How do you know if you are pregnant and how long you have been pregnant for?

Most women determine that they are pregnant if they are sexually active and have missed a period. Nausea, breast soreness, and fatigue are also common symptoms in early pregnancy. Ultrasound or pregnancy tests are the only ways to immediately be sure that a woman is pregnant.If an ultrasound is performed, the doctor can tell a woman exactly how long she has been pregnant. The doctor can also estimate the length of the pregnancy without using ultrasound. A pregnancy test cannot provide this information.

A woman can also make a reasonable calculation of about how long she has been pregnant. She must figure out when the first day of her last menstrual period was, include that day and start counting up until today.

more scientific information:Studies show that women are capable of doing this on their own.A study was carried out to see if women in the United Sates and India could calculate how long they had been pregnant. The women were given calendars and worksheets to help them do the calculations. 98 out of every 100 women in the study group in the U.S. and 87 out of every 100 women in the study group in India were able to estimate how long they had been pregnant. Approximately 9 out of 10 women could estimate the lengths of their pregnancies accurately enough to use mifepristone and misoprostol on their own. The researchers concluded, “The vast majority of women seeking first-trimester abortion in this study could accurately calculate pregnancy duration within a margin of error clinically inconsequential for safe use of unsupervised medical abortion. Most of the women’s estimates were within 1 week of the actual length of their pregnancy. This was “well within the documented margin for safe and effective medical abortions

How many weeks into your pregnancy can you do a medical abortion?

You can do a medical abortion treatment until the 9th week of your pregnancy.

More scientific information:Medical abortion was first offered for terminating pregnancies in the early first trimester (some regulations required pregnancies to be seven weeks or less, and others required nine weeks or less). It has now been shown to be effective through the first trimester (12 weeks) and has been successfully used during the second trimester 13 . In 2004, “The Royal College of Obstetricians and Gynaecologists evidence-based clinical guidelines stated that the medical regimen using Mifepristone in combination with Misoprostol would be a safe and effective alternative to surgery for women undergoing abortion at 9-13 weeks’ gestation 20 .
After 9 weeks, women who have medical abortions have a higher risk of complications. The 9 week limit is also supported by other health professionals worldwide. An official statement issued at an international conference on medical abortion in 2004 said, “For abortions up to nine weeks, the pills can be provided through primary health care services and women can safely use the method at home or in a clinical setting, according to their own preferences and personal circumstances. Medical abortion after nine weeks and in the second trimester can be carried out in a health centre or hospital
4 .

What will happen if you do a medical abortion after the first 9 weeks?

If you have been pregnant for longer than 9 weeks and do a medical abortion anyway, the medicines still work and cause an abortion. However, the risk of complications increases and it is more likely that you will need to receive treatment from a doctor afterwards (See the table below on complications to determine the exact amounts of increased risk.) If you have no other means, doing the medical abortion is still much safer than dangerous methods for causing an abortion, such as inserting sharp objects into the vagina, ingesting toxic chemicals such as bleach, or punching the abdomen. You should never use these dangerous methods!

What if you are not pregnant but take the medicines anyway?

Your health will not be harmed if you are not pregnant but take the medicines anyway.

What are hCG levels during pregnancy?

hCG levels in weeks from Last Menstrual Period :
3 weeks LMP: 5 - 50 mIU/ml4 weeks
LMP: 5 - 426 mIU/ml5 weeks
LMP: 18 - 7,340 mIU/ml6 weeks
LMP: 1,080 - 56,500 mIU/ml7 - 8 weeks
LMP: 7, 650 - 229,000 mIU/ml9 - 12 weeks
LMP: 25,700 - 288,000 mIU/ml13 - 16 weeks
LMP: 13,300 - 254,000 mIU/ml17 - 24 weeks
LMP: 4,060 - 165,400 mIU/ml25 - 40 weeks LMP: 3,640 - 117,000 mIU/ml
These numbers are just an indication, every woman’s level of hCG can rise differently.
Most women can expect their levels to return to a non-pregnant range about 4 - 6 weeks after an abortion.

What if I have a RH - bloodtype?

Usually doctors advice women who have an (surgical) abortion or miscariage or delivery to take an injection with anti D globuline. The reason is that if the fetus has a positive bloodtype and if there is an exchange in blood the woman can make antibodies in her blood that can affect the next born baby. However research with early medical abortion and first trimester (first 12 weeks) spontaneous abortions have shown that no or very little exchange in blood between the woman and the fetus takes place and that the a woman does not make any significant amount of antibodies that could affect the next fetus (62). So we do not advice you to get an injection with anti-d globuline. But if you feel unsure, you should to a doctor or hospital shortly after having the medical abortion, say you had a miscarriage and that you are rhesus -, the doctor might decide or not that he thinks he should give anti-d globuline anyway depending on his opinion.

There is minimal evidence that administering Rh immune globulin for first trimester vaginal bleeding prevents maternal sensitization or development of hemolytic disease of the newborn. The practice of administering Rh immune globulin to Rh-negative women with a first trimester spontaneous abortion is based on expert opinion and extrapolation from experience with fetomaternal hemorrhage in late pregnancy. Its use for first trimester bleeding is not evidence-based (62).


When should you not use the medicines?

you should not use the medicines if:
someone is forcing you to end your pregnancy.
you are not sure about wanting to end your pregnancy.
the first day of your last menstrual period was more than 9 weeks ago.
you have an allergy to Mifepristone, Misoprostol, or prostaglandins
you have one of the following diseases: Chronic adrenal failure, Hemorrhagic disorders or bleeding disorders/diseases, Inherited porphyries. (It is highly unlikely that you have one of these diseases and do not know it yet.)
you have is an intrauterine device (IUD). This must be removed before using the medicines.
you have an ectopic pregnancy (a pregnancy outside the womb).
you cannot get to a hospital or first aid centre within an hour.
you are alone. You should ask a partner, friend or other trusted person to stay with you while you use the medicines.

What is a contraindication and how do you know if you have one?

Contraindications are conditions or situations might keep you from being able to safely use Mifepristone-Misoprostol. These are generally things that you will already know about youself.Screening you for these contraindications on the internet is very similar to the screening process at a face-to-face visit between a doctor and a patient. The doctor generally finds out about contraindications by asking the patient if she has any of these medical conditions.You might not know whether or not you are allergic to one of the medicines, but allergic reactions to these medicines are uncommon (0,008%) and very mild (hives).

