Mifeprex Abortion Details

MIFEPREX is a drug which blocks the action of progesterone, a hormone needed to continue a pregnancy. MIFEPREX has been approved by the U.S. Food and Drug Administration (FDA) for early abortion, and has been used by millions of women in Asia and Europe (it has been referred to as RU486 or the French abortion pill). Misoprostrol is a drug used in the United States to prevent irritation or ulcers in the stomach of people using aspirin or aspirin-like pain medicine. When the FDA approved MIFEPREX, it was approved for use in combination with misoprostol. When used together, they are approximately 95% effective in causing an abortion in early pregnancy.

PROCEDURE:

1. You must be a resident of Pima County, Tucson, Arizona
(Must show proof of current residency- bank statement, government issued picture ID, utility bill)

2. Must be 18 years of age or older

3.. The provider will take your medical history, and examine you to assess how many weeks you are pregnant. An ultrasound may be done to determine how far along the pregnancy is. The ultrasound will be done by putting an ultrasound probe in your vagina or on your abdomen. You will have your blood drawn to check on your blood type. Your blood will also be tested for anemia.

4. You will swallow Mifepristione 200 mg (one tablet) in the office. This day will be called "day 1".

5. You will take Misoprostol 800 mcg (four 200 mcg tablets) orally. On morning of "day 2".

6. You will remain at home. Plan to relax for the next 4-6 hours when bleeding or cramping will likely occur. You should have access to a telephone and your providers 24-hour emergency contact information.

7. You will contact your provider at 520-323-9682 IF: you soak 2 or more maxi pads per hour for 2 consecutive hours; have a sustained fever (100.4° F) or onset of fever a few days after misoprostol; have severe abdominal pain not helped by pain medications; or have no bleeding within 24 hours after misoprostol, which may require more medication or evaluation for an ectopic pregnancy.

8. If you have cramping in your lower abdomen, you can take Tylenol (acetaminophen) or Motrin (ibuprofen) as needed every 4-6 hours. You will also be given Vicodan (AtetaminophinbHydrocodon).

9. You will receive a call to check your status on day 2 or the first business day that follows day three. You will meed to be available by phone to receive this call. A registered letter may be sent to you in the event that we do not speak to you regarding your status.

10. You will return to the office around day 14. This follow-up visit is very important to confirm that termination of your pregnancy has occurred and that there have been no complications. At this visit you will have an ultrasound, a physical examination and/or another blood test. If your abortion has occurred, then you are finished. If the pregnancy is still progressing, then you will have a surgical abortion.

RISKS:
Recent reports have described a few cases of severe infection, bleeding, and death. Although these problems are unlikely, you must remain in contact with the office and be able to return for additional follow-up if necessary. The physician will make the final decision based on you history as to whether Mifeprex is the right choice for you.

1. Incomplete abortion: As with a surgical abortion, some pregnancy tissue may remain in your uterus. If this occurs, the provider will discuss your treatment options, which include waiting one or more weeks, using more misoprostol, or having an aspiration, which is similar to a surgical abortion. If you decide to wait or use more misoprostol, and the abortion still is not complete, you will need an aspiration curettage. The risks of an aspiration curettage include a risk of making a hole in the uterus, tearing of the cervix, adverse reaction to anesthesia that may be used, infection, excessive bleeding, and failure to remove all of the tissue from the uterus.

2. Vaginal bleeding: As with a surgical abortion, heavy bleeding can occur and blood clots may come out of your vagina. If you have extremely heavy vaginal bleeding or dizziness, an aspiration curettage may be necessary to stop the bleeding. The risks of an aspiration curettage are stated above. The chance of having very heavy vaginal bleeding after using MIFEPREX/misoprostol is about 1 per 1000 (0.1%).

3. Continued pregnancy and birth defects: Your pregnancy may not end after receiving the medications. If this happens, birth defects are possible. Because of the risk of birth defects, surgical abortion is strongly recommended to end the pregnancy. The risks of a first-trimester surgical abortion include a risk of making a hole in the uterus, tearing of the cervix, adverse reaction to anesthesia that may be used, infection, excessive bleeding, and failure to remove all of the tissue from the uterus.

4. Side effects: The following side effects are possible: nausea, vomiting, diarrhea, fever, headaches, and chills. Most of these side effects last less than a day. You will have cramping in your lower abdomen and may need pain medication to resolve this condition.

5. Ectopic pregnancy: A rare condition which is a complication of pregnancy rather than abortion is a pregnancy in the fallopian tube. If the pregnancy is in the fallopian tube or outside the uterus, neither surgical abortion nor a MIFEPREX/misoprostol abortion, will remove the pregnancy. Hospitalization may be necessary as soon as it is discovered.

COSTS AND PAYMENTS
You will receive medical care for your abortion as described above (including information about birth control) at a charge of $400.00 which also includes pain medication.