Medical abortion (Mifegymiso)

At the Clinique De l’Alternative medical abortion, the pregnancy interruption done through medications, is available up until 63th day (9 weeks) of pregnancy counted from the first day of the last menstrual cycle.

Presentation

What is medical abortion?

At the Clinique De l’Alternative medical abortion, the pregnancy interruption done through medications, is available up until 63th day (9 weeks) of pregnancy counted from the first day of the last menstrual cycle.

The doctor will proceed to a physical exam and an ultrasound to insure that the pregnancy is under 9 months. If the pregnancy is under 63 days and a medication abortion is suited for you, our team will start the treatment.

Two medications have to be used when using this method of pregnancy interruption: Mifepristone and Misoprostol.

Every set of medical abortion pills contains one green box of Mifepristone and one orange box of Misoprostol.

Mifepristone is an anti-hormone. It blocks the effect of progesterone, a hormone necessary to the continuation of one’s pregnancy.

Misoprostol is a prostaglandin needed to produce uterus contractions and dilation of the cervix, which would help to the expulsion of what is contained in the uterine.

Mifepristone and Misoprostol work in pair for the interruption of a pregnancy.

Before

Before taking the medication

Medical abortion is irreversible, it will be followed by bleeding sometimes abundant accompanied by abdominal pain that could be severe. You will have to plan a follow up appointment 2-3 weeks following the abortion process in order to confirm if the procedure was successful. In certain cases, 2 more appointments might be necessary. If the process was not completed properly or did work, there is a 5% chance that you will need a curettage.

A minimum of 3 days absence is required from either work or school and also plan to have a friend or parent to stay with you in case of emergency during the expulsion process at home. Medical abortion is not advised if you are home alone or if you need to care for younger children.

A medical abortion is not suited if one of the following condition applies:

  • You are pregnant and want to carry the pregnancy to term
  • Your pregnancy is evaluated at more than 63 days
  • You have no access to emergency medical assistance 14 days following the intake of mifepristone.
  • Your pregnancy is outside the uterus (ectopic)
  • You are suffering of obesity (IMC 40)
  • You have any diagnosis related to hypo-coagulation (bleeding disorder) known or suspected
  • You are taking anticoagulant (blood thinner medications)
  • You have a severe illness necessitating steroids (i.e.: Non-controlled Asthma)
  • You are taking corticosteroid (medication that reduces the immune system such as prednisolone and cortisone
  • You are suffering from adrenal insufficiency
  • You are allergic to mifepristone, misoprostol or to all prostaglandins
  • You are wearing an IUD (intra-uterine device) – It will need to be removed before the medical abortion
  • You are breastfeeding

During

The steps of Medical abortion

From the first medical visit to the follow up appointment, the process can take up to a few weeks. At your appointment:

As mentioned previously, the meeting with the intervener aims at supporting you in your choice, not to judge the reasons that motivate your decision. The meeting is not a psychological evaluation but to listen respectfully in the most attentive way.

A urinary pregnancy test will be done at your arrival and the intervener will revise with you the questionnaire filled.

An explanation for the two types of abortion offered at the clinic will be provided: Surgical abortion and Medical abortion. The choice will depend on the patient but also of how far along the pregnancy is and certain other conditions. Furthermore, you will be able to discuss with the intervener if the different methods of contraception offered. Please keep in mind that no matter what is the choice made, our medical clinic will support throughout the whole process.

The meeting with the intervener will be done on a one on one bases, in order to for you to be at ease to ask questions and discuss of all your worries in total freedom. If you want to be accompanied for the procedure, please mention this to the intervener during the meeting.

A series of medical examination will be performed such as:

An ultrasound through the vagina in order to determine if the pregnancy is under 9 weeks (date calculated from the first day of the last menstrual cycle)

A gynaecological exam and a screening for Chlamydia and Gonorrhoea will be performed by the doctor.

A blood test will also take place in order to chart the number of pregnancy hormones before the medical abortion and to verify the Rhesus(RH) factor.

If your blood type is negative, our health care professional will have to raise awareness to avoid any conflict with the Rhesus(RH) factor before intaking the Mifegymiso pill.

There are two steps to the process

First Step :

A tablet of mifepristone (green box) will be swallowed as indicated by our staff member. Bleeding can occur for some women in between the first and the second step of the treatment. If there is worries, contact us if needed.

Second Step
:

24 to 48 hours after the intake of mifepristone, you have to take the misoprostol pill. You can decide of when to intake the second batch of pills with the intervener.

All 4 pills of misoprostol from the orange box have to be taken at the same time by placing them in the mouth between the cheek and the gums for 30 minutes. The pieces left and not dissolved can be swallowed with water.

Vaginal bleeding and cramps will shortly begin, evacuating all pregnancy tissues. It usually occurs 4 hours after misoprostol intake but it could happen anytime between 30 minutes and 48 hours. It is recommended to rest 3 hours after the intake, bleeding can persist on average for 11 days and can be abundant for 2-3 days.

Symptoms and side effects

Common symptoms

Following are the most frequent symptoms that one can experience during the medical abortion process. It is important to understand these symptoms and the risks associated to medical abortion.

After

After medical abortion

Your next periods should come 4 to 8 weeks after the procedure. Bleeding can be more abundant or contain blood clots. Your menstrual cycle will come back little by little.

  • Use hygienic pads for the first 7 days after the abortion. No tampons or menstrual cup is allowed.
  • Showers or bath are allowed but do not use public swimming pools, lake, or spas after the first week of abortion.
  • No vaginal shower for the first 7 days after abortion.
  • Do not insert anything in the vagina for 7 days.

It is preferable to avoid sexual intercourses with penetration as long as the doctor has not confirmed a successful and completed abortion. After the abortion, sexual desire can be reduced or absent, it is normal. Take the time needed to retrieve your sexual desire in order to have a satisfying sexual life. Method of contraception should start as prescribe by the doctor.

Support

Psychological support

If you need psychological support or if you need to consult a website to help you through the process of initiating a pregnancy interruption, please refer to the following resources.

Other services

Our other services

Surgical Abortion

Surgical abortion is a voluntary interruption of the pregnancy where the fetus and placenta is removed by an intervention done in 3 steps: Dilation, aspiration, and curettage.

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