Why shouldn't you be alone when you do a medical abortion and what if you do it alone anyway?

You are strongly advised to use the medicines in the presence of someone you trust. However, if you choose to do the medical abortion alone, it is not necessarily hazardous. Make sure you are near a phone or some way of contacting medical professionals. You should consider telling someone (a neighbor, a family member, or someone who is nearby) that you are not feeling well and you are going to rest. You can ask them to check on you later in the day after you use the Misoprostol. This way someone will know if you are experiencing complications and can help you, but they do not have to know that you have done a medical abortion. You can say that you think you have had a miscarriage.

Why should you be within 60 minutes of a hospital or first aid centre when you do the abortion?

It is absolutely necessary to be within one hour of help, in case you lose too much blood. This is also the case when a woman miscarries or gives birth. It is not necessary for you to live in an urban area medical abortion. Almost all areas with internet access will also have a basic first aid centre nearby.Hospitals and first aide centres must have basic medical equipment and staff. This equipment and expertise is the same that is required to care for women who have complications related to miscarriage or birth.

What painkillers can I use?

You can use Paracetamol (acetaminophen) or Aspirin (salicylic acid) or NSAID’s like Ibuprofen, Naproxen and Diclofenac. Please read the patient instructions of the package of painkillers you obtained for the maximum dosis you can use.


How should you use the medicines?

To end a pregnancy the medicines should be used in the following way:

First you should swallow one tablet of Mifepristone. This medicine blocks the effects of progesterone, the hormone that is necessary to maintain the pregnancy.

24 hours later you should put 4 tablets of Misoprostol in the space between gum and cheek (the buccal cavity) and keep there there for at least 30 minutes, until the tablets are dissolved. You can swallow your saliva. After 30 minutes you can swallow the remains of the tablets.

4 hours after using the first dose of Misoprostol, you should use 2 more tablets of Misoprostol in the space between gum and cheek (the buccal cavity).

Why should you use Misoprostol buccally, in the space between the gum and cheek?

24 hours after swallowing the Mifepristone, the Misoprostol tablets can be used in one of two ways: vaginally or buccally (in the space between gum and cheek). Both methods are equally effective in causing an abortion.

We strongly advise you to use Misoprostol in the space between your gum and cheek. This way, no remains of the pills can be found in the event that you need to go to a hospital. There are no blood tests that can show that you have taken Mifepristone or Misoprostol, so there will be no way to prove that you tried to do an abortion.

In countries where women can be prosecuted for having an abortion, it is not necessary to tell the medical staff that you tried to induce an abortion. You can say that you had a spontaneous miscarriage. The doctor CANNOT see the difference. The treatment is also the same. The treatment is curettage, also known as vacuum aspiration, during which a doctor will remove remaining tissue from the womb. Doctors have the obligation to help in all cases.

What happens if you do not use Misoprostol in time?

The doctor advises you to use the Misoprostol 24 hours after swallowing the Mifepristone tablet. However it can also be used earlier or later, from 12 hours to 72 hours after swallowing Mifepristone.

What if you take the Mifepristone and then decide not to take the Misoprostol?

If, for some reason, you take the Mifepristone and then decide you will not take the Misoprostol part of the medical abortion regimen, there are a few things that could happen.
1-You might experience a complete abortion without ever taking Misoprostol.
2-You might experience a missed abortion, which means that the fetus is no longer viable, but the products of pregnancy (blood, tissue) do not leave your body. This has to be treated with a vacuum aspiration.

3- It is also possible that your pregnancy might continue. If you decide you want to keep the pregnancy at this point, it is unlikely that the Mifepristone will cause later fetal malformations.

Can you use Mifepristone and Misoprostol if you are still breastfeeding?

It is better not to breastfeed during the first 5 hours after taking Mifepristone and after using Misoprostol. It is best to throw away the milk produced in the first 5 hours.


When will you start bleeding and how long will it last?

After using Misoprostol you should expect bleeding and cramps. Bleeding usually starts within four hours of using the pills, but it sometimes starts later. If you do not start bleeding within the first 4 hours, you should apply another 2 tablets of Misoprostol. Bleeding is often the first sign that the abortion has begun. If the abortion continues, bleeding and cramps become more severe. Bleeding is often heavier than a normal menstruation, and there can be clots. The longer the pregnancy has developed, the heavier the cramps and the bleeding will be. If the abortion is complete, the bleeding and the cramps diminish. The moment of abortion can be noticed with a peak of heavier abortion can be noticed with a peak of heavier blood loss and more pain and cramps.Normally the bleeding will continue lightly for one to two weeks after the abortion, but times may vary. The normal menstrual period usually returns after four to six weeks

What if you don’t bleed after you use the medications?

If you do not start bleeding within 4 hours of taking Misoprostol, you should apply another 2 tablets. If you still do not bleed and you are positive that you were pregnant, then you either have an ectopic pregnancy or a continuing pregnancy. You should have an ultrasound. If you experience complications such as fever, faintness, or extreme abdominal pain, then you should get medical help immediately, because you could have a ruptured ectopic pregnancy. If you have an ectopic pregnancy, the doctor will treat it. This procedure is not considered an abortion and it is necessary to save the woman’s life. If the ultrasound shows a continuing pregnancy, you can do the medical abortion again.

Can you see the products of the abortion (placenta, embryo, blood) and what should you do with them?

Most of the time women can see blood and tissue in their sanitary napkin or in the toilet. The (very small) embryo is usually passed within this blood and tissue in such as way that it goes unnoticed by the woman. However, it is possible that you might see the (very small) embryo. Depending on the length of the pregnancy, a small pregnancy sac with some tissue around it may be visible. For instance, if you are only five to six weeks pregnant, there will be no visible sac. At nine weeks, you might be able to find a sac in the blood and it is possible that you might see the embryo. With a pregnancy of 8 or 9 weeks, the embryo is about 2, 5 cm. This can be distressing.It is best to flush everything down the toilet or to wrap the sanitary pads in a plastic bag and throw them away.

What are the side effects of the medicines?

