MEDICATION ABORTION (ABORTION PILL)
We believe that every person should have medically accurate information about all pregnancy options and the freedom to decide whether, when, and how to create a family. If you decide to have an abortion, our role is to support you in your decision and to provide you with the highest quality medical care. Please call us to schedule an appointment or talk to one of our trained staff about available options and any questions or concerns you may have.
Enter the first day of your last period to see your options
- The abortion happens in the privacy of your home over the course of a few days.
- Available up to 10 weeks (70 day) from the first day of your last menstrual period, per clinician’s discretion.
- A minimum of two visits to the clinic on to receive medication and one to confirm abortion is complete.
- Two medications are used to end the pregnancy, mifepristone and misoprostol.
- Ultrasound before and after abortion (done same day of the two visits to clinic).
- Pelvic examination not usually required.
- High success rate (about 97%) Complications are rare.
- Birth control methods are offered at your second visit, including same day IUD and Nexplanon insertion.
What to Expect at Your Visit
Medication abortion is a safe and effective procedure in which two different medicines are taken to end the pregnancy. The first medication (mifepristone) blocks the hormones necessary for a pregnancy to grow; this ends the pregnancy. The second pill (misoprostol) makes your uterus contract and empty; this is similar to a miscarriage.
First Clinic Visit:
- On the day of your appointment, we’ll review your medical history, answer questions, and obtain your consent. Next, we’ll do lab work, a vaginal ultrasound, and make sure that you’re eligible for the medication.
- Next, you’ll meet our Nurse Practitioner. When you’re ready to start the process, she’ll give you the first pill to take at the clinic.
- You can use the second medication 24 to 48 hours after you've taken the first pill---you will decide what works for you. You can go about your normal activities in the time between the two medications.
- When you’re ready, you’ll insert the second medication into your mouth or vagina. You can expect to start bleeding within 1-4 hours, and the majority of the heavy bleeding usually lasts for about 5 hours and then tapers off. It is a good idea to plan to take it easy for the next 24 hours. The time it takes to complete the abortion varies from woman to woman. Light to moderate bleeding may come and go over the next 1-2 weeks. The Nurse Practitioner will review normal variations of bleeding with you.
- Bleeding and cramping are normal. Cramping can go from feeling like a normal period cramp to more intense pain. We will talk with you about how to manage your temporary pain and discomfort.
- You must be within a two hour drive of a healthcare facility and have no plans to leave the country soon.
Second Clinic Visit:
- 1-2 weeks after your abortion, you’ll come back to Health Quarters for an ultrasound to make sure the procedure is complete, and we'll check that you’re feeling well and provide you with post-abortion contraception, if you wish. The final visit is quick but important. Very rarely (1-3% of the time), will we need to provide follow-up medical care.
Call us 24/7 at (978) 922-4490 if you need us after your abortion.
Preparing For Your Visit
- You must arrive 15 minutes earlier to complete necessary counseling and consents prior to your scheduled appointment time. Please also build in time to find parking and find our clinic locations.
- Please bring proof of insurance and a valid government-issued photo ID (such as a license or passport). If this is a problem, please contact the clinic.
- If you are using insurance, we must verify coverage before your appointment. This process may take several days so make sure you provide your insurance information ASAP after scheduling. Please see our FAQs for more information.
- Copays and outstanding patient balances are due at the time of your appointment. We accept cash, MasterCard and VISA.
- It is important be well-hydrated and to eat a good meal (ideally nothing very greasy or spicy) before your appointment. We also strongly recommend taking 800mg of ibuprofen with your meal, prior to appointment. (Do NOT take aspirin.)
- Please wear full coverage underwear that you can wear with a pad and comfortable clothes that let you undress from the waist down.
- You can come by yourself and drive yourself home. However, you are more than welcome to bring a friend but they will not be permitted into the exam room with you. They must present a government-issued photo ID and comply with clinic policies.
- Do not take aspirin 7 days prior to your visit.
- Do not take any illegal drugs or alcohol 24 hours prior to your visit.
- If you are accompanied by children or babies, a separate responsible adult is required at all times to care for the child in the waiting area.
