Medical Abortion Pain, The Leading Causes of Medical Abortion Pain.

Medical Abortion Pain, The Leading Causes of Medical Abortion Pain.

When it comes to choosing the medical abortion to end an unwanted pregnancy, one may not be able to get around having the medical abortion pain and discomfort that may be associated with the procedure. Over 50% of women that undergo the medical process do not need any form of pain medication. Approximately 35 to 40% of women use a mild anti-inflammatory medication such as Motrin, Advil or Ibuprofen. Eight to ten percent of women need a stronger pain medication to help them get through the abortion process.

A medical abortion, commonly known as the abortion pill includes the intake of two distinct pills. These pills are highly effective, efficient and safe at ending pregnancy.

Emergency Contraception (“morning-after pill,”) is different from the Abortion Pill procedure. The medications used for Emergency Contraception are used to prevent pregnancy from occuring in the first place. They work by delaying or inhibiting ovulation. The Morning After Pill does not work after ovulation and does not have any effect on an established pregnancy. It does not cause fetal deformities or abnormalities, nor is it an abortifacient.

In this abortion blog, we will share with you the side-effects that come with the medical abortion procedure.

What Are The Types Of Medical Abortion Pills?

A medical abortion involves the intake of two pills, Mifepristone, and Misoprostol. The use of these two pills together increases the success rate of the abortion process when combined together. Medical studies show that there is a 94 to 99% success rate of completion. The Abortion Pill medications are available from a Abortion Pill Clinic, a private Physicians office or a hospital that provides abortion services. It is not advisable to buy the abortion pill online as proper medical supervision and follow-up are imperative to assure the process is successful and there are minimal to no complications.

How Do The Pills Work? Are They Effective In Terminating The Pregnancy?

A medical abortion pill is highly effective. When taken together, Mifepristone and Misoprostol, there is a high rate of their effectiveness in terminating the pregnancy. There is the possibility of the procedure not working. The most common complications are for the pregnancy to continue and a small amount of vaginal bleeding that may be brownish in color and not bright red. With each additional week of pregnancy, the effectiveness of the abortion pill slightly decrease with a increase in the risk of heavier vaginal bleeding and retention of pregnancy tissue inside the uterus.

How Medical Abortion Works

The first pill taken is Mifepristone (RU 486, Mifeprex). It blocks the hormone progesterone from attaching to the progesterone receptors on the uterine wall. Progesterone is highly important in maintaining pregnancy. The sudden drop in progesterone with a full term pregnancy is the cause of women going into active labor. How and why this happens remains a mystery. Without the proper amount of progesterone that is inhibited from attaching to the uterus by Mifepristone, the pressure inside the uterus begins to increase which leads to softening and opening of the cervix (lowest part of the uterus). Additionally a process called decidualization of the lining of the uterus occurs where the endometrium and blood vessels of the uterus break down and separates the pregnancy away from the uterine wall. This process begins within a short period of time after taking the Mifepristone tablet. Patient’s who are 8 weeks pregnant or less, the Mifepristone tablet alone will end their pregnancies 40% of the time. Misoprostol (Cytotec) is the second tablet taken. It can be taken simultaneously with Mifepristone or up to 5 days later. Most often Misoprostol is taken between 6 – 48 hours after the Mifepristone is given. Misoprostol is a prostaglandin that causes the uterus contract. This in turn aids to expel the pregnancy and the intrauterine content.

Who Is Eligible For Medical Abortion?

Women 10 weeks or less pregnant commonly use the Medical Abortion to terminate their pregnancy. It can also be used for patients who are 12 weeks, 14 weeks, 16 weeks or 21 weeks or further if the maternal or fetal indications are present. In essence, Medical Abortions can be performed in the first, second and the third trimesters of pregnancy. Specific medical issues also prevent women from having a medical abortion.

  • Women not willing to have a surgical abortion, in case the pills do not work.

  • Women suffering from long-term Corticosteroid usage

  • Women with certain genetic disorders

  • Women without access to emergency medical treatment facilities

  • Women with heart, kidney and liver problems

  • Women with severe adrenal gland problems

  • Women with bleeding disorders

Many other medical conditions can prevent women from using the medical abortion pill to terminate the pregnancy.

  • Women who are allergic to Misoprostol

  • Have history of severe asthma

  • Undiagnosed vaginal bleeding

  • Ectopic pregnancy

  • Severe Cervicitis

  • Recent Pelvic Inflammatory Disease

  • Patients who are Immune Compromised

  • Severe Anemia

What Makes Medical Abortion a Better Option for Terminating a Pregnancy? Are There Any Potential Risks Associated With Taking An Abortion Pill?

