How to Use RU486 (The Abortion Pill)

What to Expect at Your Doctor's Medical Abortion Appointments

Doctor explaining prescription medication to patient in clinic
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RU486 (brand name Mifeprex) has been widely, effectively, and safely used in France, Sweden, and Great Britain for years. The abortion pill RU486 is also FDA-approved to be used in the US. The abortion pill (also considered to be a medical abortion) must be provided by a healthcare professional.

In order to have a medical abortion, you will be required to visit your healthcare provider three times.

The first part of a medical abortion is taking the abortion pill RU486. Then, if necessary, RU486 must be followed up with a second medication, misoprostol, to completely terminate the pregnancy.

The First RU486 Appointment

During this visit, your healthcare provider must first determine if you are pregnant (through a pregnancy test and/or with a pelvic exam). If you are pregnant, your doctor may then date the pregnancy by using a sonogram (since this is not FDA-mandated, some providers may choose not to do a sonogram).

You will then be given three pills (200 mg each) of Mifeprex (RU-486) to be taken immediately by mouth. This dose of mifepristone will typically cause a fertilized egg to be unable to remain attached to the lining of the uterus.

You will then schedule your next appointment to take place 2 days later.

The Second Appointment

During this visit (which should be 48 hours after you have taken mifepristone), your doctor will perform an exam to see if the pregnancy has terminated.

If not, you will be given a second medication, misoprostol, in the form of two pills to be taken orally or as a vaginal suppository. This medication must be taken at the doctor’s office and should cause the pregnancy to end anywhere from six hours to one week later.

The misoprostol will cause uterine contractions, so you may experience cramping and bleeding.

Your doctor may prescribe pain medication and give you directions in case an emergency occurs.

The Final Appointment

You must follow-up with a visit to your doctor two weeks after taking the misoprostol. At this time, your doctor will confirm that the pregnancy has ended and ensure that there are no other problems (such as hemorrhaging or infection). If it is determined that you are still pregnant, it will be suggested that you schedule a surgical procedure to end the pregnancy. According to the Mifeprex label, “Patients who have an ongoing pregnancy at this visit have a risk of fetal malformation resulting from the treatment. Surgical termination is recommended to manage medical abortion treatment failures.”

More About the Abortion Pill

When taken alone, the abortion pill RU486 causes a complete abortion about 64 percent to 85 percent of the time. When misoprostol is given 48 hours later, medical abortion effectiveness is increased to 92 percent to 98 percent.

Abortion pill side effects can include cramping, possible nausea, vomiting and diarrhea, and bleeding that can last eight to 10 days.

The abortion pill RU486 is only FDA-approved for a woman who is up to seven weeks pregnant (which equals five weeks since conception) or up to 49 days after one's last menstrual period.

Although some healthcare providers will still use this method for women over seven weeks pregnant, use at this time it considered off-label (meaning, not FDA approved).

Despite popular belief, it is also important to note that the American Psychological Association has found that there is no evidence that a single abortion will cause mental health issues.

Sources:

FDA. Mifeprex label. Accessed 5/12/08.

Spitz, I.M., Bardin, C.W., Benton, L. & Robbins, A. (1998). Early pregnancy termination with mifepristone and misoprostol in the United States. New England Journal of Medicine, 338(18), 1241-47. Accessed through private subscription 5/12/08

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