Medication Abortion At Home: How To Manage It Safely
Increasing numbers of people are using self-managed or at-home methods to end pregnancies as access to clinical abortion becomes more and more constrained. Some prescription drugs can be safely administered at home, even though most over-the-counter medicines aren't considered safe or effective for ending a pregnancy.
Some studies indicate that Medication Abortion carried out at home may be just as secure and efficient as abortion carried out in a medical facility. Self-managed pharmaceutical abortion occurs when a person obtains and uses "the abortion pill" on themselves without the immediate supervision or direction of a doctor, nurse, or other clinicians.
Medication Abortion Methods:
According to preliminary data from the Guttmacher Institute, more than half of all abortions in the US will likely be medication-assisted by the year 2020. Mifepristone (Mifeprex) and misoprostol are combined to produce the most common type of medication-induced abortion (Cytotec). They cooperate to make the pregnancy leave your uterus, like a painful period or miscarriage.
The first and second trimesters are frequently used for medical abortions using mifepristone and misoprostol. Taking misoprostol by itself is an alternative if mifepristone is not available. Abortion caused exclusively by misoprostol frequently occurs in the second trimester.
You'll suffer cramping and bleeding with either approach. Other potential side effects are strong discomfort, chills, nausea, or diarrhea. This is normal and often not a cause for alarm.
Abortion At Home With Medication: How To Prepare:
The drug is technically the only thing required for a medication abortion. But there are a few items that you might want to keep on hand. For instance, keeping a phone, a phone charger, and emergency contacts close by will help give you peace of mind and guarantee that assistance is just a phone call away should you require it.
Think about noting down the names, numbers, and addresses of:
- Reliable friend or relative
- Local taxi service
- Urgent care facility
- Nearest 24-hour emergency hospital.
Free bleeding during this procedure is normal but can be messy. Stocking up on disposable period underwear or menstrual pads made for use with heavy periods may be useful. Doing this might reduce your time washing or changing your clothes.
There are several over-the-counter (OTC) medicines that can lessen any negative effects:
- Ibuprofen (Advil) or acetaminophen (Tylenol) to treat pain or lower fever
- To relieve nausea, try sodium citrate dihydrate (Nauzene) or dimenhydrinate (Dramamine).
- Imodium (loperamide) is used to treat diarrhea.
- Melatonin or doxylamine succinate (Unisom) as a sleep aid
A heating pad, hot water bottle, or stick-on heat therapy patch can also ease cramps. You can monitor your temperature and check for a fever with a thermometer.
A Quick Look At Common Abortion Medication Protocols
|Stage Of Pregnancy And Medication||Day 1||
|Less than 12 weeks pregnant, using mifepristone and misoprostol||Take 200 mg (one tablet) of mifepristone by mouth.||About 24 hours after taking mifepristone, take 800 mcg (four 200-mcg tablets) of misoprostol by inserting two tablets into each cheek pouch (the space between teeth and cheek) or by placing all four tablets under the tongue.|
|12+ weeks pregnant, using mifepristone and misoprostol||Take 200 mg (one tablet) of mifepristone by mouth||About 24 hours after taking mifepristone, take 400 mcg (two 200-mcg tablets) of misoprostol by inserting one tablet into each cheek pouch (the space between teeth and cheek) or by placing both tablets under the tongue. After 3 hours, take an additional 400 mcg (two 200-mcg tablets) of misoprostol. Repeat the same misoprostol dose again 3 hours later if you have not yet developed any cramping or bleeding.|
|Less than 12 weeks pregnant, using misoprostol alone||Take 800 mcg (four 200-mcg tablets) of misoprostol by inserting two tablets into each cheek pouch (the space between teeth and cheek) or by placing all four tablets under the tongue.||N/A|
|12+ weeks pregnant, using misoprostol alone||Take 400 mcg (two 200-mcg tablets) of misoprostol by inserting one tablet into each cheek pouch (the space between teeth and cheek) or by placing both tablets under the tongue. After 3 hours, take an additional 400 mcg (two 200-mcg tablets) of misoprostol. Repeat the same misoprostol dose again 3 hours later if you have not yet developed any cramping or bleeding.||N/A|
During Day 1 Of A Medication Abortion, What To Expect:
Pick a time when you can relax after taking the prescription, ideally in the morning. When you take the first pill, the abortion begins. Put a thick pad in your underwear before or after taking the first prescription. As required, wear and replace. Acetaminophen or ibuprofen should be taken as soon as pain or discomfort occur. Drink water continuously all day long. On the first day, ingest one pill, or 200 milligrams (mg), of mifepristone. After using mifepristone, bleeding and other adverse effects could not appear for roughly 24 hours.
