Abortion treatment - tablets |
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tablets at home (under 10 weeks)
Once you have decided on tablet treatment, the following information is important to read. It details what will happen at each stage of the treatment, instructions for taking tablets at home, and what to expect once the bleeding and pain starts.
Stage one
If you are not 100% sure that this is the right treatment for you, please tell us. We will also happily spend more time answering your questions, arrange counselling, or change procedure, if you would prefer.
If you have any medical issues that you haven’t already told us about, please tell us before starting treatment.
Tell us if you feel very sick and we can give you an injection to reduce the nausea.
You will be given:
Mifepristone 1 tablet to swallow.
If you vomit within 1 hour you must call your treatment centre and return for a second dose.
We will also give you:
• Antibiotics to swallow
• Your contraception choice, if applicable
• An Anti-D injection, if you have RhD negative blood
• A letter outlining your treatment, in case you need to attend ED or visit your GP
• Codeine Phosphate, which is a strong pain medicine, to take home. Try your paracetamol and ibuprofen first (if you are not allergic)
• 4 misoprostol tablets to take home for stage 2
Some women will start to cramp or bleed before the misoprostol (the second stage 2 medicine in 24-48 hours). You need to continue to take your misoprostol medication within the timeframe given. Continue your normal activities/eat and drink as normal.
Stage 2
Misoprostol (Cytotec) pack – 4x 200mcg tablets. These tablets contain misoprostol, microcrystalline cellulose, sodium starch glycolate, hydrogenated castor oil and hypromellose
• Keep these safe at home, and out of reach of children
• Do not use past the expiry date
• Do not store above 30 degrees
• Store in the original package
• They are prescribed for you only. It is illegal to sell or give them to anyone else
• Choose a time when you can have privacy and rest after taking the medicine
• Plan on having someone on hand to support you, or to help should you have
problems
• Don’t drive after taking the medicines, as you may feel dizzy
• Don’t use over the counter magnesium medicines as it can increase the risk of diarrhoea
You must use the second tablets at your usual home address.
The tablets work best, when they are taken 24-48 hours after the mifepristone (stage one).
• If you don’t use them within this time, they may not work.
• If you forget to take them, please call your treatment centre for advice.
You can use the tablets two ways. The first one has fewer side-effects, and is the one that we would recommend you to use:
- Push all 4 tablets high up into your vagina – you can do this one at a time. There is no specific place that you need to position the tablets. They will then dissolve naturally. Occasionally, they can fall back out, but you can re-insert them. Occasionally they come out with the bleeding.
- Put 2 in each side of your mouth, between your cheek and gum, and leave for at least 30 minutes to dissolve. After 30 minutes you can drink water to wash down what is left. The tablets can taste chalky and there is a higher risk of nausea, vomiting or diarrhoea with this method.
At this stage, you will start taking your paracetamol and be ready to go onto ibuprofen and codeine as you need.
You may get some side-effects such as diarrhoea or chills, no matter which way you take the misoprostol.
Stage 3
About 1-4 hours later, you will start to cramp, bleed and pass clots/tissue.
You may pass clots the size of a lemon. Your cramps may be bad. To help, you can use a hot water bottle, take regular pain relief, have someone rub your back or sit on the toilet for short periods. The bleeding is heaviest when the pregnancy comes out, then it should slow down. The pregnancy is small and you will probably just see blood and clots, however there is a chance that you will see the pregnancy pass. It can take up to 2 weeks for the process to complete itself, so you may continue to bleed during this time. Sometimes the bleeding stops and then restarts.
Don’t use tampons until your next period. Avoid intercourse until your bleeding stops.
We will call you after the treatment has started to ensure your treatment is going to plan.
We will give you a date to repeat your pregnancy test (usually two weeks later), and you will need to ring us with this result.
PLEASE CALL US IF YOU:
• Don’t bleed within 24 hours of taking the misoprostol medicine – stage 2.
• Have less bleeding than a normal period.
• Have less than 4 days of bleeding.
• Still have pregnancy symptoms at the end of one week.
• Don’t get your next period 4-6 weeks after treatment (some contraception may delay or stop your period).
• Are concerned that the pregnancy has not passed with the treatment.
PLEASE SEEK URGENT ATTENTION IF YOU:
• Soak 2 big sanitary pads an hour, for 2 hours.
• Have pain that is not getting better with regular pain relief.
• Feel your bleeding is very smelly.
• Have itchiness, swelling of hand, neck or face, or problems breathing following any of the medications.
• Have a temperature or fever of 38 degrees or higher.
• Have diarrhoea, vomiting or weakness more than 24 hours after stage 2 medicines.
• Are worried about any of your symptoms.
Early medical abortion from NHS Lothian on Vimeo.
This video was created by NHS Lothian (shared with consent). It is a cartoon which explains tablet abortion treatments which happen at home (under 10 weeks).
tablets in hospital (over 10 weeks)
If you are 10 or more weeks pregnant, and would like tablet treatment, this will take place in the hospital for your safety. Because the pregnancy is further along, there is a higher chance of heavier bleeding, so to make sure you are safe, we need to monitor you closely throughout the treatment.
The process of the tablet treatment is the same as above. The main difference is that you will be looked after in hospital. Stage one will occur in the EPAU clinic, and then you will go home. Stage 2 will occur 24-48 hours later when you are admitted to the hospital ward, and you will be discharged when you have passed the pregnancy and the treatment is complete. Sometimes you will have to have extra vaginal tablets, if the initial tablets don’t work.
