Medication abortion procedure

Medication abortion involves using the medications mifepristone and misoprostol instead of surgery to end a pregnancy. It can be done as soon as a pregnancy can be seen in an ultrasound. In Australia, a medication abortion is performed up to nine weeks of pregnancy.

A pregnancy needs high levels of the hormone progesterone to continue. Mifepristone works by blocking the action of progesterone to cause the pregnancy to stop progressing. Misoprostol causes the cervix to soften and the uterus to contract to allow the pregnancy to be expelled from the uterus.

The process and number of appointments for having a medication abortion varies depending on the type of clinic setting you attend, and whether certain tests you need (such as ultrasound and blood tests) are available on site or require separate appointments. A number of clinics are able to offer necessary tests and medication abortion in a single initial appointment. 

The process of having a medication abortion generally involves the following steps:

• You will have a medical consultation with a doctor and often a nurse as well, which involves a clinical assessment of medical and other relevant information, and arrangements for you to have an ultrasound and blood tests. 
• You will be given information about the methods of abortion to help you to make an informed decision about the best method for you.
• If you decide to have a medication abortion, you will be asked to sign a consent form and will be given all the relevant information about what to expect, the steps you will need to take, and about pre- and post-abortion care. 
• You will discuss what sort of pain relief, and any other appropriate medication you may require, and how to obtain it, in preparation for the abortion. 
• If you have an intrauterine device, it will need to be removed before you take the first medication (mifepristone).
• You will take a tablet of mifepristone either at the clinic or at home and obtain the other appropriate medications. 
• You will take a tablet of misoprostol 24 to 48 hours later. This softens the cervix and helps the uterus push out the pregnancy. This stage nearly always occurs at home. (If you need to travel after taking misopristol and before the abortion is complete, it is recommended that you have a responsible adult who can drive you.) 
• The abortion is usually completed some hours later, although it may take longer. You will usually need a day or two of rest or reduced activity.
• You will be encouraged to have telephone contact with the clinic you attended or another source of expert support in case you have any questions or concerns at any time during and after the procedure.