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The Abortion Pill (Medical Abortion)[Mifegymiso® (mif-ih-guy-mee-so)]

"Having a medical abortion is a major decision with emotional and psychological consequences. If you're considering this procedure, make sure you understand what it entails, side effects, possible risks, complications and alternatives." (Mayo Clinic, June 8, 2023)

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According to the Nova Scotia Health Authority, the abortion pill is typically used up to 9 weeks gestation - (counting from the first day of your last normal menstrual period) and may take up to three appointments (the first to talk with the doctor and get the prescription, the second for an ultrasound to make sure you are less than 9 weeks and the third, two weeks after taking the medication, to have a blood test to make sure the abortion was successful). Some doctors may not require the ultrasound appointment but we strongly urge you to request it to rule out a tubal pregnancy. The medication is a combination of two pills, mifepristone and misoprostol. The first pill, mifepristone, causes the death of the embryo by blocking the effect of the hormone progesterone (a hormone necessary for nurturing the embryo).

 

The second drug, misoprostol, is 4 pills tucked between the cheek and the gums for 30 minutes or inserted vaginally, and is taken one to two days after the first pill. Sometimes bleeding can occur after taking the mifepristone but before taking the misoprostol. Misoprostol causes the uterus to contract, and very strong cramping and heavy bleeding then occurs as the embryo and placenta are expelled from the uterus. This commonly occurs within 4 hours but in some cases may occur anywhere between 30 minutes and 48 hours after taking the misoprostol tablets. It is recommended to rest for 3 hours after taking the misoprostol tablets. The bleeding may be very heavy, and you may pass clots as small as quarters, or as big as lemons (or the size of your fist). The manufacturer of this medication warns that you should contact your health professional for immediate medical attention if you experience heavy vaginal bleeding (soaking two (or more) thick sanitary pads per hour for two consecutive hours or have large fist-sized clots).

 

The embryo will be expelled within 24 hours 90% of the time. That means that for 10% of the women, this takes longer than 24 hours (or it has failed to work). 

While all this is going on, these possible side effects can also be experienced: headache, breast tenderness, fainting, fatigue, hot flashes and chills. Misoprostol tablets can also add these symptoms: nausea, vomiting, diarrhea and dizziness. Patients who are less than 18 years old often get more vomiting and pain. These side effects slow down after Day 3 and are usually gone by Day 14. Although cramping and bleeding are expected as part of ending a pregnancy, rarely, serious and potentially life-threatening bleeding, infections or other problems can occur following a medical abortion. The use of this treatment is not risk free.

If you experience problems or are at all concerned about side effects you should contact your health professional, clinic or the Info-Health telephone line (811).

 

You will not know if the abortion was successful until a follow-up appointment 1-2 weeks later. The abortion pill will fail for 1 in every 20 women. This means that the dead or damaged embryo will either remain in the uterus or be only partially delivered and in these cases, surgical abortion would be required. Fever and chills after 24 hours may be a sign of infection. Soaking two (or more) large sanitary pads an hour for more than two hours may indicate hemorrhaging (problem bleeding). These signs of possible infection or hemorrhaging require immediate medical attention by calling 811.

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AMBIVALENCE

  • Do you know what “ambivalence” is? "Ambivalence" is when you have mixed feelings about something. Abortion is an irreversible process. The Guide for Dispensing Mifegymiso® for Medical Abortion in Canada says (top of page 2) that ambivalence is an "absolute contraindication" for the abortion pill. An "absolute contraindication" means that this medication must not be used. A procedure or medicine that falls under this category is to be avoided. This means that if you are experiencing ambivalence (mixed feelings), that the procedure should be avoided. We specialize in helping people work through their mixed feelings so they can make an informed health decision. Text or call us today at 902-678-6217.

  • When considering your options, it's important to note that the Canadian Guidelines for Sexual Health Education often quotes the World Health Organization which labels abortion as a "negative" condition or outcome, that means it is something to be avoided if possible, and the personal stories from all the women who have shared their abortion experience with us strongly support this idea. 

  • After a medical abortion, you'll likely experience a range of emotions — such as relief, loss, sadness and guilt. These feelings are normal. However, if, like many women who have shared their story with us, you find that your negative feelings about your abortion do not go away or get worse or they seem to be causing problems in your relationships, we facilitate after-abortion care which many women have found extremely helpful. Contact us any time to learn more about the help and support we have for you.​

 

ABORTION PILL RISKS & CONSIDERATIONS

(from Cleopharma Brochure)

  • A medical termination of pregnancy may not be suitable for you, so you should tell your health professional if any of the following apply to you:

    • you are pregnant and wish to continue with your pregnancy

    • your pregnancy is assessed as being more than 63 days duration

    • you are unable to access emergency medical care within 14 days following the administration of mifepristone

    • you have a known or suspected ectopic pregnancy (a pregnancy growing outside the uterus)

    • you have known or suspected bleeding problem

    • you are taking anticoagulants (drugs that prevent or treat blood clots)

    • you suffer from severe disease where it is necessary to take steroids (e.g. asthma uncontrolled by treatment)

    • you are taking corticosteroids (medicines such as prednisolone and cortisone, which reduce the activity of your immune system)

    • you have adrenal failure

    • you have an allergy to either mifepristone and/or misoprostol or prostaglandins

    • you have an IUD in place – this must be removed before the termination of pregnancy process is started

    • If your blood group is Rh negative, the use of Mifegymiso® requires your health professional to take measures to prevent Rhesus factor sensitization. Please ask your health professional if you are not sure about your blood group.

    • Mifegymiso® is not recommended to be taken if you are breastfeeding

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You may be considering a medical abortion as an option for your unplanned pregnancy. The Valley Care Pregnancy Centre offers information on abortion and decision making tools and support to help you make an informed health decision. An unplanned pregnancy can be difficult to experience. We are here for you.
 

Most women tell us that what they need most when facing an unplanned pregnancy is loving support and a safe place with someone who will listen. We are here for you. We have information that you may find very helpful. However, if you are only looking for abortion and do not want any other information or support or help with decision making, you may not want to visit this centre because providing or assisting with abortion is outside our scope of services, so that's important for you to know. Our first priority is you, and we look forward to seeing you.

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The above is a gleaning of information available about this medication. For complete information, you may refer to these references :

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