If you are less than 12 weeks pregnant, take four 200-mcg tablets, or 800 micrograms (mcg), of misoprostol by placing all four under your tongue or two pills into each cheek pouch (the area between your teeth and cheek). After holding the misoprostol tablets in your cheek pouches or under your tongue for 30 minutes, flush the remaining medication with water. Drink water continuously all day long. If you are 12 weeks or more pregnant, you should take 400 mcg (two 200 mcg tablets) of misoprostol by placing both tablets under your tongue or one tablet into each cheek pouch (the area between your teeth and cheek).
Take 400 mcg of misoprostol (two 200 mcg tablets) more after three hours. If cramping or bleeding has not yet started, take the same misoprostol dose one more three hours later.
Day 2 Of A Medication Abortion: What To Expect:
Take the prescribed amount of acetaminophen or ibuprofen after eating a small meal. Before performing the following action, wait at least 30 minutes. When you combine mifepristone and misoprostol to perform a medical abortion.
If you are less than 12 weeks pregnant, take 800 mcg (four 200 mcg tablets) of misoprostol around 24 hours after taking mifepristone. You can place all four tablets under your tongue or two tablets into each cheek pouch (the gap between your teeth and cheek). After holding the misoprostol tablets in your cheek pouches or under your tongue for 30 minutes, flush the remaining medication with water. Drink water continuously all day long.
If you are 12 weeks or more pregnant, take 400 mcg (two 200 mcg tablets) of misoprostol around 24 hours after taking mifepristone. You can either place both tablets under your tongue or one tablet into each cheek pouch (the gap between your teeth and cheek). Take 400 mcg of misoprostol (two 200 mcg tablets) more after three hours. If cramping or bleeding has not yet started, take the same misoprostol dose one more three hours later.
Typically, side effects begin between 30 minutes and 10 hours after taking misoprostol pills. It normally takes between 2 and 24 hours for the pregnancy to leave the body after taking both drugs. When using misoprostol alone or in combination with mifepristone to perform a pharmaceutical abortion, you should anticipate experiencing cramping. This is because the medicine induces painful uterine contractions to aid in the delivery of the pregnancy.
Ibuprofen or acetaminophen 600 mg should be used as soon as cramps start. Continue taking this dose every 6 to 8 hours with a small meal until the pregnancy ends and the discomfort disappears. Resting and utilizing a hot water bottle or heating pad may also be beneficial. As the pregnancy exits your body, you should also prepare for vaginal bleeding, which can occasionally be heavier than your regular period. Additionally, it might have tissue and clots. For a few more days, maintain using pads to help you monitor your bleeding.
The drug is typically effective when all three of these adverse effects occur.
Following taking misoprostol for the first 24 hours, it is usual to experience the following:
- Total deficiency
Detecting The End Of A Pregnancy:
The likelihood that the embryo (grey or white tissue) will pass undetected inside a blood clot increases with the speed at which a pharmaceutical abortion is carried out. Following its release, bleeding and cramping will lessen. Up until roughly nine weeks following the first day of your last menstruation, embryos are less than 1 inch in size. The cells, now known as a fetus, are around 1.5 inches long and may have distinguishable features.
Depending on your comfort level, it might be beneficial to ask a trusted friend or family member to examine any clots that pass to determine whether the pregnancy has ended.
During Days 3–5 Of A Medication Abortion, What To Expect:
A few days after delivering the baby, you can suffer a "second wave" of intense bleeding. The likelihood of increasing cramping, bleeding, and clotting is possible, especially between the fourth and fifth days.
Depending on your feelings, taking a shower, sitting on the toilet, or getting someone to touch your back may make you feel better.