- We recommend having good thick maxi pads (not tampons or pantyliners), a thermometer, pain medicine in case of cramping (Ibuprofen, Advil, or Motrin are fine, Not Aspirin), and a heating pad at home for after your appointment.
- Do not bring a bag larger than a wallet, recordings devices, or weapons to the clinic.
- Health Quarters is committed to providing all our patients with exceptional care. When a patient cancels without giving enough notice, they prevent another patient from being seen. Please call us at (888) 727-9428 by 2 p.m. on the business day prior to your scheduled appointment to notify us of any changes or cancellations. If prior notification is not given, you may be charged $25 for the missed appointment.
- We have a very full schedule, so if for any reason you need to cancel or reschedule your appointment, it is important to let us know right away. This helps ensure you're able to find another appointment soon and also frees up the spot you aren't using for someone else seeking care.
Medication Abortion Instructions
Mifeprex (MIF-eh-prex) (mifepristone) tablets, for oral use
Read this information carefully before taking Mifeprex and misoprostol. It will help you understand how the treatment works. This Medication Guide does not take the place of talking with your healthcare provider.
What is the most important information I should know about Mifeprex?
What symptoms should I be concerned with? Although cramping and bleeding are an expected part of ending a pregnancy, rarely, serious and potentially life-threatening bleeding, infections, or other problems can occur following a miscarriage, surgical abortion, medical abortion, or childbirth. Seeking medical attention as soon as possible is needed in these circumstances. Serious infection has resulted in death in a very small number of cases. There is no information that use of Mifeprex and misoprostol caused these deaths. If you have any questions, concerns, or problems, or if you are worried about any side effects or symptoms, you should contact your healthcare provider.
Be sure to call Health Quarters promptly if you have any of the following:
- Heavy Bleeding. Contact your healthcare provider right away if you bleed enough to soak through two thick full-size sanitary pads per hour for two consecutive hours or if you are concerned about heavy bleeding. In about 1 out of 100 women, bleeding can be so heavy that it requires a surgical procedure (surgical aspiration or D&C).
- Abdominal Pain or “Feeling Sick.” If you have abdominal pain or discomfort, or you are “feeling sick,” including weakness, nausea, vomiting, or diarrhea, with or without fever, more than 24 hours after taking misoprostol, you should contact your healthcare provider without delay. These symptoms may be a sign of a serious infection or another problem (including an ectopic pregnancy, a pregnancy outside the womb).
- Fever. In the days after treatment, if you have a fever of 100.4°F or higher that lasts for more than 4 hours, you should contact your healthcare provider right away. Fever may be a symptom of a serious infection or another problem.
If you cannot reach your healthcare provider, go to the nearest hospital emergency room. Take this Medication Guide with you. When you visit an emergency room or a healthcare provider who did not give you your Mifeprex, you should give them your Medication Guide so that they understand that you are having a medical abortion with Mifeprex.
What to do if you are still pregnant after Mifeprex with misoprostol treatment. If you are still pregnant, your healthcare provider will talk with you about a surgical procedure to end your pregnancy. In many cases, this surgical procedure can be done in the office/clinic. The chance of birth defects if the pregnancy is not ended is unknown.
Talk with your healthcare provider. Before you take Mifeprex, you should read this Medication Guide and you and your healthcare provider should discuss the benefits and risks of your using Mifeprex.
What is Mifeprex?
Mifeprex is used in a regimen with another prescription medicine called misoprostol, to end an early pregnancy. Early pregnancy means it is 70 days (10 weeks) or less since your last menstrual period began. Mifeprex is not approved for ending pregnancies that are further along. Mifeprex blocks a hormone needed for your pregnancy to continue. When you use Mifeprex on Day 1, you also need to take another medicine called misoprostol 24 to 48 hours after you take Mifeprex, to cause the pregnancy to be passed from your uterus.
The pregnancy is likely to be passed from your uterus within 2 to 24 hours after taking Mifeprex and misoprostol. When the pregnancy is passed from the uterus, you will have bleeding and cramping that will likely be heavier than your usual period. About 2 to 7 out of 100 women taking Mifeprex will need a surgical procedure because the pregnancy did not completely pass from the uterus or to stop bleeding.
Who should not take Mifeprex?
