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What is the abortion pill?

The abortion pill, also called medical abortion, or RU486, is a method to end pregnancy non-surgically with medication. This method is available to women under 24 weeks of pregnancy.

Does Women’s Clinic offer the Abortion Pill?

Yes. It is one of the two methods of abortion offered at women’s clinic

How late can you take the abortion pill?

If you are under 24 weeks of pregnancy you can qualify for the “abortion pill” (medical abortion).

How does the abortion pill work?

The medical abortion process (abortion pill) has two steps and includes two different medicines. First, at women’s clinic you take a pill called mifepristone which stops the pregnancy from growing. Second, at your home, 6 to 8 hours after taking the first pill, you take a set of 4 pills called misoprostol. The second set of pills empties the uterus, and you will experience cramping and heavy bleeding during this process. The abortion-by-pill has a success rate of 91-95%.

How do I prepare for the medical abortion?

There are no special preparations for medical abortion (the abortion pill). When you come in for your appointment, you will have lab work and a sonogram done, and you will meet with a licensed Clinic Social Worker to discuss your pregnancy options, the abortion procedure, and any concerns or questions you may have.

How do you know if the abortion pill has worked?

You must come back to women’s no later than 2 weeks after your procedure for your post abortion checkup and sonogram to make sure that your medical abortion was successful and your uterus is empty. If the abortion fails, you may need to repeat the process or have an in-clinic surgical abortion.

How much is the abortion pill in South Africa?

Medical abortion, also known as the “abortion pill,” is available for R600, which includes your first visit and a follow-up visit.

What happens at the clinic?

The first appointment is at Women’s Clinic Johannesburg. This first appointment will be a consultation with the doctor to discuss your pregnancy, as well as an ultrasound scan, blood tests if you haven’t already had them. As there are a number of different issues to address it may take some time so expect to spend about one hour at the clinic.

What types of termination are there?

This depends on the number of weeks pregnant you are on the day of the procedure. Pregnancy is dated from the first day of your last period and/or the scan dates.

  • Under 7 weeks pregnant: only a medical termination of pregnancy (MTOP) is available at this early stage
  • Between 7 and 9 weeks pregnant: you can choose between a medical termination of pregnancy (MTOP) or surgical termination of pregnancy (STOP
  • Between 9 and 16 weeks pregnant: the only method available is the surgical method using suction
  • Over 16 weeks pregnant: you may be suitable for a late medical termination of pregnancy using tablets or surgery.

What is a medical termination?

Medical termination is most suitable for you if:

  • You are early in the pregnancy and would need to wait for a few weeks for a surgical termination
  • You don’t want or should not have a general anaesthetic
  • You wish to avoid the risks of surgical termination

Medical termination may be unsuitable for you if:

  • Have allergies to mifepristone or misoprostol
  • Take steroids
  • Have any problems with your blood clotting / Take anti-coagulants
  • Are over 9 weeks pregnant
  • Severe asthma not controlled by medication
  • Liver or kidney disease

What risks are associated with a medical termination?

This is a safe procedure which is effective and has much less risk than having a baby. Medical terminations are safer than a surgical termination of pregnancy as there is no need for a general anaesthetic and no need to introduce instruments into the womb. The procedure is 97 to 99% effective. The risk of infection is smaller after a medical termination. All women having a termination are given a course of antibiotics to take afterwards.

  • Excessive vaginal bleeding
  • Incomplete abortion, where some pregnancy tissue is left in the uterus and may require a general anaesthetic and operation to remove them
  • Ongoing pregnancy but this risk is less than 1%

What will happen with a medical termination?

This will involve two visits, at Womens Clinic Johannesburg. It involves taking a tablet by mouth (mifepristone) on one day then returning two days later for vaginal tablets (misoprostol) and possibly further tablets by mouth.

The mifepristone tablet [abortion pill] works by blocking the action the action of progesterone, the hormone needed to maintain a pregnancy. It is used with misoprostol, which is administered vaginally to induce an abortion.

