Self-Managed Medical Abortion

WHAT IS A MEDICAL ABORTION?

A medical abortion uses medication to end a pregnancy without surgery. It can be done from the privacy
of your home or with the help of a medical provider. Medical abortion is safest and most effective during
the first trimester of pregnancy which begins on the first day of your last period and lasts until the end of
week 12. You can calculate your trimester here. For best results, it is recommended during the first 7
weeks of pregnancy.
According to Planned Parenthood, medical abortion is very effective depending on how far along you are.
● For people who are 8 weeks pregnant or less, it works about 94-98 out of 100 times.
● For people who are 8-9 weeks pregnant, it works about 94-96 out of 100 times.
● For people who are 9-10 weeks pregnant, it works about 91-93 out of 100 times. If you're given an
extra dose of medicine, it works about 99 out of 100 times.
● For people who are 10-11 weeks pregnant, it works about 87 out of 100 times. If you're given an
extra dose of medicine, it works about 98 out of 100 times.

HEALTH RISKS
Potential risks of medical abortion include:
● Incomplete abortion, which may need to be followed by surgical abortion or a dilation and
curettage (D&C). This is less likely to be needed in the first 10 weeks of pregnancy
● An ongoing unwanted pregnancy if the procedure doesn't work
● Heavy and prolonged bleeding
● Infection
● Fever
● Digestive system discomfort
You must be certain about your decision before beginning a medical abortion. If you decide to continue
the pregnancy after taking the medications, your pregnancy may be at risk of major complications,
including birth defects. Medical abortion has not been shown to affect future pregnancies unless
complications develop.

Signs and symptoms that may require medical attention after a medical abortion include:
● Heavy bleeding — soaking two or more pads an hour for two hours
● Severe abdominal or back pain
● Fever lasting more than 24 hours
● Foul-smelling vaginal discharge

LEGAL RISKS
There are a few cases of urgent care staff calling the police on women who have administered abortion
pills at home that were purchased online. If you need to seek emergency medical care, remember that you
do not need to tell your doctors or nurses that you self-managed an abortion. Doctors and medical staff
will not be able to tell if you took the pills, even with a blood test. You have the constitutional right to
remain silent. Use it if confronted by the legal system.
To better understand the laws and legal risks, contact the Repro Legal Helpline online at
reprolegalhelpline.org or by phone at 844-868-2812. They provide free and confidential legal advice and
also defend people who are prosecuted or threatened with prosecution for self-managing their abortion.
This fact sheet also has some great information about legal issues.
Another legal resource is the National Advocates for Pregnant Women. The NAPW defends women who
are pregnant and attempt to have an abortion, actually have an abortion, or are mistaken as someone who
has had an abortion.
METHODS OF MEDICAL ABORTION
Medical abortion can be done using the following medications:
● Oral mifepristone (Mifeprex, RU-486) and oral misoprostol (Cytotec). This is the most common type of
medical abortion. These medications are usually taken within seven weeks of the first day of your last
period. You can learn more about access to this option at plancpills.org.
Mifepristone, usually taken first, prevents the embryo from implanting and growing by blocking the
hormone progesterone. Misoprostol, a medication typically prescribed to prevent gastric ulcers, causes
the uterus to contract, expelling the embryo through the vagina. Misoprostol is sold over-the-counter in
Mexico. You can find out more at womenonwaves.org
Depending on your state, if you chose to see a doctor for this type of medical abortion, you may take the
mifepristone in your doctor's office or clinic, and take the misoprostol at home, hours or days later. You
can find your local health or family planning clinic by using the Title X Family Planning Clinic Locator
provided by the Department of Health and Human Services, or by visiting plannedparenthood.org. This
regimen is approved by the Food and Drug Administration (FDA).
● Oral mifepristone and vaginal, buccal, or sublingual misoprostol. This type of medical abortion uses the
same medications as the previous method, but with a slowly dissolving misoprostol tablet placed in your
vagina (vaginal route), in your mouth between your teeth and cheek (buccal route), or under your tongue
(sublingual route).
The vaginal, buccal, or sublingual approach lessens side effects and may be more effective. These
medications must be taken within nine weeks of the first day of your last period.
● Methotrexate and vaginal misoprostol. Methotrexate (Otrexup, Rasuvo, others) is rarely used for
elective, unwanted pregnancies, although it's still used for pregnancies outside of the uterus (ectopic
pregnancies). This type of medical abortion must be done within seven weeks of the first day of your last
period, and it can take up to a month for methotrexate to complete the abortion. Methotrexate is given as
a shot or vaginally and the misoprostol is later used at home.
● Vaginal misoprostol alone. Vaginal misoprostol alone can be effective when used before nine weeks of
gestation of the embryo. But vaginal misoprostol alone is less effective than other types of medical
abortion.

Some research studies on the efficacy of these medical abortion regimens:

● Comparison of Mifepristone Followed by Misoprostol with Misoprostol Alone for Treatment of Early
Pregnancy Failure: A Randomized Double-Blind Placebo-Controlled Trial
● Misoprostol Alone for Early Medical Abortion in a Latin American Clinic Setting
● WHO multinational study of three misoprostol regimens after mifepristone for early medical abortion. I:
Efficacy

RESOURCES
Aidaccess.org: Online consult for abortion pills by mail.
Plancpills.org: Plan C provides information on how to access abortion pills.
https://www.guttmacher.org: The Guttmacher Institute shares data on abortion access and legal restrictions to
abortion in each state. Find their overview of abortion laws by state here.
Prochoice.org: The National Abortion Federation provides direct service to patients who need help accessing
abortion care.
Plannedparenthood.org: Planned Parenthood delivers vital reproductive health care, sex education, and
information to millions of people worldwide.