The medical abortion treatment normally causes side effects such as pain and cramping, as well as bleeding accompanied by the passage of blood clots and tissue. Nausea, vomiting, diarrhea, headache, dizziness, and hot flashes or fever may also occur. An allergic reaction to the medication can cause hives (itchy welts or bumps on the skin.)
More scientific information:Most women will experience pain and cramping during the medical abortion, in particular after using the Misoprostol 26 . In most of the scientific studies on the topic, the majority of women describe the pain as only a little bit worse than the pain they experience during a menstrual period 26 .Some women will experience nausea, vomiting, or diarrhea, but it is thought that this is an effect of early pregnancy as much as it is due to Mifepristone or Misoprostol 26 . Usually these side effects go away by themselves and do not require medical attention 26 . Headache, mild dizziness, fever and hot flashes are symptoms that also should go away by themselves.

What is a complete, successful abortion and how do you know you've had one?

A complete abortion means that the body has expelled all the products of pregnancy (blood, tissue, embryo) and there is no need for surgery (vacuum aspiration) afterwards. The only way to make sure that you've had a complete abortion is to have an ultrasound 10 days after using the medicines. You should not have extreme pain, prolonged heavy bleeding, or fever. You will bleed for 1 to 3 weeks.


How do you know if you have complications and what should you do?

If performed in the first 9 weeks, a medical abortion carries a very small risk of complications. This risk is the same as when a woman has a miscarriage. A doctor can easily treat these problems. Out of every 100 women who do medical abortion, 2 or 3 women will have to go to a doctor, first aid center or hospital to receive further medical care.
These are the possible complications, their symptoms and treatment:

Heavy bleeding (occurs in less than 1% of medical abortions)
Symptom: Bleeding that lasts for more than 2 hours and soaks more than 2 maxi sanitary pads per hour. Feeling dizzy or light-headed can be a sign of too much blood loss. This is dangerous to your health and must be treated by a doctor.

Treatment: a vacuum aspiration (curettage.) Very rarely (less than 0.2%) a blood transfusion is needed.
Incomplete abortion
Symptoms: heavy or persistent bleeding and/or persistent severe pain.
Treatment: a vacuum aspiration (curettage)

Symptom: If you have a fever (more than 38 degrees Celsius) for more than 24 hours, or you have a fever of more than 39 degrees, there might be an infection that needs treatment.
Treatment: antibiotics and/or vacuum aspiration.

If you think you might have a complication you should go to a doctor immediately. If you live in a place where abortion is a crime and you don’t have doctor you trust, you can still access medical care. You do not have to tell the medical staff that you tried to induce an abortion; you can tell them that you had a spontaneous miscarriage. Doctors have the obligation to help in all cases.

The symptoms are exactly the same and the doctor will not be able to see or test for any evidence of an abortion, as long as the pills have completely dissolved. If you took the pills buccally, between the gums and the cheek as our protocol recommends, the pills should have dissolved within three hours of taking them. If you took the pills vaginally, you must check with your finger to make sure that they are dissolved. Traces of the pills may be found in the vagina up to four days after inserting them.

Less than 1% of women experience ongoing pregnancy. This can be determined by a pregnancy test after 3 weeks or an ultrasound after 10 days. If the medical abortion treatment failed, there is a slight increase in the risk of birth defects such as deformities of the hands or feet and problems with the nerves of the fetus. To treat an ongoing pregnancy you must repeat a medical or surgical abortion.

More scientific information:
Research has shown that very few serious complications result from medical abortions compared to the number of women who experience successful medical abortions. 16 17 20 21 22 . In the few cases that a surgical intervention such as a curettage (vacuum aspiration) is needed, this can be managed by the same health care facilities that care for women who have had miscarriages.
Legnth of pregancy
% of women who needed further medical care
0- 49 days (0-7 weeks) 2 %
40-63 days (7-9 weeks) 2.5%
64-70 days (9-10 weeks) 2.7%
71-77 days (10-11 weeks) 3.3%
77-84 days (11-12 weeks) 5.1%
85-91 days (12-13 weeks) 8%
(Further medical care consists of vacuum aspiration for a continuing pregnancy or an incomplete abortion.)

How do you know if you have a post-abortion infection?

Infections following medical abortions are very rare. If you feel weakness, nausea, vomiting, diarrhea, fever, pain in your belly, if your belly feels sore or tender, if you bleed a lot or for a long time, or if you have vaginal discharge that smells bad, you might have an infection and you should go to a doctor immediately. The infection should be treated with antibiotics.

Medical abortion is a safer alternative in places where surgical methods are dangerous for a woman’s health, or in places where the availability of safe abortion is restricted. The risk of infection is greater when a woman has a child than when she has a medical abortion.

How do you know if you have an incomplete abortion?

An incomplete abortion is an abortion that has only been partially successful. The pregnancy has ended— no fetus will develop, but your body has only expelled part of the tissue and products of pregnancy. If you have prolonged bleeding, too much bleeding (much more than a regular menstrual period), pain in your belly that does not go away after a few days of taking the Misoprostol, pain that is unbearable, fever, continued bleeding after three weeks, or pain when pushing on your belly, you may have an incomplete abortion. You must go to a hospital or a doctor to complete the abortion if you have any of these symptoms. This is absolutely necessary because the tissue and blood that remains in the body can cause heavy bleeding or an infection. The treatment of an incomplete abortion is legal everywhere.In countries where women can be prosecuted for having an abortion, it is not necessary to tell the medical staff that you tried to induce an abortion; you can that say that you had a spontaneous miscarriage. There are no tests that can show that a woman has done a medical abortion. It is extremely important to treat an incomplete abortion. The treatment for incomplete abortion is called a vacuum aspiration, or “curettage." Any clinic that can deal with complications of miscarriage can also help women with incomplete abortions, because the symptoms are the same.

How do you know if you have a continuing pregnancy?

Continuing pregnancy is a pregnancy that continues to develop even after the use of Mifepristone and Misoprostol. In this case, the abortion has failed completely and the woman remains pregnant. Even if you bleed, you can still have a continuing pregnancy. Bleeding does not mean that you have had a successful abortion. If you still have symptoms of pregnancy such as sore breasts or nausea, you may be experiencing a continuing pregnancy. You should have an ultrasound or do a pregnancy test 3 weeks later to confirm that the pregnancy has ended. Most pregnancy tests that are done 3 weeks after the abortion are reliable. It is necessary to wait 3 weeks after the abortion because the pregnancy hormones can remain in the body and can make the pregnancy test falsely positive. If you have an ongoing pregnancy after you did a medical abortion you can try to do a medical abortion again or have a surgical abortion. Because Misoprostol can increase the risk of fetal malformations, we advise women with continuing pregnancies undergo surgical or medical abortion to terminate the pregnancy.

