The term Abortion Pill is most commonly used to reference the medications mifepristone and misoprostol taken to terminate the pregnancy of a developing baby. Methotrexate is another abortion-related medication sometimes called the abortion pill. Some individuals confuse the morning after pill or emergency contraception with the abortion pill. The two are not the same. According to the World Health Organization, every woman has the recognized human right to decide freely and responsibly without coercion and violence the number, spacing, and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health (ICPD 1994). Access to legal and safe abortion is essential for the realization of these rights. One in four pregnancies ends in abortion. Abortions include various clinical conditions such as spontaneous and induced abortion (both viable and non-viable pregnancies), incomplete abortion, and intrauterine fetal demise.
Abortions are safe if they are done with a method recommended by WHO that is appropriate to the pregnancy duration and if the person providing or supporting the abortion is trained. Such abortions can be done using tablets (medical abortion) or a simple outpatient procedure.
Unsafe abortion occurs when a pregnancy is terminated either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards or both. Unsafe abortion procedures may involve the insertion of an object or substance (root, twig, catheter, or traditional concoction) into the uterus; dilatation and curettage performed incorrectly by an unskilled provider; ingestion of harmful substances; and application of external force. In some settings, traditional practitioners vigorously pummel the woman’s lower abdomen to disrupt the pregnancy, which can cause the uterus to rupture, killing the woman.
Women, including adolescents, with unwanted pregnancies, often resort to unsafe abortion when they cannot access safe abortion. Barriers to accessing safe abortion include:
- restrictive laws
- poor availability of services
- high cost
- the conscientious objection of healthcare providers and
- unnecessary requirements, such as mandatory waiting periods, mandatory counseling, provision of misleading information, third-party authorization, and medically unnecessary tests that delay care.
The health impact of abortion depends on whether abortion is performed safely. Pregnancies terminated either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards can have devastating physiological, financial, and emotional costs to the woman and her family, as well as to her community at large. Complications of unsafe abortion include hemorrhage, sepsis, peritonitis, and trauma to the cervix, vagina, uterus, and abdominal organs. Moreover, one in four women who undergo an unsafe abortion is likely to develop temporary or lifelong disability requiring medical care. The risk of abortion-related -death surges when the rates of unsafe abortion increase.
What are the possible risks of taking the abortion pill?
Medication abortion has been used safely in the U.S. for more than 20 years. Serious complications are really rare but can happen. These include:
- the abortion pills don’t work and the pregnancy doesn’t end
- some of the pregnancy tissue is left in your uterus
- blood clots in your uterus
- bleeding too much or too long
- allergic reaction to one of the medicines
These problems aren’t common. And if they do happen, they’re usually easy to take care of with medication or other treatments.
In extremely rare cases, some complications can be very serious or even life-threatening. Call your doctor or health center right away if you:
- have no bleeding within 24 hours after taking the second medicine (misoprostol)
- have heavy bleeding from your vagina that soaks through more than 2 maxi pads in an hour, for 2 or more hours in a row
- pass large clots (bigger than a lemon) for more than 2 hours
- have belly pain or cramps that don’t get better with pain medication
- have a fever of 100.4 or higher more than 24 hours after taking misoprostol
- have weakness, nausea, vomiting, and/or diarrhea that lasts more than 24 hours after taking misoprostol
Feeling sick with nausea, vomiting, diarrhea, belly pain, or a fever for more than 24 hours after taking misoprostol (the second set of pills) can be a sign of infection. Call your doctor or nurse right away if you have any of those symptoms. Serious problems can cause death in the rarest cases, but abortion is typically very safe. In fact, pregnancy and childbirth are riskier than most abortions.
If you have complications during your medication abortion, you may have to go back to the doctor’s office or health center. In the unlikely event that you are still pregnant, your doctor or nurse will discuss your options with you. You may need another dose of medication or to have an in-clinic abortion to end the pregnancy.
Mifepristone Side Effects
Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- a fever higher than 100.4 degrees F (38 degrees C) lasting longer than 4 hours;
- a general ill feeling or fast heartbeats;
- severe pelvic pain or tenderness;
- severe or ongoing nausea, vomiting, diarrhea, weakness; or
- no vaginal bleeding at all after taking Mifeprex.
