Medical Abortion – Abortion Pill (Plan C)

Your Pregnancy Situation 

Are you considering a medical abortion (the abortion pill)?  

An unplanned or unexpected pregnancy can include many emotions like surprise, anxiety, confusion, fear, and others. Helping you through your emotions and understanding the facts is important. 

Obria Medical Clinics are where you can get low cost or FREE Pregnancy Options Counselling, medically accurate facts, answers to your questions, and respectful compassionate help that you want and need. We are here to walk with you through your pregnancy options for you to make the best decision for your situation.

Obria Medical Clinics do not perform nor refer for abortion services. 

We Can Help You Address Your Pregnancy Questions

• Am I pregnant? 
• How do I know if I’m pregnant? 
• I don’t have health insurance. How can I get medical care? 
• What about my future? 
• What do other pregnant women do? 
• What options do I have? 
• What are the details, risks, side effects, and costs of abortion? 
• What if I’m not sure about my pregnancy decision? Or I change my mind? 
• What will my parents say? 
• Should I tell the father? How do I tell him? 
• How will I finish school? 
• What will my classmates/professors/teachers think? 
• How can I provide for a child? 
• Where can I get parenting education?

Understand Abortion is a Medical Procedure 

It is important to understand that both types of abortion are medical procedures:  

• medication abortion (abortion pill) 
• surgical abortion

Like any medical procedure, it is important that you fully understand what you will experience before, during, and after the abortion procedure. You have the right to know everything about abortion before making such a serious decision

What is the Abortion Pill (Medical Abortion)?

The Abortion Pill is considered a medical abortion, medication abortion, chemical abortion, or non-surgical abortion. It can be called an in-home abortion since it occurs in the patient’s home, not in a medical facility. It is also called “Plan C”. Some people may describe it as self-induced abortion, self-managed abortion, or online abortion, although these latter terms are not the best description. 

The Abortion Pill is a combination of two prescription drugs, in two separate pills – Mifepristone (Mifeprex brand name) (RU-486) and Misoprostol (Cytotec brand name) – designed to induce an abortion or terminate a pregnancy. It should not be used if it has been more than 70 days since your last period, should only be used under careful medical supervision, and after confirming you are a candidate. ¹

Abortion Pill Procedure Details 

The FDA-approved regimen for the Abortion Pill (RU-486) is a multi-step process including supervision by a medical healthcare provider or pharmacy, possibly using ultrasounds or other testing, and using two different medication pills¹. Two in-person ultrasound and exam visits for medication abortion are useful. In some states within the United States, most women undergo ultrasound for 1) pregnancy dating and 2) confirmation of complete abortion. In most states, one visit to a medical provider or a telehealth visit are still required to obtain the prescription. ²

1. A medical appointment or telehealth appointment is had with a medical provider.  
2. The two medications are prescribed by a licensed or certified medical provider and purchased by the patient.  
3. Mifepristone (Mifeprex brand) – The patient takes this first medication Mifepristone which blocks the placenta from working properly. Once the placenta ceases to work properly, the pregnancy will lose the blood supply. Mifepristone should be given to you by a healthcare provider in a clinic, medical office, or hospital.
4. Misoprostol (Cytotec brand) – After 24 to 48 hours after the patient takes the first medication (Mifepristone), the patient then takes the second medication Misoprostol, which contracts the uterus and expels the pregnancy and any other tissue inside. 
5. Two weeks (14 days) later, another visit to the clinic is recommended for an ultrasound to be sure all the contents of the uterus are expelled and assessed for any complications or issues.

Telehealth

Some advertisements make medical abortion sound quick and simple with an abortion through telemedicine (virtual/remote/video) medical care, which prevents travel to an abortion clinic. In this scenario, an abortion clinic or provider conducts virtual treatment primarily through the internet and prescribes the medications to the patient.³   

In-Person Comfort

For many people, when there is a health risk involved, there is something that feels safer and more comforting about being in person, in the room with a doctor and/or a nurse, and having easy, quick access to them. Many people want someone who takes the time to carefully listen, be supportive and help, and explain the specific details – in person. Telehealth has some notable limits. 

The Facts

It is important to have all the facts, so you understand how this will affect you.  

• The medication. The U.S. FDA warns that you should not buy Mifeprex or its approved generic over the Internet because you will bypass important safeguards designed to protect your health. Also, drugs purchased from foreign Internet sources are not the FDA-approved versions of the drugs, and they are not subject to FDA-regulated manufacturing controls or FDA inspection of manufacturing facilities.¹ 
• Ultrasounds. This is a way to see inside you – it is a very useful diagnostic tool. The ultrasounds should be done by a trained sonographer. 

• Medical Provider Care. There are multiple issues for you to address during the preliminary pregnancy choices counseling and the abortion procedure. This can be challenging to address through a brief telehealth interview and/or telehealth follow-ups. It is important to confirm what type and level of care you will receive during the procedure. 

