Personal and confidential abortion care for women since 1992.
2431 - 5th Avenue N.W.
Calgary, Alberta T2N oT3
Appointments
403 283-9117
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403 283-9139
Medical Abortion
If your pregnancy is 7 weeks or less, counting from the first day of your last normal menstrual period, you may wish to consider a medical or medication abortion. Medical abortion is done using a medication called Methotrexate. This procedure is only available to women in the Calgary area as it requires at least two and sometimes three or more visits to the clinic. You must also be willing to have a surgical abortion if the medical treatment fails as Methotrexate may cause fetal damage if it does not successfully terminate the pregnancy.
Methotrexate works by blocking folic acid from embryonic cells so they cannot divide. The embryo stops growing and the pregnancy ends. The second medication given in this treatment is Misoprostol. It is a prostaglandin that causes uterine contractions which will work to expel the no longer viable embryo and placental tissue. Misoprostol is in tablet form and is self-administered at home on the 5th to 7th day after the injection. These medications are safe in small doses and have no long term side effects when used in this manner. They leave your body after several days and will not affect your next pregnancy.
Most women do not experience any symptoms after the Methotrexate injections but a few report feeling like they are coming down with the flu for a few days. Following administration of the Misoprostol tablets, heavy bleeding, moderate to severe cramping, chills, fever, nausea, diarrhea, or a combination of all these symptoms may be experienced. Some women report that it is like a heavy period and they manage to carry on with their day, while others have more difficulty and feel quite ill for a short period of time.
At the first visit to the clinic, a transvaginal ultrasound is done to determine the age of your pregnancy. It must be no more than 7 weeks 0 days from your last menstrual period. If it is more than 7 weeks you will not be eligible for a medical abortion and may have to wait two or more weeks to obtain a surgical procedure.
Seven to eleven days following the injection, after the Misoprostol tablets you were sent home with have been taken, you will return to the clinic for another transvaginal ultrasound. This examination will determine whether the pregnancy has ended. About 75% of pregnancies are successfully terminated at this point. Another 22%, have a delayed reaction, meaning the pregnancy has ended but has not yet been expelled from the uterus. If you have a delayed reaction you will have to return for a 3rd appointment for another ultrasound examination. Most, but not all, are finished at this point. If you still have not expelled the pregnancy at the 3rd visit you will be offered a surgical procedure. As well, 3% of medical abortion treatments fail to stop the pregnancy from developing. If this happens, we strongly recommend a surgical procedure as Methotrexate may cause fetal damage.
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Advantages & Disadvantages of Medical Abortion
Some women choose medical abortion because it seems more private and less invasive than a surgical procedure. In some respects this is true. However, medical abortion is not for everyone. Consider the following as you make your decision.
- You need to have reliable transportation and the time available to make 2 or more visits to the clinic. Early surgical abortion on the other hand, requires only one visit to the clinic.
- Medical abortion eliminates some of the risks associated with surgical abortion, but surgical abortions are one of the most common surgical procedures in Canada and are very safe.
- Medical abortions have a higher failure rate than surgical abortions, and if your treatment fails you will have to have a surgical procedure anyway.
- During a surgical abortion you are sedated, so you will have little discomfort. With a medical abortion you may have more severe cramping and you will have heavier bleeding for a few days. This is normal and part of the procedure, but you need to be prepared to manage your symptoms at home on your own with over-the-counter medications.
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Risks of Medical Abortion
- Failure of the medication to stop the pregnancy occurs in 2 to 3% of cases. The abortion must then be completed surgically.
- Nonviable pregnancy tissue can be retained in the uterus, requiring repeated doses of the medication that causes uterine contractions. It may take up to six doses over six weeks, or the tissue can be removed by suction (surgical abortion).
- Cramps can sometimes be very severe, rarely requiring D&C for relief.
- Bleeding can sometimes be very severe, rarely requiring D&C for control.
- Allergic and other reactions to the medications, such as severe side effects, can occur but are rare.
- Infection in the uterus is very rare and usually can be treated with oral antibiotics.
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