We have created this information sheet to help you understand what happens when you have a
medical (medication) abortion.
BEFORE THE PROCEDURE
We provide medication abortions up to 7 weeks after the start of your last menstrual period.
When you book your appointment, you will be asked to do the following when you arrive:
1. Come it at your appointed time, no earlier or later
2. Complete a health history
3. Provide a urine sample
Expect to be with us for 2 hours. You may bring a support person with you, but they will need to
wait for you in our reception area.
Our Nurse Practitioner will meet you at reception and take you to our ultrasound room for an
ultrasound, Rh test, and a blood pressure and heart rate test. She will then review your health
history with you and explain how medication abortions work including:
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What we will do at the clinic to start a medication abortion
What you need to do at home to finish it
What to expect while the medications you are taking are in effect
How to take care of yourself while you are taking the medications
How to follow up with our clinic or another healthcare provider
Feel free to ask her any questions you may have.
Our Nurse Practitioner will talk about the safety and effectiveness of medication abortion as
well as the side effects and risks of the drugs you will be taking. If you are sure that you want to
have a medication abortion, she will give you a consent form to review and sign.
SAFETY
There are several different drugs used around the world for causing abortions, and by now
millions of medication abortions have been completed. Both medication and surgical abortions
are safe: the chance of complications or problems with medication abortion is the same as with
a natural miscarriage. Both forms of abortion are also actually safer than carrying a pregnancy
to term.
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EFFECTIVENESS
The overall success rate for medication abortion with our medication abortion drugs is about
95%. Our Nurse Practitioner will discuss when and why a surgical procedure may also be
required.
At Choice in Health Clinic we use two drugs to end a pregnancy. The first drug, methotrexate,
stops cell growth. It has been safely used in Canada for over 50 years to treat cancer, some
kinds of arthritis, and ectopic (tubal) pregnancies. Methotrexate helps end a pregnancy by
stopping the growth of the pregnancy. If there is a multiple pregnancy, our Nurse Practitioner
will inform you about how long it takes to complete the process.
The second drug is misoprostol. This drug is sold for prevention and treatment of stomach
ulcers. It is also used to help bring on labour at the end of a pregnancy and for softening the
cervix before abortion procedures. It is used in medication abortion to make the uterus
contract and push out the pregnancy tissue after the methotrexate has stopped its growth.
HOW THE MEDICATIONS ARE GIVEN
Methotrexate is given by injection into a muscle. The dose is calculated according to your
height and weight. You will get this injection at your first visit (Day 1).
Misoprostol comes as tablets, with four tablets used at one time. The tablets must be placed in
your vagina, as far in as you can put them. You will have to use these at home, between Day 3
and Day 7. If you do not have much bleeding or cramps after you use the misoprostol, you
should use a second dose 24 hours later.
The Nurse Practitioner will give you a calendar with detailed instructions to follow so you
know what to expect.
THE SIDE EFFECTS
The dose of methotrexate used to cause an abortion is much less than for cancer treatment.
Serious side effects are rare with this dose.
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COMMON side effects from one dose include:
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Nausea and fatigue (40%)
Vomiting (12%)
Diarrhea (8%)
Headache (11%)
RARE side effects (1% or less) from one dose include:
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Skin sensitivity to sunlight – easy burning with sun or tanning lights
Inflammation of the membrane covering the eye
Sores in mouth and throat
Temporary hair loss
Low blood counts (bone marrow suppression), inflammation of the lung (pneumonitis) only rare case reports with one or two doses
COMMON side effects of misoprostol include:
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Chills (shivering and feeling cold) and fever - common in first few hours after use
Nausea, vomiting, fatigue, diarrhea, and headache - common, usually mild
Cramps and bleeding beginning as soon as a few hours after use - common
Failure to expel the tissue with heavy bleeding and needing an emergency surgical
procedure.
The process is similar to a miscarriage. At times there will be a lot of cramps and bleeding,
including passing clots and small amounts of tissue. For many this will last for only a few hours,
but some have these symptoms on and off for several days. If the pregnancy is not ended by
the medications, you will need a surgical abortion procedure, because the medications can
cause severe birth defects.
WHAT YOU WILL HAVE TO DO AT HOME
1. You will have to put the misoprostol tablets into your vagina one or two times.
2. You will not know exactly when to expect symptoms from the medications or from
the abortion process itself.
3. You may have trouble going to work or caring for young children, so may want to
consider taking time off or getting help with childcare.
4. You may have to explain your symptoms or missed work to family, friends, or coworkers.
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5. You will have to abstain from sexual intercourse until the abortion is complete.
You will need access to a telephone in case you need to call us, and you must have
transportation to the clinic or a source of emergency care if necessary. You must stay in touch
with clinic staff by telephone during this process.
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