What are the chances that the fetus will be malformed if you have an ongoing pregnancy?

If you have an ongoing pregnancy after using Misoprostol, the risk of having a baby with fetal malformations is increased. However, this risk is still small, less than 1 in 1000. This risk is smaller than the normal risk of having a baby with Down Syndrome.

We advise women with ongoing pregnancies to undergo surgical or medical abortions to terminate the pregnancy in order to entirely avoid the risk of having a malformed fetus.


Do you require psychological counseling after you have had an abortion?

Most women do not need any psychological help after an abortion. Feelings of regret after abortion are rare. Indeed, the most common emotional response after abortion is relief. Transient feelings of guilt, sadness, or loss are common but most women can overcome negative feelings that might affect them. It is normal to feel emotional after an abortion. While you may experience sadness or sadness or grief, these feelings usually go away after a few days. But in countries where the taboo and social stigma is big, it is more common for women to suffer feelings of guilt and shame.If you are not sure if a medical abortion treatment is right for you, we encourage you to discuss it with a trusted friend.

How do women feel after an abortion?

Every woman is unique in how she feels after an abortion. Most women report feeling a sense of relief that they have made the best decision under the circumstances. This is the most common response. For some women, however, abortion can raise a number of emotional responses including sadness, guilt, rage, shame and regret. Some women feel bad about themselves because they don’t feel guilty about having an abortion, but think they should feel guilty. In general, understanding your emotional pain can help you to begin to let go of the grief, guilt, rage or shame you may be feeling. It is important to acknowledge that you are hurting and to take good care of yourself if you are experiencing difficulty.

You are not a bad person because you had an abortion. You are also not alone in having chosen abortion. Many women are surprised to learn that about 46 million women worldwide have abortions each year.

What kinds of things might contribute to a woman feeling distress after an abortion?

Your hormones are changing back to their pre-pregnancy state. This chemical change can cause feelings of sadness and weepiness. Someone else may have pressured you into having an abortion, rather than letting you make the decision for yourselfYou might not have much support from your friends or family. Isolation is a major reason that women may find themselves in distress after an abortion.
You might feel very divided inside about your decision to have an abortion. It may not have been clear to you that abortion was the right decision in your circumstances.You may feel abandoned and alone. Maybe your were hoping the man who got you pregnant would want to have a baby with you. Maybe he was not willing to do that, contributing to your sadness.Perhaps you have low self-esteem and often feel bad about yourself.Other parts of your life may be very stressful — school, your job, your kids etc.

You might fear that you will never again be able to get pregnant. If this is a worry to you, be assured that a safe medical abortion does not cause infertility in the future.

Anytime you make a difficult decision, it is natural to worry "what if I had made a different choice?" and to agonize over the decision.Abortion may bring up old experiences or feelings you have been repressing. For instance, if sexual abuse is a part of your past, you may find yourself re-living feelings related to your abuse. Feeling vulnerable about the pregnancy and abortion may trigger you to remember a time in the past when you felt frightened and vulnerable.

Is it normal to feel depressed after an abortion?

In rare cases, women may become clinically depressed after having an abortion. If your feelings are overwhelming and do not seem to be resolving or you are suffering symptoms of depression, you should consult a professional.
There are some factors which are known to contribute to the risk of depression after abortion, including having a history of depression, anxiety or panic. Depression is a very serious illness. It is extremely important that you seek help from a professional such as a doctor, counsellor or therapist if you believe you are depressed.

What is “Post-abortion Syndrome"?

A general consensus has been reached in the medical and scientific communities that most women who have abortions experience little or no psychological harm. However, many people who are opposed to abortion claim that women who have had abortions will suffer from a type of post-traumatic stress disorder called “post-abortion syndrome".

Reliable, unbiased studies have shown that, although psychological disturbances do occur after abortion, they are uncommon and generally mild and short-lived.Most psychiatric experts doubt the existence of “post-abortion syndrome and point out that abortion is not significantly different from any other stressful life experience that might cause trauma in some people.

What can I do to help myself heal after an abortion?

After an abortion, there are concrete things you can do to help you come to terms with your decision. The following suggestions can help you accept and deal with your feelings, make your feelings of sadness go away and help you reach some "closure" to your abortion experience.

Allowing yourself to express any sadness and grief that you are feeling will help it to diminish. You won't always feel this way.Don't be hard on yourself. Talk to yourself in ways that are affirmative. You are a good person. You are a moral person.

Remind yourself that you are brave -- you made a difficult decision.

Remind yourself why you made the decision to have an abortion.

Remember you made the best decision you could under the circumstances.

Ask yourself, if you hope to have a planned pregnancy some day, how would it differ from the situation you have just been in?

Write your feelings down in a journal or special book which no one else will see.

Think about things you can do which will make you feel good. Write them down and try to do several of these each day.

Remind yourself of the future. Make a list of things you are looking forward to doing.

Consider creating an "end" to your relationship with your pregnancy by writing a good-bye letter and keeping it in a safe place or burning it.

Practice relaxation exercises to help deal with stress.

Read about other women's experiences at the "I had an abortion" part of this website. This can be reassuring and make your own feelings more clear. 60 (60)

Different women have different feelings about and experiences with abortion. Psychological studies show that women do not suffer for prolonged periods of time due to abortions they choose to have. These studies show that women can overcome negative feelings that might affect them. “Multiple studies have demonstrated that feelings of regret after abortion are rare. Indeed, the most common emotional response after abortion is relief. Transient feelings of guilt, sadness, or loss are common, but no evidence indicates that routine counseling is essential or even beneficial in coping with these feelings 1 . Evidence suggests that most women do not need counseling after an ABORTION.

Does medical abortion increase the risk of breast cancer?

No, having an induced abortion does not increase a woman’s chance of developing breast cancer.

