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Early medication abortion is a non-surgical abortion method which uses two medications (mifepristone and misoprostol) to end a pregnancy.
Some people will also call it medical abortion.
The medications end the pregnancy by causing a miscarriage. Pregnancy tissue is passed out of the body from the vagina, like a heavier and more painful period.
Pregnancy tissue is the cells that start to grow in the womb when you become pregnant.
Early medication abortion is safe and effective for pregnancies up to 9 weeks (63 days) gestation.
The brand name of the medications is MS-2 Step, and some people will use this term to talk about the medication.
Abortion medication is prescribed by a doctor, either a local GP or doctor at the MSI clinic.
Early medication abortion will be successful for about 93 of every 100 people who have one.
About 7 people will need to have another dose of medication or a surgical procedure to complete the abortion.[1] Complete means that the pregnancy has ended.
Early medication abortion is a safe and common procedure. But like other treatments there are risks.
One of the more common risks is called retained tissue. This is where some of the pregnancy tissue isn’t passed out of the uterus during the abortion. The uterus is medical term for the womb.
Another common risk is the medication fails and the pregnancy continues.
You may need another dose of medication or a surgical procedure if these happen.
The risk of serious problems is rare. About 1 in 1000 people will have a serious problem.
Serious problems could be an infection, very bad bleeding, or bleeding that continues for a long time. Your doctor will give you information about what to look out for. They will tell you when to access extra medical care.[2]
The risks of an early medication abortion are the same as with a miscarriage. They are also treated in the same way.
Different people experience different levels of pain from an early medication abortion.
You will usually find it more painful than a regular period. You may also have more bleeding than a regular period.[3]
You can use pain relief such as Panadol (paracetamol) and Nurofen (ibuprofen). Your doctor may also prescribe you stronger pain relief.
You can also use heat packs, massage your lower tummy, walk around, or have a warm showers to help with the pain.
The worst pain shouldn’t last longer than 24 hours.
If you have severe pain, or pain that continues beyond the first day and doesn’t get better with Nurofen or Panadol, you should seek medical care. Your doctor will tell you where to go for medical care.
You will also have heavy bleeding while the pregnancy tissue is being passed. You may have light to medium bleeding for up to 4 weeks.[4]
You should talk to your doctor about your medical history so they can see if an early medication abortion is safe for you. Your doctor may also use blood tests and ultrasounds for this.
If you cannot have a medication abortion, having a surgical abortion is possible.
You will need to have a support person who can help you at the time of taking the second medication.
You will need to have a safe place, usually your home, to have your abortion. This place should include a toilet for when you pass the pregnancy.
You will need to be within 2 hours of a hospital, preferably for 2 weeks after taking the medication.
If you have an intrauterine device (IUD), this will need to be removed before a medication abortion by a doctor.
If you work or go to school or university, you will need to take a day off and arrange care for any children or people you care for at the time you take the second medication (misoprostol).
Some people prefer early medication abortion because the second medication can be taken at home or in a safe, private place. This means that you can have the abortion at home.
Some people also prefer medication abortion because there is no anaesthetic or surgery.
You can use this section to learn detailed information about the steps in having an early medication abortion. We use medical language in this section.
See below for more information about the different places you can see a doctor for early medication abortion.
You will start by having one to two appointments with a doctor.
Your doctor will ask you about your last period to make sure the gestation of the pregnancy is under 9 weeks (at the time of the abortion).
The doctor will also ask you about other health conditions you have or medications you take. This is to make sure it is safe for you to have an early medication abortion.
Your doctor might also ask about any risk of sexually transmitted infections (STIs). This is important because some STIs increase your risk of infection after abortion.
Your doctor may also talk to you about contraception options [Link] if you would like to. This includes an option to have an intra-uterine device or contraceptive implant for free if you live in the ACT.
You can also ask any questions you may have about having an abortion. You can prepare any questions you have in advance.
You can use the Health Direct Question Builder to help you with this. Question Builder is for all heath conditions, not just abortion.
You may have an ultrasound and some blood tests to check the gestation and that it is safe for you to have an early medication abortion.
An ultrasound uses a special probe or wand to take a scan inside your body. The ultrasound and blood tests may be done at a separate services.
Usually, the ultrasound will be abdominal. This means that the images of the uterus or womb will be taken by a probe which is passed over your tummy.
If the gestation of the pregnancy is early (less than about 6 weeks) or if it cannot be seen from a scan of your tummy, you may need to have a vaginal ultrasound.
This is where a special probe is inserted into the vagina to take images of the uterus from inside the vagina.
You may find this uncomfortable, especially if you have experienced sexual violence. You will be asked to give your consent before the ultrasound.
Abortion medication is two different medications (mifepristone and misoprostol) which come in a single pack. The brand name of the medication is MS-2 Step.
The first medication is called mifepristone. It is a single pill which you swallow.
It works by stopping a hormone in your body called progesterone. This starts a miscarriage by softening the cervix. The cervix is where the uterus narrows and connects to the vagina. It also gets the uterus ready for the second medication.
