Medical Abortion
A medical abortion involves the use of medications to end (terminate) a pregnancy. The most effective medication combination is mifepristone + misoprostol, available in Canada as Mifegymiso.
If you want to end your pregnancy, and it is 10 weeks or less since the first day of your last period, medical abortion may be a good option for you.
There is no cost for the medication (the cost is covered by the Ministry of Health for all BC residents with a valid MSP number). For people from out of province, the cost of the visit is covered, but not the cost of the medication. Some extended health plans will cover the cost of the medication.
For people with no Canadian health insurance, please tell the staff when you call to book an appointment. They will review the cost with you.
The Process
If you are interested in a medical abortion, you will first talk with our nurse educator to discuss your options in detail. Your medical history will be taken, and you can discuss a birth control plan if desired. A physician will perform an ultrasound to measure your pregnancy and clarify which options are available to you. You may also have some blood work and STI testing done, and your physician will obtain your consent. You can choose to start the abortion process the same day as your clinic appointment.
We will arrange for follow-up appointments or testing to review the outcome of your abortion and check in on how you’re feeling.
We will support you throughout the process - you will be given the phone number of our on-call physician, and will have 24/7 access to medical advice throughout your abortion.
Day 1
You will take the first medication, mifepristone. Mifepristone will destabilize the lining of your uterus and end the pregnancy. Once you take this medication the effects are not reversible.
24-48 hours later
You will take the second medication, misoprostol which are tablets that you insert into your vagina or into the cheeks of your mouth. You will start to bleed within 1-4 hours. As you can expect to have heavy bleeding and strong cramping, you should choose a time when you are able to stay home for the rest of the day. The bleeding and cramping may continue for several hours. After that, lighter bleeding may continue off and on for 3-4 weeks or more.
Day 7-14
We will arrange a phone follow-up to check in and see how you are doing.
Week 4
We will arrange for you to do an at-home urine pregnancy test to confirm the pregnancy has ended. It is important that you contact the clinic if the pregnancy test is positive. There is a 1% failure rate with these medications. In the case of a failed abortion, you may need to take further medication or have a uterine aspiration (D&C) to complete the abortion.
Side Effects
Most women will need pain medications such as ibuprofen, naproxen, or acetaminophen to help with the pain associated with medical abortion. In some cases, narcotics may be required. Heavy bleeding resulting in soaking 1-2 maxi-pads every hour can occur for 2-3 hours. Nausea, vomiting, diarrhea, fever, chills, headaches and fatigue are common and expected side effects of the medications. Some women will find these side effects can be intense, but are short-lived (usually 2-3 hours).
Medical vs. Surgical
There are pros and cons to each method of abortion.
Please consider carefully which method of abortion best suits you. Our staff will be happy to assist you and answer your questions and address any concerns as you work through your options.
Here are some considerations:
Your pregnancy must be under 9 weeks from the beginning of your last period. You are at home for a medical abortion. This may seem more private or feel more natural for you. You can choose to have someone with you if you prefer. You also avoid anesthesia, or instruments in your body. You can do it on your own schedule, which might help to avoid missing work or school. You don’t need someone to drive you to the appointments.
On the other hand, a surgical abortion takes only a few minutes and can be done even when the pregnancy is over 9 weeks. It takes place at the hospital. The pre-operative and post-operative time is 1-2 hours. In total, you are usually at the hospital for 3-5 hours. The physician will be placing instruments inside the uterus and you will be given sedative medications by an anesthetist which may cause side effects. You must have someone to drive you home as you will be legally impaired by the medications. The abortion procedure is not done during the evenings or on weekends.