More scientific information:“Abortion does not increase a woman’s risk for cancer. Flawed epidemiologic studies led to claims that abortion elevates a woman’s risk for breast cancer in later life. …After review of the evidence, both the World Health Organization and the National Cancer Institute in the Unites States have concurred that no credible evidence supports a link between abortion and breast cancer"

Will you be able to get pregnant and have children after a medical abortion?

Yes, a medical abortion does not affect your ability to conceive or bear a child in the future.

More scientific info:The results of one study suggest that if a woman who has never given birth has an early medical abortion using Mifepristone, it will not cause problems during a future wanted pregnancy 23 .
A publication intended to help doctors understand induced abortion states, “Induced abortion does not harm a woman’s reproductive capacity. Premature birth, infertility, ectopic pregnancy, spontaneous abortion, and adverse pregnancy outcomes are not increased in frequency after abortion
30 . There is disagreement among researchers as to whether induced abortion increases the chance that a woman will experience the problem of placenta previa in a later pregnancy. Placenta previa is a condition in which the placenta covers all or part of the cervix, or implants at the edge of the cervix. Some studies have shown an increased risk of placenta previa, but others have not 30 .

When can you get pregnant again after doing the medical abortion?

You can get pregnant again immediately after doing the medical abortion. It is very important to start using contraceptives as soon as possible. The contraceptive pill can be started on the first day of the first normal menstruation after having the medical abortion (and after that as well of course) . Condoms can be used immediately. An IUD can also be put in place by a doctor during the first normal menstruation after the medical abortion. (and after that as well of course).

How can you prevent a future unwanted pregnancy?

About 85% of sexually active women who do not use contraceptives become pregnant within a year. A woman can become pregnant while breastfeeding, from about 10 days after childbirth, and even during her menstruation. Withdrawal of the penis prior to ejaculation and periodic abstinence does not prevent pregnancy or spread of sexually transmitted diseases. Here you can read more about several forms of contraceptives.

You can prevent an unwanted pregnancy with:1- Total Abstinence2- Use of contraceptives
If you are sexually active and do not want to get pregnant, always use contraception.

Methods of Contraception:No method of contraception gives 100% protection.The male latex condom is the only contraceptive method considered highly effective in reducing the risk of sexually transmitted diseases (STD's). Birth control pills, Implant and IUDs do not protect against STD infection.

For the Woman
DIAPHRAGM is a rubber disk with a flexible rim that covers the cervix and must be used together with spermicide. It is available by prescription only and must be fitted for size by a health professional. The diaphragm protects for six hours and should be left in place for at least six hours after intercourse but not for longer than a total of 24 hours.

ORAL CONTRACEPTIVES protect against pregnancy by the combined actions of the hormones estrogens and progestin. The hormones prevent ovulation. The pills have to be taken every day as directed and do not work after vomiting or diarrhoea. Side effects of the pill can be nausea, headache, breast tenderness, weight gain, irregular bleeding, and depression.

DEPO-PROVERA is a hormonal contraceptive injected into a muscle on the arm or buttock every three months. The injection must be repeated every 3 months. The menstruation can become irregular and sometimes even absent.
IMPLANTS (such as Norplant or implanon) are made up of small rubber rods, which are surgically implanted under the skin of the upper arm, where they release the contraceptive steroid levonorgestrel. Their protection lasts from 3 to 5 years. Side effects include menstrual cycle changes, weight gain, breast tenderness and loss of bone mass.

IUD is a T-shaped device inserted into the uterus by a health-care professional. The IUD can remain in place for 5- 10 years. IUD’s have one of the lowest failure rates of contraceptive method. Sometimes the IUD can be expelled and a woman has to check each month after her period with her finger if she can still feel the threads of the IUD. Other side effects can include abnormal bleeding and cramps, but this usually only occurs during and immediately after insertion.

FEMALE STERILIZATION is done surgically. The tubes are ligated, preventing the egg-cells from encountering the sperm cells and preventing any future pregnancies. It is a permanent form of contraception.

EMERGENCY CONTRACEPTION must be taken within 72 hours of unprotected sex in order to prevent an unplanned pregnancy. A woman must take 1 Norlevo and a second pill 12 to 24 hours later. Beside Norlevo, most combination (estrogens and progesterone) birth control pills can also be used. Take within 72 hours of unprotected sex. One dose

100 µg ethinylestradiol + 500 µg levonorgestrel (2-4 birth control pills), 12 hours later a second dose.MORNING-AFTER IUD must be inserted within 5 days of unprotected intercourse. The IUD can stay for 5 to 10 years.

For the Man
CONDOMS are usually made from latex rubber and can be used only once. Some have spermicide added to kill sperm. They act as a mechanical barrier, preventing direct vaginal contact with semen, infectious genital discharges, and genital lesions. Condoms are the most effective method for reducing the risk of infection from the viruses that cause AIDS and other sexually transmitted diseases (STD’s). It is important to put a condom on properly before intercourse

MALE STERILIZATION also known as vasectomy, is a quick operation performed under local anaesthesia with possible minor postsurgical complications, such as bleeding or infection. The ability to get an erection and an ejaculation does not disappear. The sperm cells are just a very small part (1%) of the fluid and a man will not notice any difference in ejaculation. The body will absorb the sperm cells

If you do want to become pregnant again after doing a medical abortion, it is also better to wait until after the first normal menstruation, so please use contraceptives until then.

Abortion Myths

People who are against free choice create many myths about abortion which have never been proven.

- Fertility problems: safe abortion does not increase the risk of future infertility or pregnancy problems, though sexual transmitted diseases and unsafe abortion do.

- Other medical problems: there is no evidence of any medical illness related to safe abortion, although opponents of abortion (using selective and unscientific interpretation of research) try to suggest that there is an increased risk of breast cancer.

- Psychological problems: for most women the decision to have an abortion is difficult and may provoke feelings of sadness or guilt. Still, most women also feel relieved afterward. There is no evidence of increased risk of long term 'post-abortion' stress, depression or anxiety, or any other psychological illness.

I had an abortion

Every year 46 million women have an abortion. Every 7 minutes a woman dies unnecessarily from an illegal abortion. Show your face, share your story, donate your money and help women around the world get access to safe abortions. Discuss and share information with others. Look for support if you are considering an abortion. Participate to support abortion rights, also if you did not have an abortion.

