Medical Abortion with Methotrexate / Misoprostol

Medical abortions are offered for women who are less than 7 weeks from the first day of their last period, or 5 weeks from the date of conception. This will be checked by ultrasound.

There will be at least 3 visits in our office. Your first visit will last about 2 hours and will include an examination and an ultrasound with the doctor, and time with our counselor. All of your questions will be answered and we will help you find an effective method of birth control. A blood test for hemoglobin and Rh will be done. (If you have a blood donor card, you will have one less blood test).

The next day you will return to our office to receive your dose of methotrexate. This is the medicine that stops the pregnancy. STOP TAKING ANY VITAMINS WITH FOLIC ACID (which interferes with methotrexate). We will also give you a package of medications to take home with you.

One to six days later, at home, you will insert misoprostol tablets into the vagina. The misoprostol tablets make the uterus cramp, you will bleed heavier than a period and the pregnancy will come out.

Some women have side effects such as nausea, diarrhea, headache, fever and chills. You will be given medications for side effects. These side effects usually go away within a few hours.

Your third visit will last about 15 minutes and will be about a week later. For most women, this will be their last visit. If the ultrasound shows that there is still tissue left in your uterus, you may be given more misoprostol and asked to return to our office for another ultrasound. This is called a delayed reaction and we will watch your progress until the ultrasound shows an empty uterus.

In about 1-2% of women this procedure will not work and a surgical abortion will be required, usually at our clinic. Another 4-5% of women choose surgery because they are having delayed reactions to the medication and don't want to wait. Less than 1% have complications such as infection or serious bleeding.

The medications leave your body within one week and will not affect future pregnancies or general health.

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