- A typical treatment schedule for a medical abortion usually requires at least two visits to your doctor over several weeks. For the first visit, one medicine is taken during the visit and a second medicine is given to be taken at home. Vaginal bleeding may last about 14 days. Usually about 2 weeks after the first medical visit, a follow-up examination is needed to see if you are recovering well and to make sure the procedure worked.
- Medical care before and after a medical abortion includes physical exams and lab tests, education about what to expect, self-care instructions, information on when to call your doctor, and birth control planning.
Medicines currently available in the United States for inducing abortion are:
- Misoprostol. This hormone softens and opens (dilates) the cervix and triggers uterine contractions. Misoprostol used alone may end a pregnancy but is much more effective when used with other medicines, such as mifepristone or methotrexate, in first-trimester abortions.
- Mifepristone and misoprostol. Mifepristone, also known as Mifeprex or RU-486, blocks the effects of the hormone progesterone. This stops the placenta’s growth, softens the cervix, and makes the uterus ready for labor. Misoprostol is then used to start contractions to clear the uterus of all tissue.
Surgical methods in the first trimester (5 to 12 weeks)
- Manual vacuum aspiration (MVA) or machine vacuum aspiration uses suction through a small tube to empty the uterus of all tissue.
Surgical method in the second trimester
- Dilation and evacuation (D&E) is typically done when an abortion occurs in the second 12 weeks (second trimester) of pregnancy. It usually includes a combination of vacuum aspiration, dilation and curettage (D&C), and the use of surgical instruments (such as forceps) to clear the uterus of fetal and placental tissue.
A D&E is most commonly used during the second trimester because it has a lower complication risk than induction abortion.
Nonsurgical method in the second trimester
- Induction abortion ends a second-trimester pregnancy by using medicines to start (induce) contractions, which expel (push) the fetus from the uterus. If the fetus has severe medical problems, a woman may choose to have an induction abortion.