Some women should not take Mifeprex. Do not take Mifeprex if you:
- Have a pregnancy that is more than 70 days (10 weeks). Your healthcare provider may do a clinical examination, an ultrasound examination, or other testing to determine how far along you are in pregnancy.
- Are using an IUD (intrauterine device or system). It must be taken out before you take Mifeprex.
- Have been told by your healthcare provider that you have a pregnancy outside the uterus (ectopic pregnancy).
- Have problems with your adrenal glands (chronic adrenal failure).
- Take a medicine to thin your blood.
- Have a bleeding problem.
- Have porphyria.
- Take certain steroid medicines.
- Are allergic to mifepristone, misoprostol, or medicines that contain misoprostol, such as Cytotec or Arthrotec.
Ask your healthcare provider if you are not sure about all your medical conditions before taking this medicine to find out if you can take Mifeprex.
What should I tell my healthcare provider before taking Mifeprex?
Before you take Mifeprex, tell your healthcare provider if you:
- cannot follow-up within approximately 7 to 14 days of your first visit
- are breastfeeding. Mifeprex can pass into your breast milk. The effect of the Mifeprex and misoprostol regimen on the breastfed infant or on milk production is unknown.
- are taking medicines, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Mifeprex and certain other medicines may affect each other if they are used together. This can cause side effects.
How should I take Mifeprex?
- Mifeprex will be given to you by a healthcare provider in a clinic, medical office, or hospital.
- You and your healthcare provider will plan the most appropriate location for you to take the misoprostol, because it may cause bleeding, cramps, nausea, diarrhea, and other symptoms that usually begin within 2 to 24 hours after taking it.
- Most women will pass the pregnancy within 2 to 24 hours after taking the misoprostol tablets.
Follow the instruction below on how to take Mifeprex and misoprostol:
Mifeprex (1 tablet) orally + misoprostol (4 tablets) buccally
Figure A (2 tablets between your left cheek and gum and 2 tablets between your right cheek and gum).
- Take 1 Mifeprex tablet by mouth.
- Your healthcare provider will either give you or prescribe for you 4 misoprostol tablets to take 24 to 48 hours later.
Day 1: 24 to 48 hours after taking Mifeprex:
- Place 2 misoprostol tablets in each cheek pouch (the area between your teeth and cheek - see Figure A) for 30 minutes and then swallow anything left over with a drink of water or another liquid.
- The medicines may not work as well if you take misoprostol sooner than 24 hours after Mifeprex or later than 48 hours after Mifeprex.
- Misoprostol often causes cramps, nausea, diarrhea, and other symptoms. Your healthcare provider may send you home with medicines for these symptoms.
Follow-up Assessment at Day 7 to 14:
- This follow-up assessment is very important. You must follow-up with your healthcare provider about 7 to 14 days after you have taken Mifeprex to be sure you are well and that you have had bleeding and the pregnancy has passed from your uterus.
- Your healthcare provider will assess whether your pregnancy has passed from your uterus. If your pregnancy continues, the chance that there may be birth defects is unknown. If you are still pregnant, your healthcare provider will talk with you about a surgical procedure to end your pregnancy.
- If your pregnancy has ended, but has not yet completely passed from your uterus, your provider will talk with you about other choices you have, including waiting, taking another dose of misoprostol, or having a surgical procedure to empty your uterus.
When should I begin birth control?
You can become pregnant again right after your pregnancy ends. If you do not want to become pregnant again, start using birth control as soon as your pregnancy ends or before you start having sexual intercourse again.
What should I avoid while taking Mifeprex and misoprostol?
Do not take any other prescription or over-the-counter medicines (including herbal medicines or supplements) at any time during the treatment period without first asking your healthcare provider about them because they may interfere with the treatment. Ask your healthcare provider about what medicines you can take for pain and other side effects.
What are the possible side effects of Mifeprex and misoprostol?
Mifeprex may cause serious side effects. See “What is the most important information I should know about Mifeprex?”
