Expert: Doctor Early Options - 6/4/2008

Question
QUESTION: Hi Dr. Joan,
I began the medical abortion process today by insertion the misoprostol pills.  I have used 800 mcg. I  had read many places that the cramping should have started within 3-4 hrs after insertion pill.But so far I don't feel anything at all. No pain 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? Pls advice me. thanks

ANSWER: Dear Anna,
That's great news - maybe you won't have cramps with this.  The abortion pill usually causes cramping, but some women do not get significant cramps.  The abortion pill does tend to be completed more easily the earlier you are, and four weeks is very early!  The main concern is whether you are bleeding. You should bleed like a period or more, or else it may not have worked.  Either way, you should have a follow up visit scheduled with the doctor who gave you the pills.
You may find more information on our websites: earlyabortion.com, earlyabortionoptions.com.
I hope this is helpful,
Doctor Joan

---------- FOLLOW-UP ----------

QUESTION: Hi Dr. Joan,
Thanks a lot for the reply. After 7 hours of pill insertion I have got bleeding. That is very little, some drops only. Again no pain at all. I am planning to insert another 4 more pills today night. My worry is that do I have tubular pregnancy? How can I find this? Thanks a lot
Anna

ANSWER: Dear Anna,
Light bleeding after the abortion pill usually normal with the abortion pill at four weeks, however it should be heavier than a period.  It is good you are repeating the misoprostol pills tonight. A reputable doctor's office would not have prescribed the pills if there was an indication of a tubal pregnancy.  Did you get an ultrasound? They should have identified a tiny "gestational sac" on ultrasound to confirm that the pregnancy was in the uterus.  If this occurred, you should be reassured that it's not a tubal pregnancy.  You should have a follow up visit to assess that the pregnancy is over.
I hope this is helpful,
Doctor Joan
Earlyabortionoptions.com
New York City



---------- FOLLOW-UP ----------

QUESTION: Hi Dr. Joan,
Thanks for the reply. I did use another 4 more misoprostol insertion  pills today and the heavier is almost same, no pain, not much bleeding, less than a period. I like to tell you that I am Rh negative and I have received a protective injection of Rho(D) mini dose along with Methotrexate shot. As you suggested I took appointment with another Gynecologist on Friday. I am more worried now. Can I wait till Friday  Or Do I need to go for an emergency? I don’t have any another symptoms another than tension.

Thanks a lot.Anna  

Answer
Dear Anna,
It is better to wait until Friday to see what happens. Even in very unlikely event that this is ectopic, it is too early for there to be a problem. It would also be better to go back to the doctor who prescribed the pills, rather than a new gynecologist.  They will have the original informaion that they will need to determine whether it worked or not.  
I hope this is helpful,
Doctor Joan
earlyabortion.com