Complications after using abortion pills are rare, but the risk increases slightly with a longer pregnancy duration. Complications can be treated when detected on time.
Possible complications are:
- Heavy bleeding (haemorrhage) that fills more than 2 regular pads per hour, for 2 hours or more in a row. If this happens, take 4 extra misoprostol pills (200mcg each) under the tongue and seek medical care immediately. Treatment may include misoprostol, other medication, a vacuum aspiration, intravenous fluids, or on very rare occasions (0.03-0.6%) a blood transfusion.
- Incomplete abortion when remaining tissue causes prolonged bleeding that does not decrease in the weeks after the abortion. In case of an incomplete abortion, options are either waiting for the body to expel the remains, or treatment with misoprostol or a vacuum aspiration. Incomplete abortions that require treatment occur in around 5% of abortions with pills.
- Infection can develop in the days after the abortion due to the presence of bacteria such as chlamydia and gonorrhea. Signs are a fever of 38°C (100.4°F) lasting more than 24 hours after taking the pills, foul (rotten) smelling vaginal discharge, and severe, persistent, or increasing pain in the lower belly after the abortion. Treatment is with antibiotics. Some people may need a vacuum aspiration. Serious infections are very rare (0.01-0.5%).
Sources
- World Health Organization. 2023. Clinical Practice Handbook for Quality Abortion Care. https://www.who.int/publications/i/item/9789240075207
- Kapp, Nathalie, and Patricia A. Lohr. 2020. ‘Modern Methods to Induce Abortion: Safety, Efficacy and Choice’. Best Practice and Research: Clinical Obstetrics and Gynaecology 63:37–44. https://doi.org/10.1016/j.bpobgyn.2019.11.008
- Ferguson, Ian, and Heather Scott. 2020. ‘Systematic Review of the Effectiveness, Safety, and Acceptability of Mifepristone and Misoprostol for Medical Abortion in Low- and Middle-Income Countries’. Journal of Obstetrics and Gynaecology Canada 42 (12): 1532-1542.e2. https://doi.org/10.1016/J.JOGC.2020.04.006
