What is a successful abortion and how do you know you've had one?
A medical abortion is successful when the pregnancy stops developing and there is no need for additional medical care. Research has shown that 99.5 % of the women who do a medical abortion in the first 9 weeks of pregnancy with mifepristone and misoprostol will have an abortion that ends the pregnancy. Only 3% of the woman will need additional medical care. In 97% of abortions, women’s bodies will eliminate all the remains naturally and without any other medical intervention. It is important that you understand that an abortion is a process. It takes time for the uterus to empty and for the abortion to be complete. It is normal for the bleeding and clotting to continue for 1-3 weeks or even longer. Every woman’s body is different.
If you have extreme pain, prolonged heavy bleeding, abnormal vaginal discharge or fever, it might be a sign that you have a complication and should go to a doctor. You should also go to the doctor and do an ultrasound after taking the medicines if you have any doubts about whether the abortion has been successful.
Many women can tell when the abortion is successful. They feel the symptoms of pregnancy (nausea, tender breasts, need to urinate) going away or have seen the embryo come out. By having an ultrasound you can learn whether the medicines have worked and if your pregnancy has ended within a few days after the abortion. An early ultrasound will tell you if the pregnancy has ended, but it is best wait for an ultrasound for 10 days after using Mifepristone, as only 23% of abortions are totally complete after 7 days. 71
The urine home pregnancy test can be done only 3 weeks after taking the medicines, because before 3 weeks, the pregnancy hormones are still in your body and the test might show an unreliable, falsely positive result. Your body might need several days or weeks (until your next menstrual period) to expel the tissue and blood completely. The ultrasound will show what is still in the uterus. Some doctors will recommend a vacuum aspiration, but if you have no pain or fever or signs of infection, it is better to wait and let your body empty naturally. A vacuum aspiration or a D & C is an invasive procedure that involves risks and can be painful.
More scientific information:
Several studies suggest that women often correctly assess whether their medical abortions are complete or not, especially with protocols that include Mifepristone. One analysis used data from a clinical trial of Mifepristone-Misoprostol abortion in China, Cuba, and India. "Of 222 women, none incorrectly believed their abortions were complete when, in fact, they were not. 110 women incorrectly believed that the abortion was not yet complete, but this error would simply have led them to seek professional assistance, even if it were not routinely scheduled.1 Another study involving women in the United States concluded, “Women and clinicians are very accurate at determining expulsion of the gestational sac during medical abortion with Mifepristone and Misoprostol without an ultrasound or a physical exam.29
New research self assessment medical abortion:
- Self-assessment of the outcome of early medical abortion versus clinic follow-up in India: a randomised, controlled, non-inferiority trial.Iyengar K1, Paul M2, Iyengar SD3, Klingberg-Allvin M4, Essén B2, Bring J5, Soni S3, Gemzell-Danielsson K6. Lancet Glob Health.2015 Sep;3(9):e537-45. doi: 10.1016/S2214-109X(15)00150-3.
Clinical follow-up compared with self-assessment of outcome after medical abortion: a multicentre, non-inferiority, randomised, controlled trial. Lancet.2015 Feb 21;385(9969):698-704