What Is A Medical Abortion?
The Ultimate Guide
A medical abortion, also termed medication abortion, is a non-surgical abortion procedure that terminates an early pregnancy using abortion medications called mifepristone (RU-486) and misoprostol. This abortion method is widely used in many countries all over the world and supported by healthcare professionals for its safety, privacy, and effectiveness.
When used within the approved gestational age abortion medication is very effective with fewer complications. It can be carried out either in a licensed abortion clinic or self managed at home – medically supervised.
Key Points
- Medical abortion is a safe, non-surgical method.
- It is more effective within the first 10 weeks of pregnancy.
- Common side effects include cramps and light bleeding.
- Available at licensed women’s clinics in Johannesburg.
- Always done under professional medical supervision for safety.
What Is a Medical Abortion?
A medical abortion is a non-surgical way of terminating a pregnancy in the first trimester without surgery. This procedure uses prescribed pills mifepristone and misoprostol which the FDA first approved Mifeprex in 2000 and approved a generic version of Mifeprex, Mifepristone Tablets, 200 mg, in 2019.
Mifepristone blocks progesterone the hormone needed to support a pregnancy. Misoprostol causes Causes uterine contractions “cramping” and bleeding to empty the uterus.
Why is a medical abortion performed?
Having a medical abortion is a personal decision and there many reasons why a woman decides to end an early pregnancy safely with pills. Common reasons may include:-
- Personal circumstances: A woman may feel like she’s not ready to have a baby
- Health concerns: The pregnancy poses a high risk to the woman’s life.
- Fetal diagnosis: The fetus has an unexpected health problem.
- Treating a Miscarriage: Abortion pills help expel remaining tissue when a miscarriage hasn’t occurred on its own.
How Many Weeks Can You Have an Abortion?
In South Africa, a pregnancy can be legally terminated up to 20 weeks under the Choice on Termination of Pregnancy Act (Act No. 92 of 1996). The law states that every woman has the right to choose to terminate a pregnancy for any reason in the first 12 weeks.
From 13 to 20 weeks of pregnancy, abortion is permitted if specific conditions are met:
- The pregnancy is the result of rape or incest.
- The pregnancy poses a risk of injury to the woman’s physical or mental health.
- There’s a substantial risk that the foetus would suffer from a severe physical or mental abnormality
- If continuing the pregnancy would significantly affect the social or economic circumstances of the woman.
How Does a Medical Abortion Work?
The procedure begins with having a one on one consultation with a doctor or registered nurse or can even be conducted via a Tele-abortion platform The steps followed may differ slightly but might involve:-
- Confirming the pregnancy.
- Urine tests / ultrasound scan may be done.
- You will then be briefed on how the abortion process works.
What happens during a medical abortion?
Step 1
You will start by taking mifepristone (Mifeprex® or RU-486). It can be dissolved under the tongue or swallowed with water.
This medicine works by blocking the hormone progesterone, which is needed for the pregnancy to continue. Without progesterone, the uterine lining thins, and the pregnancy cannot stay attached.
Step 2
Within 24 to 48 hours, you then take misoprostol, which is usually inserted vaginally for effectivness. Misoprostol (Cytotec®) causes your uterus to contract, and expel the pregnancy.
You will then be required to stay relaxed and wait for the medicine too start working.
Step 3
After both steps are done, you might expercience nausea, vomiting, and cramping similar to period pains. These are temporary and usually gradually go away on their own. Bleeding is expected within 4 to 6 hours, although it can vary from person to person.
What Is the Effectiveness of Medical Abortion?
Medical abortion is highly effective when used within early weeks of pregnancy and in line with proper clinical guidelines. The combined use of mifepristone and misoprostol achieves a success rate of approximately 95–98% up to about 9 weeks of gestation, allowing most women to complete the process without additional abortion medication.
Effectiveness is influenced primarily by gestational age:
- Up to 8 weeks:- ~ 94-98% effective.
- 8 to 9 weeks:- ~94-96% effective.
- 9 to 10 weeks:- ~91-93% effective.
- 10 – 11 weeks:- ~87% effective. ( An extra dose may be required)
Factors that affect effectiveness
- Gestation:- Effectiveness slightly reduces as the pregnancy matures.
- Medication:- The combination of mifepristone and misoprostol is more effective than using misoprostol alone.
- Follow-up Appointment:- Follow-up care ensures incomplete or failed abortions are detected and treated early, which improves overall success and safety.
In cases of incomplete abortion, an additional dose of misoprostol may be recommended, or a surgical procedure may be performed, depending on the assessment of the abortion provider.
What Are the Side Effects of Abortion?
During the termination, nearly every woman encounters a range of side effects resulting from medication, and it is important to recognize that the side effects of abortion can vary significantly from one individual to another. The side effects might include:-
- Nausea
- chills
- Fever
- Vomiting
- Diarrhea
- Severe to mild cramping
How does passing an abortion look like?
Passing an abortion usually looks like a heavy period and may include cramping as the uterus empties. You may also see blood clots and some pregnancy tissue.
Possible Risks of a Medical Abortion
Abortions, when performed by trained medical professionals and at the correct gestation period, are considered very low-risk procedures. However, the likelihood of complications / abortion risks increases as the pregnancy progresses and is significantly higher in cases of unsafe or illegal abortions. Possible abortion risks might include:
- Infections.
- Incomplete abortion.
- Future preterm births.
- Or even death in rare cases.
