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Mifepristone

Definition, Purpose, Precautions, Description, Preparation, Aftercare, Risks, Normal results, Abnormal results

Mifepristone is a pill that can be taken as an alternative to a surgical abortion.

Purpose

This medication is best-suited for ending early pregnancies.

Precautions

Women who are more than seven weeks pregnant (or 49 days since their last menstrual period) should not take mifepristone. Other reasons to avoid mifepristone include: use of an intrauterine device (IUD), ectopic pregnancy, use of blood thinners, bleeding disorders, use of steroid medications, allergies to mifepristone or similar drugs and lack of access to medical help within two weeks after the treatment.

Description

Mifepristone, sold commercially under the name Mifeprex, also is known as RU-486, the abortion pill, the early option pill or medical abortion. While it has been used for many years in Europe, mifepristone has only been available for use in the United States since the U.S. Food and Drug Administration (FDA) approved it in 2000 for use in abortion.

This drug causes pregnancy to end by blocking the female hormone progesterone. The lack of progesterone makes the uterus shed its lining, which causes bleeding similar to a menstrual period. Three days after taking mifepristone, women are given a second drug, misprostol, to cause uterine contractions that expel the contents of the uterus. Most women are able to remain in their own home while they pass the fetus, and many prefer to have this privacy.

Preparation

Before taking mifepristone, healthcare providers likely will give the woman a urine or blood test to be sure that she is, in fact, pregnant. They also may give her some counseling and support. Once she has made the decision to use mifepristone, they will ask her to sign a written statement that she has decided to end her pregnancy.

Aftercare

Using mifepristone and misoprostol causes heavy bleeding and cramping. Doctors can offer pain medicine, such as Motrin, to ease the cramps. For two weeks after treatment with mifepristone, healthcare providers likely will ask patients to abstain from sexual intercourse, heavy lifting and strenuous exercise. They also may advise against breastfeeding, since scientists are not sure if the drug is present in breast milk.

Physicians require patients to come in for a follow-up visit 14 days after their first dose of mifepristone to verify that they are no longer pregnant and that they are properly healing.

Risks

Other common side effects include: fatigue, headaches, dizziness, nausea, vomiting, diarrhea and low-back pain.

Since pregnancy hormones are in flux after a medical abortion, many women have emotional side-effects, such as mood swings, depression or a mild case of the blues. These feelings usually subside when hormones stabilize a few weeks later. For those who feel stuck in their grief or anger about the situation, counseling or support groups may offer relief.

Normal results

Most women feel better after about two weeks. Bleeding and spotting usually occurs for nine to 16 days, but may last for a month.

Abnormal results

In some cases, mifepristone does not completely end the pregnancy. If the fetus is still left inside the uterus, a doctor may recommend a surgical abortion, or a procedure called dilation and curettage (D and C). About five to eight out of 100 women who take mifepristone go on to have a surgical abortion, according to the FDA. During a D and C, which usually is done at a hospital or clinic under a local anesthetic, a physician dilates the cervix, then uses an instrument to scrape any residual tissue away from the walls of the uterus. This allows the heavy bleeding to eventually stop so a woman can return to her normal cycle sooner.

Resources

BOOKS

Lader, Lawrence and Eleanor Smeal. A Private Matter: RU 486 and the Abortion Crisis. New York: Prometheus Books, 1995.

PERIODICALS

"The Abortion Pill's Grim Progress." Mother Jones 24 (January 1, 1999).

ORGANIZATION

Post Abortion Stress Syndrome Support Site. For information and online support groups. <http://www.afterabortion.com>.

U.S. Food and Drug Administration Center for Drug Evaluation and Research 5600 Fishers Lane, Rockville MD 20857-0001. Mifepristone fact sheets available: 1-888-463-6332. <http://www.fda.gov/cder>.

Melissa Knopper

Additional topics

Health and Medicine EncyclopediaHealth and Medicine Encyclopedia - Vol 17