What is a medical termination at home?

A medical termination involves taking a tablet by mouth called mifepristone on one day and then two days later vaginal tablets called misoprostol.

The mifepristone tablet works by blocking the action of progesterone (the hormone needed to maintain a pregnancy) and sensitising the womb to the effects of misoprostol. The misoprostol tablets are put in the vagina and will induce a termination.

Visit to the hospital

You will attend the Outpatients Department 2 on the 1st floor at Chelsea and Westminster hospital on either a Monday afternoon or Wednesday morning.

You may have an ultrasound scan and blood test on the day of the appointment. If you have had a scan before, this does not need to be repeated. Blood tests are not always required.

You will then see the nurse and/or doctor for a consultation.  If you are suitable, you will be offered a medical termination, which can be carried out at home. 

Is this method suitable for me?

This method is suitable for patients who are less than 9 weeks pregnant but may not be suitable if you:-

  • Are under 18 years
  • Do not have someone at home to support you
  • Have significant medical problems
  • Are taking certain medications
  • Have had reactions to misoprostol or mifepristone

What will happen?

1st Day You will be given a tablet called MIFEPRISTONE by the doctor or nurse at the end of the clinic appointment.

You will then be given other medications each with instructions on.

2nd Day (usually approximately 36-48 hours later)

Two days later insert 4 tablets of MISOPROSTOL high up into your vagina. You can use your fingers or a cardboard tampon applicator to do this.

You can take 2 tablets of codydramol every 4 hours and 2 tablets of ibuprofen 200mg every 8 hours for pain if required.

If you are more than 7 weeks pregnant, after 4 hours take 2 more tablets misoprostol by mouth. You will have been given extra tablets to take. (Please note pregnancies are NOT dated from conception.)

In the evening you can start taking the 3 day course of the antibiotic called DOXYCYCLINE. The capsule is taken twice a day for 3 days and reduces the risk of infection.

Day 1: Mifepristone     

If you vomit within 2 hours please call the number below, or come back to clinic as you will need to take another tablet.

Usually you will not have any symptoms after taking the mifepristone but some people can experience:

  • Crampy / period type pains / nausea / vomiting
  • Very occasionally you may start to bleed before you take the next tablets. There is a small chance of passing the entire pregnancy after taking the first medication.

If you experience crampy pains, you can take painkillers.

Day 2: Misoprostol

Misoprostol will cause cramping which will be painful. This will help your body pass the pregnancy. You can take co-codamol and/or ibuprofen to help with this pain. You will experience:

  • Period type pain
  • Vaginal bleeding

The pain builds up to a peak then will settle when the tissue is passed, usually within 6-8 hours.

You should have someone staying with you at home for the day and overnight.

The Medications

  • Mifepristone – this tablet will be given to you at the end of your clinic appointment by the doctor or nurse.
  • Misoprostol tablets: taken on day 2 (36-48 hours after the first tablet) - place the 4 tablets high up in the vagina. You can use a tampon applicator to help put them high into the vagina. If you are more than 7 weeks pregnant, you will take 2 more tablets of misoprostol  by mouth 4 hours later.
  • Doxycycline is an antibiotic.  One capsule is taken in the evening of the 2nd day and continued for 3 days (one tablet twice a day) 

Pain relief: (check you are not sensitive to any of these)

  • Codydramol - you can take 2 tablets 4 times a day to help with the pain.
  • Ibuprofen 200mg  -you can take 2 tablets 3 times a day.

You can take both codydramol and ibuprofen together.

What else to expect?

  • You will have heavy bleeding with pain and then this usually settles after 6-8 hours. You can continue to have light bleeding for up to 2-3 weeks.
  • If you experience heavy bleeding or severe pain at any time (using more than three pads soaked in an hour or any amount that you worried about), please call the helpline or attend accident and emergency and you will be referred to the gynaecologist on call for further assessment.
  • You can wear sanitary pads but do NOT use TAMPONS during the first week.
  • Please do a urine pregnancy test 3 weeks afterwards and if this is positive, please call the clinic booking number.
  • There is no evidence to suggest that a termination of pregnancy affects your future fertility. However, if you develop an infection and this isn’t treated quickly, it could affect your fertility. If you have any symptoms of an infection such as fever, smelly discharge or an increase in bleeding after it has initially settled, you should see your GP, our clinic or accident and emergency to consider antibiotics.
  • You can get pregnant very quickly after a termination so you must start contraception as soon as possible. This will be discussed with you at your appointment in the hospital.
  • You will have your next period 3-6 weeks after the procedure. 
  • It is also very difficult to predict how you will feel emotionally after this process. Some women feel sad and others feel relief. If you need support please contact your GP or our helpline.

Helpline telephone number: 020 3315 3905 / 3906

Clinic booking number (9am -5pm): 0203 315 8381

Contributors
Liz Alden