📌 To Learn More Read :- The Common Risks of Abortion ↗
Why Is Medical Abortion Preferred?
Medical abortion is a common choice in South Africa because it’s a simple and safe way to end an early pregnancy. Other key reasons for its preference include:-
- No anaesthetic is needed.
- It carries more risks compared to surgical abortions
- It’s offers more privacy and be self-managed at home.
- It feels more natural similar to having a heavy period or miscarriage.
- Medical abortions are more affordable compared to surgical procedures.
The choice between a medical and surgical abortion is a personal choice usually based on individual circumstances and previous medical history. To learn more read our blog post on the best abortion method for you.
Does medical abortion affect fertility?
No, medical abortion does not cause long-term fertility problems. According to current medical evidence, an uncomplicated medical abortion also does not increase the risk of ectopic pregnancy or breast cancer.
How Do I Take Care of Myself After a Medical Abortion?
After terminating a pregnancy medically, taking care of your physical and emotional health is important for a smooth recovery. Your healthcare provider will guide you on how to care for yourself in the days following a medical abortion.
Physical Recovery
- Rest for the first 24–48 hours if possible.
- Use a heating pad and pain relief as recommended by your provider.
- Avoid strenuous activities, exercise, or lifting heavy items.
- Drink plenty of water and eat healthy, nourishing foods.
- Use sanitary pads to monitor and track bleeding.
Emotional Support
- Acknowledge your feelings. Some women feel relieved, while others may feel sad or guilty.
- Seek support by talking to a trusted friend, family member, or counsellor if needed.
When to Seek Medical Attention
- Fever over 100.4°F (38°C).
- Severe abdominal cramps that are not relieved by medication.
- Soaking through two maxi pads in one hour for two consecutive hours.
Contraception
Fertility can return quickly after a medical abortion, sometimes within a few weeks. It is advisable to discuss birth control options with your abortion provider to help prevent an unplanned pregnancy.
After terminating a pregnancy medically, taking care of your physical and emotional health is important for a smooth recovery. The healthcare provider will advise on how to take care of yourself in the days following the abortion. Self-care tips may include:
Pro-Choice Vs. Pro-Life: Understanding Both Stances
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Patient Rights and Confidentiality
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How Much Do Abortion Services Cost?
Abortion costs in Johannesburg can vary depending on the clinic, the stage of pregnancy, and the type of care included in the service (such as ultrasounds or follow-up visits). At Carlton Women’s Clinic, we aim to keep our pricing clear and affordable, but it’s important to know what may or may not be included in a quoted price.
For a detailed breakdown of possible additional charges and how to avoid unexpected expenses, see our guide on The Hidden Costs of Abortion: What You Need to Know ↗
Cost of a Medical Abortion
Across Johannesburg, the average cost of a medical abortion typically ranges from R1000 to R2,000. Prices can vary based on factors such as how far along the pregnancy is and what level of after-care support will b included.
Cost of Abortion Pills
The abortion pill cost alone in South Africa usually ranges from R599 to R1,200, depending on where it’s obtained and whether medical supervision is included. It’s important to only use approved abortion pills (Mifepristone and Misoprostol) from a registered women’s clinic to ensure safety and effectiveness.
Where to Get a Medical Abortion in Johannesburg
When choosing where to have a medical abortion, it’s important to make sure the provider is licensed and legally approved to offer abortion services. You can safely get a medical abortion from a licensed women’s clinic, a registered healthcare provider, or through a telehealth consultation if you’re less than 12 weeks pregnant.
Although there may appear to be many abortion providers when you search online, not all are trustworthy or licensed to offer pregnancy termination services. Here are a few reputable providers you can contact:-
Public providers (free)
In South Africa, safe abortion services are available for free at government hospitals and public health clinics. However, many women choose to visit private women’s clinics because they offer shorter waiting times, greater privacy, flexible appointments. Learn more on How To Choose And Find Legal Abortion Providers Near You. ↗
Private providers (fee-based)
Private clinics play a crucial role in ensuring access to abortion services.These clinics typically provide their services for a fee, but they often maintain high standards of professionalism and medical expertise. Among the most reputable providers countrywide are:-
- Carlton Women’s Clinic Johannesburg: A trusted abortion provider offering safe, professional and affordable medical and surgical procedures in johannesburg and other major cities. Many clients have shared positive experiences and appreciated the clinic’s compassionate care.
- Abortion Support South Africa: This organization provides a telemedicine service, allowing for at-home, pill-based abortions after an online consultation with a nurse.
- Cavewell Abortion Clinic: A registered women’s clinic providing a range of reproductive health services, including safe and legal abortion. They offer pregnancy termination up to 2o weeks, but it’s best to confirm the exact legal limit based on how far along you are.
Cross-Border Access from Southern Africa
Women who have undergone a medical termination
Medical Abortion vs Other Abortion Methods
When it comes to abortion procedures, both medical abortion, which uses medication to end a pregnancy, and surgical abortion, which removes the pregnancy through a clinical procedure, are considered safe and effective when provided by trained healthcare professionals and performed within approved medical guidelines.
The choice between the two often depends:-
- Personal preference
- How far along the pregnancy is,
- Access to clinical care,
- and comfort with either a medication-based process or an in-clinic procedure.
Many women choose medical abortion for its privacy and ability to manage the process at home, while others prefer surgical abortion for its speed and completion under direct medical supervision.
Myths and Facts About Medical Termination of Pregnancy
Women who have undergone
Additional Resources and Support
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