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Abortion - medical

Medical abortion is the use of medicine to end a pregnancy. The medicine helps remove the fetus and placenta from the mother's womb (uterus).

There are different types of medical abortions.

  • Therapeutic medical abortion is done because the woman has a health condition.
  • Elective abortion is done because a woman chooses (elects) to end the pregnancy.

An abortion is not the same as a miscarriage. Miscarriage is when a pregnancy ends on its own before the 20th week. 

Surgical abortion uses surgery to end a pregnancy.

Description

A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman's last period. A combination of prescription hormone medicines are used to help the body remove the fetus and placenta tissue. The doctor may give you the medicines after performing a physical exam and asking questions about your medical history.

Medicines used include mifepristone, methotrexate, misoprostol, prostaglandins, or a combination of these medicines.

Why the Procedure is Performed

Medical abortion might be considered when:

  • The developing baby has a birth defect or genetic problem
  • The pregnancy is harmful to the woman's health (therapeutic abortion)
  • The pregnancy resulted after a traumatic event such as rape or incest
  • The woman may not wish to be pregnant (elective abortion)

Risks

Risks of medical (nonsurgical) abortion include:

  • Continued bleeding
  • Diarrhea
  • Pregnancy tissue not passing completely from body, making surgery necessary
  • Infection
  • Nausea
  • Pain
  • Vomiting

Before the Procedure

The decision to end a pregnancy is very personal. To help weigh your choices, discuss your feelings with a counselor, health care provider, or a family member or friend.

Test done before this procedure:

  • Pelvic examination is done to confirm the pregnancy and estimate how many weeks pregnant you are.
  • HCG blood test may be done to confirm the pregnancy.
  • Vaginal or abdominal ultrasound may be done to determine the exact age of the fetus and its location in the womb.

After the Procedure

Physical recovery usually occurs within a few days, depending on the stage of the pregnancy. Expect some vaginal bleeding and mild cramping for a few days.

A warm bath, a heating pad set on low, or hot water bottle filled with warm water on the abdomen may help relieve discomfort. Rest as needed. Do not do any vigorous activity for a few days. Light housework is fine. Sexual intercourse should be avoided for 2-3 weeks. A normal menstrual period should occur in about 4-6 weeks.

You can get pregnant before your next period. Be sure to make arrangements to prevent pregnancy, especially during the first month after the abortion.

Outlook (Prognosis)

Complications (problems) rarely occur.

Alternative Names

Therapeutic medical abortion; Elective medical abortion; Induced abortion; Nonsurgical abortion

References

American College of Obstetricians and Gynecologists. Clinical management guidelines of obstetrician-gynecologists. Medical management of abortion. Obstet Gynecol. 2005 Oct;106(4):871-82. Reaffirmed 2009.

Annas GJ, Elias S. Legal and ethical issues in obstetric practice. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 54.

Jensen JT, Mishell Jr DR. Family planning: contraception, sterilization, and pregnancy termination. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 13.

Simpson JL, Jauniaux ERM. Pregnancy loss. In: Gabbe SG, Niebyl JR, Simpson JL, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 26.

Update Date: 11/8/2012

Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, Stephanie Slon, and Nissi Wang.

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