1. The licensed medical provider needs to be aware of your medical history. Some circumstances would make a medical abortion unsafe. Before prescribing the two types of medical abortion pills a licensed medical provider needs to determine if medical abortion is the appropriate course of action for you.
2. You should clearly understand the following: 
   • The potential costs including financial, physical, mental health, and others.  
   • The risks and side effects.  
   • Your legal rights.

   3. Your questions and concerns should be addressed completely, so you feel comfortable with your choice and knowledgeable about the procedure and details. NOTE – Depending on the clinic / provider, you may not be under constant close medical supervision during some of the abortion process that occurs at your home. Therefore, you or someone with you (family, friend, significant other) will need to be responsible for your care, to assess if your symptoms require urgent medical attention and/or mental health care.

   4. Complications. There may be problems that occur along the way. If there are any occurrences, for example, unusual health symptoms, excessive bleeding, or flu-like / fever symptoms that indicate a possible infection, you need to be able to quickly contact your medical provider or a hospital for help.¹ They need to be immediately available. 

Cautions 

We can discuss the details of these issues during your visit to Obria Medical Clinics. Realize that:

There are potential costs to medical abortion, including financial, physical, mental health, family, and others. 

If this abortion method fails, a surgical abortion may be required for the successful abortion of the fetus. ^4,5

If complications or issues exist, then additional medical care may be required. 

Mifepristone may cause serious side effects and should not be used if the patient has certain medical conditions. It should not be used under certain pregnancy conditions – for example, if implantation in the uterus has not occurred, which means the pregnancy is ectopic.⁶The abortion pill will not abort an ectopic pregnancy nor should be used if you have ever had an ectopic pregnancy. An ectopic pregnancy can be life-threatening.  

NOTE – The U.S. FDA has enough of a safety concern that they have the medical abortion drug Mifepristone under their Risk Evaluation and Mitigation Strategy (REMS) program. This program is for certain medications with serious safety concerns to help ensure the benefits of the medication outweigh its risks. While all medications have labeling that informs health care stakeholders about medication risks, only a few medications require a REMS.⁷

It is not recommended to take the abortion pill after the 9-week pregnancy mark.⁶ The FDA mandates that abortion pills must be prescribed under a medical health provider. However, since certain abortion pills are allowed to be purchased online, many patients take the abortion pill without the in-person supervision of a medical health provider. This is risky, since without the proper guidance and information, abortion pills can be hazardous.  

The Abortion Pill – What it is Not: Morning After Pill / Plan B 

The abortion pill (“Plan C”) is not the same as the “morning after pill,” also called the “Plan B pill” or an “emergency contraceptive.” The abortion pill is intended for women who have a verified pregnancy and is used to terminate an existing pregnancy.  

The “morning after pill” is intended to prevent a pregnancy from occurring – it is used shortly after sexual intercourse. The newest morning after pill, Ella, works on a similar fashion as the first pill in the RU-486 protocol, in that its action blocks progesterone receptors. It is approved by the FDA for use up to five days after intercourse and has abortifacient effects.⁸

For either pill it is advisable to speak with a medical professional before considering them, due to health considerations.

The Abortion Pill – Risks 

• American Psychological Association (APA) research states, “It is important that women’s varied experiences of abortion be recognized, validated, and understood.”⁹ 

  If you’re considering this procedure, make sure you understand what it entails, side effects, possible risks, complications, and alternatives. Therefore, an abortion decision should not be made without careful thought and understanding all the details. It’s important to know the potential impact it could have on your body and future health. 

  Abortion health risks, danger of abortion, and abortion side effects vary by the type of abortion procedure, your specific physical and mental health conditions, and how far along in the pregnancy you are.

  Medical Abortion Side Effects 

  Most women experience some of the following during and/or after a medication abortion. ^{10, 11}

  • Abdominal pain 
  • Cramping 
  • Nausea
  • Diarrhea 
  • Spotting/bleeding

  Medical Abortion Complications (Potential) ^{4, 6} 

  These are some possible complications that may occur: 

  • Heavy or persistent bleeding that is heavier than a normal menstrual period 
  • Infection or sepsis 
  • Incomplete Abortion  
  • Allergic Reaction  
  • Fever

Long-Term Abortion-Related Health Risks 

There is literature to support the possibility of these future abortion-related health care risks:  

• Future Pre-term Deliveries ¹² 
• Mental Health Impacts ¹³ 
• Infertility & Future Childbearing (if complications occur) ^{12, 14}

Note: Pregnancy Assessment services – might be FREE depending on patient insurance / income, including: Low cost or FREE medical grade urine pregnancy verification testing verified by a nurse, Low cost or FREE pregnancy confirmation via Ultrasound, and Low cost or FREE pregnancy options education. However, no patient is ever turned away due to inability to pay!