also known as the abortion pill, can end a pregnancy up to nine weeks from a
woman's last menstrual period. It
stops the hormones of pregnancy from working and ends the pregnancy process.
During the following two days after taking the abortion pill, a woman will take a second
medication, Cytotec (misoprostol), which causes a miscarriage by making the uterus contract.
Typically patients experience two to four hours of cramping and bleeding.
Over 95% of women who have chosen to end their pregnancies with this
medication would choose it again or recommended to a friend.
RU-486 works the first time for up to 98 out of 100 women who take it. It
was approved by the FDA in September of 2000.
The medication does not in any way hamper future pregnancies, because it
passes quickly and completely from your body shortly after you take it.
IS A NON-SURGICAL ABORTION?
A: A non-surgical
or medical abortion is a method for ending a woman's pregnancy without surgery.
In the United States, the conventional, more common method for performing an
abortion is a surgical procedure called a dilation and curettage or D&C. A
surgical abortion is simple and quick. In a very small percentage of surgical
abortions, however, certain risks and complications can occur, which are related
to the surgical procedure. With a medical abortion, however, there is no
surgery, and therefore these complications are avoided. Instead of surgery,
medications are administered which cause the body to abort the pregnancy, very
like a miscarriage.
IN PREGNANCY IS MEDICAL ABORTION POSSIBLE?
A: Medical abortion
is recommended only in early pregnancy. Medical abortion can be
done as soon as the pregnancy is confirmed up until 56 days (8 weeks) after the
first day of the last normal menstrual period. It is important that a woman
confirm a pregnancy as soon as possible if she wants to consider medical
LONG DOES THE MEDICAL ABORTION PROCESS TAKE?
A: Medical abortion
involves several steps and requires at least two office visits. During the
first visit, you will have an ultrasound examination to confirm the length of
the pregnancy. If you qualify for the medical abortion you will take the first
medication (mifepristone). The second medication (misoprostol) is placed into
the mouth between the gums and cheeks one or two days later. The abortion
usually occurs within 4 hours after inserting the second drug, but it can take
24 hours or longer. In a very small number of cases, the woman may need to
return to the office for another dose of medication. A final visit is required
within the next 2 weeks for a checkup.
HOW EFFECTIVE IS MEDICAL ABORTION?
A: Medical abortion
is about 98% effective. This means that approximately 98 out of 100 women who
take the medications will have a complete abortion with no further medical
treatment. In the 2 out of 100 cases in which abortion does not occur or is not
complete, a vacuum abortion procedure is required. Once a medical abortion has
been started, it must be completed, because the drugs used for medical
abortion could cause birth defects.
WHAT WILL THE BLEEDING BE LIKE, AND HOW LONG WILL
A: The amount and
length of bleeding after medical abortion is different for each woman.
The amount and length of bleeding depends on how far along the pregnancy
is. The length of the pregnancy is easily determined by ultrasound.
There is usually more bleeding and cramping than during a heavy period.
Women typically report some amount of bleeding for about two weeks after taking
WHAT HAPPENS AFTER A MEDICAL ABORTION?
A: Medical abortion
has no long-term effects on a woman's health. Fertility returns
quickly-ovulation is likely within the first two or three weeks after the
abortion, or sooner, with a normal menstrual period expected about two weeks
after that. Because fertility returns so rapidly is important to begin using an
effective family planning method immediately.
IS THERE AN ALTERNATIVE TO MEDICAL ABORTION?
aspiration abortion, also called surgical abortion, is possible during
early pregnancy and also can be used after the 9-week cut off point for medical
IS MEDICAL ABORTION THE RIGHT CHOICE FOR ALL
women will have their own perspective on the advantages and disadvantages of
abortion options. Some women who choose medical abortion say that they wish to
avoid surgery and anesthesia, have a more "natural" and less invasive"
experience, and participate in the process more actively. Women who choose
vacuum abortion say that they like the method's speed, simplicity, and
effectiveness without out the need for the additional office visits.
CAN THE NON-SURGICAL ABORTION BE PERFORMED?
A: In order to have a medical abortion
with RU-486, you must be less than 9 weeks from the first day of your last
normal period, or less than 7 weeks from the time of conception. Dr. Brandeis
will do an ultrasound to confirm that you are early enough in the pregnancy to
have a medical abortion and your medical history will be reviewed to be sure you
MEDICATIONS ARE USED?
A: Mifepristone (Mifeprex) also known as
RU-486 is the only FDA approved pill for ending early pregnancy. RU-486
is given at the time of the first visit. RU-486 is a hormone which works by
blocking the action of progesterone, a hormone needed to maintain pregnancy.
