The main points

  • Medical abortion offers a safe and common method to end a pregnancy of up to 9 weeks.
  • A combination of the tablets mifepristone and misoprostol are used for medical abortion.
  • It is usual to experience heavy vaginal bleeding and strong abdominal (tummy) pain and cramping during a medical abortion.
  • Medical abortion is not suitable for all people seeking abortion.
  • There are many abortion service providers located across Victoria in a range of health services and private practices.

It is estimated that around a quarter of all pregnancies in Australia are unplanned. For many people abortion, also known as termination of pregnancy, is the best option in their circumstances. Abortion is a safe and common method to end a pregnancy.

There are two types of abortion: medical and surgical. Both are low-risk and have a high success rate.

Some services offer medical abortion through telehealth appointments.

Preparing for a medical abortion

Before booking an abortion, some services will offer a clinic appointment or phone call with a nurse to discuss both medical and surgical abortion so you can decide what is the best option for you.

There are some medical conditions and social circumstances that restrict the type of abortion you can have. At your first appointment the doctor or nurse usually takes a medical, social and sexual health history. You will have the opportunity to ask questions and be given any information you may need. What you discuss will be kept confidential.

Before an abortion, the doctor or nurse will confirm the pregnancy with a urine test and organise blood tests and an ultrasound to check the stage (length) of pregnancy. It may also be recommended you test for sexually transmitted infections (STIs).

You may also want to discuss contraception options with your doctor or nurse. Some contraception can be organised at your first appointment.

Once you have all the information you need and have consented (agreed) to a medical abortion, you can go ahead with the procedure.

Do I have to have counselling first?

No, you do not. It is an option.

Most people do not need counselling or support from a professional to make a decision about abortion.

It is usually helpful to find someone supportive to talk to. Choose someone you trust. This may be your partner, a friend, a family member or a health professional.

For more information see: Abortion and Emotional Support

Medical abortion procedure

Medical abortion involves taking a combination of tablets to bring on a miscarriage. The tablets are prescribed as a pack. Your doctor or nurse may also prescribe additional tablets to minimise side effects (such as pain and nausea). Your doctor or nurse will discuss how to take the tablets – including the timing.

During a medical abortion you will:

  • take a tablet (mifepristone) at an agreed time
  • 36 to 48 hours later, take a second dose of tablets (misoprostol), which softens the cervix and helps the uterus push out the pregnancy
  • experience cramping and bleeding similar to a miscarriage between one and 24 hours after the second medication.

During and after the procedure, you will have the option of telephone contact with the clinic or a 24 hour help line in case you have any questions or concerns.

Most services organise a pregnancy hormone blood test 7 days after you have taken your first tablet, to check that the hormone level has dropped and you are no longer pregnant.

Around two weeks after taking the tablets you will have a follow-up appointment to make sure the pregnancy has ended and check for complications. You will have the opportunity to review your contraception.

What to expect after a medication abortion

The first tablet (mifepristone) usually does not cause any side effects. You can continue with your normal activities.

After taking the second tablets (misoprostol) you may experience nausea, vomiting, diarrhoea, dizziness, headaches and fever for a short time.

Vaginal bleeding and abdominal (tummy) pain and cramping usually start 1 – 4 hours after taking the second tablets. Bleeding is usually heavier than a period and there may be large clots. Pain and cramping are generally much stronger than period pain.

After 2 – 6 hours the bleeding usually settles to the level of a normal period and continues like that of a normal period for another 3 – 7 days. A small number of people may experience unpredictable, irregular or prolonged bleeding that can last for up to 5 weeks.

General anaesthetic: a medicine used to make you unconscious. This is usually applied during surgery so you are not aware and unable to feel the pain.  

Complications of a medical abortion

Complications are uncommon after a medical abortion, but may include:

  • Reactions to the medications.
  • Small pieces of tissue left in the uterus (womb) requiring a minor surgical follow-up procedure to clear the lining of the uterus (around 1 in 20 – 1 in 33 cases). This procedure is done under general anaesthetic.
  • The medical abortion does not work and the pregnancy continues (around 1 in 100 cases). The abortion tablets can be repeated if the pregnancy is not more than 9 weeks otherwise a surgical abortion may be required.
  • Haemorrhage – very heavy bleeding. In rare cases a blood transfusion is needed.
  • Infection requiring antibiotic treatment (symptoms include persistent pain, an unusual vaginal discharge, fever and feeling generally unwell).

Contact your abortion provider, doctor or nurse if you experience:

  • heavy bleeding or bleeding that is not settling
  • pelvic pain that is not settling
  • an unusual or smelly vaginal discharge
  • unexplained fever
  • feeling generally unwell.

Recommendations after a medical abortion

After taking the medical abortion tablets it is recommended you:

  • use pain medication such as ibuprofen or paracetamol to help manage the cramps (your doctor or nurse can prescribe stronger medication if needed)
  • massage your abdomen and use heat packs
  • rest and take time off work or study.

To lessen the risk of infection during the week after having the procedure, you should not:

  • insert anything into the vagina (including tampons and menstrual cups – which should not be used until your next period)
  • have vaginal sex
  • perform any strenuous activity, including sport or heavy physical work, until the bleeding is no longer heavy
  • go swimming or have a bath (you can shower).

Follow-up after a medication abortion

Most services organise a pregnancy hormone blood test 7 days after you have taken your first tablet, to check that the hormone level has dropped and you are no longer pregnant.

Around two weeks after taking the tablets you will have a follow-up appointment to make sure the pregnancy has ended and check for complications. You will have the opportunity to review your contraception.

Medical abortion may not be suitable if you:

  • are more than nine weeks pregnant
  • have an ectopic pregnancy (a pregnancy occurring outside the uterus, usually in the fallopian tubes) have certain medical conditions such as anaemia, bleeding disorders, severe asthma, heart disease, high blood pressure, diabetes or a liver, kidney or adrenal condition
  • are taking long-term steroid or blood-thinning medication have had an allergic reaction to the medication’s mifepristone or misoprostol
  • have an intrauterine device (IUD)the IUD needs to be removed before taking mifepristone
  • cannot stay somewhere within a 1 hour drive of an emergency medical service from the time when the second tablets are taken until 2 – 3 weeks later
  • do not have a support person who can stay with you from the time you take your second dose of tablets until the miscarriage has happened
  • cannot have a blood test – to check your pregnancy hormone level has dropped – 1 week after you have started your tablets
  • cannot be reviewed by the clinic for at least one follow-up appointment.

Where can I access medical abortion?

Abortion service providers are located across Victoria in a range of health services and private practices. The costs, procedures and time required can vary from service to service. Having an abortion earlier in a pregnancy can minimise procedure costs and maximise your options.

To find surgical or medical abortion services in Victoria contact 1800 My Options phone line 1800 696 784.

Medical abortion at Family Planning Victoria (FPV)

If you have a booking for a medical abortion at Family Planning Victoria, please refer to our Client Information Medication Abortion information sheet.

Where to get more information and support

If you are using the internet for information, only use reliable and reputable websites, such as the ones provided above. Be aware of anti-abortion or pro-life websites containing inaccurate and harmful information and imagery.

Disclaimer

This website and any related materials are for general information purposes only and should not be relied on as (or in substitution for) medical or other professional advice. You should seek specific medical or professional advice for your individual circumstances.

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Last updated: 2 September 2021

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