AboutDoctor Joan Expertise I am a family doctor who has provided abortion care for over a decade. I can answer any health or medical related questions about early abortion, including the aspiration procedure, the abortion pill (RU486), or surgical abortion. I run a practice called Early Options, located in New York City: earlyabortionoptions.com. The practice is dedicated to making early abortion part of mainstream medical care. There are other family doctors around the United States who practice a similar approach to early abortion care: see earlyabortion.com.
Experience Experience in the area: I am a board certified family doctor who has been providing abortion services for 12 years. I am the founder of Early Options (earlyabortion.com) dedicated to making early abortion part of mainstream medical care.
Organizations:
National Abortion Federation
American Association of Family Physicians
Education/Credentials: Harvard Medical School
Expert: Doctor Joan Date: 4/16/2008 Subject: Abortion pill
Question Hi Dr. Joan,
I began the medical abortion process yesterday by taking the mifepristone pill. I thought I had read somewhere that the bleeding should have started, but so far I don't feel anything at all. I was wondering if that's normal. I am 4 weeks along, so it's still very early, does that have anything to do with it? Should I have waited longer to begin the medical abortion?
Also, this is my second abortion, my last one was 6 months ago, and I know I can't emotionally go through another one. The first time I got pregnant I was on the ring. Now this time I was on the pill. Since both of those have failed for me in the past, I was thinking about getting an IUD, and also taking the pills or the depo shot, do you think that's recommendable? I am also really worried about my fertility, I see that I am very fertile right now, but I wouldn't want my fertility to be effected by taking two birth control methods. Although right now is not the right time, I do want to have children in the future and so does my boyfriend, but we want to be married first (although he doesn't know i'm having an abortion).
And my last question is I got the ring to start it right after the abortion process is over, but they never told me when I can start using the ring again, so I was wondering when I could start it. Thanks
Answer Dear Patricia,
The bleeding should start after the second medication, misoprostol. The bleeding typically starts hours after taking it, but it can take up to 24 hours. If it doesn't happen in 24 hours it may not have worked, and you may need to try the second medication again. As far as how early to take the pill, the doctor should have been able to see on ultrasound that the pregnancy is going to develop in the uterus (is not an ectopic pregnancy). Usually this can be seen 3 weeks after conception.
I am a big fan of the IUD. I have used them myself, and have inserted 100's of them, and rarely have a problem. I recommend the one WITHOUT hormones. When you want to get pregnant, you simply have the doctor pull it out.
You can start the ring the Sunday after you take the pills, so next Sunday. I would recommend that you stay on the ring until you get the IUD.
I know you are upset by doing this twice, but it is very normal, and of no concern to your future fertility. The pill and the aspiration procedure (you've probably never heard of it - earlyabortionoptions.com) are the safest ways to end early pregnancy and do not affect future fertility.