You take the second medication at home roughly 24-48 hours after the mifepristone. You generally take the medication in the early morning. This medication is called misoprostol.
Misoprostol is 4 tablets which you take buccally. Buccally means you place the tablets between the gums and cheeks of your mouth. You leave the tablets in your mouth for 30 minutes to dissolve.
Misoprostol softens the cervix more and causes the uterus to cramp and push out the pregnancy tissue.
This will feel like cramping and bleeding. You can expect it to be worse than your normal period. It will last for a few hours. You may see pregnancy tissue when it is passed and there may be some large blood clots.
Most people will pass the pregnancy tissue within 6 hours. After this, the bleeding and cramping should ease. It will become more like a normal period but will last for 10-16 days.
Lighter bleeding can continue for up to a month afterwards.
You may also have some side effects from the medication including vomiting, diarrhoea, dizziness, tiredness or mild fever. These should only last for a short period. These symptoms should not continue to the next day.
If the pregnancy is closer to 9 weeks gestation, it is possible, but not very easy, to see an early embryo. An embryo is a group of cells that will grow into a foetus, and eventually a baby.
Some people will find it a relief to see this tissue. Others may find it upsetting.
For more information on the abortion medication, see NPS MedicineWise.
You will be able to return to work and exercise as soon as you feel well enough.
You may wish to avoid physical work or intensive exercise for about 1 week after the procedure.
Some people return to work the next day, but this might depend on the kind of work you do. If you do work that is physical, you may need more time to rest.
To reduce the risk of infection, you should not put anything into your vagina for 1 week after the abortion.
This includes tampons, menstrual cups, fingers or having penis in vagina sex. You should also not go swimming or have baths during this time.
You can expect your period to return 4-8 weeks after the procedure, unless you are using a type of contraception that affects your period.
You can have an early medication abortion by:
Each option has slightly different steps. You can find out more about the steps of each options below. You can also refer to this page for other things to know before an appointment.
For more information on the early medication abortion process, see Health Direct.
Your doctor will ask you about your last period to check the gestation of the pregnancy is expected to be less than 9 weeks. They will refer you to have an ultrasound and may also ask you to do have some blood tests done at a pathology service.
You can take a support person with you to this appointment. A support person might be able to help you feel more comfortable or at ease asking questions. Your doctor might also ask to speak to you alone for some parts of the appointment.
You may also wish to organise care for any children or people you care for while you attend this appointment. This is important if you want to keep the discussion private.
Ultrasound with an imaging service, and blood tests with a pathology service, to confirm the gestation of the pregnancy and to make sure it’s safe for you to have an early medication abortion.
If you live in the ACT, any ultrasounds or tests you need are free. There is a list of places you can go to for an ultrasound and blood tests here.
A second appointment where your doctor will discuss the outcomes of your tests with you and advise whether an early medication abortion will suit you.
If it is, your doctor will also prescribe you abortion medication and any pain and anti-nausea medication they decide you need.
If you choose to, you can start some types of contraception at this appointment.
You will need a valid prescription from a doctor for abortion medication.
Not all pharmacies stock the medication, so it is important to check before going there. You can find information about pharmacies that always have abortion medication and provide free medication to people who are ACT residents here.
Taking the medications at home or in a safe, private place with a bathroom.
Follow up appointment with the doctor to check that the abortion is complete and whether you need any other care. This may involve blood tests or a urine pregnancy test.
A consultation with a doctor to discuss your medical history. Your doctor will ask you about your last period to make sure the gestation of the pregnancy is under 9 weeks. You will have an ultrasound during your appointment to confirm this.
Your doctor will discuss the outcomes of your tests with you. They will tell you if an early medication abortion will suit you.
If it is, your doctor will also prescribe you abortion medication and any pain and anti-nausea medication you may need.
You will take your first medication in the clinic.
If you choose to, you can start some types of contraception at this appointment.
Taking the second medication at home or in a safe, private place with a bathroom roughly 24-48 hours after the first medication.
A special urine pregnancy test done after 2-3 weeks to check that the abortion is complete and whether you need any other care.
You will be given the test at your first appointment at the clinic.
If you need any other care you can call the MSI Aftercare phoneline. You may need other tests or an appointment in the clinic to follow up.
More information about the process is available from MSI Australia here.
A phone consultation with a doctor to discuss your medical history and whether an early medication abortion is safe for you.
You will be sent a referral form.
At your second phone consultation your doctor will discuss the outcomes of your tests with you and advise whether an early medication abortion will suit you. You can also ask questions at this consultation.
You will be sent the abortion medication by courier once your doctor has confirmed it is safe for you to have a medication abortion.
You will also be sent pain and anti-nausea medication and a special pregnancy test to check the abortion has been successful.
You will need to be able to accept the delivery from the courier in person.
Taking the medications at home or in a safe, private place with a bathroom.
After 2-3 weeks, you will do a special urine pregnancy test to check that the abortion is complete and whether you need any other care. You will be sent the test with your medication.
If you need any other care you can call the MSI Aftercare phoneline. You may need other tests or an appointment in the clinic for follow up.
More information about the process available from MSI Australia here.
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