Medication termination of pregnancy (MToP) process
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.
If you choose a medication termination, this is the process you can expect:
- A number of appointments with a doctor or nurse.
- An ultrasound, blood tests and swabs.
- Taking medications that cause the termination.
- A blood test and review to confirm the termination has completed.
- Discussion about your ongoing contraception needs.
You will see Family Planning doctors and nurses for the following appointments.
- Assessment appointment (60 minutes) – please arrive 15 minutes early. A Family Planning doctor will assess whether a medication termination is right for you and refer you for an ultrasound and tests.
- Phone call (15-30 minutes) – once we have the results of your ultrasound and blood tests, a Family Planning doctor will call you at a pre-arranged time to discuss the results and confirm a medication termination is right for you.
- Medication appointment (60 minutes) – please arrive 15 minutes early. The termination medication is given to you with written instructions. Most people take the first tablet at home and the second tablet 36 hours later. If you have a negative blood group, you will also need an anti-D injection.
- Phone call (15 minutes) – a nurse will call you 48-72 hours after your second appointment to check you are ok. You must have a phone that we can reach you on. 7-10 days after taking the medication, you will have a blood test.
- Appointment/phone call 3 (30 minutes) – 14-21 days after you take the medication, you will have a check-up with an FPT doctor or nurse to review your blood test results to confirm the termination is complete.
- Your Medicare card or number.
- Any health care or pension cards.
- Enough money in your account for payment of the consultation. Find information about fees here.
- A list of any questions you would like answered.
- You are welcome to bring a support person, but we will need to speak to you on your own for some of the appointment.
Medication termination is a two-stage process.
You take two medications in tablet form. The first tablet, swallowed whole, called mifepristone, 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.
The second medication, dissolved in the mouth at home, called misoprostol, is taken 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).
What will you experience during the termination?
After taking medication termination tablets, you can expect the following:
- 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, at home, 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
We will provide you with pain and anti-nausea medication.
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 also help.
You should rest wearing loose, comfortable clothes and avoid alcohol until the termination is complete.
Have maxi pads ready when you take medication. Using pads not tampons until your next period will help lessen the risk of infection.
Rare medication termination complications
- 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 the woman requires a surgical procedure or further medication (one in 25 cases).
- The medication does not work and the woman may then require 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.
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 will not 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 counselling appointment (30 minutes with either a doctor or nurse).
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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