Unplanned pregnancy

If you have had sex in the last five days and do not want to be pregnant you can use emergency contraception such as the emergency contraceptive pill or non-hormonal copper IUD.

If you are pregnant and do not want to be it is your choice what you would like to do, regardless of your age or relationship status. Unplanned pregnancy is very common and there are many support services available. You have the following options:

• Abortion (medical or surgical)
• Continuing the pregnancy and parenting
• Continuing the pregnancy and adoption or foster care

Medical abortion involves taking a combination of tablets to bring on a miscarriage. The tablets are prescribed as a pack. Your doctor or nurse may also prescribe additional tablets to minimise side effects (such as pain and nausea). Your doctor or nurse will discuss how to take the tablets – including the timing.

During a medical abortion you will:

• take a tablet (mifepristone) at an agreed time
• 36 to 48 hours later, take a second dose of tablets (misoprostol), which softens the cervix and helps the uterus push out the pregnancy
• experience cramping and bleeding similar to a miscarriage between one and 24 hours after the second medication.

During and after the procedure, you will have the option of telephone contact with the clinic or a 24 hour help line in case you have any questions or concerns.

Most services organise a pregnancy hormone blood test 7 days after you have taken your first tablet, to check that the hormone level has dropped and you are no longer pregnant.

Around two weeks after taking the tablets you may complete a self–assessment checklist or be offered a follow-up appointment to make sure the pregnancy has ended and check for complications. You will have the opportunity to review your contraception.

The first tablet (mifepristone) usually does not cause any side effects. You can continue with your normal activities.

After taking the second tablets (misoprostol) you may experience nausea, vomiting, diarrhoea, dizziness, headaches and fever for a short time.

Vaginal bleeding and abdominal (tummy) pain and cramping usually start 1 – 4 hours after taking the second tablets. Bleeding is usually heavier than a period and there may be large clots. Pain and cramping are generally much stronger than period pain.

After 2 – 6 hours the bleeding usually settles to the level of a normal period and continues like that of a normal period for another 3 – 7 days. The bleeding becomes lighter and usually settles after a total of 2 weeks. A small number of people may experience unpredictable, irregular or prolonged bleeding that can last for up to 5 weeks.

Complications are uncommon after a medical abortion, but may include:

• Reactions to the medications.
• Small pieces of tissue left in the uterus (womb) requiring a minor surgical follow-up procedure to clear the lining of the uterus (around 1 in 20 – 1 in 33 cases). This procedure is done under general anaesthetic.
• The medical abortion does not work and the pregnancy continues (around 1 in 125 cases). The abortion tablets can be repeated if the pregnancy is not more than 9 weeks otherwise a surgical abortion may be required.
• Haemorrhage – very heavy bleeding. In rare cases a blood transfusion is needed.
• Infection requiring antibiotic treatment (symptoms include persistent pain, an unusual vaginal discharge, fever and feeling generally unwell).

Contact your abortion provider, doctor or nurse if you experience:

• heavy bleeding or bleeding that is not settling
• pelvic pain that is not settling
• an unusual or smelly vaginal discharge
• unexplained fever
• feeling generally unwell.

After taking the medical abortion tablets it is recommended you:

• use pain medication such as ibuprofen or paracetamol to help manage the cramps (your doctor or nurse can prescribe stronger medication if needed)
• massage your abdomen and use heat packs
• rest and take time off work or study.

To lessen the risk of infection during the week after having the procedure, you should not:

• insert anything into the vagina (including tampons and menstrual cups – which should not be used until your next period)
• have vaginal sex
• perform any strenuous activity, including sport or heavy physical work, until the bleeding is no longer heavy
• go swimming or have a bath (you can shower).

Most services organise a pregnancy hormone blood test 7 days after you have taken your first tablet, to check that the hormone level has dropped and you are no longer pregnant.

Around two weeks after taking the tablets you may complete a self –assessment checklist or be offered a follow-up appointment to make sure the pregnancy has ended and check for complications. You will have the opportunity to review your contraception.

• are more than nine weeks pregnant
• not had an ectopic pregnancy ruled out (a pregnancy occurring outside the uterus, usually in the fallopian tubes)
• have certain medical conditions such as anaemia, bleeding disorders, severe asthma, heart disease, high blood pressure, diabetes or a liver, kidney or adrenal condition
• are taking long-term steroid or blood-thinning medication have had an allergic reaction to the medication’s mifepristone or misoprostol
• have an intrauterine device (IUD) – the IUD needs to be removed before taking mifepristone
• cannot stay somewhere within a 1 hour drive of an emergency medical service from the time when the second tablets are taken until 2 – 3 weeks later
• do not have a support person who can stay with you from the time you take your second dose of tablets until the miscarriage has happened
• cannot have a blood test – to check your pregnancy hormone level has dropped – 1 week after you have started your tablets
• cannot be reviewed by the clinic for at least one follow-up appointment.

Abortion service providers are located across Victoria in a range of health services and private practices. The costs, procedures and time required can vary from service to service. Having an abortion earlier in a pregnancy can minimise procedure costs and maximise your options.

To find surgical or medical abortion services in Victoria contact 1800 My Options phone line 1800 696 784.

If you decide to have a medical abortion, you will first have an appointment with a nurse, followed straight after by an appointment with a doctor, either in our clinic or by telephone. You can expect your appointments to take 1-2 hours.

If you have a booking for a medical abortion at Sexual Health Victoria, please refer to our Client Information Medication Abortion information sheet for more information.

• Sexual Health Victoria
• 1800 My Options phone line - 1800 696 784
• A doctor or nurse
• Your local community health service
• A public hospital (some provide a limited number of free abortions)
• A private abortion provider
• A psychologist or counsellor
• Your youth worker, social worker, support worker
• An obstetrician or gynaecologist
• Better Health Channel
• Equinox – for transgender services
• Jean Hailes
• Marie Stopes Australia
• Multicultural Centre for Women’s Health
• The Women’s (The Royal Women’s Hospital)

If you are using the internet for information, only use reliable and reputable websites, such as the ones provided above. Be aware of anti-abortion or pro-life websites containing inaccurate and harmful information and imagery.