Expert: Doctor Early Options - 11/5/2009

Question
What is a medical abortion?  Is it the same thing as the abortion pill?  How is a medical abortion different from a surgical abortion? Which is safer? I am early, about 6 weeks, what are my options?
Thanks, MaryBeth

Answer
Dear Dawn,
Thank you for your questions regarding medical abortion and the Abortion Pill (RU486).  I have also added information on the Aspiration abortion procedure. Many women are confused about their early abortion options.  

Medical abortion refers to abortion induced by medications.  No instruments are used.  The abortion pill (RU486, Mifepristone)is the most effective medical abortion available.  Medical abortion with the abortion pill is effective up to 9 weeks of pregnancy, so it sounds like you are eligible to choose this option.

The abortion pill is 95-98% effective.  It is a 3 step process. 1) You take one pill (mifepristone or RU486) in the doctor's office. The first pill blocks the pregnancy hormones to stop the developing pregnancy; 2) You take a second set of pills, usually at home (misoprostol or Cytotec).  Within hours, these pills induce the miscarriage, so you will have cramping and bleeding.  3) You return to the doctor's office to make sure the medical abortion was successful.  

I always encourage women who are considering the Abortion Pill to learn more about the other nonsurgical early abortion procedure, called the Aspiration Procedure.  It is a noninvasive procedure that does not involve scraping, electric suction, or the need for general sedation.  The Aspiration Procedure has many advantages over medical abortion - it can be completed in just a few minutes, there is significantly less bleeding and cramping, and it is more effective (over 99%).

The World Health Organization recommends the Abortion Pill (RU486) and the Aspiration Procedure as the safest early abortion methods.  They are safer than surgical (D&C) abortions.  

There is much more information on medical abortion, the abortion pill, and the Aspiration procedure on my website: http://www.earlyabortionoptions.com

There are other medications that can be taken to induce an early abortion, however these medications are less effective, and tend to have an unpredictable bleeding pattern.  Methotrexate is now mainly used to treat ectopic pregnancy.  Cytotec abortions (misoprostol) are only 80% effective, and often require several rounds of medication.  

I hope this is helpful,
Doctor Joan
New York City