Early Medical Abortion at Home

Early Medical Abortion at Home

During your consultation, we have assessed that you are suitable to have a medical abortion at home (EMAH), and you have confirmed that this is your preferred option. You may not require to attend the clinic in person. We will prepare a treatment pack for you, which will include the medicines you need for the abortion treatment, plus some pain-killers and anti-sickness tablets. There will be a medicine instruction sheet in the pack. You can collect the pack from the clinic during our opening hours, or we can arrange delivery to your home address. If you are further away, we can post the treatment pack to your home address.
There are some situations where we require you to attend the clinic in person before we can decide if you are suitable for EMAH. This could be if you are uncertain of how many weeks pregnant you are, if you have had any pain or bleeding, or if you have had pregnancy related complications in the past. If we confirm that you are suitable for EMAH, we will give you the treatment pack when you attend.

We can offer EMAH if you:

• are under 10 weeks pregnant by scan, or under 10 weeks from the start of your last period
• if you are between 10-12 weeks pregnant, we may still be able to offer EMAH, but we will need you to attend for a blood group test prior to starting your treatment
• are 16 years of age or over
  are in good health, with no significant previous pregnancy problems
• have a phone so you can call for advice if needed
• have access to transport so that you can attend clinic/hospital if you are concerned.

We also recommend that you consider having a supporting person with you on the day of the second part of treatment.

What to expect at home

The first part of the treatment is a single tablet, called mifepristone which you swallow. You should only take this tablet if you are sure of your decision.
You may take one of the anti-sickness tablets also, to reduce the chance of vomiting the tablet. If you are sick within 1 hour of taking the mifepristone tablet, call us for advice
You may experience bleeding between your first and second treatment days. Even if this happens, it is very important that you still take the second medication – both treatments are needed to ensure the abortion is successful.

The second part of the treatment is tablets called misoprostol. You will have four tablets, which you place either up into the vagina, or under your tongue. This should be started between 24 – 48 hours after the first tablet. After you use this medication, you will have bleeding that is going to be heavier than your normal period, and is likely to include some large clots. The bleeding will usually start within 2-3 hours of the second treatment.
There are an extra two misoprostol tablets for you to place under your tongue four hours after the first dose. If you are 10 weeks pregnant or more, we will give you some extra misoprostol tablets to use under your tongue until the pregnancy is passed.
We recommend that you take painkillers when you use the misoprostol medication, as you are going to get pain which is likely to be stronger than your normal period cramps.
You should make sure you have plenty large or night-time sanitary towels at home. You should use the toilet as often as you need to, and can flush it as normal, and dispose of the sanitary towels as normal. Do not use tampons or menstrual cups.
You may notice that the vaginal tablets come back out with your bleeding – this doesn’t matter, as the drug will already be absorbed and working.
You should eat and drink as normal during your treatment.

After your treatment

The bleeding will be quite heavy for the first few days, and will get lighter after that. Most people bleed for 7-10 days in total after treatment, although sometimes the bleeding will last for a few weeks.

You will be fertile again very soon after your treatment, so it is very important that you start using contraception straightaway. If you have chosen contraceptive pills, you will have a supply to start straight after your treatment. If you have chosen an implant or injection, this can be given at the time you collect the pack from us, or we can arrange a return appointment for this if you are having the pack delivered. If you wish an intra-uterine method (coil) we will arrange an appointment to return for this, and offer you an interim method.

Confirming that the abortion treatment has worked

Although this treatment is very effective, there is a small chance that it may not work and that you may still be pregnant. This happens in around 1 in 100 people. To make sure that the treatment has been successful, you need to do a pregnancy test three weeks after your treatment. This is a special type of test which detects if there is still a high level of pregnancy hormone, which could indicate that you are still pregnant. We will supply this test for you. Do not use a standard pregnancy test, as this will remain positive for several weeks.

If the test is positive, or you are concerned that you could still be pregnant, we will arrange for you to return for a scan. If your test is negative, and you have no concerns, there is no need to return.

If you are not happy to do the pregnancy test yourself, you can ask for an appointment and return to the clinic for a test.

Contact us for advice in the following circumstances

• if you experience continuous heavy bleeding (soaking three or more pads in one hour whilst resting)
• if you do not have any bleeding within 24 hours of your second treatment
• if you bleed for less than 4 days in total
• if you develop a smelly discharge, fever or abdominal pain that does not respond to painkillers
• if you still ‘feel’ pregnant (sore breasts, sickness, bigger tummy) after one week
• if you do not take your medication as instructed
• if the follow-up pregnancy test is positive or invalid
• if you have any other concerns

Contact details

Sandyford TOPAR advice: 0141 211 8620 – you can leave a message and one of the team will call you back.

TOPAR is open Monday to Thursday 8.45am – 7pm and Friday 8.45am – 4.30pm.

If you need urgent advice outside these hours contact Gynaecology ward 49 at Queen Elizabeth University Hospital on 0141 201 2282, and speak to one of the nurses

If you have very heavy bleeding or severe pain, which is making you faint or feel very unwell, you should go to your nearest A+E unit.