(Note: This information is intended for general education purposes only, and should not be relied upon as a substitute for professional medical advice.)

1. Mifeprex (Abortion Pill, RU-486): approved by the FDA (Food & Drug Administration) for elective abortions ONLY up to 49 days after the last menstrual period. The procedure usually requires 2-3 doctor visits. On the first visit, the woman is given pills to cause the death of the embryo (the drug works by blocking the effect of progesterone hormone which results in the detachment of the pregnancy from the wall of the uterus and the onset of bleeding and cramping). Two days later, if abortion has not occurred, she is given a second drug which causes cramps to expel the embryo. The last visit is to determine if the procedure has been completed.
• Expected side effects include: bleeding (for 9-16 days); abdominal cramping, nausea and vomiting, diarrhea.
• Failure rate (ie abortion did not occur) among pregnancies up to 49 days of gestation is 5%; 15% for pregnancies beyond 49 days. These patients then undergo a surgical abortion, too
• Ectopic (tubal) pregnancy; Mifeprex will not work in the case of a tubal pregnancy. This is a potentially life-threatening condition in which the embryo lodges outside the uterus, usually in the fallopian tube. If not diagnosed early, the tube may burst, causing internal bleeding and, in some cases, death of the woman
•  Severe bleeding: 1 woman in 100 bleed enough to require surgery to stop the bleeding
• Risk of fetal malformations among abortion ‘failures’
• Psychological impact: Unknown. No information on how this procedure may impact women’s psyche.
• FDA health advisory: Cautions after the death of 5 Mifeprex users after an unusual form of sepsis (total body infection).  



2. Methotrexate: cancer drug used to non-surgically treat ectopic (tubal) pregnancies and also used to abort normal intrauterine pregnancies.
• Side effects & Risks:nausea, vomiting, diarrhea, abdominal distress, severe (sometimes fatal) bone marrow suppression (rare), reversible hair loss (rare), liver toxicity, severe skin reactions (occasionally fatal) and pneumonia
• 23% experience nausea; 18% abdominal pain; !7% fatigue and headache
• increased risk of ectopic (tubal) pregnancy among ‘failures’
• Studies are lacking on the safety of long-term and repeated use among adolescents, therefore the true risks among this group is not known
• Brief window for conception to occur throughout month; EC taken during infertile time in cycle results in unnecessary exposure to high levels of hormones.

1. Manual Vacuum Aspiration (up to 7 weeks after last menstrual period): A long, thin tube is inserted into the uterus. A large syringe is attached to the tube and the embryo is suctioned out.
2. Suction curettage (6-14 weeks): This is the most common surgical abortion procedure. Because the baby is larger, the doctor must first stretch open the cervix using metal rods. Opening the cervix may be painful, so local or general anesthesia (fully asleep) is typically needed. After the cervix is stretched open, the doctor inserts a hard plastic tube into the uterus, and then connects this tube to a suction machine. The suction pulls the fetus’s body apart and out of the uterus. The doctor may also use a curette (loop-shaped knife) to further scrape out the uterus. The medical term ‘products of conception’ is used to describe the membranes, placental tissue and skeletal fragments of the dismembered fetus.
• Immediate physical risks: bleeding, infection, damage to organs; less than 1% ; risk of death: less than 1 per 100,000
• Long-term risks: see Risks
3. Dilatation and Evacuation (13-24 weeks): This surgical abortion is done during the second trimester of pregnancy. At this point, the fetus is too large to be broken up by suction alone and will not pass through the suction tubing. The cervix must be opened wider than in a first trimester abortion further because the fetal parts are much larger. This is typically done by inserting numerous thin rods made of seaweed (called laminaria) a day or two before the surgical procedure. These sticks absorb fluid and begin to soften and stretch the cervix. In the operating room, anesthesia is given (local or fully asleep). Once the cervix is stretched open, the doctor pulls out the fetal parts with forceps (grasping instrument). The fetus’s skull is crushed to ease removal. A curette (loop-shaped knife) is also used to scrape the uterus, to remove any remaining tissue. In order to determine if all fetal tissue has been removed, the fetus is ‘reassembled’ on the operating room table at the end of the procedure.
• Immediate physical risks: hemorrhage, retained fetal tissue and damage to organs are greater than in 1st trimester abortions; risk of death 3 to 9 women per 100,000 women.
• Long-term risks: see Risks
4. Dilatation and extraction; D & X (‘partial birth abortion’) (From 20 weeks to term): This procedure typically takes 3 days. During the first two days, the cervix is stretched open using thin rods made of seaweed (laminaria), and medication is given for pain. On the third day, the abortion doctor uses ultrasound to locate the legs of the fetus. Grasping a leg with forceps, the doctor delivers the fetus up to the neck. At this point, scissors are used to puncture the head near the base of the skull and a large suction tube is used to remove the brain, and collapse the skull. This has two purposes: to make sure there is not a live baby and to make the head easier to deliver through the partially dilated cervix.
• Immediate physical risks: significant bleeding, retained placenta requiring further surgery, overall risks significantly increased over first trimester procedure. Risk of death 12 per 100,000 women.
• Long-term risks: see Risks

Note: Care Net Pregnancy Center does not provide or refer for abortion or abortifacients.