The Abortion Pill Procedure (medical abortion, mifeprex, mifepristone, RU 486, Abortion Pill) has swiftly gained favor in the U.S. since 2001 when the FDA approved RU486 for terminating pregnancy between 3 and 7 weeks. There have been multiple studies in the U.S. and throughout the world that demonstrate the abortion pill is effective up to 9 weeks from a patient's last menstrual period with minimum side effects. RU 486 has been examined in several countries both on an in and outpatient basis and found to be effective and safe up to 14 weeks from the last menstrual period.
It is well published that patients less than 6 weeks gestation, who receive RU 486 alone, have a 40 to 60% success rate of expelling the pregnancy tissue (i.e., miscarriage). In order to reduce the length it took to complete the abortion process, along with diminishing the chance of uterine infection, vaginal bleeding or having retained tissue, Cytotec (misoprostol) was added. Cytotec is a prostaglandin known to cause uterine contractions. RU 486 causes an increase in the intrauterine pressure and separates the pregnancy tissue from the uterine wall. Changes also occur locally in the cervix (lower part of the womb) allowing the cervix to dilate (open) and become soft which helps the pregnancy tissue to be discharged from the uterus. This process can take on average between 4 to 6 hours after insertion of the Cytotec tablets. On average, there is a 2 to 6% failure rate using the combination of RU 486 and Cytotec to carry out the abortion procedure on patients between 3 and 14 weeks pregnant. Patients less than 6 weeks gestation have a 97 to 99% success rate. In essence, the earlier in gestation the medical abortion procedure is performed, the greater the success rate.
Abortions using RU 486 and Cytotec are associated with minimal complications. Side effects of RU 486 can include the possibility of headache, abdominal discomfort and diarrhea. Initial chills, fever, nausea vomiting and diarrhea can occur with the use of Cytotec.
Complications associated with the abortion procedure in general are retained (tissue remains behind in uterus) or failure of the procedure, continued or excessive bleeding, all of which require a surgical abortion procedure to be performed. In rare cases, blood transfusions have been required, and there have been reports of sporadic deaths due to a rare type of infection. There has been no conclusion that these deaths were directly caused by the abortion procedure. In general, patients who are further along in their pregnancy have more discomfort with their uterine contractions, and there is a slightly higher chance of a continued pregnancy which requires surgical removal of the pregnancy.
In summary, medical abortion with RU 486 and Cytotec has been used for many years to terminate pregnancies up to 9 weeks gestation and can now be used in many cases up to 14 weeks gestation. Patients who are further than 10 weeks must be advised that they may see fetal tissue if they look at the material that is expelled from their vagina. Performing the Abortion Pill procedure up to 14 weeks is to a high degree safe and effective alternative to the surgical abortion.