Abortion in countries like: Afghanistan, Algeria, Angola, Antigua, Argentina, Bahamas, Belize, Benin, Bhutan, Bolivia, Botswana, Brazil, Brunei, Burkina Faso, Burundi, Cameroon, Central African Republic, Chad, Chile, Colombia, Comoros, Congo Brazzaville, Congo, Democratic Republic of the, Costa Rica, Côte d'Ivoire, Djibouti, Dominica, Dominican Republic, East Timor Timor Timur, Ecuador, Egypt, El Salvador, Equatorial Guinea, Eritrea, Ethiopia Gabon, Gambia, Georgia, Ghana, Guatemala, Guinea, Guinea-Bissau, Guyana, Haiti, Honduras, Hong Kong, Indonesia, Iran, Iraq, Ireland, Republic of Ireland, Northern Ireland, Jamaica Jordan, Kazakhstan, Kenya, Kiribati, Kuwait, Kyrgyzstan, Laos, Lesotho, Liberia, Libya, Madagascar, Malawi, Malaysia, Maldives, Mali, Malta, Marshall Islands, Mauritania, Mauritius, Mexico, Federated States of Micronesia, Mongolia, Morocco, Mozambique, Myanmar, Namibia, Nauru, Nepal, Nicaragua, Niger, Nigeria, Oman, Pakistan, Panama, Papua New, Guinea, Peru, Philippines, Poland, Portugal, Qatar, Rwanda, Saint Kitts and Nevis, Saint Lucia, Samoa, San Marino, Sao Tome and Principe, Saudi Arabia, Senegal, Sierra Leone, Solomon Islands, Somalia, South Africa, Sri Lanka, Sudan, Suriname, Swaziland, Syria, Tajikistan, Tanzania, Thailand, Togo, Tonga, Trinidad and Tobago, Turkmenistan, Tuvalu, Uganda,United Arab Emirates, Uruguay, Vanuatu, Venezuela, Western Sahara, Yemen, Zambia, Zimbabwe

Is it legal?

In most countries the customs regulations are not violated when you receive the medicines at your home address.

Persons are allowed to receive medicines for personal use only in most countries.
Mifepristone and Misoprostol are on the list of essential medicines of the WHO. They are not narcotics (like morphine or cocaine) or pleasure drugs (like ecstasy) or contraband or controled substance.

Misoprostol is registered in most countries and can also be used to prevent stomach ulcers.
Mifepristone is not registered in all countries but this should not be a problem because the medicines are for personal use only. Mifepristone can also be used for the cure of depression, breast cancer etc.

The possession of small quantities of Mifepristone or Misoprostol for personal use only is allowed in most countries.

Customs regulation in most countries around the world allow for people to have medicines for personal use send to them. It is not permitted to receive medicines by mail for commercial use without an import and distribution license.

Customs clearance is your responsibility: when a shipment reaches your country there is a possibility that your package may be subject to import duties. In that case you will be contacted by the courier company because import duties have to be paid before delivery of the package. If you do not pay the import duty, which varies per country, the package will be destroyed. As you are intending to use the medication for personal use only and not re-sell, this should be a rare occurrence. In addition, please note that once the goods have been dispatched to the courier company, ownership of the goods passes to you.

Is it safe to get a consultation for a medical abortion over the internet?

A consultation on the internet is very similar to a face to face consultation. In the online consultation the doctor asks you questions in order to get all the information needed to make sure you can safely have a medical abortion. The doctor depends on the information you give, as is also the case in a face to face consultation.

There are few reasons why you might not be able to take the medicines that cause an abortion. You should not use the medicines if:
  • someone is forcing you to end your pregnancy.
    the first day of your last menstrual period was more than 9 weeks ago.
  • you have an allergy to Mifepristone, Misoprostol, or prostaglandins.
  • you have one of the following diseases: chronic adrenal failure, hemorrhagic disorders or bleeding disorders/diseases, Inherited Porphyries, severe anemia, or severe untreatable asthma. (It is highly unlikely that you have one of these diseases and do not know it yet.)
  • you have an intrauterine device (IUD). This must be removed before using the medicines.
  • you have an ectopic pregnancy (a pregnancy outside the womb).
  • you can not get to a hospital or first aid centre within an hour.
  • you are alone. You should ask a partner, friend or other trusted person to stay with you while you use the medicines.

Is a medical abortion dangerous?

Medical abortions performed in the first 9 weeks of pregnancy have a very low risk of complications. This risk is the same as when a woman has a natural miscarriage. These problems can easily be treated by a doctor. Out of of every 100 women that do medical abortions, 2 or 3 women have to go to a doctor, first aid center, or hospital to receive further medical care. In countries where childbirth is safe, 1 in every 10.000 women dies during childbirth. Less than 1 in every 100,000 women who use a medical abortion die, making medical abortions safer than childbirth and about as safe as naturally occurring miscarriages. This means that a safe abortion with Mifespristone and Misoprostol is always lifesaving.

Ensure safe and legal abortion

Empower women, Prevent unwanted pregnancy, Safe abortion, Reduce suffering, Liberalize the law

Empower women to make conscious, well informed decisions about family planning.

Prevent unwanted pregnancy.

Ensure safe and legal abortion.

Reduce unnecessary physical or psychological suffering and deaths from illegal abortions.

Catalyze support for liberalization of abortion laws worldwide.

What is a medical abortion?

A medical abortion uses a drug or combination of drugs to cause the non-surgical termination of an early pregnancy up until the 9th week of pregnancy. The safest, most effective type of medical abortion requires the use of two different drugs. These medicines, called Mifepristone and Misoprostol, provoke the spontaneous expulsion of the pregnancy from the uterus.

More scientific information:

Mifepristone and Misoprostol are on the list of essential medicines of the World Health Organization Mifepristone blocks the hormone progesterone, which is required to sustain a pregnancy. Without this hormone, the uterine wall breaks down, the attachment of a fertilized egg to the uterine wall is disrupted, and the uterus contracts. Misoprostol enhances contractions and helps to expel the products of conception from the uterus.

Mifepristone with Misoprostol are proven to be highly effective, safe and acceptable for early first trimester abortions. The effects of this method of abortion include cramping and prolonged menstrual-like bleeding. Common side effects include nausea, vomiting and diarrhea. The risk of serious complication is exceptionally low. Research indicates that it is safe to perform the medical abortion procedure at home as long as the woman lives near a hospital or other emergency service.

