Medical abortion

1. It can only be done up to 9 weeks 6 days weeks after the first day of your last period.
2. The process takes longer than an aspiration abortion and more appointments are necessary (usually one longer in-clinic appointment on the first day and 2 short phone follow-up ones later) and may require more time to rest.
3. Failure rates are a bit higher than with an aspiration abortion (although still very low).
4. Cramping can be strong and usually lasts longer than with an aspiration abortion.
5. Bleeding is typically heavier with a medication abortion – it may be very heavy at times and usually lasts longer than with an aspiration.
6. Misoprostol, one of the medications used, may cause flu-like symptoms.
7. During the abortion itself, you will not have on site support from medical staff and counsellors.
8. It may be harder to keep a medication abortion private, especially from people you live with (because of significant bleeding, cramping and other side effects) and because the medications involved can show up on Pharmanet which can be seen by doctors, nurse practitioners, and pharmacists.
9. Viewing the pregnancy tissue can be difficult for some, especially when the pregnancy is over 8 weeks and you may see an embryo or fetus.
10. If you do not have BC medical insurance, a medication abortion is more expensive than an aspiration.
11. Those with anemia (very low iron) and/or severe vomiting are not good candidates for a medication abortion.

1. Some people prefer to consciously experience the process of ending the pregnancy at home rather than being sedated during an aspiration (although sedation with your aspiration is not required).
2. It does not require a ride, a companion on transit, or a taxi to get home from the clinic – you can come by yourself for the first appointment and stay home for the follow-up phone appointments.
3. You can be at home instead of in a clinic during the actual abortion, which may feel more comfortable, or may provide a sense of less intervention and more control – in particular, for some survivors or sexual abuse/assault. You can choose who you have with you during the process.
4. It seems like a miscarriage, which for some can feel more natural.
5. It almost always avoids a medical procedure where a doctor inserts instruments into the uterus.

With valid BC Medical Services Plan (MSP) coverage, the cost of the procedure and the medical abortion medication is covered There is an additional cost of about $34 for the pain medicine and the second dose of misoprostol but this cost may be covered at least partly by an extended health plan or by Fair Pharmacare. If you have First Nations status the cost  is covered. Bring your card with you if you are coming to the clinic or have it handy if you are having a virtual appointment (i.e. Blue Cross, Green Shield, Manulife, Fair Pharmacare, First Nations status card or number).

Without valid BC Medical Services Plan (MSP) the procedure and medication appointment will be about $985 altogether, which includes the medications and the one week follow-up appointment. If you have medical insurance from another province other than Quebec, the cost will be about $410 for the medications unless you have insurance as listed above. If you are in the 5 percent that need an aspiration to complete the abortion the cost is $250 for those without insurance. Please note: without MSP an aspiration abortion is $700. With either a medication or aspiration abortion, if additional testing or appointments are needed there would be additional charges. We accept credit (Visa, Mastercard), debit, or cash payments.

Refund Policy

1. Mifepristone

The first medication, mifepristone, disrupts the pregnancy. If you have a lot of nausea from the pregnancy you can take Gravol before you swallow the pill.

If you are vomiting a lot because of the pregnancy you might be better to have an aspiration abortion procedure because with a medical abortion you need to keep the mifepristone pill down for at least 20 minutes.

2. Misoprostol

The second medication, misoprostol, makes the pregnancy come out. It must be used between 24 hours and no later than 48 hours after the first one. This is when the heaviest bleeding and cramping is likely to happen. You will be prescribed medication to help manage pain.

3. Side effects

There can also be other side effects such as chills, fever, nausea, vomiting, dizziness or headache. You will need to be somewhere comfortable during this time and it is best to have someone close by in case you need help. It’s great if you can have everything ready that you need to be as comfortable as possible – such as a heating pad, medications, food – before you use the misoprostol. You may also need to rest for one or two days after using the misoprostol.

Menstrual-like cramping pain is normal after a medication abortion. Use Tylenol or Ibuprofen (Motrin, Advil) if needed. Do not use aspirin (A.S.A., Entrophen) as it may increase bleeding. Heat from a hot water bottle or heating pad can also be very helpful for cramps.

Mood swings or emotional upset often accompanies the drop in pregnancy hormones and may last for a few days or even a couple of weeks. Morning sickness should disappear within two days and breast changes usually settle by the end of the first week but both may persist if you are on hormonal birth control.

4. Bleeding

The amount of bleeding varies. It is likely to be heavier than a period at first, and stay at least as heavy as a period for a few days. Ten days is the average time of bleeding, although some will bleed on and off or continuously until their next period comes in 4-6 weeks. It is also possible that you may only have a few hours of heavy bleeding or lighter bleeding.

5. Your next period

Your normal period should begin four to six weeks after the abortion.

6. Precautions

Do not drive or operate hazardous equipment if you take Gravol or Tylenol 3. You should also avoid alcohol if you take these medications.
Do not do a pregnancy test in the first 4 weeks afterwards as the pregnancy hormones leave the body slowly. A test can still be positive for weeks after an abortion has removed the pregnancy. We will explain about when to do a test afterward. We will give you a pregnancy test to do before the second follow-up phone call.

7. Emotions

Free post-abortion counselling is available by phone from the clinic for those who feel it would be helpful. If you experience prolonged sadness or emotional turmoil you may benefit from this service. There is no charge for this. To make an appointment for this service please call 604-322-6692 during normal clinic hours or use the email address on the information we will give you..

For more resources see our resources and referrals section. For support persons, we have information on how to support someone after an abortion.

1. First appointment

Your first appointment will take about 1.5 to 2 hours. You will speak with the counsellor first, and then see the nurse and doctor for tests and an ultrasound.

About 95-97 percent of the time the pregnancy will be gone and the abortion complete one week after starting the medications. If you are in the 3-5 percent where the abortion is not complete, you may need more medications or an aspiration abortion. There is no cost for an aspiration whether or not you have BC medical coverage.

2. Follow-up appointments

You must also have a short telephone follow-up appointment 1-2 weeks afterwards so we can check to make sure the abortion is complete. This appointment is very important for your safety.  The doctor will check with you to make sure the abortion is complete. There will be another short follow-up phone appointment with the doctor 4 weeks after using the medications.

Fertility returns very quickly after a medical abortion. If you do not wish to become pregnant soon after, it is recommended to start on birth control the day after taking the misoprostol pills (the second medication). Research shows that those who do not start a birth control method at the time of an abortion have about a 50% chance of having another pregnancy within two years.

We will speak with you about birth control options during your appointment. If you want an IUD or an implant we can insert one for you after a medical abortion is complete or at the end of an aspiration abortion.If you want an IUD we can arrange the insertion appointment at our clinic. If you are eligible and want to get an IUD for free through the Safe Methods program, it needs to be put in within two weeks of your final follow-up appointment.

If you do not have MSP coverage the cost of an IUD or implant insertion is $230, plus the cost of the device itself.

Find out more about birth control in birth control options.