Cramping and bleeding. Cramping and vaginal bleeding are expected with this treatment. Usually, these symptoms mean that the treatment is working. But sometimes you can get cramping and bleeding and still be pregnant. This is why you must follow-up with your healthcare provider approximately 7 to 14 days after taking Mifeprex. See “How should I take Mifeprex?” for more information on your follow-up assessment. If you are not already bleeding after taking Mifeprex, you probably will begin to bleed once you take misoprostol, the medicine you take 24 to 48 hours after Mifeprex. Bleeding or spotting can be expected for an average of 9 to16 days and may last for up to 30 days. Your bleeding may be similar to, or greater than, a normal heavy period. You may see blood clots and tissue. This is an expected part of passing the pregnancy.
The most common side effects of Mifeprex treatment include: nausea, weakness, fever/chills, vomiting, headache, diarrhea and dizziness. Your provider will tell you how to manage any pain or other side effects.These are not all the possible side effects of Mifeprex.
Call your healthcare provider for medical advice about any side effects that bother you or do not go away. You may report side effects to FDA at 1-800-FDA-1088.
General information about the safe and effective use of Mifeprex.
Medicines are sometimes prescribed for purposes other than those listed in a Medication Guide. This Medication Guide summarizes the most important information about Mifeprex. If you would like more information, talk with your healthcare provider. You may ask your healthcare provider for information about Mifeprex that is written for healthcare professionals.
For more information about Mifeprex, go to www.earlyoptionpill.com or call 1-877-4 Early Option (1-877-432-7596).
Medication Abortion At-Home Tips
Be comfortable. When you take misoprostol, choose a time when you have had a light meal and plenty of rest. Be in a comfortable place – do not take misoprostol at work or at school. You must take the misoprostol even if you have started to bleed after taking mifepristone.
Be prepared. Before taking the 4 misoprostol pills at home make sure you have maxi pads and pain medication (Motrin, Advil/ibuprofen, or Tylenol/acetaminophen, not Aspirin).
Take pain medication 1 hour before taking misoprostol. Take 800mg of Motrin or Advil/ibuprofen (4 tablets of 200mg each) or 1,000mg of Tylenol/acetaminophen (2 tablets of 500mg each). You can take Motrin or Advil up to every 8 hours or Tylenol every 4 – 6 hours. You can also use a heating pad to relieve pain. Do not take Aspirin.
If you are taking misoprostol vaginally instead of by mouth: Thoroughly wash and dry your hands. One at a time, place each of the four pills of misoprostol as far into the vagina as you can comfortably place them. Limit activity for the next 30 minutes to avoid the pills coming out. If after 30 minutes one of the pills falls out during bathroom use or otherwise, there is no reason to be concerned. After 30 minutes there is no reason to remove the pills; they will be absorbed or come out on their own.
Cramping and bleeding is normal and some clots of blood might be the size of an orange. You may bleed for up to 2 weeks after the abortion.
Drink lots of fluids and avoid rich, fried, or spicy foods. Drink plenty of fluids, particularly water. Avoid caffeinated beverages (tea/coffee/soda) and sugary beverages (juice/soda).
Emotions. Most women feel relieved when the abortion is over. Some women also feel sad, feel like crying, or are moody. These feelings are partly from the changes in hormones now that you are no longer pregnant. Feeling emotional at this time is normal. If you think your emotions are not what they should be, please talk to us as we can provide helpful resources.
Pregnancy Symptoms: Nausea and breast tenderness should go away in 1 – 14 days. Do not take a home pregnancy test – it could be positive even though you are no longer pregnant for 6 – 8 weeks until the pregnancy hormones are completely out of your system. The only way to ensure the completion of the procedure is to return for your follow up visit.
Breastfeeding: Wait for 5 hours after you took Mifeprex in the office and wait another 5 hours after taking misoprostol at home before breastfeeding. It is safe to breastfeed after having a medication abortion.
Sex and bathing. Once heavy bleeding has stopped you may have sexual intercourse when you are ready. It is okay to swim, shower, or take a bath any time after the abortion.
Birth control. You can get pregnant any time after an abortion, even before you get your next period, so using birth control is important if you want to prevent pregnancy. Start your birth control as discussed during your first abortion visit, and it will be discussed again at your follow up visit.
Getting your period. You can expect a period in 4 – 8 weeks. It is not the same for all women. Please contact us if your period does not return in 4 – 8 weeks.