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0:00 Introduction
0:27 How do abortion pills work?
1:15 How effective are abortion pills?
1:32 Combination or mifepristone and misoprostol
2:05 Is medication abortion safe?
2:27 Potential risks and complications
3:07 who shouldn't choose medication abortion
3:40 What does recovery after a medication abortion entail?
A medical abortion, also known as medication abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage.[5] Medical abortions are more common than surgical abortions in most places, including Europe, India, China, and the United States.[6][7]
Medical abortions are typically performed by administering a two-drug combination: mifepristone followed by misoprostol. When mifepristone is not available, misoprostol alone may be used in some situations.[8]
Medical abortion is both safe and effective throughout a range of gestational ages, including the second and third trimester.[9] In the United States, the mortality rate for medical abortion is 14 times lower than the mortality rate for childbirth, and the rate of serious complications requiring hospitalization or blood transfusion is less than 0.4%.[10][11][12][13] Medical abortion can be administered safely by the patient at home, without assistance, in the first trimester.[14] Starting with the second trimester, it is recommended to take the second drug in a clinic or provider's office.[14]
Medical abortion should not be confused with emergency contraception, which typically involves drugs (such as Levonorgestrel or "Plan B") taken soon after intercourse to prevent a pregnancy from beginning.
Drug regimens
200 mg mifepristone and 800 μg misoprostol, the typical regimen for early medical abortion
Less than 12 weeks' gestation
For medical abortion up to 12 weeks' gestation, the recommended drug dosages are 200 milligrams of mifepristone by mouth, followed one to two days later by 800 micrograms of misoprostol inside the cheek, vaginally, or under the tongue.[15] The success rate of this drug combination is 96.6% through 10 weeks' pregnancy.[16]
Misoprostol should be administered 24 to 48 hours after the mifepristone; taking the misoprostol before 24 hours have elapsed reduces the probability of success.[17] However, one study showed that the two drugs may be taken simultaneously with nearly the same efficacy.[18]
For pregnancies after 9 weeks, two doses of misoprostol (the second drug) makes the treatment more effective.[19] From 10 to 11 weeks of pregnancy, the National Abortion Federation suggests second dose of misoprostol (800 micrograms) four hours after the first dose.[20]
After the patient takes mifepristone, they must also administer the misoprostol. Failure to take the misoprostol may result in any of these outcomes: the fetus may be terminated, but not fully expelled from the uterus (possibly accompanied by hemorrhaging) and may require surgical intervention to remove the fetus; or the pregnancy may be successfully aborted and expelled; or the pregnancy may continue with a healthy fetus. For those reasons, misoprostol should always be taken after the mifepristone.[21]
If the pregnancy involves twins, a higher dosage of mifepristone may be recommended.[22]