A medical abortion makes it easier to terminate the pregnancy without the need of going through an operation. The significant advantages offered by a medical abortion include;

  • No Anesthesia required

  • Less invasive as compared to a surgical abortion

  • Medical abortion does not carry the risk of uterine perforation

  • A early medical abortion is performed in the comfort of her home, there is more privacy and the woman can have someone present who she feels comfortable to support her through the process.

Although the medical abortion procedure is a safe option, there is a slight chance that certain complications may occur. These can include:

  • An Incomplete abortion where the fetus and gestation tissue might remain in the womb and may lead to infection.

  • Undetected Ectopic pregnancy, which can be is a medical emergency and at times leads to maternal death.

  • Blood clots that remain inside the uterus

  • Heavy vaginal bleeding

What Are The After Effects Of Medical Abortion?

There are many options available for women to take care of unplanned pregnancy; one such method includes taking abortion pills. Although, this is less intrusive as compared to a surgical procedure, but has its share of side-effects.

Hence, before taking an abortion pill, make sure that you are aware of its side-effects that include:

Fever and Chills

It is common that women who take Misoprostol get chills within the first 30 minutes of taking medications. It occurs in approximately 30 to 40% of patients. A low grade temperature may occur in 30 minutes to an hour. Ibuprofen or Tylenol can be rotated every two hours to control temperature that is greater than 100.4.

Intense Pain

You may experience medical abortion back pain after taking the pill. Severe pain in the abdominal and pelvic region is unusual as the majority of patients are able to tolerate the discomfort without having to take any pain medication. Most women describe the pain as bad menstrual cramps that is accommodated by heavy vaginal bleeding. The pain and heavy bleeding immediately subsides with the passage of the pregnancy tissue through the cervix. Women begin to feel significantly better and begin consuming fluids and their appetite returns.

Severe Uterine Cramps

At times, you might feel more than just the discomfort and cramping of a bad menstrual period after taking the abortion pill. The excessive cramping and pain in 8 to 10% of patients may require prescribing a narcotic pain medication. Once again; there is almost immediate pain relief after the pregnancy tissue leaves the uterus through the cervix.

Some people take Ibuprofen or Motrin 30 minutes to an hour before taking the Misoprostol tablet. Other methods to help reduce the lower abdominal and pelvic pain is to perform a uterine massage. This is where one lies down on the bed and places one hand just below the navel and press deep and move hand and fingers toward the pubic bone. Lift hand to below the navel again and continue to repeat this process. This is quite helpful to expel blood and clots out of the uterus. The buildup of blood and clots in the uterus can be extremely painful. Thus performing this massage technique may go a long way in alleviating the discomfort. A heating pad placed on the lower abdomen or taking a warm to hot shot may also help to decrease the pain and discomfort. Sitting on the toilet is similar to performing the uterine massage and is helpful in expelling clots and blood from the uterus. If have additional Misoprostol, it can be taken to help the uterus clamp down and reduce significant vaginal bleeding. The fasted method to control heavy vaginal bleeding with Misoprostol is to insert it rectally. Usually within 15 to 20 minutes the heavy bleeding will subside.

Incomplete Abortion

At times, a medical abortion may not lead to complete passage of the pregnancy tissue inside the uterus. This is called an incomplete abortion. Taking additional Misoprostol may lead to passage of the pregnancy tissue within a few minutes or hours. If there is an indication that a surgical procedure should be performed (temperature greater than 100.4, significant cramping and uterine and pelvic tenderness) starting antibiotics and surgical evacuation must be considered due to signs and symptoms of a uterine infection.

Smelly Vaginal Discharge

After taking the abortion pill, some women might experience a smelly vaginal discharge. This is not a sign to ignore as a foul smelly vaginal discharge may be a early sign of sepsis. This could rapidly deteriorate to multiple organ failure and death within a 24 hour period of time without an elevation in temperature. Aggressive IV hydration, starting on antibiotics and surgical emptying of the uterus must be immediately considered.


Nausea from initially taking the Mifepristone and Nausea and Vomiting after taking Misoprostol are very common side-effects of taking the abortion pill. If one vomits within 2 hour of taking the Mifepristone, then repeating the dose should be considered with taking some form of anti-nausea medication 30 to 60 minutes beforehand.

After the taking the second pill (Misoprostol), vomiting may begin as early as 30 minutes to an hour after taking them. It is important to remain hydrated. Drinking hot tea may help reduce vomiting and help relieve the lower abdominal and pelvic discomfort.


Although, medical abortion may save you the physical stress and pain of undergoing a surgical abortion procedure, patients must be aware of the complications and side effects that may occur with the use of the medical abortion. Headaches are a common side effect with taking Mifepristone or and Misoprostol. Normally the headache is mild. At times it may become so uncomfortable that a narcotic medication may be required. It is one of the medical abortion pains, which you might have to face. Proper hydration, rest and sleep may be beneficial to help with headaches.


