Medical Abortion Pill (Mifegymiso)

The medical abortion pill has been utilized around the world since 1980. It is health Canada approved for the termination of pregnancies up to 63 days post last menstrual period (LMP), but has evidence for it’s use up to 70 days. Mifegymiso consists of two medications: mifepristone and misoprostol. The mifepristone is taken orally and is followed by misoprostol 24-48 hours later. The average time for bleeding and passing the conceptus is 4-6 hours after taking the misoprostol.

How effective if mifegymiso?

The medical abortion pill is 97% effective up to 49 days post-LMP and 95% effective up to 70 days post-LMP.  In <1% of people it won’t be completely effective, and a surgical abortion will be required. Another 4% of people may have to repeat the misoprostol, or may choose to do surgical abortion to ensure complete passing of the conceptus.

What are the potential side effects?

Most of the side effects are associated with the misoprostol medication. The most common symptoms are bleeding and cramping. Bleeding up to 2 large pads/hour for 2 hours is normal. Anything more than that should be further assessed. Other symptoms may include nausea, vomiting, diarrhea, and chills. These symptoms may last 4-6 hours, and can generally be easily managed with ibuprofen, naproxen, gravol, or other medications that may be prescribed at the initial visit.

Any long-term risks associated with fertility?

No, there is no indication that having a medical abortion with mifegymiso decreases future fertility. The medications leave the body within 7 days and have no bearing on fertility or future pregnancies.

Who should not use this method?If you are more than 10 weeks from your last period, or have any of the below conditions:

on blood thinners, allergic to the medications, have blood clotting problems, porphyria, severe anemia, uncontrolled asthma, or uncontrolled seizures.

Can I change my mind after taking the first pill- mifepristone?

No, you cannot change your mind after taking mifepristone. There are potential birth defects associated with the mifegymiso portion of the treatment, so it must be completed with the second medication misoprostol.

What are the pros and cons to medical abortion pill verses surgical abortion?

Surgical abortions are not offered at Integrated Health Clinics. You will be referred out to a local centre should this procedure be deemed necessary.

How much does it cost?

If you have a valid BC Medical Card, the abortion medication is free; however, there are charges for the doctor visits.  If you do not have a valid BC Medical Care Card, you will need to pay an additional $400.00 (approximately) for the medications at the pharmacy.

The cost for the appointments are:

• $40- medical abortion screening (virtual 15 minute visit- optional) Available if a consult is requested prior to booking the medical abortion.
• $150 for the 30-minute initial visit with doctor (includes ultrasound)
• $140 – initial blood work (drawn in clinic)
• $85 – subsequent blood work (drawn at local life labs)
• $75 – follow up visit (phone)
• Total- $450.00

Further additional costs may be incurred on a per-patient basis if the procedure requires further follow up consultations, or should an IUD insertion be requested.

Process to initiate a medical abortion appointment.

• Fill out MA inquiry form (below).
• Care coordinator will call to book either a medical abortion 15- minute screening visit (optional) or a 30-minute consultation + ultrasound with the doctor.
• Lab work will be ordered, if suitable Mifegymiso will be prescribed.
• Repeat blood work 3- 7 days post initiating treatment.
• 7-10 day follow up in person or phone consult (mandatory to ensure effectiveness and no complications).

Other visits may be required should any complications arise. Birth control options are discussed and IUD insertions, contraceptive rods can be placed at 10-14 day follow up visit.

Dr. Karen Parmar, ND is a member of the Society of Obstetrics and Gynecologists of Canada (SOGC). She first completed the medical abortion training course in 2018 and has recently completed the SOGC revised MA course. Dr. Parmar is a member of RAICE (Rapid access IUD centres of Excellence) and provides emergency IUD insertions for up to 7 days post unprotected intercourse (UPI).

All medical abortion inquiries must be submitted by completing this form below. Any inquiries through email or phone will be directed back to complete the MA inquiry form below.

We make every effort to respond within 24-36 hours (except Sundays within 48-60 hours).