To perform a medical abortion, we primarily use Mifepristone 200mg and Misoprostol 200mcg (4 pills) for a pregnancy up to the first 10 weeks or 12 weeks. You can even use Misoprostol (Cytolog) alone. However, the use of anti-progesterone medication combination is preferable. The medicine course lasts 2 to 3 days, wherein you take Mifepristone orally with water on day one. After 24 to 48 hours, you take Misoprostol pills either buccally (place the tablets under the tongue to dissolve and consume), or vaginally (insert abortion pill inside the vagina).
It takes around 2 to 24 hours for the pregnancy portions to pass out of the vagina and for the uterus to empty. The medication method of ending a pregnancy is effective and safe, highly accessible, and a great option for an early pregnancy, and for women who prefer a non-invasive technique. The medicines are also cost-effective. However, the intake of Mifepristone and Misoprostol may have some expected outcomes and side effects.
While there are barely any Mifepristone side effects, the other prostaglandin E1 analog medicine may cause heavy vaginal bleeding and abdominal cramps, which are normal to expect. However, more severe side effects may occur due to the wrong usage of the pills, if a person having ectopic pregnancy takes the pill, or intake of the medicines for a pregnancy over 12 weeks.
In the following blog, we will talk about the common and unusual side effects of abortion pill, how to tackle them, and when to seek medical attention.
Common Side Effects of Mifepristone and Misoprostol
Below-mentioned are Mifepristone and Misoprostol side effects, which are temporary and related to the procedure. However, keep a lookout for the severity of the symptoms if they linger unusually:
1. Nausea and Vomiting
After using Misoprostol, you may feel sick and nauseated, similar to morning sickness. This is normal and does not last long. However, if the side effect continues for more than 24 hours, you can consult a healthcare provider. Other effects include vomiting, diarrhea, and weakness, which again do not linger long. You may take an anti-emetic medicine for nausea and vomiting. This may help reduce the nauseous feeling. Even if these effects linger unusually, it could be a sign of an infection.
2. Abdominal Cramps
Among the Misoprostol side effects, abdominal pain and cramps are common. The medicine is a synthetic prostaglandin, which causes uterine contractions to expel the conception products from the womb and vagina. The contractions are essential to push out the detached pregnancy parts from the uterus. If these do not occur, it is then a sign of concern. So, if you experience cramping, the meds are working fine. To reduce the abdominal pain, you can take over-the-counter (OTC) pain-relief medicine. Do not take aspirin, as it can increase the bleeding.
3. Chills and Fever
During a medical abortion with Mifepristone and Misoprostol, elevated body temperature for a few hours is normal. Fever and chills are common consequences. However, like nausea, this is temporary. If the fever is 100.4°F and is present for 4 hours or more, get the help of a healthcare professional as this can be a sign of infection or an ectopic pregnancy, causing a defensive reaction from your immune system. Keep track of your body temperature, especially for 24 hours after consumption of Misoprostol.
4. Fatigue and Feeling Sick
With bleeding, abdominal pain, and other effects, it is normal to feel exhausted, weak, tired, and sick. This is a temporary feeling again and once the other side effects diminish; you may feel healthier and back on your feet. You may not have anything much to worry about. You may get dehydrated for which you should drink plenty of water or alcohol-free natural beverages such as fruit juice, vegetable soups, etc. While Mifepristone does not cause any of these, Misoprostol may do so. The ‘feeling sick’ is a phase and is not a permanent effect.
5. Heavy Vaginal Bleeding
As the pregnancy exits the body, heavy vaginal bleeding occurs. The bleeding is more than your period. You may find large blood clots and tissues related to pregnancy and the broken endometrial lining. Wear large maxi sanitary pads for a few days rather than tampons and menstrual cups. The pads will soak blood better and assist you in keeping track of bleeding. If the bleeding is too heavy even after 2 – 3 days, you should seek immediate medical attention as it could be a sign of an incomplete abortion, for which surgery may be required.
Also, if the bleeding is heavier than expected and outlived its duration, possibly it is a sign of sepsis. Another symptom of which is a smelly vaginal discharge or yellow/green discharge. Though abortion pill do not cause this effect, inappropriate dosage or a contraindication could be the culprit behind the situation, for which, you should get admitted into emergency care.
Serious Side Effects of Using Abortion Pills
Medical pregnancy termination works for most women. Sometimes, however, it may not have the expected outcomes for a reason or more. Thus, it is important to follow up with your physician after 7-14 days and get a health check-up done, including an ultrasound scan of the abdomen. This will confirm if the Mifepristone and Misoprostol pills worked as needed, or if there are conception products still in the uterus. Here are some severe side effects to look for:
1. Uterine Blood Clots
Finding blood clots in vaginal bleeding is normal in medical abortion. Some clots are large-sized like a lemon. You may pass these out for a couple of hours or more. However, if the pregnancy tissues stay clogged in along with pregnancy portions, the uterus will get affected and form clots within. The common symptoms of these are not enough bleeding or heavy ones, associated with severe abdominal cramping (more than usual according to what it should be on taking abortion pill). Contact a healthcare provider immediately if you experience or suspect uterine blood clots.
2. Heavy Bleeding That Requires Emergency Care
While heavy bleeding is among the common Misoprostol side effects, in some cases, you may need emergency care, especially if you cannot tolerate the bleeding amount of bleeding. For instance, if you soak two full-size pads every hour for a minimum of 2 hours, you may contact your healthcare provider soon. You can seek a surgical procedure than have the bleeding lingering, to empty the uterus. One in every 100 women may experience this rare effect.
You may have to either go through surgical aspiration, wherein gentle suction is applied through equipment in the uterus to remove the conception products. Or, you may go through dilation and curettage where a suction tool or scraping is used to remove the pregnancy tissues from the uterus. The latter is usually applicable for later-term pregnancies, where abortion pill should not be used.
3. Consistent and Severe Abdominal Pain
Abdominal pain from uterine contractions is expected during a medical abortion. However, severe cramps and pain that persist for more than a couple of days could be a sign of infection or ectopic pregnancy, where the pregnancy is located outside the uterus. Anyone with an extrauterine pregnancy should not take Mifepristone or Misoprostol because of the hormonal effects products, which can lead to earlier rupture of the implantation site.
None of the abortion pills can end an ectopic pregnancy, for which a surgical interruption is necessary. Such side effects are possible if you have an IUD (intrauterine device) unremoved and take the pills, it can result in excessive abdominal cramps and uterine contractions. Your healthcare provider may conduct a few additional tests along with ultrasound, as sometimes a scan may miss detecting a pregnancy outside the uterus.
4. Vaginal or Uterus Infection
If you feel sick or have excessive pain in the stomach for more than 24 hours, it is possibly an infection. Contact medical care immediately, especially if you also have a fever for more than 4 more of high-temperature 100.4°F or beyond. Another rare situation is sepsis, which may even cause death because of the infection and toxin spreading quickly in the body. Such bacterial infection in the uterus or vagina may affect the blood and toxify it.
To Conclude
While Mifepristone and Misoprostol abortion pill can effectively end an early pregnancy and carry expected outcomes, some side effects may turn out to be serious given the various reasons we discussed above. Thus, whenever you take the medicines for termination, monitor your health, notice the symptoms and effects, and immediately report anything unexpected or unusual to your healthcare provider.