Common side effects may include:
- heavy vaginal bleeding for 2 days;
- light vaginal bleeding or spotting for up to 16 days;
- fever, chills, weakness;
- dizziness; or
- nausea, vomiting, diarrhea.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects.
Misoprostol Side effects requiring immediate medical attention
Along with its needed effects, misoprostol may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention. Check with your doctor immediately if any of the following side effects occur while taking misoprostol:
- heavy bleeding
- painful menstruation
Incidence not known
- Bladder pain
- bloody nose
- bloody or black, tarry stools
- bloody or cloudy urine
- blurred vision
- body aches or pain
- chest pain
- difficult, burning, or painful urination
- difficulty with breathing
- difficulty with moving
- difficulty with swallowing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- ear congestion
- feeling unusually cold
- frequent urge to urinate
- hives, itching, or skin rash
- loss of voice
- lower back or side pain
- muscle pain or stiffness
- nasal congestion
- pain in the joints
- pale skin
- pounding in the ears
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- runny nose
- severe stomach pain
- slow or fast heartbeat
- sore throat
- tightness in the chest
- troubled breathing with exertion
- unusual bleeding or bruising
- unusual tiredness or weakness
- vomiting of blood or material that looks like coffee grounds
Side effects not requiring immediate medical attention
Some side effects of misoprostol may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
- Abdominal or stomach pain
- Acid or sour stomach
- excess air or gas in the stomach or intestines
- full feeling
- passing gas
- stomach discomfort or upset
Incidence not known
- Blistering, crusting, irritation, itching, or reddening of the skin
- breast pain
- burning, dry, or itching eyes
- change in taste
- continuing ringing or buzzing or other unexplained noise in the ears
- cracked, dry, scaly skin
- discharge, excessive tearing
- hair loss or thinning of the hair
- hearing loss
- lack or loss of strength
- paleness of the skin
- redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
- weight changes
What is the outlook for fertility following an abortion?
According to the American College of Obstetricians and Gynecologists (ACOG), having an abortion doesn’t generally affect your ability to get pregnant in the future. It also does not increase the risks of pregnancy complications if you do choose to get pregnant again. Many doctors recommend using some type of birth control immediately after abortion because it’s possible a woman can get pregnant again when she starts ovulating.
Doctors will also usually recommend a woman refrain from sexual intercourse for a certain time period after an abortion to allow the body time to heal. If you do have difficulty getting pregnant after an abortion, it’s important to consider some of the other factors that could potentially affect your fertility, since a past abortion isn’t likely to cause problems conceiving. These factors can also affect fertility:
Age: As you age, your fertility decreases. This is especially true for women older than age 35, according to the Centers for Disease Control and Prevention (CDC).
Lifestyle habits: Lifestyle habits, such as smoking and drug use, can affect your fertility. The same is true for your partner.
Medical history: If you have a history of sexually transmitted infections (STIs), such as chlamydia or gonorrhea, these can affect your fertility. The same is true for chronic diseases such as diabetes, autoimmune disorders, and hormonal disorders.
Partner’s fertility: Semen quality can affect a woman’s ability to get pregnant. Even if you have gotten pregnant with the same partner in the past, lifestyle habits and aging may affect your partner’s fertility.
If you are experiencing problems getting pregnant, talk to your gynecologist. They can advise you on lifestyle steps that may help, as well as recommend a fertility specialist who can help you identify potential underlying causes and possible treatment options.
Does the abortion pill have long-term side effects?
Like all medications, the abortion pill isn’t right for everyone. The abortion pill may not be right for you if you have certain medical conditions or take certain medications. Your doctor or nurse will talk with you and help you decide if the abortion pill is the right option for you.
Unless there’s a rare and serious complication that’s not treated, there’s no risk to your future pregnancies or to your overall health. Having an abortion doesn’t increase your risk for breast cancer or affect your fertility. It doesn’t cause problems for future pregnancies like birth defects, premature birth or low birth weight, ectopic pregnancy, miscarriage, or infant death.
Serious, long-term emotional problems after an abortion are rare and about as uncommon as they are after giving birth. They are more likely to happen in people who have to end a pregnancy because of health reasons, people who do not have support around their decision to have an abortion or people who have a history of mental health problems. Most people feel relief after an abortion.
There are many myths out there about the effects of abortion. Your nurse or doctor can give you accurate information about abortion pill side effects or any other concerns you may have.