At our office, it can be done between 5 weeks to 9 weeks of pregnancy.

At our office:

We review your history and do an examination.

We perform an ultrasound to check the location, age and condition of the pregnancy.

We check for uterine and ovarian abnormalities.

We draw blood for the RH factor to see if someone’s blood is RH positive or negative.

We provide two medications for the medical termination:

• Mifeprex – This stops the growth of a pregnancy by blocking the hormone called progesterone. You will take this medication in our office along with an antibiotic.

• Misoprostol – This causes strong uterine cramps that miscarry the pregnancy. We will give you these pills to take home. You will receive a total of 800 mcg of tablets – 8 tablets total.

• We will also give you the antibiotics necessary to prevent an infection. One of the antibiotics you will take at our office and more for later at home. These antibiotics are dispensed from our office.

Pharmacy Services

1. Pain Medication

You may purchase at ours or yours. Pharmacy NSAIDs like prescription strength ibuprofen. You may use Vicks Vaporub or China Ice. You may need a heating pad.

2. Anti-nausea Medication

You may need in case of nausea due to medications.

3. Additional Misoprostol to prevent bleeding for patients with history of heavy periods or for patients with prior pregnancies of over eight weeks gestation.

At your home

It’s best to have a trusted adult with you the night you insert the pills. You may experience anxiety, fear and may feel sad. This person should understand your decision and the pregnancy termination process. This person may help you in the unlikely case of an emergency.

Place your Misoprostol tablets vaginally as instructed. Best time is the same night or the next night after your office visit.

• Before you start, use the bathroom to empty your bladder or your bowels.
• Wash externally your private parts and wash your hands afterwards.
• Dry them both.
• Use your dry hands to insert all given tablets (a total of 800mcg of Misoprostol, 8 tablets total) inside the vagina, as high up as possible.
• Place a sanitary pad on your panties.
• Wash your hands again and dry them.
• Take 1 ibuprofen at once, BEFORE the pain starts.
• Go to bed. Avoid walking around so that you do not lose the vaginal tablets. They usually stay in place if properly placed high up in the vagina.
• You may have around a hot compress, a hot water bottle or a heating pad when you go to bed to use it if you need it.
• The cramps will start from 6-48 hours later and the miscarriage would then follow.
• If you are having heavy bleeding, more than 2 pads per hour, for 2 hours, then take under the tongue the additional tablets of Misoprostol we prescribed or dispensed. Let them dissolve, swallow the saliva.
• Take them every 6-8 hours are needed. Finish them all. These will help you decrease the amount of bleeding you are having.
• Take your antibiotics as we prescribed to prevent an infection.
• Take your nausea tablets as prescribed if your nausea prevents you from using your antibiotics.

The bleeding can be heavy the first 48 hours but then decreases. You may pass clots and tissue which is normal for this process.  You will have cramps, back pain and lower abdominal pain.

• If you are NOT bleeding within 48 hours.
• If the bleeding is less than a heavy period.
• If your pregnancy symptoms such a nausea, vomiting and feeling tired, do not go away in 48 hours after placing the vaginal pills.
• If you are bleeding heavily – more than 2 pads per hour and for more than 2 hours! You should take your extra Misoprostol tablets as prescribed but also call us for an appointment to see you as soon as possible.
• If you are experiencing an allergic reaction with bumps, redness or shortness of breath.
• If you develop fever, abdominal pain and foul smelling discharge.
• If pain is unbearable, we may have you return to our office for a pain relieving shot or may direct you to the nearest emergency room.

94% effective.

A week after your initial visit, you will return to have a repeat ultrasound to confirm completion of the process. You should no longer be pregnant. It is normal to have some bleeding or cramping still.

You may still have some clot inside the uterus which works to stop any further bleeding.

This clot may come out on its own either whole or in pieces. This is normal but is often associated with more bleeding and cramping.

If there is a pregnancy still, you have two options:

• Try additional medication to cause more cramps so as to miscarry the pregnancy, or
• Have a surgical procedure to remove the pregnancy using the suction method.

These options are discussed in detail at the follow up visit and we decide together what is best for you.

• If there are medical reasons to worry about heavy bleeding such as fibroids, twin gestation, scarring of the uterus from prior cesarean sections and advanced gestational age.
• If there are abnormal clotting conditions.