Is this method suitable for me?

You may choose to have an early medical termination if you are less than nine weeks. This will be confirmed by an ultrasound scan.

However, this method may not be suitable for you if you:

  • Have allergies to mifepristone or misoprostol
  • Take steroids
  • Have any problems with your blood clotting
  • Take anti-coagulants
  • Have severe asthma/ kidney or liver disease
  • Allergic reactions to mifepristone or misoprostol

What happens at the first visit for medical termination?

You will be seen by the doctor who will give you the mifepristone tablet to swallow with water and answer any questions you may have about the procedure.

Please allow up to half an hour for this appointment. Between the medications, you can live a normal life at home or at work. You may feel no different to normal but you may have some bleeding or period type pains.

  • IF YOU HAVE ANY DOUBTS ABOUT YOUR TERMINATION, PLEASE TELL US DURING THIS VISIT.
  • YOUR TERMINATION CAN BE DELAYED AND FURTHER COUNSELLING ARRANGED.
  • IF YOU HAVE ANY DOUBTS ABOUT HAVING THE TERMINATION, YOU SHOULD NOT TAKE THE MIFEPRISTONE TABLET.

What happens when I have taken the mifepristone tablet?

You may experience:

  • Crampy, period type pains
  • Nausea/ vomiting
  • Very occasionally you may start bleeding before your next visit to hospital. There is a small possibility of passing part or the entire pregnancy after taking the first medication.

If you vomit within 2 hours of taking the tablet, you may need another. Please come back to Outpatients 2 straight away.

If you experience crampy pains, you must only take tablets containing paracetamol and codeine type medications. Please do not take painkillers containing aspirin or ibuprofen (Eg. Nurofen) or similar drugs. Check with the doctor that the painkillers you have at home are suitable to take at this time. If you experience heavy bleeding please phone your doctor or report to casualty if concerned or mention this on your next visit. (Heavy bleeding may be more than three pads soaked in an hour or any amount that causes distress.)

What happens at the second part of the medical termination?

You will be seen at Women’s Clinic Johannesburg 2 days after you have taken the mefipristone tablet. A nurse or doctor will administer tablets of misoprostol (cytotec) vaginally, or you can do it yourself.

If you do it yourself, you will be given some tablets of misoprostol, which will need to be inserted into your vagina or in some cases may be taken by mouth. If you are familiar with using tampons you may be able to insert the tablets with a tampon. This medication causes contractions which help your body pass the pregnancy. These can be painful but pain relief is available.

If you are over 7 weeks pregnant, you may be given two more tablets to swallow to help things along. Pains will usually start after a few hours.

The products of pregnancy should pass over the next few hours. If they haven’t been passed completely by this time, it is likely they will over the next 24 hours. We recommend you have someone to stay with you over this time. If you are concerned, please ring your designated doctor.

What happens when I have taken the vaginal medication?

You will experience:

  • Period type pain
  • Bleeding
  • As pain is a very individual experience, it is important that you discuss how you are feeling with your named nurse who can then give you appropriate pain relief.
  • You will need to stay indoors for 6-8 hours after taking the abortion tablets. The pregnancy should be passed during this time.
  • If your blood group is rhesus negative you may need an anti D injection.
  • You should arrange for a friend or relative over 18 to stay with you overnight. Antibiotics (doxycycline) can be taken from the evening of the second part of the procedure. You will also be given pain killers and antibiotics to take at home.
  • You will be asked to do a pregnancy test three weeks after the procedure to ensure you are no longer pregnant. Some patients may be booked for a repeat scan two – three weeks after the termination if this is positive to ensure the pregnancy is not ongoing (less than 1-2% chance).
  • If you experience heavy bleeding and/or severe pain phone your contact or report to Accident and Emergency and you may be referred to the emergency gynaecologists on call for further assessment. (Heavy bleeding may be more than three to four pads soaked in an hour or any amount that causes distress.)
  • You can telephone the doctor whom you are under as necessary.

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