Medical Abortion (Pill) FAQ

A: Medical abortion is an abortion done using medication rather than surgery.

A: In Canada, medical abortions are available to women up to 63 days (9 weeks) from the first day of their last menstrual period.

A: Mifegymiso is the Canadian brand name for the combination of medications comprising of Mifepristone and Misoprostol.

A: Mifepristone blocks the effect of progesterone that is required for the pregnancy to continue and develop. Misoprostol is a prostaglandin which causes the uterus to contract and relax thus helping to push out the contents of the uterus. These two medications work together to end the pregnancy.

A: Yes, Mifegymiso is fully covered by OHIP (Ontario Health Insurance Plan). Uninsured patients will have to pay. Fees may be reimbursable in part or in full by the patient’s provincial health insurance plan. Out-of-Country patients may also be reimbursed by their own private health insurance. Patients covered by University Health Insurance Plan (UHIP), Interim Federal Health Plan (IFHP) or private insurance may have the fees reimbursed in part or in full by their relevant Plans. (Please check with your insurance provider).

A: Mifepristone has been available in France and China for nearly 60 years. It is currently available in 60 countires. The World Health Organization has declared Mifepristone to be effective and safe.

A:

  • If your pregnancy is assessed as being over 63 days (9 weeks) duration
  • If you are unable to access emergency medical care within 14 days following the administration of Mifepristone
  • If you have or may have an ectopic pregnancy (a pregnancy outside the uterus)
  • If you have or may have hypo-coagulation disease (a bleeding disorder)
  • If you are taking anticoagulants (drugs that prevent blood clots
  • If you suffer from severe disease where it is necessary to take steroids (for example asthma uncontrolled by treatment)
  • If you are taking corticosteroids (medicines such as cortisone or prednisolone which reduce your immune system
  • If you have renal failure
  • If you have an allergy to either mifepristone and/or misoprostol or prostaglandins
  • If you have an IUD in place, this must be removed before the termination of the pregnancy process can begin
  • If you have a pelvic infection

A: Mifegymiso comes in a package containing one Mifepristone tablet of 200 mg in a green pack and four Misoprostol tablets of 200 mcg in an orange pack.

The medication is taken in 2 steps. First the one tablet of mifepristone (tablet in the green pack) is taken orally under the supervision of a healthcare giver.

Then 24 to 48 hours later all four tablets of misoprostol (tablets in the orange pack) are taken by holding them in your mouth between your gum and cheek for 30 minutes.

A:
Vaginal Bleeding

  • Onset of vaginal bleeding within 4 hours of taking the misoprostol tablets (orange pack), most women will experience bleeding within 48 hours.
  • Sometimes the bleeding might begin after taking the mifepristone (green pack) before taking the misoprostol (orange pack)
  • Bleeding can range from light to heavy. Bleeding is usually more than a typical period.
  • Bleeding should diminish once the pregnancy is terminated.
  • Vaginal bleeding does not mean that the pregnancy tissue has been expelled. It is normal to see blood clots and tissue. A follow-up assessment is necessary to confirm the termination of the pregnancy.
  • Bleeding lasts on average 10 to 16 days. Light bleeding can continue for 30 days or more but does not normally go beyond the first period following treatment.

Cramping

  • Cramping can start within 4 hours of taking the misoprostol tablets.
  • Cramping can range from mild to severe and is usually more than a typical menstrual period.
  • Significant cramping should diminish once the pregnancy is expelled. This does not usually last longer than 24 hours.

Pain Management

  • Rest
  • Use hot packs on your abdomen or back.
  • Massage the lower abdomen frequently.
  • Take pain relief medications as directed by your doctor.

A:
Problem Bleeding

  • If you saturate two or more sanitary pads per hour for 2 consecutive hours.
  • If you experience problem bleeding or are concerned about the amount of bleeding you are experiencing, you should contact your doctor, clinic, pharmacist or the Telehealth Ontario. Toll-free: 1-866-797-0000 Toll-free TTY: 1-866-797-0007.

Possible Side Effects

  • Headache
  • Breast tenderness
  • Fainting
  • Hot flushes skin rashes or itching

Misoprostol can cause

  • Nausea
  • Vomiting
  • Diarrhoea
  • Dizziness
  • Abdominal discomfort, abdominal pain, cramps
  • Short term fever and chills

These side effects are usually short and do not last more than 24 hours.

A: Yes, you must attend a follow-up visit as arranged with the clinic. The visit is to ensure that the abortion is complete. Should the abortion be incomplete, treatment options will be reviewed which may include surgery.