1. Will I be able to work during my medical abortion?
How you are feeling, and your ability to function, will depend on where you are at during the medical abortion process.
After the FIRST step (mifepristone), it is likely that you will be able to continue your normal life without feeling very different. However you may start to bleed so it’s a good idea to wear a pad in your underwear. After the first step, you may feel less pregnant but otherwise you should feel pretty normal.
However, on the day when you plan to take the SECOND step of the medical abortion, you will need to plan NOT to work. You will need to be somewhere safe and comfortable, and not make ANY plans for the whole day. This includes NOT working, NOT meeting people or looking after young children. We recommend you get support from someone who knows you and cares about you, as you will feel UNWELL and have limited ability to carry out normal activities.
You may also consider taking the following day off, after the day of taking the second step medication (misoprostol). We can give you a work certificate for these 2 days if you require one.
If you feel well enough on the third day after taking the misoprostol, you can resume your normal schedule, though you may continue to bleed for up to 3 weeks after the medical abortion. If you have significant pain on the third day after taking the misoprostol, you should seek medical attention locally.
2. How long will the medical abortion process take?
We will likely be in contact with you for approximately 3 to 7 days after you register, prior to you actually getting the pills for the medical abortion . This is so that we can make sure we have all the test results and information we need before we can safely guide you through the medical abortion process. The actual medical abortion itself, which has 2 steps, will take somewhere between 36 to 72 hours depending on the timings of your medications.
The first medication (mifepristone) can be taken at any time, preferably as soon as possible after you get the tablets. Then 24-48 hrs later you will take the second step (misoprostol) . This second step should be taken in the morning after a light breakfast. Make sure you are well hydrated on the day you take the second step.
About 30 mins after taking the misoprostol tablets (the second step) you will have bleeding and cramping which may be severe. For this reason, you should not make any plans to be anywhere other than at home or somewhere safe and familiar, and be supported by someone who knows what is happening and who is able to care for you.
On the second day after the misoprostol, (second step) you will feel tired . You will still have bleeding and you should plan to have a quiet day.
On the third day after the misoprostol, you can resume your normal activities of daily living but don’t expect too much of yourself. You may continue to bleed for up to 3 weeks after the medical abortion. During this recovery time, you can go to work or study or look after others, but you should not have sexual intercourse until we have given you the all clear that the medical abortion has been successful. This is to help prevent infection.
You will have a blood test 5 to 10 days after the medical abortion and you will have a tele-health consultation with one of our clinicians approximately 3 to 4 weeks after the medical abortion. If you wish to make contact with us after the medical abortion but before the scheduled follow-up please email us at email@example.com.
3. Will it be painful?
Yes it will be painful. However, a woman’s experience of pain during medical abortion varies. Some women describe medical abortion as being like a period pain, whereas others are in excruciating pain and need to be hospitalised (though this is unusual). Most women describe moderate to severe pain which subsides after a few hours of intensity.
4. What can I do to manage the pain?
Simple measures that you can take are to have a warm pack or hot water bottle available; be prepared to mobilise around your settings; keep moving. Being upright and able to sit on the toilet is useful.
We will usually prescribe strong pain relieving tablets at the same time as the medical abortion pills. You will collect pain relief medication at the same time as when you collect your medical abortion pill prescription. Ibuprofen and paracetamol can be purchased in any supermarket and are useful to have on hand as well.
Note; The pain is usually at its worst for 6 to 7 hours after the second step (misoprostol), and then should subside significantly. So, if you take the misoprostol, in the morning you should be in a comfortable state by late afternoon and should be able to have a good night’s rest, after the misoprostol has worn off.
5. Why do I need to get the tests done urgently?
Medical abortion is licensed in Australia for pregnancies up to 63 days or 9 weeks. We cannot prescribe a medical abortion for you if your pregnancy is past this date. It is therefore very important that we get the information about your pregnancy as quickly as possible, so that we can help you in a timely manner. This means that the blood tests and the ultrasound scan results need to be collected and sent to us urgently.
If there is a delay, and we do not get the test results back in time, it may be too late. We need to have the essential information, in order for us to get the medication to you before you get past 63 days. If we don't get the results in time, we may not be able to offer you a medical abortion .If you are over 63 days when we are satisfied that you meet the criteria for a medical abortion, you will need to make another plan.
If your pregnancy is later than 63 days, then you can choose to have a surgical abortion (termination of pregnancy).
6. If I don’t go through with the medical abortion, or if there are complications, do I get a refund?
No. If you don't want to, or are unable to proceed with the medical abortion, for whatever reason, there will be NO refund. This also applies if there are complications and further treatment from a local health service provider is necessary. Although we try to keep costs to a minimum, we are unable to offer a refund to patients, as there are costs involved in providing the service, even if you do not go ahead.
