Home Abortion with Mifepristone & Misoprostol: Procedure & side effects

One common question I get in my inbox is how to have a home abortion safely.

If you are reading this post, it is likely you are pregnant, or your girlfriend or wife is pregnant. If you are trying to get rid of your pregnancy at home, I have put together a simple guide to walk you through the process.

But first, you must understand that numerous complications can arise from an abortion. Some of them could be mild, while others could be so severe.

In my eight years as a practicing medical professional, I’ve come across serious Abortion complications.

Just last week, I had a patient that was rushed into the Accident and Emergency room on a complaint of Heavy vaginal bleeding after trying an abortion at home.

In fact, when she came, she has lost so much blood that she was unconscious. It took the help of my medical team to resuscitate her.

This means, if you are trying to get pregnant, you must understand that there are risks involved. Consequently, if you want to get rid of your pregnancy at home with minimal risk to your health, It is crucial you go through this guide step by step.

So, is it safe to get rid of pregnancy at home? Yes. You can easily have an abortion at home without any complications. In fact, you may not even need to see a doctor. But, that’s risky (more on that later).

Should I abort or not?

This is the first question you need to answer on your own. “On your own” means you are not under any pressure.

I’ve seen a lot of girls ending their pregnancy because of pressure from their partner. Your husband or boyfriend may not be ready for a baby; but are you ready?

Here are some questions you need to think through before getting started with an abortion

1. Are you ready for an abortion?

Ending a pregnancy could severely affect your mental state for a while. That guilt of taking a life will sink in for some days or weeks.

It becomes even worse if you were forced to terminate your pregnancy.

Think about it this way. If you really want to have a baby and you are forced to do an abortion, you will never be happy with your decision.

Be 100% sure you want an abortion. This is the most important step in the process.

2.  Is your partner ready for a baby?

Except in cases of rape, it is also important you talk to your partner about your decision. Yes, you have the final say, and you need no consent from your partner to have an abortion.

But, this may vary depending on culture and the part of the world you live in. Is your husband aware of your decision? Will he get angry with your decision? Are you ending the pregnancy for already diagnosed medical defects?

If your partner insists you keep the baby, its important you let him know your reasons for deciding for an abortion.

In the end, especially for couples that are married, it helps build trust and harmony in your relationship.

Nevertheless, if he insists you do not, and you really want to have an abortion, your decision is most important.

3.  What are your plans?

This is another important question you need to answer to get started. Are you are a student? Are you single? Is abortion legal in your country? Are you divorced? Are you happily married?

I did abortion for my girlfriend in medical school. Yes, I was not ready, and she was not ready too. We also did not have any plans to have a baby or get married.

It just happened, and we needed to get rid of it. Most ladies that want an abortion can relate to my experience. If you are, then taking an abortion is not a bad idea.

However, if you know you really want to keep the baby, and you are forced to take an abortion, it is best you go with your decision.

Preparing for a Home abortion

If you’ve decided to terminate your pregnancy, let’s get started.

But first, I’m discussing safe home abortion here. So, we must get prepared. If you really want to get this done on your own without complications now or in the future, here are some things you must do before an abortion.

1.  Take a pregnancy test

I’ve seen ladies want to have an abortion without ever taking a pregnancy test. Yes, you might feel pregnant, but it is important you take a test to confirm.

If you’ve already taken a test and you are positive, there might be no need to retake your test if you are sure you did everything correctly.

There so many reasons you can have a positive pregnancy test result without even being pregnant. This could happen from poor test technique or if you are on some fertility medications.

2. Check for pregnancy symptoms

If you are still in doubt despite a positive pregnancy result, you can examine yourself for some signs of pregnancy.

Of course, the most common sign you will notice is a delayed period. Others include breast pain, increase in breast size, increased vaginal discharge, watery looking discharge, back pain, vomiting and nausea, mood swings, mild spotting from the vagina, increased appetite and feeling tired.

If you have these symptoms with a positive pregnancy test result, you are pregnant.

3.  Determine your gestational age

This is an essential step of the process. It is important you determine how long you’ve been pregnant to reduce your chances of having complications.

Medically, first semester abortions are safer than those carried out in in the second trimester. In other words, the earliest you can have an abortion, the less likely you will have complications.

So, how do you determine your gestational age? LMP and an Abdominal ultrasound.

LMP is an acronym that stands for the first day last menstrual period. Doctors calculate the age of a pregnancy from the first day of your last menstrual period.

This means, if you just missed your period, you are already four weeks pregnant.

Are you still confused? Let me explain further. Let’s assume you were supposed to get your next period today. This means, if you’ve already tested positive, you count the number of weeks from the first day of your last period – that’s about four weeks.