Misoprostol is given either the same day or in the following two days. The
misoprostol causes the cervix to open and the contents of the uterus to expel,
thus effecting a miscarriage.
IS A MEDICAL ABORTION DONE?
A: After Dr. Brandeis confirms
through lab work, a medical history, an examination and ultrasound that you are
eligible for a medical abortion, the actual procedure for the medical abortion
will proceed as follows:
You will receive the RU-486 pill.
Day 2 or 3:
tablets can be inserted either on day two or three. The decision to use the misoprostol tablets either the
same day or on day two or three is the patient's choice. The majority of patients will abort about four hours after the
Misoprostol tablets are inserted.
Day 7 through 14:
A follow-up visit at the office is necessary to determine that the abortion
is complete. This visit will include a pelvic exam, an ultrasound, and possibly
a blood test to check the level of pregnancy hormone in your blood.
THE PROCEDURE ALWAYS WORK?
A: RU-486 is up to 98% effective in
inducing abortion during the first 8 weeks of pregnancy. It has close to the
same level of effectiveness as a surgical abortion performed during the early
weeks of pregnancy. In the unlikely event that the medical abortion process does
not satisfactorily terminate the pregnancy, the patient will talk with Dr.
Brandeis about choices, including a surgical abortion to ensure the abortion is
ABOUT LONG-TERM HEALTH RISKS?
A: Extensive clinical tests since 1990
have not revealed any evidence of long-term health effects on women who use
RU-486, and such effects appear unlikely given the very short time women are
exposed to the drug. One of the reasons doctors like RU-486 is that it
metabolizes quickly and is soon out of the system. Studies show that half the
dose has left the body 20 hours after being taken.
ARE THE ADVANTAGES OF THE NON-SURGICAL ABORTION?
Pregnancy termination with RU-486 is non-surgical, requires no anesthesia, and
puts women at no risk of perforation (damage to the uterus) or infection from
surgical instruments. Patient satisfaction is very high. According to a recent
study, 96 percent of women who have used RU-486 would recommend the method to
ARE THE DISADVANTAGES OF THE NON-SURGICAL ABORTION?
A: RU-486 is only effective during the
first 9 weeks of pregnancy. RU-486 takes longer than a surgical abortion. A
surgical abortion is done in 10-15 minutes. RU-486 requires two trips to the
THE NON-SURGICAL PROCEDURE PAINFUL?
A: Approximately two to four hours after
the insertion of the misoprostol into the vagina there is an onset of lower
abdominal cramps and vaginal bleeding. In most cases, the discomfort of lower
abdominal cramps is relieved by the administration of Motrin or a stronger pain
medication such as Percocet.
DOES NOT QUALIFY FOR A MEDICAL ABORTION?
A: A medical abortion is not recommended if
. are more than 56 days pregnant
· take anti-clotting medication or have blood-clotting disorders
· have severe heart, liver, or active inflammatory bowel disease
· have certain severe kidney problem
· have a serious immune system problem, such as HIV
· have seizures more than once a week
· take any medicine that should not be combined with methotrexate, mifepristone,
· cannot return for follow-up visits
· have a tubal pregnancy
· have an intrauterine device (IUD) in place (it must be removed before taking
· have problems with adrenal glands
· have been treated with certain steroid medications for a long time
· had an allergic reaction to RU-486, misoprostol, or similar drugs
· are unwilling or unable to have a surgical abortion if the medical abortion
is incomplete or not successful
MUCH DOES THE PROCEDURE COST?
A: The non-surgical procedure is $470.
This includes the initial consultation, the preliminary ultrasound to determine
the exact weeks and location of pregnancy, and the cost of the medications used
in the office such as the RU-486 and the misoprostol. The $470 also includes all
follow-up visits in the Brandeis Medical Center to ensure a completion of
non-surgical abortion. The $470 also includes any surgical procedure performed in
the Brandeis Medical Center as a follow-up of the non-surgical abortion. The $470
does not include any services performed outside the Brandeis Medical Center or
by any other provider other than Dr. Brandeis. If the initial consultation and
preliminary ultrasound is not conclusive of the pregnancy in the uterus at an
appropriate gestational age there might be an additional cost to determine the
location of the pregnancy prior to administering the RU-486. There is a $65
additional charge for an injection of RhoGam, a medication prescribed for
patients whose blood type is Rh negative.
IS THE MORNING-AFTER-PILL?
A: The Morning-After-Pill
refers to the use of high dosage birth control pills taken within 72 hours of
unprotected intercourse to prevent the pregnancy from occurring.