Sexual Health Services and abortion clinics

Family Planning Association of Nepal (FPAN )
Harihar Bhavan Pulchowk, Lalitpur Kathmandu
PO Box 486Nepal
Tel: +977(1) 5532 004 , (1) 5524 440 , (1) 5524 670 Fax: +977(1) 5524 648

Sunaulo Parivar Nepal
GPO Box No. 11254
Char Khal AddaDillibazar
KathmanduNepalTel: 00 977 1 207 0223
Fax: 00 977 1 442 0416

Family Planning Association of India (FPAI )
Bajaj Bhavan Nariman Point Mumbai 400 021India
Tel: +91(22) 22029080 , (22) 22025174 Fax: +91(22) 22029038/(22) 22048513
Population Health Services8-2-120/86/9/A/13ARaju Estate, RoadNo. 2 Banjara HillsHyderabad 500 034IndiaTel: 00 91 40 2355 1140Fax: 00 91 40 2355 1139

Japan Family Planning Association, Inc. (FPFJ )
Hoken Kaikan Shinkan Bldg 1-10 Ichigaya Tamachi,
Shinjuku-ku Tokyo 162-0843Japan
Tel: +81(3) 3269 4041 Fax: +81(3) 3269 4750Korea

Korean Family Planning & Maternal Child Health Association of DPRK (KFP&MCHA ) Waesong-dong Central District Pyongyang City Korea, Dem. People's Rep of
Tel: +850(2) 3217 626 , (2) 3217 6926 Fax: +850(2) 381 4009

South Korea
Planned Parenthood Federation of Korea (PPFK )
Youngdeungpo-gu dangsan-dong 6ga
121-146 Seoul 150-808Republic of Korea
Tel: +82(2) 467 8201 , (2)2634 8211 Fax: +82(2) 467 1394
Hosan HospitalTel.: 546-3674Address: 617-5 Shinsa-dong, Gangnam-gu, Seoul
Mirae Wha Heenang (Future and Hope)
ClinicTel.: 3446-0011532-7 Shinsa-dong, Gangnam-gu, Seoul

China Family Planning Assocation (CFPA )
No 35 Shaoyaoju Chaoyang District Beijing 100029 China
Tel: +86(10) 846 57811 , (10) 8465 7975 Fax: +86(10) 8465 7975
Marie Stopes ChinaBuilding 18, Room 103,Euro-classic Compound,No172 Bei Yuan Road,Chao Yang District,Beijing 100101Tel: 00 86 10 8485 4988Fax: 00 86 10 8485 4988

Family Planning Association of Bangladesh (FPAB)
(FPAB ) 2,
Naya Paltan Dhaka 1000 Bangladesh
Tel: +880880-2-8311423 , 880-2-8319343 , 880-2-9354238 Fax: +880880-2-8313008
Marie Stopes Clinic SocietyHouse 6/2 Block FLalmatiaKazi Nazrul Islam RoadDhaka 1207BangladeshTel: 00 880 2 8114 392Fax: 00 880 2 811 7673

Why is this help service needed?

A safe abortion service is required to protect a woman's life and health when she needs to end her unwanted pregnancy.

This abortion help service relies on women to make conscious, well-informed decisions about their bodies.Abortion is the most performed medical intervention in the world. According to the World Health Organization, each year 46 million women choose to have an abortion for all sorts of private reasons.

Still many women do not have access to safe abortion services and are forced to risk their lives and health. They try to end their pregnancies with knitting needles, soap solutions, blows to the abdomen. They get abortions from individuals without medical training in unsanitary conditions. This is very dangerous and should never be done. This service provides a safe alternative by giving women to access safe medical abortions.

Abortion Facts

Every 6 minutes a woman dies needlessly as a result of an unsafe illegal abortion.

Police photo of Gerri Santoro, mother of two children, who died in 1964 at age 27 in a Connecticut motel room after a botched illegal abortion. She was left to die alone in the motel by the man that operated on her using borrowed medical implements and a textbook. See

Induced abortion is one of the most performed medical interventions. Making abortion illegal does not reduce the number of abortions. 20 million of the 46 million abortions performed annually are illegal and unsafe. Legalization of abortion can prevent unnecessary suffering and death of women.

Worldwide more than 1/3 of all pregnancies are unplanned. Every year nearly 1/4 of all pregnant women worldwide choose to have an abortion (circa 46 million annually). The legal status of abortion makes little difference to overall levels of abortion incidence. Where illegal, most abortions are done with unsafe methods. Where illegal, it is primarily women without financial means who take recourse to unsafe abortion methods, resulting in the death of a woman every 6 minutes.

At the International Conference on Population and Development in Cairo, unsafe abortion was recognized as a major public health problem. The WHO estimates that 20 million of the 46 million pregnancies which are terminated by induced abortion every year are performed under unsafe conditions and in an adverse social and legal climate, resulting in approximately 80,000 deaths each year due to infection, hemorrhages, uterine injury and the toxic effects of agents taken to induce abortion.

At this moment approximately 25% of the world population lives in 54 countries (mainly in Africa, Latin America and Asia) with highly restrictive laws that either ban abortion entirely or permit it only to save the life of the pregnant women.

The poorer women are, the more likely it is that, faced with unwanted pregnancy, they will provoke an abortion themselves or go to a person without medical training, increasing health risks and the risk of hospitalization due to complications. Availability of safe and above all affordable abortion will also have implications for the future financial situation of such women and/or their families and can therefore be considered part of the struggle against poverty.

Rumania provides a unique case study of the factors that influence the use of unsafe abortion: in 1966 legal abortion was restricted and the abortion-related maternal mortality rate increased sharply, ten times higher than the average for the rest of Europe; in 1989 abortion was again made available on request and the number of maternal deaths fell sharply. By contrast the Netherlands has the lowest reported abortion rate because of a non-restrictive abortion law within a comprehensive framework that includes universal sex education in schools and easily accessible family planning services and the provision of emergency contraception. Of the 29,266 abortions performed there in 1997, the complication rate for first trimester treatments was 0,3% with no resulting deaths whatsoever.

Restrictive abortion laws violate women's human rights based on agreements made at the UN International Conference on Population and Development in Cairo, the Fourth World Conference on Women in Beijing and the Universal Declaration of Human Rights

Show your face

Send your portrait and share your experience.

