Mifepristone and misoprostol are the abortifacient medicines which induce abortion or miscarriage in pregnant women. This article discusses about how long will you bleed after taking mifepristone and misoprostol and can you continue pregnancy after taking mifepristone?
These medicines can be used separately as each of them is capable of causing abortion in early stages of pregnancy. Often, misoprostol is also used to cure some side effects of NSAIDs like ulcers. Both the medicines cause abortion through a sequence of changes like bleeding, contraction of uterus, dilation of cervix, separation of endothelium and placenta, finally expelling the uterine contents. Out of these, bleeding is the first and foremost sign of abortion as observed in many cases.
How Long Will You Bleed After Taking Mifepristone and Misoprostol?
The dosing schedule and the treatment regimen varies and is best decided by the treating doctor. However, usually mifepristone 200 mg is followed by misoprostol 800 microg at decided intervals of either 6 to 8 hours or 24, 48 and 72 hours after mifepristone.1
In some pregnant women, mifepristone is enough to start bleeding which results in abortion. In such cases, bleeding starts within 1 or 2 days. In many cases where mifepristone is not sufficient to cause abortion, it is used with misoprostol. In those cases bleeding starts within 4 to 5 hours of taking misoprostol. The quantity of bleeding would also be higher than in normal menstrual period. Per hour heavy bleeding is enough to soak two or more thick sanitary pads.
How long you will bleed after taking mifepristone and misoprostol depends on the drug regimen, dose, intervals and the period of gestation. If the pregnancy is progressed and abortion is done at later stages, bleeding also will increase according to the development of fetus. Normally in the first trimester of gestation, abortion may cause bleeding up to 24 hours and gradually decreases thereafter. Some women bleed even up to 48 hours and sometimes blood clots are expelled. Doctors use different doses of mifepristone and misoprostol for the process at different stages of gestation. It is the most important thing to note here that in case if the bleeding occurs for more than 24 hours or else any clot more than the size of golf ball is expelled out, immediately the patient should seek doctor’s advice.
On What Factors Does Bleeding Depend on During Abortion?
According to some researches, mifepristone has the power of reducing the side effects and also over bleeding caused by misoprostol. Some studies suggest that using misoprostol intravaginally 6 to 8 hours after mifepristone is more effective and has fewer side effects like heavy bleeding as compared to using it after 24 hours.2
Generally, bleeding at the time of miscarriages depends upon various factors.
- Gestational age
- Dosage of the abortifacients
- Age of the pregnant women
- Anemia in pregnant woman
- Hemophilic condition of pregnant woman
- Under any medication like anticoagulants
- Allergies towards mifepristone
- Ectopic pregnancy
Can You Continue The Pregnancy Even After Taking Mifepristone?
It is very essential to be under medical supervision or the advice should be taken frequently either over telephone if the abortion is taking place at home or to have a second consultation as soon as possible. Let us understand of you can continue pregnancy even after taking mifepristone.
In some women, bleeding starts by mifepristone dosage alone. In case if the dosage of mifepristone is not sufficient, misoprostol is prescribed. Even after 24 hours, in a very few cases, bleeding does not occur. In such cases, there are chances of continuing pregnancy. Here, the combination is given as a second course after a gap of 3 hours of last misoprostol. In case, if the combination does not work properly in first dosage and if the pregnancy continues, the survived child would have congenital abnormalities.3 The individual role of mifepristone, misoprostol and prostaglandins in causing congenital defects needs to be evaluated as these are used in combination.
One more situation can happen here, when the patient does not complete the course of mifepristone and misoprostol dosage as prescribed by the doctor for some reason, then she may experience a missed abortion. In such a condition, the death of fetus would be caused by mifepristone but the contents of uterus would not be expelled.
Vacuum aspiration is the method which helps to treat this problem. In this method, the numbness of cervix is done with an injection (skipped if general anesthesia is already used for the whole process). The uterine products are sucked with the help of suction machine. Clearance of uterine substances can also be done by Dilation and Curettage, where curette, an instrument is used to empty the content of the uterus. In this technique, blood loss would be more than in manual vacuum aspiration.
Even though mifepristone and misoprostol work together for aborting in all the trimesters, sometimes they are used by the doctors separately, depending on the age of fetus and also health conditions of mother. How long you will bleed after taking mifepristone and misoprostol depends on several factors. Also, the question of whether you can continue the pregnancy even after taking mifepristone also depends on the other treatment combination that you have been exposed to. While there are instances when women change their mind or accidentally, pregnancy continues, depending on the exposure to these drugs there is a risk of child been born with congenital defects.
When using these pills for abortion, though there is no restriction for diet, the patient would not feel to eat because of nausea. Though abortion can be carried out at home or in clinics, it is always better to be under medical supervision and follow medical advice to avoid complications.