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These are the doctor's instructions for the medical abortion procedure and the precautions you should take. Please print this page. These users instructions will be sent to your email address as well but will not be included in the package!! You can also find this information under Questions and Answers on the website.

Please print this page.

Read the instructions carefully before using the medicines. Keep all medicines out of the reach of children!

Content of packet
1 tablet Mifepristone (200 mg) 6 tablets Misoprostol (200 mcg) The medicines Mifepristone and Misoprostol are used to end a pregnancy by causing an abortion. Before using the medicines you should do a pregnancy test or have an ultrasound to tell you how long you have been pregnant and to detect an ectopic pregnancy (a pregnancy outside the womb). The risks of this kind of abortion are similar to the risks of a miscarriage (spontaneous abortion). The abortion can be done until 9 weeks of pregnancy.

You should not use the medicines if:

Someone is forcing you to make the decision 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. 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 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.

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, put 4 tablets of Misoprostol under your tongue and keep the tablets there for at least 30 minutes, until the tablets are dissolved. You can swallow your saliva. After 30 minutes you can swallow any remains of the tablets. 4 hours after using the first dose of Misoprostol, put 2 more tablets of Misoprostol under your tongue. Again keep them under your tongue for 30 minutes, until the tablets are dissolved. After 30 minutes, you can swallow any remains of the tablets. These last two pills are very important to ensure that the abortion is complete, even if you are already bleeding after the first dose.

Normal side effects of the medicines:

You may get painful cramps, vaginal blood loss that is more than a normal menstruation, nausea, vomiting and diarrhea. You can use painkillers to relieve the pain. Blood loss is often heavy with clots. If the abortion is complete, the bleeding and the cramps diminish. Do not use tampons, but only pads! Bleeding will last about two weeks, but it is possible that you might bleed for a shorter or longer period of time. The normal menstrual period usually returns after four to six weeks. Bleeding and pain does not always mean that the abortion took place and that the abortion is complete. The only way to be completely sure that you are no longer pregnant is to have an ultrasound 10 days after using the medicine, or wait 3 weeks to take a urine pregnancy test.I t is normal for the uterus to slowly empty for 1-3 weeks after taking the medicines; so you may have light bleeding for 1-3 weeks. You do NOT need any surgical intervention (like curettage) if there are no signs of a problem, such as heavy bleeding, pain, fever or abnormal vaginal discharge. A pregnancy test can be done 3 weeks after the medical abortion. Sometimes the pregnancy test is still positive 3 weeks after taking the medicines because the pregnancy hormones are still in the blood. If that is a case, you can repeat the pregnancy test in a few days or have an ultrasound.

Complications
Heavy bleeding
Symptoms: 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 surgical abortion (also called vacuum curettage). Very rarely (less than 0.2% of women) a blood transfusion is needed.

Incomplete abortion (2%)

Symptoms: Heavy or persistent bleeding and/or persistent severe pain. Treatment: A surgical abortion (vacuum curettage)

Infection (0.08%)
Symptoms: If you have a fever (more than 38 degrees Celsius) for more than 24 hours or if you have a fever of more than 39 degrees at any time, there might be an infection that needs treatment. Treatment: Antibiotics and or surgical abortion (vacuum curettage).

Ongoing pregnancy (1%)

Symptoms: a positive pregnancy test after 3 weeks or an intact pregnancy visible with ultrasound after 10 days. If the abortion failed and you continue the pregnancy, 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. Treatment: repeat medical or surgical abortion.

Always contact a medical doctor or go to a hospital if you suspect a complication.

If there is a problem, you can always go to the hospital or to any doctor and say that you had a miscarriage. The doctor will treat you as if you had a spontaneous abortion (miscarriage) I read and printed the doctor's instructions. Continue the consultation

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