Similarly, if you are one-week late for your period, you are already five weeks pregnant.

Why is LMP necessary for abortion?

Your LMP is important to determine if you can have an abortion at home. If you’ve calculated your gestation age and its more than 10 weeks, I’m sorry, this post is not for you.

If you must have a home or DIY abortion, you must be at most 10 weeks pregnant. This reduces your chances of complications.

What if I’m more than ten weeks pregnant?

Late abortions are still possible. But it is expected that you will have much more bleeding. Therefore, see your doctor for help.

Why is an ultrasound necessary before a home abortion?

Taking an obstetrics scan right before an abortion is vital to confirm that you are pregnant. This step is critical if you are at least 5-6 weeks pregnant.

First, it confirms you are pregnant and tell the age of the gestation. If you are more than 10 weeks pregnant, it is important you talk to a doctor for help.

Another reason to get an ultrasound carried out is to confirm your baby is inside the womb. A type of pregnancy, called ectopic pregnancy, happens when your baby is located outside the uterus.

Typically, during ectopic pregnancy, the baby resides in the fallopian tube. If you’ve taken only a pregnancy test, you will get a positive result.

If you go on and have an abortion with mifepristone and misoprostol, it could lead to rupture of the fallopian tube, massive intraabdominal bleeding, and death.

4.  Check your Hemoglobin level

This is another important step you must do. During a medical abortion, it is expected that you will bleed for a week or so. This test becomes important to reduce complications from blood loss.

The hemoglobin level is more like the measure of blood in your body. This means when it is low, you can become symptomatic with moderate vaginal blood loss.

To check your Hemoglobin levels, you can visit a nearby laboratory and take a complete blood count. Normal values are 12 to 16 gm/dL. If your Hemoglobin levels are lower than normal, you cannot have a home abortion. Instead, talk to your doctor for help.

5.  Check your Blood group and Rhesus factor

This is another test that must be carried out if you want to reduce complications to the minimum.

If you are Rhesus negative, then you will have to see your doctor for help.

Abortion for Rhesus negative women increases the chances of infertility and recurrent miscarriages in future pregnancies.

Medications for Home Abortion

If you’ve carried out the above-listed instructions as recommended, then you are ready to have an abortion with little or no complications.

Here are the drugs you need to abort a pregnancy at home.

1.  Mifepristone

Mifepristone is one of the drugs used in a home abortion. It is safe and affordable. This drug is not recommended if your pregnancy is more than 70 days.

So, if you are already ten weeks or more pregnant, please talk to your doctor.

Mifepristone acts by blocking the pregnancy hormone called progesterone. This hormone is produced by the corpus luteum and primarily ensures you do not have a miscarriage.

2. Misoprostol

This is the second drug you will use to end a pregnancy at home successfully. This drug is used mainly in the later stages of pregnancy to induce labor.

Misoprostol acts by stimulating the muscles of the uterus and causing strong rhythmic contractions, thereby resulting in the expulsion of the uterine content.

It is more effective when used in combination with Mifepristone.

How to abort at home with Mifepristone and misoprostol?

Now we’ve gotten to the most important step. If you’ve already carried out the recommended tests, it is now time to get abortion underway.

Go to a nearby pharmacy and purchase the above medications. You may need a doctor’s prescription to get Mifepristone tablets

Dosage for mifepristone is 200mg. If you don’t get 200mg tablets in your country, you can use 300mg tablets.

Next, purchase four tablets of misoprostol. Misoprostol comes in 200micrograms. So, you need about 800microgram for the abortion procedure.

Now, If you stay alone, you need a friend around. Yes, this is important in case of unexpected complications from the procedure. Talk to your boyfriend or husband or any trusted friend and request their presence for at least three days.

If you can’t get them to stick around for three days, you must try to convince them to stay for the last day of the procedure.

You can now take the mifepristone 200mg tablet. At this point, you may or may not experience any sign that you will have an abortion.

Everything may seem normal, and you may begin to have doubts if abortion will happen. You should not panic as this is normal. Also, If you get light spotting or bleeding, there is still no reason to panic.

After 24 – 48 hours after ingestion of Mifepristone, you are ready for the next medication.

Get your misoprostol tablets, elevate your tongue, and place the four tablets under your tongue. Allow at least 30 minutes, and then you can now swallow up the remaining drugs with water.

At this stage, as already advised, you need someone around just in case there are unexpected complications. Within 2-6 hours after ingestion of misoprostol, you will have a successful abortion.

