Medical Abortions May Be Performed From 3 to 14 Weeks

The abortion pill procedure (non-surgical abortion, Mifeprex, Mifepristone, Medical Abortion Pill) has been quickly gaining recognition in the United States since 2001 when the FDA approved RU 486 for terminating pregnancy between 3 and 7 weeks. Numerous studies conducted in the U.S. and throughout the world have demonstrated the abortion pill to be effective with minimum side effects up to 9 weeks from a patient's last menstrual period. Several studies have found the abortion pill to be safe and effective up to 14 weeks from the last menstrual period.

It has been well documented that patients with a pregnancy of less than 6 weeks have a 40 to 60% rate of successfully expelling the gestational tissue (i.e., miscarriage) when prescribed RU 486 as the sole medication. Cytotec (Misoprostol) was then added to decrease the length of time it took to complete the abortion process and reduce the chance of uterine infection, vaginal bleeding or retained tissue. Cytotec is a prostaglandin known to cause uterine contractions, increase intrauterine pressure and separate the pregnancy tissue from the uterine wall. Changes also occurred locally in the cervix (lower part of the womb) allowing it to dilate (open) and become soft which further helped to eliminate the pregnancy tissue from the uterus. This process can take approximately 4 to 6 hours from insertion of the Cytotec tablets. On average, there is a 2 to 6% failure rate using the combination of RU 486 and Cytotec for patients who are between 3 and 14 weeks pregnant. For patients who are less than 6 weeks, the success rate is between 97 and 99%. In essence, the earlier in gestation the RU 486 abortion procedure is performed, the higher the success rate.

Abortions using Mifeprex and Misoprostol are associated with very few complications. Side effects of the abortion pill can include the possibility of headache, abdominal discomfort and diarrhea. Initial chills, fever, nausea, vomiting and diarrhea can also occur with the use of Cytotec.

Side effects associated with the abortion procedure in general are retained tissue or incomplete abortion and continued or excessive bleeding; all of which require a surgical abortion procedure to be performed. In a few cases, blood transfusions were required. There have been reports of death due to a rare type of infection. There has been no conclusion that these deaths were directly caused by the abortion procedure. In general, patients who are further along in their pregnancy have more discomfort caused by uterine contractions and there is a slightly higher chance of a continued pregnancy which requires surgical removal.

In summary, the combined Mifepristone and Misoprostol abortion pill procedure has been used for many years to terminate pregnancies up to 9 weeks gestation. It is now used in certain cases up to 14 weeks. Patients who are further than 10 weeks must be warned about the possible appearance of fetal tissue. For this reason, patients who may find this bothersome are asked to avoid viewing the pregnancy tissue. Performing the abortion pill procedure up to 14 weeks is otherwise a highly safe and practical substitute to the surgical abortion procedure.