Morning After Pill
The Morning After Pill (also known as Plan B, Plan B One Step, or Ella) is considered emergency contraception and is FDA approved to take within 72 hours of unprotected sex to prevent pregnancy. It is not the same as RU486. The morning after pill works by delaying ovulation, and it may also interfere with fertilization and/or prevent implantation.
Before taking the morning after pill, you should know that it won’t work if you are already pregnant, it does not protect against STDs, and it is not recommended as a routine contraceptive. In addition, common side effects include nausea, abdominal pain, fatigue, headache, and menstrual changes. (Source: Manufacturer's Prescribing Information for Plan B (Levonorgestrel) tablets, 0.75 mg. Mfg. by Gedeon Richter, Ltd., Budapest, Hungary for Duramed Pharmaceuticals, Inc., Subsidiary of Barr Pharmaceuticals, Inc., Pomona, NY 10970. Revised Aug 2009.11001524)
RU486, Mifepristone: (Abortion Pill)
Within 4 to 7 weeks after last menstrual period (LMP)
This drug is only FDA approved for use in women up to the 70th day after their last menstrual period. It is recommended by the creators of RU486 that the procedure take place over three office visits. On the first visit, the woman is given medication to cause embryonic death or stop further embryo development. Two days later at the second visit, a second medication called misoprostol is taken which induces uterine contractions to expel the embryo. A follow up visit is required about two weeks after the initial visit to determine if the procedure has been completed. In 3-8% of cases**, the medical abortion is incomplete and a surgical abortion procedure will be required. If you have taken RU486 and are having doubts about continuing with the procedure, call us. Help may be available to reverse the effects of the medication.
RU486 will not work in the case of an ectopic pregnancy. This is a potentially life-threatening condition in which the embryo lodges outside of the uterus, usually in the fallopian tube. If not diagnosed early, the tube may rupture, causing internal bleeding and in some cases, the death of the woman. For this reason, an ultrasound is recommended to confirm location of pregnancy.
Up to 14 weeks after LMP
This surgical abortion is done early in a pregnancy up until 14 weeks after the woman's last menstrual period. Local anesthetic is usually provided. The cervix is dilated using dilators to allow a tube to be inserted into the uterus. Depending on the gestational age of the fetus, a syringe or suction system is attached to the tube. The fetus, placenta, and membranes are then removed from the uterus using suction.
Dilation and Curettage (D&C)
Up to 14 weeks after LMP
This is the most common type of surgical abortion. Local anesthetic is usually provided and the cervix is dilated using dilators. Dilating the cervix may cause cramping. After the cervix is stretched open, the provider inserts a spoon-like instrument called a curette into the uterus and runs it along the walls of the uterus to remove the fetus, placenta, and membranes. A follow up visit is important to ensure the abortion was completed. If the abortion was not completed, vacuum aspiration may be required.
Dilation and Evacuation (D&E)
Starting 14 weeks after LMP
This surgical abortion is done during the second trimester of pregnancy. In this procedure, the cervix must be opened wider than in a first trimester abortion. This can be done using medication or by placing absorbent dilators into the cervix several hours or the day before the abortion procedure to open the cervix. Dilating the cervix may cause cramping. Once the cervix is stretched open, the provider uses medical instruments like forceps and/or suction curettage to remove the fetus and placenta. Depending on how far along the pregnancy is, it may be necessary to use medication to stop the fetus’s heart prior to the procedure. It may also be necessary to dismember the fetus during the procedure.
Dilation and Extraction (D&X)
Within 20 weeks after LMP to full-term
This procedure can take up to three days. The cervix is first dilated by placing absorbent dilators into the cervix which will typically stay in place up to two days. Dilating the cervix may cause cramping. On the third day, the provider will provide local or general anesthesia before the abortion procedure. The fetus is removed using instruments such as forceps, suction, and/or curettes. Depending on how far along the pregnancy is, it may be necessary to use medication to stop the fetus’s heart prior to the procedure. It may also be necessary to dismember the fetus during the procedure.
*Minnesota Department of Health. Division of Community and Family Health. (January 2009). If You Are Pregnant: Information on Fetal Development, Abortion and Alternatives. http://www.health.state.mn.us/wrtk/handbook_eng.pdf
**Am J Obstet Gynecol. (August 2000). Abortion with mifepristone and misoprostol. http://www.ncbi.nlm.nih.gov/pubmed/10944369