What are the possible complications of medical abortion (abortion with pills)?

What are the possible complications of medical abortion (abortion with pills)?

If performed in the first 12 weeks, a medical abortion carries only a small risk of complications. This risk is the same as when a woman has a natural miscarriage and can be easily treated by a doctor. Out of every 100 women who do a medical abortion, 2 to 3 women will seek further medical care.
 
Please see the list below for possible complications, their symptoms, and treatment:
 
Severe bleeding (occurs in less than 1% of medical abortions)
  • Symptoms: Very heavy beeding that lasts for more than 2 hours, and soaks more than 2 maxi sanitary pads per hour. Feeling dizzy or light-headed can be a sign of too much blood loss. This requires urgent medical attention in a hospital.
  • Treatment: A vacuum aspiration to remove any remaining bits of the pregnancy. Fluids are given intravenously.  Very rarely (less than 0.2% of cases) a blood transfusion is needed.
 
Incomplete abortion
  • Symptoms: heavy or persistent bleeding and/or persistent severe pain.
  • Treatment: another 2 tablets of misoprostol to complete the abortion, and/or a vacuum aspiration to remove any remaining bits of the pregnancy.
 
Infection
  • Symptoms: If you develop a fever of more than 38 degrees Celsius, there might be an infection that needs treatment. A smelly vaginal discharge is also a sign of infection. This requires urgent medical attention in a hospital. Please note that a low grade fever (between 37 and 38 degrees Celsius) for a few hours after using Misoprostol can be a can be a side effect of Misoprostol and is not necessarily a complication.
  • Treatment: antibiotics and/or vacuum aspiration to remove any remaining bits of the pregnancy.
If you think you might have a complication you should seek medical attention immediately. In Malta, this means going to Mater Dei Hospital, and in Gozo to Gozo General Hospital. You do not have to tell the medical staff that you tried to cause an abortion; you could tell them that you had a natural miscarriage. Doctors have the obligation to help in all cases and know how to handle a miscarriage.
 
The symptoms of a miscarriage and an abortion with pills are generally the same and the doctor will not be able to test for any evidence of an abortion, as long as the pills have completely dissolved. If you took the Misoprostol under the tongue the pills should have dissolved within 30 minutes. If you took the pills vaginally, you can check with your finger to make sure that they are dissolved. Traces of the pills may be found in the vagina up to four days after inserting them.
 
Less than 1% of women who use abortion pills experience ongoing pregnancy. If pregnancy symptoms such as morning sickness continue after using abortion pills, or if a pregnancy test is still positive after three weeks from when you used abortion pills, you should arrange to have an ultrasound to see if the pregnancy has continued. If the abortion pills failed to work, there is a slight increase in the risk of birth defects in the fetus. In these cases you may wish to repeat the medical abortion (if you are still less than 12 weeks pregnant), or opt for an abortion in a clinic abroad.
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