7. Is there a Medicare rebate for tele-abortion?
No. Unfortunately there is no item number or rebate provided by Medicare or state governments for any aspect of tele-abortion. This is a shortfall in the Australian Health Service and we would encourage you to write to your local MP requesting better access and support for Australian women seeking abortion care. There is currently varied and patchy provision of abortion care across Australian states. Often the most vulnerable and disadvantaged women are the ones least likely to be able to access safe and affordable abortion care.
8. Will you help me choose a good method of contraception?
Yes. All our clinicians are highly skilled in contraceptive counselling and will be able to help you make the right choice of contraception. This will help give you control and decide when to get pregnant . Effective contraception will help prevent further unplanned pregnancies, but you need to find a contraceptive which suits you. It is likely that we will be able to include a contraceptive prescription at the same time as we provide you with the abortion pill prescription.
9. I don’t want anybody in my community to know that I am having a medical abortion. What can I do to maintain my privacy?
We understand your need for complete privacy. This is one of the advantages of tele-abortion, as it provides you with medical attention in the privacy of your own home. Concerns about privacy and confidentiality are especially important for women undergoing abortion, due to the stigma that women who seek abortion often experience in their communities.
We will never share your information, unless you request that we do so and/or give us your permission to do so.
However we will advocate for you and support you in any way that we can. This includes liaising with with other health professionals on your behalf.
For example; we will give you a choice of local dispensing pharmacies where you can collect your medication. This means that you can choose a pharmacy which is not in your local community if you wish.
10. How do I get my medical abortion pills?
During the video consultation we will give you a choice of dispensing pharmacists where we can send your prescription. However it is your responsibility to liaise directly with your chosen pharmacy and pay by credit card for delivery, or arrange to collect and pay for the medications in person. Pharmacists are bound by professional confidentiality in the same way as doctors and nurses.
11. What happens if I have problems or my medical abortion doesn't work properly?
If you do need to seek assistance with your GP or at your local hospital, we will speak directly with the healthcare professionals as required.
12. What happens if I am treated badly by local health services because I chose to have an abortion?
During follow-up, if we find that there have been any incidents of unprofessional behaviour we will advocate for you, for example, by making a report to the Australian Health Professionals Registration Authority ( AHPRA) or assisting you with a submission to the Health Care Complaint Commission (HCCC). It is not acceptable for health professionals to discriminate or judge patients unfairly because they have had an abortion. Access to abortion care should be as easy as access to any other type of health care. Doctors, nurses or anyone else involved in your journey have no right to judge you according to their own personal held beliefs.
13. What if I have a Rhesus negative blood type?
If you have a Rhesus negative blood type, we recommend that you have an injection of Anti-D Immunoglobulin during the medical abortion process. Anti-D will help protect your unborn child, if you have future pregnancies.
This is because women who have a Rhesus negative blood type, who don’t recieve Anti-D, may form antibodies to pregnancies.
The most likely place for you to get the Anti-D injection is your nearest Emergency Department. If you have a Rhesus negative blood type, we will give you a letter to take to the Emergency Department explaining the need for Anti D and requesting that the hospital staff give you the injection which is usually into the buttock or thigh.
14. Why is tele-abortion so expensive?
Unfortunately there is no rebate from Medicare to support medical abortion delivered via tele-health. Gynaecare/Clinic 66 is not a registered charity and we have no funding to provide abortion care. We are a small private medical practice, passionate about providing women with access to safe and effective abortion care, and we need to cover the costs of providing the service.
In addition, the medical abortion medication is listed on the PBS, and it quite affordable. However, if you do not have a medicare card, it is substantially more expensive (around $40 with medicare and over $300 without).
15. I am financially disadvantaged; can I have a discount?
If you are suffering genuine financial hardship and are struggling to find the money to pay for the tele-abortion, we will discuss your particular circumstances with you. Please alert us to your situation at the time of your registration appointment.
16. Why do I have to deal directly with the dispensing pharmacist?
Pharmacy medications are sensitive to heat and cold, and can be lost during delivery. By making contact with the pharmacist yourself, it will reduce the risk of loss or damage, and ensure your pills are kept safe and properly dispensed . You and your pharmacist can make a plan for pick up or delivery, enabling you to receive your medication safely and in a timely manner.
17. What happens if there is a complication?
In about 4% of cases, medical abortion is not straightforward. Complications can include excessive bleeding, excessive pain, infection and failure of the medication to work partly or completely. We may recommend that you have further treatment and/or investigations if you have a complication. We will help you if this is occurs, and ensure you get any medical attention you need. In about 1-2% of cases of medical abortion, a surgical procedure is required to complete the process.
Unfortunately, there is no refund of our fees if you experience a complication which requires further investigation or medical assistance.