A common side effect after taking Misoprostol is diarrhea. General this abates within 3 to 4 hours of taking the medication. If the diarrhea continues for more than 24 hours, then the woman must be evaluated for an infection. Adequate hydration must be maintained which at times requires IV fluids.

Excessive Bleeding

With use of the Abortion Pill process where Mifepristone affects the the attachment of progesterone to the uterus the fetus becomes detached from the uterine wall because the lining becoming thin and the increase in the intrauterine pressure causes the fetus to be expelled. This may lead to bleeding that can be a bit heavier than the monthly period bleeding. Bleeding for more than 2 pads an hour for more than two hours in a row needs to be evaluated by medical personnel immediately.

The chance of having to be admitted to the hospital for a blood transfusion is calculated to be less than 1 in 650 procedures.

Due to the higher risk of heavy bleeding and retained tissue, women who are 14 weeks or further should complete the medical abortion pill process in a medical facility.


Dizziness is one of the common side-effects of the medical abortion procedure; it generally subsides within an hour or two of taking the medications. However, if fainting sensation continues for 12 to 24 hours, then medical personnel should be contacted immediately.

How Will I Feel After The Medical Abortion?

It is important to follow all written instructions that are given to women prior to being released from the medical abortion facility. A 24 hour emergency number will be in the paperwork for women to call if there is any suspicion of problems or complications that are written on the discharge instruction sheet. This is the best way to prevent any serious complication from occuring.

The majority of women feel great the day following the medical abortion procedure. Most women pass the fetal tissue within 4 to 24 hours after taking the second medications. In some women it may take several days to complete the termination of pregnancy. It is important to follow-up in two to four weeks for a pregnancy test or sonogram to assure the abortion process is complete. There are studies that show if the pregnancy test is negative, a sonogram is not required. On the other hand, a positive pregnancy could mean the possibility of a continued pregnancy. If there is absence absence of a gestational sac or fetal parts, and the patient is asymptomatic (no cramps, uterine bleeding, pelvic tenderness or elevation of temperature) multiple studies suggest that no further intervention is required.

How Will the Medical Abortion Affect Future Fertility?

There is minimal to no chance of the medical abortion pill process affecting a woman’s fertility. Patient’s who follow the instruction sheet and call the medical facility when there is a problem, then patients have no problems with getting pregnant in the future.

How Does Medical Abortion Affect the Menstrual Cycle?

The menstrual cycle generally returns within 4 to 6 weeks after completion of the abortion procedure. It may come a week earlier or several weeks later.

Ovulation can occur in 5 to 6 days after the abortion is complete. Women are able to engage back with sexual activity as soon as they are comfortable. There are many women who are not able to discuss the fact that they underwent the medical abortion pill procedure and thus may find themselves having to have sexual intercourse either the same day or the following day of taking the Misoprostol tablet. Sperm are able to live as long as 5 days. Thus one can see why it is important to discuss some method of birth control including Emergency Contraception (Morning After Pill). There are medical abortion clinics that give away free the morning after pill when they have their abortion performed in their facility. The Plan B (Levonorgertrol 1.5 mg) can cost between $45 and $65 at Walgreens, CVS or Walmart. Thus there is a significant savings when the Emergency Contraception is free and included in the fee of the medical abortion procedure.

It is important to start birth control immediately. Although the Emergency Contraceptive Pill is highly effective if taken immediately (up to 96% prevention of pregnancy) after the unprotected event or birth control failure (condom breakage or leakage), it is still not as protective against preventing pregnancy as other forms of birth control (birth control pills, progesterone pellet or injection, IUD etc.).

The Conclusion

The medical abortion pains during the abortion pill procedure are temporary. In the majority of cases, the Physician gives the woman the first medication (Mifepristone). Most women are able to take the second medication (Misoprostol) in the comfort of her home. At times there may be the need by State law or another reason to return for the second medication between one to three days later. The heavy bleeding and cramping pains usually only lasts for 4 to 6 hour for the majority of women. The average amount of bleeding lasts from 5 to 16 days. In rare cases bleeding may last up to 60 days. It is important to follow-up in 2 to 4 weeks to assure that the abortion pill process is complete.

A medical abortion is a highly safe and effective of patients (96 to 99%) do not experience any side effects or complications. The most common side effect is continuation of the pregnancy. However, certain side effects may occur and may be significant. It is important to follow the instructions on the take home instruction sheet and to contact medical personnel if there are problems. This will be the best way to assure a safe and healthy recovery.

Dr James S Pendergraft Orlando Abortion

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