Medication Abortion – Frequently Asked Questions

IUDs, contraceptives, medication abortion, Vancouver abortion clinic, Dr. Ellen Wiebe

1. Will it hurt?
The amount of pain patients feel with a medication abortion varies a lot. Some people report that they felt nothing, or it was like a normal period. Other patients are very uncomfortable and use the pain killers that are provided. It is hard to predict how you will feel. We will provide medications to reduce any pain that you may have.

2. Will this affect future pregnancies?
No. The medications leave your body within a few days.

3. How much bleeding will I have?
Usually, the bleeding is heavier than a normal period. Often there are clots. The bleeding starts off heavily, and then gets less and less, as a period does.

4. How long will I bleed?
The length of time is different for everyone, but will be longer than a period. Once the bleeding starts, it can be as short as a week but can last much longer, most often from 5 to 20 days. It is not heavy all the time.

5. What is the failure rate?
95% of patients are complete within the first week. 4% will have a delayed reaction and may require more medication or request surgery. 1% will require surgery for a continuing pregnancy.

6. What happens if this doesn’t work?
If you wait 2 or more weeks, and you don’t lose the pregnancy, we will schedule you for a minor surgical procedure. We will make the appointment for you at a local clinic. This procedure is very safe. There is less than 1% chance of any complications.

7. Is this safe?
Yes, this procedure is very safe. There is a very small risk of infection or bleeding which would require treatment.

8. What are the short-term side effects?
The side effects of a medication abortion won’t last long. Some patients will have chills, headache, fever, nausea, vomiting or diarrhea that may last a day or so on the day of taking the medication. Some people experience none of these. We will provide you with a package of medications that you can use to reduce the side effects if needed.

9. Do I have to make an appointment?
Yes. You must make an appointment by phone for a medication abortion. Because we need to have some information ahead of time, you cannot just “walk in”. Usually we are able to schedule you within a week.

10. Why do I have to come to your office so many times? (pre-COVID)
You need to come in to our office at least twice and possibly 3 times to be sure everything is safe and to ensure that the procedure worked well. On the first appointment, you will be assessed, see the doctor, have a vaginal ultrasound and then see a counselor to review the procedure. You will have some blood work done. You will then go to the pharmacy to pick up medication to take home with you. If the doctor has been unable to see anything on the ultrasound you may need to go to the lab for an extra blood test and we may have to book you to come back the next day. You will need a second appointment approximately one week later to be sure that the abortion has been successful and there are no problems – CURRENTLY you will have 1 in clinic appt with a follow up virtual appt scheduled for 1 week later. Further appointments will be made in clinic or virtual as needed. 

11. Do you do ultrasounds?
Yes, our doctors are trained to do pregnancy related vaginal ultrasounds. This means they can assess the dates of your pregnancy, and check to see if it is gone afterwards.

12. What are the blood tests I will have?
You may have a hemoglobin test (finger poke). A few people will need to go for extra blood tests to measure the level of pregnancy hormone.

13. Do I have to have an injection?
No. Mifepristone is a pill that you swallow.

14. What if I am very nauseated or vomiting.
We can give you a pill or shot before you take the medication if you feel you will not be able to keep it down. If we do this you will not be able to drive so you will need to bring someone with you to drive you home or take a taxi or transit.

15. How is my pregnancy calculated?
We calculate the dates of your pregnancy from the first date of your last menstrual period. Patients usually get pregnant (conceive) 2 weeks after this. For example, when you miss your period by one week, it is likely only 3 weeks since you got pregnant, but it would be 5 weeks since the first day of your last normal period. We would call this a 5 week pregnancy.

16. How much time will I have to take off work/school?
 We recommend that you should be at home on the day you use the pills. You may even need to take an additional day. It is very specific timing as to when that day should be. The misoprostol must be taken 24 – 48 hours after the Mifepristone so you should arrange your schedule accordingly. We can give you an off work/school note ($20 Fee).

17. Can I have a medication abortion if I am breast-feeding?
Yes. Although a small amount of the medication does go into breast milk, that is not dangerous for your baby. If you can feed as little as possible for a few days, that would be better than breast-feeding right away.

18. Do you have translators?
No. Unfortunately, we receive no government funding for counselling, medications or translation. If you don’t speak and read English very well, you need to bring a friend or relative with you who can help you to understand the instructions or contact 604-254-8022 for a paid interpreter.

19. When can I start my birth control?
You should start your birth control pills right after you have the bleeding. If you want an IUD inserted, you will have your follow up visit in one week and then we will book you to come back for the insertion as soon as possible.  You can discuss all other forms of birth control with the counselor at your initial visit or with the physician at your follow up visit.