A medical abortion involves taking two medications to end the pregnancy. You won't need surgery or an anaesthetic.
You must be no more than 12 weeks pregnant on the day of the abortion. This is unless you are having an abortion under certain circumstances. This is the law.
Before a medical abortion
You have to have a pre-abortion consultation.
There has to be at least 3 days between your pre-abortion consultation and the abortion.
You must be no more than 12 weeks pregnant on the day of the abortion, unless you are having an abortion under certain circumstances.
If you are more than 9 weeks pregnant, you will have the medical abortion in hospital. Your GP or doctor will refer you.
What happens during a medical abortion
A medical abortion can be slightly different depending on where you have the abortion. But it usually involves 3 steps.
The doctor will check and confirm that you are still no more than 12 weeks pregnant on the day the abortion begins.
You will be asked to sign a medical abortion consent form (PDF, 1.52mb) on the first day of the abortion.
If you are under 9 weeks pregnant, you'll be asked to give your consent verbally by phone or video link. This is a temporary measure due to the coronavirus outbreak.
Step 1 — first medication (mifepristone)
You first take a medication called mifepristone. Mifepristone comes as a tablet.
The tablet stops the hormone that allows the pregnancy to continue. The lining of the uterus breaks down and the pregnancy can't continue.
You'll be able to do your normal activities afterwards.
Most women do not have bleeding or pain after taking mifepristone. But if you think the pregnancy has left your body before taking the second medication call the My Options helpline on freephone 1800 828 010.
After taking mifepristone, you might also feel like you need to vomit.
If you vomit within 1 hour of taking this tablet, contact your GP or doctor as soon as possible. You will need to take the tablet again.
Once you take mifepristone, the abortion will begin. It is irreversible. If you decide not to take the second tablet, there is a risk of harm to the foetus if you continue the pregnancy.
If your blood type is rhesus negative and you are between 9 to 12 weeks pregnant, you will get an anti-D injection in hospital.
Step 2 — second medication (misoprostol)
Usually 24 to 48 hours later you take a second medication called misoprostol.
Misoprostol comes as two tablets.
You will take the tablets either at home or in hospital, depending on what stage of pregnancy you are at.
You place each of these tablets between your gum and cheek and let them dissolve in your mouth.
Misoprostol makes the womb contract, causing cramping and bleeding. Heavy bleeding usually starts 2 hours after taking misoprostol. But it may start sooner or later.
You should plan this process so that it fits in with your daily schedule. You should take time off and make sure that you have support available at home, if you need it.
Bleeding and cramping usually last for at least a few hours. You will probably need to take pain relief medication (ibuprofen) at this stage.
You might also:
- feel dizzy
- feel nauseous or vomit
- have a headache
- have diarrhoea
- have temporary flushes or sweats
Step 3 — abortion completed
Within 4 to 6 hours of taking the second tablet, the lining of your womb will break down. This will cause bleeding and for most women the pregnancy will leave your body.
If you are between 9 to 12 weeks, you will have to stay at the hospital while this happens.
For others it may be quicker or may take longer. It can occasionally take a few days.
You may see large blood clots or tissue at the time of the abortion. The tissue will be larger and more recognisable at higher gestations.
Under 8 weeks, you are only likely to see the sac within which the early pregnancy is developing. You can decide how to dispose of the pregnancy remains. They can be flushed down the toilet, or wrapped in tissue and disposed of as you wish.
You will generally bleed for up to a week afterwards. This bleeding will be like your regular period.
Up to 9 weeks pregnant
If you are no more than 9 weeks pregnant, you can have a medical abortion by contacting a:
- GP surgery that provides abortion services
- family planning clinic that provides abortion services
- women’s health clinic that provides abortion services
9 weeks is 63 days since the first day of your last period.
The doctor will tell you to collect the medication from the surgery or clinic. You can send someone else to collect the medication for you. But you'll need to give their name to your doctor in advance.
You'll get instructions on how to take the two medications.
If you have any questions or concerns after taking the medication, phone your doctor. You can also call the My Options helpline on 1800 828 010 to speak to a nurse.
A follow-up consultation can take place with your doctor to make sure the abortion is complete. Your doctor can discuss the timing of this call with you.
9 to 12 weeks pregnant
If you are more than 9 weeks pregnant, but no more than 12 weeks pregnant, you can only have an abortion in a hospital.
12 weeks is no more than 84 days since the first day of your last period.
Your doctor will refer you to a hospital for the abortion.
A doctor in the hospital will also check that you are less than 12 weeks pregnant. They will then help you decide which method — medical or surgical — is best for you.
If your blood type is rhesus negative, you will get an anti-D injection in hospital.
You’ll take the first tablet in the hospital. You can then go home.
You will have to go back to the hospital to take the second tablet between 24 to 48 hours later. This will complete the abortion.
If you have the abortion after 9 weeks, it may take longer for the medication to end the pregnancy.
You may have to stay in hospital for up to 8 hours for observation.
You are unlikely to have to stay overnight in hospital. But you may need to if the pregnancy has not passed.
After 12 weeks
If you are having an abortion after 12 weeks, you will have a medical abortion in hospital.
You can only have an abortion after 12 weeks in exceptional circumstances.
Find out more about an abortion after 12 weeks.
Most women will have strong cramping during a medical abortion. These cramps are stronger than usual period pains.
You can lessen the pain if you:
- wear comfortable clothes
- apply a heat pad or hot water bottle to your lower stomach
- use pain medicine like ibuprofen
Always read the patient information leaflet that comes with these medicines.
Your doctor can give you a prescription for pain medication if you need it.
After a medical abortion
Your GP or doctor will give you a special pregnancy test to take at home 2 weeks after the abortion.
This is a low-sensitivity test. It is different to a normal pregnancy test. This is to confirm that the pregnancy has ended.
The risk of an ongoing pregnancy is:
- between 9-12 weeks — 2 in every 100 medical abortions
- under 9 weeks pregnant — 1 to 2 in every 100 medical abortions
You will also have the choice to visit your GP or doctor about 2 weeks after the abortion. The GP or doctor will make sure the abortion is complete and that you are healing properly.
This final visit is optional. But it is free and you should attend it.
If you don't go to your post abortion check-up, the doctor might call you instead.
Medical abortion: risks and complications
Medical abortions are generally very safe. Most women won't experience any problems.
But like any medical treatment, there is a small risk that something could go wrong.
There is a greater risk of complication the later in your pregnancy that you have an abortion. You may need to go to hospital for treatment.
Risks and complications of a medical abortion include:
- the abortion may take longer than you thought
- pregnancy tissue remaining in the womb after the abortion. This happens in 2-3 in every 100 abortions. You may need a minor surgical procedure to remove it.
- a continuing pregnancy can happen in up to 2 in every 100 abortions. It is less likely to happen the earlier you have an abortion. You will need further treatment if this happens.
- infection in 1-2 in every 1,000 abortions
- excessive bleeding, possibly requiring a blood transfusion (less than 1 in 1000 women)
- irregular or prolonged bleeding after the abortion
- mental health problems such as feeling down or upset
Common side effects
It is common to experience some pain after the procedure. You may also experience:
- fever or chills
If complications do occur then further treatment, including surgery, may be required. This could include a:
- surgical abortion (in cases of failed or incomplete abortion)
- laparoscopy or laparotomy – this is an operation to look inside the abdomen (stomach) in the event of an ectopic pregnancy
Success rate of medical abortion
A medical abortion has a 98% success rate of ending pregnancy. This means it is very successful.
But there is a small chance that it will not be successful.
You may need to have a surgical abortion or further medication if the abortion fails to end the pregnancy.