MEDICAL ABORTIONS COSTS INFORMATION

Medical abortions are brought about by taking medications that end the pregnancy. The advantages of a first trimester medical abortion are:
? The procedure is non-invasive; no surgical instruments are used.
? Anesthesia is not required.
? Drugs are administered either orally or by injection.
? The outcome resembles a natural miscarriage.

Disadvantages of a medical abortion are:
? The effectiveness decreases after the seventh week.
? The procedure may require multiple visits to the doctor.
? Bleeding after the abortion lasts longer than after a surgical abortion.
? The woman may see the contents of her womb as it is expelled.

As of 2003, two drugs were available in the United States to induce abortion: methotrexate and mifepristone.

METHOTREXATE. Methotrexate (Rheumatrex) targets rapidly dividing fetal cells, thus preventing the fetus from further developing. It is used in conjunction with misoprostol (Cytotec), a prostaglandin that stimulates contractions of the uterus. Methotrexate may be taken up to 49 days after the first day of the last menstrual period.

On the first visit to the doctor, the woman receives an injection of methotrexate. On the second visit, about a week later, she is given misoprostol tablets vaginally to stimulate contractions of the uterus. Within two weeks, the woman will expel the contents of her uterus, ending the pregnancy. A follow-up visit to the doctor is necessary to assure that the abortion is complete.

With this procedure, a woman will feel cramping and may feel nauseated from the misoprostol. This combination of drugs is approximately 92 - 96% effective in ending pregnancy. Approximately 50% of women will experience the abortion soon after taking the misoprostol; 35 - 40% will have the abortion up to seven days later.

Methotrexate is not recommended for women with liver or kidney disease, inflammatory bowel disease, clotting disorders, documented immunodeficiency, or certain blood disorders.

MIFEPRISTONE. Mifepristone (RU-486), which goes by the brand name Mifeprex, works by blocking the action of progesterone, a hormone needed for pregnancy to continue. It was approved by the Food and Drug Administration (FDA) in September 2000 as an alternative to surgical abortion. Mifepristone can be taken up to 49 days after the first day of a womans last period.

On the first visit to the doctor, a woman takes a mifepristone pill. Two days later she returns and, if the miscarriage has not occurred, takes two misoprostol pills, which causes the uterus to contract. Approximately 10% will experience the abortion before receiving the dose of misoprostol.

Within four days, 90% of women have expelled the contents of their uterus and completed the abortion. Within 14 days, 95 - 97% of women have completed the abortion. A third follow-up visit to the doctor is necessary to confirm through observation or ultrasound that the procedure is complete. In the event that it is not, a surgical abortion is performed. Studies show that 4.5 - 8% of women need surgery or a blood transfusion after taking mifepristone, and the pregnancy persists in about 1%. Surgical abortion is then recommended because the fetus may be damaged. Side effects include nausea, vaginal bleeding, and heavy cramping. The bleeding is typically heavier than a normal period and may last up to 16 days.

Mifepristone is not recommended for women with ectopic pregnancy or an intrauterine device (IUD), or those who have been taking long-term steroidal therapy, have bleeding abnormalities, or on blood-thinners such as Coumadin.