Break the taboo and give mental support to women around the world.

(you can also just write about your experiences. photo not required)

What do misoprostol pills look like?

What do abortion pills (Mifepristone, RU486, Mifeprex, Mifegyne) look like?

How do you know if you are pregnant?

Do a test to make sure

If you did not have your period on time and you have had sex (vaginal intercourse) after your last period, it is possible that you became pregnant.

Good home pregnancy tests can be bought at a pharmacy or drugstore. You only need to put a bit of urine on the tester and after a few minutes you will see if you are pregnant or not. You can also go to your general practioner or family doctor for a pregnancy test.

You can do a pregnancy test from the first day you missed your expected period and onwards. Before this time, the level of hormones produced by the pregnancy is too low to show up on the test and you may get a 'false negative' result.

If you think you may be pregnant, it is important that you get tested, especially if the possible pregnancy is unwanted. Sometimes the fear of being pregnant alone causes enough stress to delay the period.

Emergency Contraceptive pills

You can prevent an unwanted pregnancy after unprotected sex by taking Emergency Contraceptive pills (EC) also called "the morning after pill". For extensive information, please go to: To find out how you can use different normal contraceptive pills from around the world as the morning after pill (emergency contraception)

NEPAL: Only Half of Women Know Abortion is Legal

Marty Logan
KATHMANDU, Sep 9 (IPS) - As the 21st century began, more women were dying during childbirth in Nepal than in almost any other country and it was estimated that half of maternal deaths in hospitals were caused by unsafe abortions.

Today, 59,000 Nepali women have had safe abortions, performed by 260 trained doctors at 133 approved centres, and if plans hold, trained nurses will soon be providing the service.
But for every positive number there are many more that reveal the challenges ahead for the Safe Abortion Programme.
“Well over 50,000 women have received safe abortion services through this suction (MVA or manual vacuum aspiration) method,” says Cherry Bird, director of the Support to the Safe Motherhood Programme. “It’s not scraping or cutting or anything else. Women get up off the table a half-hour later: it’s amazing.”

But “it’s going to take 20 years to end unsafe abortions”, she added in an interview Thursday after a meeting to review the work of the growing number of facilities providing comprehensive abortion care (CAC).

The government decriminalised abortion in 2002 after years of a sustained campaign by activists and researchers. Today, abortion is available on demand up to 12 weeks, until 18 weeks if the pregnancy resulted from rape or incest and any time, with a doctor’s consent, if the women’s health is in danger or the foetus is severely deformed.
The government, private and NGO sectors all offer abortion services in this South Asian nation of 25 million people. Apart from the capital Kathmandu, Nepal’s largest city, government services predominate in rural areas and private/NGO clinics in urban settings.

Lack of awareness, uneven supply of services, poverty and social taboos are just some of the barriers that women with unwanted pregnancies face.

For example, 13 percent of women who sought abortions at 22 facilities from January to March this year were rejected because they were more than 12 weeks pregnant, according to a study released at Thursday’s meeting.
The report also found that some government centres were refusing to provide abortions if patients were nine weeks pregnant or more, despite the law permitting abortion on demand up to 12 weeks.

“Such a practice has deprived clients of their rights to safe and legal abortion up to 12 weeks of gestation from any government approved facility of her choice,” says the ‘National Facility-based Abortion Baseline Study’ by the Centre for Research on Environment Health and Population Activities (CREHPA).

The research also revealed that only 50 percent of CAC clients were aware that abortion is now legal. The number was even lower in rural areas: 45 percent.

“Many people don’t know that abortion services are legal,” confirmed Kasturi Malla, director of Kathmandu’s Maternity Hospital, at Thursday’s meeting. “This really has to be disseminated at the community level.”
Others agree. “A big challenge is educating women (and men) of their rights to safe abortion and what is safe abortion (when they had to do it clandestinely for years),” says Wendy Darby of Ipas, a US-based NGO that has given considerable financial and technical support to Nepal’s programme.

Despite those rights, obstacles to abortion mean women are still resorting to unsafe methods. CREHPA’s study found that of 1,560 cases treated at the post-abortion care unit at Maternity Hospital from April 2004 to April 2005, 138 were for complications caused by induced abortion.

One-quarter of those clients had sought an abortion from a private unlisted clinic, about one-sixth from an unskilled provider and one in eight tried to abort using unapproved drugs. The remaining one-fifth had used herbs, “unidentified substances or other measures” to end their pregnancies.

“Oral intake of medicines not revealed by clients and insertion of sticks are the common clandestine methods used,” a group of doctors told CREHPA researchers in interviews in 2005.

While statistics show that 68 of Nepal’s 75 districts now have at least one trained service provider, “23 of them are not yet providing services, for a variety of reasons”, Darby told IPS via e-mail from the United States.

According to Bird, “There are still a lot of service providers who see CAC services as a luxury. Sure I can understand that in the districts, where they are alone and have to treat everything from broken legs to internal injuries, but not in the cities,” added the former manager of the Ministry of Health’s Technical Committee for the Implementation of Comprehensive Abortion Care (TCIC).

Added a representative of an international non-governmental organisation (INGO): “At one district hospital the doctor didn’t agree with the incentive (30 percent of the total fee) being offered so he decided that he would perform CAC services only one day a week”.

Such infrequent service is one way in which rural women are being deprived of their abortion rights, according to Lokhari Bashyal of the Forum for Women Law and Development (FWLD). “Sometimes women pass the legal deadline for an abortion (12 weeks) for lack of knowledge. Or, if there is an authorised hospital or clinic, sometimes the doctor is not there,” he told IPS.

One woman who went to her district hospital for an abortion did not have the money to pay the fee (which averages 1,000 rupees - 13.61 U.S. dollars û in government hospitals versus 1,350 rupees in NGO clinics.) She returned home and months later reported that her baby had been stillborn.

A district court sentenced her to 10 years for homicide but an appellate court reduced that to three years. “The court realised that because of a woman’s right to abortion, it should use its discretion and sentence her to a lesser amount,” said Bashyal.

Surprisingly, such understanding is lacking in some places where you would expect to find support for women seeking abortions. Nearly half (44 percent) of women who went to government hospitals for CAC services were told that they first had to agree to start using birth control after the procedure, a pre-condition “which is against human rights”, reported CREHPA. (END/2006)