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Medication termination of pregnancy (MToP) process

Important: if you are attending an MTOP appointment that includes an ultrasound, please make sure you come with a full bladder (drink water before you come and don’t go to the toilet).

This page discusses the process you will go through if you choose to have a medication termination of pregnancy (MToP), or abortion.

You should read our medication termination overview information before you read this page, because it explains MToP and may help you to make your decision about whether it is right for you.

You can also choose a surgical termination to end your pregnancy. Find out more about surgical terminations.

If you choose a medication termination, this is the process you can expect.

What are the steps to get a medication termination?

A medication termination involves a number of steps:

  1. A number of appointments with a doctor or nurse.
  2. An ultrasound, blood tests and swabs. Family Planning Tasmania can now provide many ultrasounds in our clinic when you come to your appointment. Your receptionist will let you know if this is an option for you.
  3. Taking medications that cause the termination.
  4. A blood test and review to confirm the termination has completed.
  5. Discussion about your ongoing contraception needs.

What fees are involved?

Fees apply for everyone a medication termination but no-one will be turned away. If you can’t pay, we will access funding on your behalf. Just let your doctor or receptionist know if you need financial help.

You can find our medication termination of pregnancy fees here: Fee estimates.

What appointments do I need?

You will see Family Planning doctors and nurses for up to three appointments, depending on the circumstances. We will contact you by telephone once you have taken the medication to check you are ok.

What happens during a medication termination?

You take two medications in tablet form:

  1. The first tablet is called mifepristone. It is swallowed whole. It works by blocking a hormone called progesterone (this hormone is necessary for a pregnancy to continue). When progesterone is blocked, the lining (endometrium) of the uterus (womb) breaks down, stopping a pregnancy from continuing.
  2. The second medication is called misoprostol. You dissolved it in your the mouth approximately 36 hours later. Misoprostol makes the muscles of the uterus contract (tighten). This causes bleeding, cramps and a miscarriage (pushing out the early pregnancy from the womb).

After taking the tablets, you can expect to experience the following things:

  • After taking the first tablet (mifepristone) you may not have any symptoms or you may have some vaginal bleeding and cramps. Sometimes, the miscarriage happens before taking the second dose of tablets; if this does happen, it is still important to take the second lot of medication.
  • After taking the second tablet (misoprostol) you will experience pain and bleeding. The bleeding will be heavier than a normal period and may include blood clots that can be the size of a lemon. Nausea, diarrhoea, dizziness, headaches and fever are also common.
  • Most people pass the pregnancy (miscarry) within four to five hours of taking the second dose of tablets.
  • Unpredictable, irregular or prolonged bleeding can last for up to four weeks after treatment.

Managing pain and bleeding

You will experience some cramping and you are likely to feel more pain than with a usual period. A heat pack on your tummy can help and we will provide you with pain and anti-nausea medication.

You should rest wearing loose, comfortable clothes and avoid alcohol until the termination is complete.

We recommend you have maxi pads ready when you take medication. Using pads not tampons until your next period will help lessen the risk of infection.

What are the possible complications?

Rare medication termination complications include:

  • Haemorrhage (very heavy bleeding), requiring a blood transfusion (less than one in 1000 cases).
  • Infection, needing antibiotic treatment (one in 100 cases).
  • An ectopic pregnancy (pregnancy in the tubes) that is not diagnosed before medication is taken (one in 7,000 cases).
  • The uterus doesn’t empty completely and requires a surgical procedure or further medication (one in 25 cases).
  • The medication does not work and requires a surgical termination (one in 150 cases).

In an emergency

You may need to seek medical care if you have very heavy bleeding or very painful cramps or pain in the abdomen. Signs of a serious complication can include vomiting, a raised temperature, flu-like symptoms and weakness more than 24 hours after taking the medication.

We will give you information on what to do in an emergency at your appointment.

In the event of a medical emergency please phone 000.

For after hours care please go to tasafterhours.com

Or for 24/7 assistance, Health Direct (call 1800 022 222) is available.

Emergency contraception can be purchased from a pharmacy.

How will I feel after the medication termination?

Physically, most people feel better once the pregnancy has passed. Sometimes the pain and cramps continue for the next few days. Irregular vaginal bleeding can last for up to four weeks.

Some symptoms of pregnancy, including tender breasts, can last for around two weeks. It is normal for a pregnancy test to be positive for two to three weeks after the miscarriage. This is because hormone levels have not yet gone back to normal.

A medication termination won’t affect your future fertility.  You can become fertile within two weeks of the termination. Your Family Planning doctor can help you with ongoing contraception.

Mentally, how you feel after a medication termination will depend on the reasons for having it and how comfortable you feel about your decision. If you need support, please let your Family Planning doctor or nurse know.

If you have decided to have a termination (abortion), please contact Family Planning Tasmania or your GP or other health professional as soon as possible. If you are unsure about your decision, contact us to request a non-judgmental and confidential pregnancy options appointment (30 minutes with either a doctor or nurse).

Video: What is a Medication Termination (Medical Abortion)?

Find out more about the process in this video produced by Family Planning Victoria. They have a range of helpful and informative videos, which you can view on YouTube here.

This content is provided for general information and education purposes only and does not take into account individual circumstances. It is not to be relied on in substitution for specific advice from a medical professional and Family Planning Tasmania does not accept responsibility for such use. Family Planning Tasmania has taken every effort to ensure that the information is up to date and accurate, however information and knowledge is subject to change. Family Planning Tasmania advises that you always consult a medical professional for individual advice.

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