Stage one
This is exactly the same as with the home medical treatment (see information above). You will be given:
Some women will start to cramp or bleed before the misoprostol (the second stage 2 medicine in 24-48 hours). Continue to take your misoprostol medication within the timeframe given. Continue your normal activities/eat and drink as normal.
Stage two
You will be given a date and time to come to the women’s health ward at Peterborough City Hospital. This is normally 24-48 hours after stage one. You will have your own side room with an ensuite. Before we start the treatment, you will have a cannula placed into your arm or hand (this is incase you bleed heavily and we need to give you any medication or fluid). The nurse will then place four small tablets (misoprostol) into your vagina. You may get some side-effects such as diarrhoea or chills. You will then be given paracetamol, the nurses will have ibuprofen and codeine to give you as and when you require it.
Stage 3 – in hospital
About 1-4 hours later, you will start to cramp, bleed and pass clots/tissue.
You may pass clots the size of a lemon. Your cramps may be bad. To help, we will give you regular pain relief, if you have someone with you they could rub your back, or you can try sitting on the toilet for short periods. The bleeding is heaviest when the pregnancy comes out, then it should slow down. There is a chance that you will see the pregnancy pass. We will repeat the vaginal tablets every three hours until the pregnancy has passed. Once this has happened, and the bleeding has slowed down, you will be discharged home.
Before you go home we will give you:
• Your contraception choice, if applicable
• An Anti-D injection, if you have RhD negative blood
• A letter outlining your treatment, in case you need to attend ED or visit your GP
It can take up to 2 weeks for the process to complete itself, so you may continue to bleed during this time. Sometimes the bleeding stops and then restarts. Don’t use tampons until your next period. Avoid intercourse until your bleeding stops.
PLEASE CALL US IF YOU:
• Still have pregnancy symptoms at the end of one week.
• Don’t get your next period 4-6 weeks after treatment (some contraception may delay or stop your period).
PLEASE SEEK URGENT ATTENTION IF YOU:
• Soak 2 big sanitary pads an hour, for 2 hours.
• Have pain that is not getting better with regular pain relief.
• Feel your bleeding is very smelly.
• Have a temperature or fever of 38 degrees or higher.
• Have diarrhoea, vomiting or weakness more than 24 hours after stage 2 medicines.
• Are worried about any of your symptoms.
The process of the tablet treatment is the same as above. The main difference is that you will be looked after in hospital. Stage one will occur in the EPAU clinic, and then you will go home. Stage 2 will occur 24-48 hours later when you are admitted to the hospital ward, and you will be discharged when you have passed the pregnancy and the treatment is complete. Sometimes you will have to have extra vaginal tablets, if the initial tablets don’t work.
Stage one
This is exactly the same as with the home medical treatment (see information above). You will be given:
- Mifepristone 1 tablet to swallow
- Antibiotic tablets to take
Some women will start to cramp or bleed before the misoprostol (the second stage 2 medicine in 24-48 hours). Continue to take your misoprostol medication within the timeframe given. Continue your normal activities/eat and drink as normal.
Stage two
You will be given a date and time to come to the women’s health ward at Peterborough City Hospital. This is normally 24-48 hours after stage one. You will have your own side room with an ensuite. Before we start the treatment, you will have a cannula placed into your arm or hand (this is incase you bleed heavily and we need to give you any medication or fluid). The nurse will then place four small tablets (misoprostol) into your vagina. You may get some side-effects such as diarrhoea or chills. You will then be given paracetamol, the nurses will have ibuprofen and codeine to give you as and when you require it.
Stage 3 – in hospital
About 1-4 hours later, you will start to cramp, bleed and pass clots/tissue.
You may pass clots the size of a lemon. Your cramps may be bad. To help, we will give you regular pain relief, if you have someone with you they could rub your back, or you can try sitting on the toilet for short periods. The bleeding is heaviest when the pregnancy comes out, then it should slow down. There is a chance that you will see the pregnancy pass. We will repeat the vaginal tablets every three hours until the pregnancy has passed. Once this has happened, and the bleeding has slowed down, you will be discharged home.
Before you go home we will give you:
• Your contraception choice, if applicable
• An Anti-D injection, if you have RhD negative blood
• A letter outlining your treatment, in case you need to attend ED or visit your GP
It can take up to 2 weeks for the process to complete itself, so you may continue to bleed during this time. Sometimes the bleeding stops and then restarts. Don’t use tampons until your next period. Avoid intercourse until your bleeding stops.
PLEASE CALL US IF YOU:
• Still have pregnancy symptoms at the end of one week.
• Don’t get your next period 4-6 weeks after treatment (some contraception may delay or stop your period).
PLEASE SEEK URGENT ATTENTION IF YOU:
• Soak 2 big sanitary pads an hour, for 2 hours.
• Have pain that is not getting better with regular pain relief.
• Feel your bleeding is very smelly.
• Have a temperature or fever of 38 degrees or higher.
• Have diarrhoea, vomiting or weakness more than 24 hours after stage 2 medicines.
• Are worried about any of your symptoms.
Further information and consent forms
Please read the appropriate leaflet and consent form before your telephone consultation.
| FPH347 home medical treatment |
| FPH359 inpatient medical |
