Medical Termination of Pregnancy
Medical termination of pregnancy is the use of medicines, rather than surgery, to end a pregnancy in its early weeks. The approach has become the more common method globally.
Key points
- Two medicines are usually used together, one blocking the hormone that sustains the pregnancy and the other, given later, prompting the uterus to contract.
- Misoprostol can also be used on its own where the other medicine is not available, and both feature on international essential medicines lists.
- Cramping and bleeding usually start within hours of the second medicine and can continue, lightening gradually, for one to three weeks.
- A follow-up scan or blood test afterwards confirms the process is complete, and heavy bleeding, high fever or severe unrelieved pain need urgent attention.
How the medicines work
The standard regimen combines two agents. Mifepristone blocks the hormone that sustains the pregnancy; misoprostol is taken one to two days later and causes the uterus to contract and expel the pregnancy. Misoprostol is also used alone in settings where mifepristone is unavailable. Both medicines have been on the WHO essential medicines list for many years.
What to expect
Cramping and bleeding begin within a few hours of taking misoprostol and typically peak in the first four to six hours. Lighter bleeding can continue for one to three weeks. A follow-up check, usually by ultrasound or a blood test, confirms that the process is complete.
Seek urgent medical attention for soaking more than two thick pads per hour for two or more consecutive hours, fever above 38 C lasting more than 24 hours, or severe pain not relieved by standard analgesics.