When abortion is mentioned, most people immediately think of the drug RU486. So, what is RU486?
Dr. Hong Zhichen, an obstetrician and gynecologist, explains that using RU486 for abortion refers to a medication abortion, also known as a medical abortion.
RU486 is a drug that contains an anti-progesterone component, which works by inhibiting progesterone. When combined with other medications, it can effectively achieve abortion. It is considered the simplest and least harmful method of abortion.
What is a medication abortion?
A medication abortion is suitable for pregnant women who are early in their pregnancy (around 6–7 weeks), primarily for voluntary abortion or when there are issues with the embryo in the early stages of pregnancy. For example, if the heartbeat stops, the fetus has no heartbeat, or there are genetic abnormalities, the medication will be used to terminate the pregnancy as early as possible within the first three months of pregnancy.
How much does a medication abortion cost?
The typical cost of a medication abortion ranges from 2,500,000 VND to 3,000,000 VND or more (this can vary depending on the clinic and location). Pregnancy tests cost between 200,000 VND to 1,000,000 VND.
In addition to these costs, depending on the individual case, there may be additional expenses such as: hospital bed charges, medication costs, follow-up appointments, laboratory tests, ultrasounds, etc.
Who is a medication abortion suitable for, and what are its risks?
In principle, medical abortion primarily requires attention to follow-up appointments to ensure that the abortion is complete and to monitor lochia after the procedure. This helps prevent infections, such as septicemia, caused by incomplete expulsion of the uterine lining.
If the pregnancy is between 6-7 weeks, there is a higher risk of the abortion being unsuccessful. In such cases, surgery may be needed, which typically costs an additional 2,500,000 VND to 5,000,000 VND (costs may vary depending on the clinic, so it’s important to check beforehand).
Is a medication abortion suitable for everyone?
- Group 1: Ectopic pregnancy
Ectopic pregnancy occurs when, during pregnancy, the embryo is not visible in the uterus, but the pregnancy hormone (β-HCG) levels rise significantly, though not at the expected rate. This could be because the fertilized egg implants outside the uterus.
- Group 2: No response to the medication
A medication abortion works by affecting the body's hormones. However, some individuals may not experience any bleeding or expulsion of tissue after taking the medication, which could indicate that their body is not responding to the drug. In such cases, alternative abortion procedures may be required. Since the response varies from person to person, there is no definitive research yet to indicate who may not be suitable for the medication, and it’s only through trying the medication that its effectiveness can be determined, allowing doctors to make the most accurate diagnosis.
- Group 3: Women with blood clotting disorders or cardiovascular diseases
The medications used in medication abortion often promote vasoconstriction, which could be problematic for women with platelet dysfunction, blood clotting disorders, or cardiovascular diseases. In these cases, doctors generally do not recommend medication abortion.
Things to note when using RU486 for medication abortion
During the medication abortion process, depending on the individual's physical condition, various side effects may occur, such as abdominal cramps, nausea, and vomiting. Therefore, it is best not to eat too much before using RU486. A lighter, simpler meal is recommended to avoid exacerbating the discomfort caused by the side effects of the medication.
How long does a medication abortion take? Is hospitalization required?
While it is said that medication abortion only requires taking the medication at the hospital and does not need an overnight stay, you will still need to remain in the hospital for monitoring after taking the medication. Once you return home, it is recommended to rest for at least 2 days. First, the timing of the medication must be precise for optimal effectiveness. Second, the side effects of the medication can be significant, and a comfortable, stress-free environment is necessary for proper rest.
Can you go to work after taking RU486?
If you take the first dose of medication, the effects are generally mild, and you can return to work as long as you feel no significant discomfort. However, for the second dose, it is advisable to rest for two days, as mentioned above.
The process of medication abortion with RU486 and its side effects
The entire medication abortion process can be divided into three types of medications, each with different components: anti-progesterone, prostaglandin, and uterine contraction drugs. The first two types are prescription medications that require a doctor’s diagnosis and consultation.
