Medical abortion

Day 1 – Appointment to the midwife or doctor at the gynecology clinic at the hospital

• We will check your blood pressure, iron levels and ask for a urine sample. There will also be a gynecological examination and a vaginal ultrasound.
• At the hospital you’ll be given a Mifegyne tablet to swallow. This tablet stops the hormone that allows the pregnancy to continue.
• It is good idea to eat something before you take the tablet,  as this reduces the likelihood of nausea or vomiting. If you vomit within an hour of taking the tablet return to the clinic for another one.
• You may experience abdominal pain similar to menstrual cramp. If needed, you can take a pain killers like Alvedon or Ipren.
• Sometimes you may start bleeding before you take Cytotec, the next treatment step. If this happens, it is important that you continue the treatment and take Cytotec as planned despite the bleeding.

Day 2-4 – Continue treatment at home (in some cases on the hospital)

Ideally 24–48 hours, up to 72 hours after Mifegyne tablet.

• To prevent discomfort take the pain killers you were given at the hospital, and then insert four Cytotec tablets in your vagina.
• Usually within 1–6 hours the uterus starts to contract causing bleeding similar to menstrual bleeding, with some clots.
• If you haven not started bleeding after three hours, take two more Cytotec tablets orally.
• If you are in pain take Oxynorm 5mg. If you need to you can take more painkillers during the day or the next few days, for example Ipren 500mg or Alvedon 1g. It can help to take a walk or to use a hot water bottle.
• You may feel nauseous. It helps if you eat and drink small amounts. If you have been given medication for the nausea, it is fine to take it. When the bleeding gets heavier, the pain and nausea usually get better. Shaking and diarrhoea can occur, these are a side effects of the medication.
• Normally you will bleed for around ten days, but it may continue to bleed for a month or longer. Your menstruation usually returns 4–6 weeks after the abortion and can be heavier than usual at first. Pregnancy symptoms such as swollen tender breasts, tiredness and nausea usually disappear within a few days. Contact your midwife if you still have pregnancy symptoms a week after the abortion.
• While you are bleeding the risk of developing an infection is higher. Please contact emergency gynecology clinic (gynakuten) if you experience severe abdominal pain, foul-smelling discharge, high temperature or heavy bleeding which does not slow down.

Contraception

If you want to use the contraceptive pill or patch you can start using it the same day as the abortion or the following day. A vaginal ring can be used from when your bleeding has slowed down. If you have a prescription for a hormone injection or spiral (IUD), collect them from the pharmacy and take them with you to your next appointment.

We recommend that you take a home pregnancy test 2–3 weeks after the abortion.