What If the Abortion Pill Does Not Work?

The abortion pill is 93 to 98% effective at ending a pregnancy within the first 10 weeks, so for the vast majority of patients the two-pill process works completely with no extra treatment needed.

The pill works best earlier in pregnancy. At 7 weeks or less, the success rate is about 98%. Between 7 and 9 weeks it is about 95 to 97%, and between 9 and 10 weeks it is around 93 to 95%. The doctor at The Center for Women does an ultrasound at your appointment to confirm how far along you are.

These are strong success rates compared to most medical treatments, but no medicine works 100% of the time. Knowing what happens in the rare cases where the abortion pill does not fully work can help you feel prepared.

When the abortion pill does not fully work, it usually means one of two things. One is an ongoing pregnancy, where the pregnancy is still growing. The other is an incomplete abortion, where the pregnancy has ended but some tissue remains in the uterus.

An ongoing pregnancy after taking both pills is rare, happening in about 2 to 5% of cases. An incomplete abortion, where most of the pregnancy has passed, is somewhat more common. In many of those cases, the remaining tissue passes on its own over the next few days.

Neither situation is an emergency in most cases, but both need follow-up care. That is why The Center for Women includes a follow-up visit as part of your care.

In rare cases, the pill may not work because the pregnancy is growing outside the uterus. This is called an ectopic pregnancy, and the abortion pill cannot treat it. It is a life-threatening emergency, so doctors have to rule it out if an ultrasound has not confirmed the pregnancy is in the uterus. Warning signs include severe pain on one side of the lower belly, shoulder pain, dizziness, or fainting. If you have any of these signs, go to your nearest emergency room right away.

The follow-up visit at The Center for Women is how you confirm the abortion is complete. The doctor checks that all pregnancy tissue has passed and that your body is healing normally. This visit is included in the $380 cost of your appointment.

Between your appointment and your follow-up, there are signs the process is working. Most patients have cramping and heavy bleeding within 1 to 4 hours of taking misoprostol. Bleeding heavier than a normal period is expected, and so is passing blood clots. After the heaviest bleeding, you may have lighter bleeding or spotting for up to 2 weeks.

Call the clinic if you have no bleeding at all within 24 hours of taking misoprostol. Very light bleeding with no cramping is another reason to call. So are pregnancy symptoms, like nausea and sore breasts, that do not fade over the next few days. The number for The Center for Women is (708) 450-4545.

If the follow-up visit shows that some pregnancy tissue remains in the uterus, the doctor will go over your options. In many cases, the remaining tissue passes on its own with more time. The doctor may suggest watchful waiting, with another follow-up visit to check.

If the tissue does not pass on its own, the doctor may prescribe another dose of misoprostol. The same is true if you would rather not wait. The extra dose helps the uterus pass the remaining tissue, and it is a common and straightforward step.

In the rare cases where medicine alone is not enough, a brief procedure called aspiration may be recommended. The Center for Women does not perform surgical procedures, so the doctor would refer you to a facility that does. The referral would be handled for you, so you know exactly where to go and what to expect.

An ongoing pregnancy after taking both mifepristone and misoprostol is uncommon. When it does happen, doctors advise against continuing the pregnancy, because mifepristone can affect how the fetus develops. The doctor will explain your options clearly.

Those options are another dose of misoprostol or an aspiration procedure. The doctor will walk you through both and help you decide what is right for you. If an aspiration is needed, The Center for Women will refer you to a trusted facility.

The important thing to know is that this is found at your follow-up visit. You will not be left without a clear path forward.

No. The follow-up visit is included in the $380 cost of your appointment at The Center for Women. That price covers your first visit, ultrasound, both medicines (mifepristone and misoprostol), and your follow-up appointment. There is no extra charge for the follow-up.

If the doctor decides you need a second dose of misoprostol, ask about the cost at that time. The Center for Women will be upfront about any costs before you agree to more treatment.

Call The Center for Women at (708) 450-4545 to schedule your appointment. Same-day, evening, and weekend appointments are available. The doctor will do an ultrasound to confirm how far along you are and review your health history before prescribing the abortion pill.

The Center for Women is at 10215 W. Roosevelt Rd. #101, Westchester, IL 60154. The $380 cost includes your appointment, ultrasound, medications, and follow-up visit, so follow-up care is built in and you will be supported through the whole process.