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An Overview of Medical Abortion for Clinical Practice

Bryant, Amy G. MD, MSCR*; Regan, Elizabeth BA; Stuart, Gretchen MD, MPHTM

Obstetrical & Gynecological Survey: January 2014 - Volume 69 - Issue 1 - p 39–45
doi: 10.1097/OGX.0000000000000017

Medical abortion is a safe, convenient, and effective method for terminating an early unintended pregnancy. Medical abortion can be performed up to 63 days from the last menstrual period and may even be used up to 70 days for women who prefer medical abortion over surgical abortion. Counseling on the adverse effects and expectations for medical abortion is critical to success. Medical abortion can be performed in a clinic without special equipment, and it is perceived as more “natural” than a surgical abortion by many women. Follow-up for medical abortion can be simplified to include only serum human chorionic gonadotropin measurements when necessary, although obtaining an ultrasound remains the criterion standard. Pain associated with medical abortion is best treated with nonsteroidal anti-inflammatory medications, possibly in combination with opioid analgesics. Medical abortion can contribute to continuity of care for women who wish to remain with their primary care providers for management of their abortion.

Target Audience: Obstetricians and gynecologists, family physicians

Learning Objectives: After completing this CME activity, physicians should be able to describe the most effective regimens for medical abortion, to identify appropriate candidates for medical abortion, to counsel patients on the adverse effects and expectations for medical abortion, and to implement the appropriate follow-up regimens for medical abortion.

*Assistant Professor, Department of Obstetrics and Gynecology; †Research Assistant, Gillings School of Public Health; and ‡Associate Professor, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

The authors have disclosed that the US Food and Drug Administration has not approved the use of misoprostol, mifepristone, and methotrexate in medical abortion as discussed in this article. Please consult the products’ labeling for approved information.

Correspondence requests to: Amy G. Bryant, MD, MSCR, Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, 3031 Old Clinic Bldg CB# 7570, Chapel Hill, NC 27599. E-mail:

© 2014 by Lippincott Williams & Wilkins.