For about 10 minutes, gently massage the pelvic, uterine, and abdominal regions if you are bleeding heavily. In addition to using a heating pad and reducing any other physical exertion, you can also take acetaminophen or ibuprofen. Take your temperature twice a day for 48 hours if you feel feverish. If your temperature remains at 101.4°F (38.6°C) or higher for more than 12 hours straight, it qualifies as a medical emergency.
You may: During this time.
- Observe enormous blood clots that are as large as lemons
- Gastrointestinal discomfort
- Tummy aches
- Suffer temporary chills or a little fever
- Possess severe cramping
- Release a creamy nipple fluid
Rest And Recovery After A Medication Abortion:
Allow yourself the time and space to deal with any feelings that may surface. Due to the hormonal changes following an abortion, feelings of relief, grief, joy, or melancholy are frequent and may be strong. Some people discover that these emotions pass quickly.
With the passing of hours and days, cramping will lessen. During the first 1 to 2 weeks following a medication abortion, it's typical to pass clots, especially upon getting out of bed. Wearing period underwear or menstruation pads may benefit you during this time. This may make it simpler to determine how much bleeding you have. After the intense bleeding subsides, you can switch to tampons or other period supplies. Spots or further minor bleeding could persist for up to four weeks or longer. Tenderness and swelling in the breasts or chest may persist for up to two weeks.
For at least a week after a medication abortion, refrain from doing the following:
- Arduous exercise, which might worsen cramps and bleed
- Fingering and penis-in-vagina intercourse is penetrative vaginal sexual activities that can spread bacteria to the vulva and vagina.
- Internal period devices, such as menstrual cups or tampons, can make it challenging to monitor bleeding and clots.
- Goods such as body wash, bath bombs, or other "feminine" toiletries with fragrance or other components that might irritate the vulva and vagina
- Nipple stimulation (if you have discharge from your nipples)
Four to eight weeks following the abortion, your first period should start.
How To Confirm A Medication Abortion Worked:
After a pharmaceutical abortion, a false-positive pregnancy test result may appear up to 4 weeks later. This is because it takes some time for your hormone levels to return to normal. After all, they are still affected by your prior pregnancy.
We advise getting a pregnancy test about two weeks after finishing all drugs or ending the pregnancy. Make a note of the day and the pregnancy test result you received, and then test the following week again. If the first and second tests returned negative, the abortion most likely went as planned.
You should have the third test the following week or speak with a doctor or other healthcare provider if the outcomes of the first and second tests are different (one is positive, and the other is negative). A surgical abortion can be necessary to help end the pregnancy if the first and second tests are both positive.
When To Seek Medical Attention:
Before attempting an at-home medication abortion, see a doctor or other healthcare provider if you:
- Are past their 12-week due date
- Possess ectopic pregnancy signs
- Own an IUD
- Are you severely anemic or have a blood clotting issue?
- Having ongoing adrenal insufficiency
- Use steroids as prescribed
- Are sensitive to misoprostol or mifepristone
If you have concerns about your eligibility or potential side effects, you can speak with a clinician by phone or online. Before distributing the prescription, a prescribing pharmacy or other healthcare platforms can respond to queries via email or online chat.
Seek immediate medical help if you used medicine to induce an abortion if you:
- Within 24 hours of taking misoprostol, you shouldn't notice spotting or bleeding.
- They cannot take another dose of misoprostol because they vomit within two hours.
- Vomit continuously for more than four to six hours.
- I have had a temperature of at least 100.4°F (38°C) for more than 12 hours straight.
- Pass blood clots larger than a lemon or lasting longer than two hours.
- They are bleeding intensely for more than 12 hours or through two full-size pads every hour for more than two hours.
- Suddenly experience intense shoulder or abdominal pain, combined with general weakness and fainting
- Bleeding that is heavier than usual for two weeks or longer
- Experience pregnancy symptoms for at least two weeks
When seeking medical attention, try to remember and have on hand the following information:
- How many pads have you used in the last one to two hours?
- Your body's temperature throughout the previous one to two hours
- The name and contact information for a nearby, Pharmacy open.
The Bottom Line:
Breathe in deeply. You are not alone in this journey, whether you are reading this for yourself, a friend, a family member, or another loved one. Before, during, and after an abortion, these resources can provide support:
- Abortion Resource
- Federation for National Abortion
- National Abortion Funds Network
- Pregnancy Centers