What is a medical termination of pregnancy?

The Mifepristone tablet (abortion pill) works by blocking the action of progesterone, the hormone needed to maintain a pregnancy and you will be given this tablet to take orally(by mouth) on Day 1 and is used with Misoprostol tablets, which are administered vaginally to induce an abortion on Day 2.

You have the option of inserting the misoprostol tablets in your vagina on your own at home and you will be given full instructions along with the tablets by the nurse you see on Day 1. This is very simple and is equivalent to inserting a tampon into your vagina. However, should you not be comfortable with this, you will be given an appointment to return to the hospital on Day 2 and the tablets will be inserted by the nurse. You will also be given painkillers and antibiotics to take.

Is this method suitable for me?

You may choose to have an early medical termination if you are less than 9 weeks.  This will be confirmed by an ultrasound scan.

However this method may not be suitable for you if you:-

  • Have allergies to Mifepristone or Misoprostol
  • Take steroids
  • Have any problems with your blood clotting
  • Take anti-coagulants
  • Have severe asthma/kidney or liver disease

First stage for medical termination

Should you choose this method, this will be done at the same time as your first appointment after your consultation with the doctor on Monday morning. Alternatively, you could choose to have it the following week or another day; however this would be only dependent on the staff availability to administer the medication on different days. 

You will be seen by one of the nurses who will give you the Mifepristone tablet to swallow with water and answer any questions you may have about the procedure.  You will be given full instructions along with the Misoprostol tablets and the other medication you may require if you are happy to insert them on your own on Tuesday.

Should you not want to do it yourself, you will be given an appointment to return the next day to 1st Floor Twickenham House, West Middlesex Hospital. If unable to attend please call 07879445042 ASAP.

Between the visits you can live a normal life at home or at work.  You may feel no different to normal but you may have some bleeding or period type pains.

  • If you have any doubts about your termination, please tell us during this visit
  • Your termination can be delayed and further counselling arranged
  • If you have any doubts about having the termination, you should NOT take the mifepristone tablet

What happens when I have taken the Mifepristone tablet?

You may experience:

  • Crampy, period type pains
  • Nausea/vomiting
  • Very occasionally you may start bleeding before your next visit to hospital.  There is a small possibility of passing part or the entire pregnancy after taking the first medication.

If you vomit within 2 hours of taking the tablet, you may need another.  Please come back to Outpatients straight away.

If you experience crampy pains, you must only take tablets containing paracetamol and codeine type medications. Please do not take painkillers containing aspirin or ibuprofen (eg. Neurofen) or similar drugs. Check with the nurse or doctor that the painkillers you have at home are suitable to take at this time.

If you experience heavy bleeding please report to casualty if concerned or mention this on your next visit (heavy bleeding may be more than three pads soaked in an hour or any amount that causes distress).

Second stage for medical termination

Almost 24 hours after the first tablet, you should insert the Misoprostol tablets (given to you on Day 1) into your vagina. You should insert the tablets with your fingers as far in as it goes followed by a tampon. Don’t worry as you will not be doing any harm by going too deep.

If you wished to come to the hospital, you will report to 1st Floor, Twickenham House, West Middlesex Hospital (same place as the first visit) at your given appointment time. You are requested to bring a tampon to be inserted after the vaginal tablet.

You will see the nurse on arrival.  The nurse will insert the Misoprostol tablets into your vagina followed by a tampon. Sometimes a doctor may do this in the absence of the nurse. You will go home after insertion of the tablet. 

Please remove the tampon 3 hours after the insertion of the vaginal tablets.

This medication causes contractions which help your body pass the pregnancy. You will have heavy bleeding with pain and then this usually settles after 6 - 8 hours. You will continue to have light bleeding for up to 2 weeks.

To help with the pain you can take 1 or 2 tablets of co-codamol up to 4 times a day. In addition to this you can buy ibuprofen. You can take 2 tablets of 200mg ibuprofen up to 3 times a day. You can take both co-codamol and ibuprofen at the same time.

If you experience heavy bleeding (heavy bleeding is regarded as more than  n three pads soaked in an hour ) or pain that you cant cope with, then please report to the A&E (casualty) of West Middlesex Hospital. If there is any problem or you have further questions or concerns, please call or text 07879445042 at any time.

You will be called or texted by the nurse at  around 18:00 hours to enquire about your  circumstances .

There is a small possibility the products of pregnancy haven’t been passed completely within 24 – 48 hours. If you have not had heavy bleeding, please call the number above to inform the nurses who  may book you in  for a repeat appointment or scan on the following Monday morning.

If you are experiencing heavy and continuous bleeding for 2 – 3 weeks please contact us on 07879445042 or 02083215005/5008 or attend A & E. If you are experiencing any signs of infection such as fever, continuous pain in the lower part of your abdomen (tummy), foul smelling vaginal discharge, please contact us or see your GP. In an emergency situation, please report to A&E. There is no evidence to suggest that a termination of pregnancy affects your future fertility.  However if you develop an infection that is not treated quickly this may affect fertility and therefore it is important that you complete your antibiotics and seek help if you have any signs of infection as detailed above, from your GP, the clinic that referred you or A & E. 

You can get pregnant again very quickly after a termination therefore you must start using contraception immediately and condoms with a new partner.If you have decided on the injection for contraception, this could be given at your second visit after the vaginal tablets. A separate appointment can be made if you have opted to have the second stage at home.  If you have opted for other forms of contraception, please see your GP to organise this as early as possible

If you blood group is rhesus negative you will need an anti D injection. An appointment for this will be given to you by the nurse in the week following your termination

You will be asked to use a pregnancy test 3 weeks after the procedure to ensure you are no longer pregnant.  Some patients may be booked for a repeat scan 2 – 3 weeks after the termination.

It is difficult to predict how women will feel emotionally after the termination, for some they may feel very sad, for others a sense of relief.  If you have any feelings of desperation please contact your GP or 0203 315 8381 and we may be able to arrange counselling help for you.

Contributors
Liz Alden