What to expect after an abortion with Mifepristone and misoprostol

If you’ve taken both medications already, here are four things you must know

1. It is efficient

Taking an abortion comes with lots of complications when carried out without expert advice. If you’ve entirely followed through with this guide, you should have no reason to panic.

If you were unable to get both drugs and instead used either mifepristone or misoprostol, you are likely to end up with complications.

When both medications (mifepristone and misoprostol) are used together, you will have a complete abortion. That is, all uterine contents are expelled.

The success rate of this procedure is over 95 percent. In other words, if 100 persons were to use both drugs for an abortion, more than 95 persons will have a successful procedure.

2.  Vaginal bleeding is not abnormal

One common complication of having an abortion is vaginal blood loss that may last for weeks. If you’ve followed my instructions, it is unlikely that you will have excessive blood loss from the procedure.

This does not mean vaginal bleeding is unexpected. You may have bleeding for about a week and will notice the flow reduces within a week. If you have heavy bleeding lasting more than a week, its time to see your doctor.

Most times, this happens when there are remnants of the fetus in your womb. And so, it blocks the cervix and prevents contraction to occurs resulting in bleeding.

At the clinic, you may receive further medications, or a surgical abortion technique is carried out to suction the remaining fetal parts from your womb.

If you’ve followed my instructions, you are unlikely to have excessive vaginal bleeding.

3.  You need analgesia, not anesthesia

Lower abdominal cramps and back pain are common during an abortion procedure. Abdominal pain will get severe after ingestion of misoprostol.

At this stage, you may need analgesic for about two days. Once the fetal parts are entirely expelled, abdominal cramp will subside on its own.

Unlike a surgical abortion, you need no mild sedation or complete anesthesia. Drugs like Ibuprofen and diclofenac tablets will help with pain relief.

4.  You may get febrile, and it is not abnormal

Recently, I had a patient that had a missed abortion, and she preferred a medical abortion. After ingestion of misoprostol, she started having a fever with chills.

This is not abnormal with misoprostol as its a side effect. Most times, it goes away on its own without needing any treatment at all. Acetaminophen (Tynelol) may be useful if needed.

If you have a fever for days, it is likely not due to misoprostol. You should inform your doctor.

Complications of Home abortion

It is possible that you could have complications from the procedure. So, I’ve listed down the possible causes and the signs to expect if your home abortion procedure is not working as expected.

1.  Incomplete abortion

An incomplete abortion means your abortion medications have failed to remove the products of conception completely. That is, some parts of the fetus are remaining inside of the uterus.

This is unlikely to occur if both medications we used as instructed. It is still possible to have an incomplete abortion when both drugs are used. If you’ve taken misoprostol so early or so late after ingestion of Mifepristone, you could have an incomplete abortion.

But most commonly, incomplete abortion happens when only mifepristone or misoprostol is used.

Signs of Incomplete abortion include heavy vaginal bleeding, intermittent passage of blood clots and fetal parts, lower abdominal pain, back pain that may be excruciating, body weakness, fatigue, and pallor.

If you get any of the above symptoms, talk to your doctor ASAP. At this point, you need a doctor right away.

2.  Infections

If you’ve informed your doctor before starting an abortion, you will be screened for infection. This is likely to happen because you are already pregnant. That is, you’ve had unprotected intercourse that increases your risk of catching sexually transmitted infections.

If you are infected, you may be placed on prophylactic medications. Common vaginal infections are chlamydia, Gonorrhea, and trichomoniasis.

These infections, when left untreated, may cause pelvic inflammatory disease. You can read more about this here.

Signs of infection after abortion are foul-smelling vaginal discharge, back pain, painful urination, vaginal itching, abnormal or irregular periods, infertility, and fever.

So, what’s next after a DIY abortion?

If you’ve successfully carried out an abortion on your own without complications, you must now see a doctor. This is important for the following reasons

1. To ensure that you are still not pregnant.

I’ve seen multiple cases of a failed abortion. And while you think you’ve gotten it right, you may not have successfully removed the pregnancy. So, to prevent this from happening, it is crucial you now see a doctor to confirm if you are still pregnant.

Your doctor will request an ultrasound scan. If abortion has been unsuccessful, a diagnosis of incomplete abortion will be made.

2.  To check for signs of pelvic infections

During your clinic visit, your doctor will ask you some questions and will examine your vaginal area and your abdomen. If he finds abnormal signs, he will request for some investigations.

Pelvic infections are treated with antibiotics.

3.  Counseling for contraception

Few weeks after your abortion, ovulation begins. If you do not use any of the available contraception methods, you may get pregnant again.

I hope this helped. Good luck.