhea that may last a day or so on the day of taking the medication. Some women experience none of these. We will provide you with a package of medications that you can use to reduce the side effects if needed..
9. Do I have to make an appointment? Yes. You must make an appointment by phone for a medical abortion. Because we need to have some information ahead of time, you cannot just “walk in”. Usually we are able to schedule you within 2-3 days.
10. Why do I have to come to your office so many times? You need to come in to our office at least twice and possible 3 times to be sure everything is safe, and worked well. On the first appointment, you will be assessed, see the doctor, have an ultrasound and then see a counselor to review the procedure. You will have some blood work done and you will have the medication to end the pregnancy. If the doctor has been unable to see anything on the ultrasound you may need to go to the lab for an extra blood test and we may have to book you to come back the next day. You will need a second appointment approximately one week later to be sure that the abortion has been successful and there are no problems.
11. Do you do ultrasounds? Yes, our doctors are trained to do pregnancy related ultrasounds. This means they can assess the dates of your pregnancy, and check to see if it is gone afterwards.
12. What are the blood tests I will have? You will have a hemoglobin test, and may have one for the Rh factor in your blood (your blood type) unless you have written proof of your blood type. Some women may have a third test if they have an illness, like hepatitis or kidney disease. A few women will need to go for extra blood tests to measure the level of pregnancy hormone.
13. Do I have to have an injection? No. With the Mifepristone, it is a pill that you swallow. The Methotrexate can be by injection or you can drink the medication mixed in orange juice.
14. What if I am very nauseated or vomiting. For the Mifepristone, we can give you a gravol pill or shot before giving you the medication if you feel you will not be able to keep it down. If we do this you will not be able to drive so you will need to bring someone with you to drive you home or take a taxi or transit. If you have chosen the Methotrexate, we would recommend that you have the injection, so that you don’t vomit the medication.
15. How is my pregnancy calculated? We calculate the dates of your pregnancy from the first date of your last menstrual period. Women get pregnant (conceive) 2 weeks after this. For example, when you miss your period by a few days you may think it is only 3 weeks since you got pregnant, but it would be 5 weeks since the first day of your last normal period. We would call this a 5 week pregnancy.
16. How much time will I have to take off work/school? We recommend that you should be at home on the day you use the pills. You may even need to take an additional day. With the Mifepristone it is very specific timing as to when that day should be. The misoprostol must be taken 24 – 48 hours after the Mifepristone so you should arrange your schedule accordingly. The misoprostol after the Methotrexate can be used any time up to 7 days after you take it so you can arrange that for your regular day off.
17. Can I have a medical abortion if I am breast feeding? Yes, with both Mifepristone and Methotrexate. Although a small amount of the medications do go into breast milk, that is not dangerous for your baby. If you can feed as little as possible for a few days, that would be better.
18. Do you have translators? No. Unfortunately, we receive no government funding for counselling, medications or translation. If you don’t speak and read English very well, you need to bring a friend or relative with you who can help you to understand the instructions or contact 604-254-8022 for a paid interpreter.
19. Why do I have to pay? Unfortunately, we receive no government funding for medications and your medical insurance Care Card does not pay for medications. If you have extended medical coverage, it may reimburse you for all or a portion of the fee. We will give you a detailed receipt upon request for you to submit to your plan but we cannot guarantee how much or if you will be reimbursed.
20. When can I start my birth control? You should start your birth control pills right after you have the bleeding. If you want an IUD inserted, you will come for your follow up visit in one week and then we will book you to come back for the insertion within one week. All other forms of birth control you can discuss with the counselor at your initial visit or the physician at your follow up visit.
MEDICAL DIRECTOR: DR ELLEN WIEBE