- First dose: RU486 (anti-progesterone)/ about 3-4 pills per dose
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Effectiveness |
This is the first step in the medication abortion process. The "anti-progesterone" medication is taken to block progesterone, which loosens the fertilized egg and implanted tissue, while also preventing further development of the embryo. |
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Fasting |
Fasting is usually not necessary, but some doctors believe fasting can enhance the effectiveness of the medication. It’s a good idea to call the clinic in advance to confirm their recommendations. |
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Side effects |
After taking the medication, some individuals may experience nausea. |
- Second dose: Cytotec (prostaglandin) / About 3-4 pills per dose
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Effectiveness |
After taking the first dose, you will need to return to the clinic to take the second dose of "prostaglandin" 36-48 hours later (some clinics may allow you to take it at home). The purpose of this medication is to stimulate uterine contractions and expel the tissue from the uterus. |
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Fasting |
It is necessary to fast for two hours before taking the medication. |
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Side effects |
Bleeding will occur, accompanied by side effects such as cramping, nausea, and vomiting. Dr. Hong Zhichen explains that the pain during this stage will progressively intensify as the uterus continues to contract. This pain may be stronger than regular menstrual cramps, and if needed, you can take pain-relieving medication to alleviate the discomfort. |
- Third dose: Uterine contraction medication / Take continuously for 1 week (depending on the case)
After completing the first two doses, the "uterine contraction medication" is taken last. It continues to help the uterus contract and gradually expel any remaining tissue. Typically, the doctor will prescribe the medication for up to one week. After completing the treatment, you will return to the clinic for a check-up to confirm if the abortion was successful. If not, the doctor may prescribe another week of medication for monitoring.
Dr. Hong Zhichen shares: "In clinical experience, most medication abortions are successful after using uterine contraction medication for 1-2 weeks. However, if there is still remaining tissue after two weeks, you should consider other methods such as suction curettage."
Q: How is the fetus expelled after taking RU486?
Dr. Hong explains that the discharge is a mixture of plasma, clotted blood, placenta fragments, and some other fluids. If you want to see the actual appearance, you can search on Google for related images. However, be aware that some images may not be accurate or may be excessively graphic, so please consider carefully before viewing.
Q: Should I choose a medication abortion (RU486) or a surgical abortion (suction curettage)?
For pregnancies within seven weeks, either a medication abortion or a surgical abortion can generally be chosen. So, how do you choose the method that suits you? In addition to listening to your doctor’s advice, you can also refer to this article for guidance.
Recovery and care after taking RU486 medication abortion
How to monitor your condition after a medication abortion?After a medication abortion, the lochia (post-abortion discharge) primarily consists of blood with blood clots and some tissue, similar to regular menstrual blood. The amount of bleeding will gradually increase depending on the number of weeks into the pregnancy.
What’s more important to note is that infections or even sepsis may occur if the blood is not completely expelled.
Therefore, if any of the following symptoms appear during this time, you should see a doctor as soon as possible:
- Recurrent fever
- Infections
- Rapid heartbeat
- Low blood pressure
Is it necessary to have a follow-up appointment after a medication abortion?
Typically, one week after completing the medication abortion, a follow-up appointment will be scheduled to check the progress. Dr. Hong Zhichen emphasizes that follow-up visits should be adhered to according to schedule because only through detailed ultrasound examination can it be confirmed whether the abortion is complete and if there is any remaining blood clots in the uterus.
What should be avoided after a medication abortion?
Dr. Hong Zhichen shares that she once had a patient who believed that the blood had been completely expelled from the uterus and resumed normal activities, including working, smoking, and drinking alcohol. However, the patient later experienced heavy bleeding and almost needed emergency surgery, which was quite dangerous. Therefore, doctors usually advise women who have undergone a medication abortion to avoid foods that can cause irritation, such as spicy foods, coffee, alcohol, etc. It is also recommended not to overdo supplementation during this period to prevent excessive bleeding. After confirming the complete expulsion of the fetus and completing the medication, you can begin herbal regulation with Traditional Chinese Medicine (TCM).
Regarding pregnancy, everyone has their own plans, and we have the right to choose the pace that suits us. If you are in the first trimester of pregnancy, you may consider a medication abortion as a safer and less risky option. Although this method is the safest and least harmful, don't overlook the importance of monitoring and recovery after the abortion. Health is our lifelong wealth, and no matter what the final decision is, you must take good care of your body and love yourself.
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Author Information
Dr. Hong Zhichen (杜丞蕓) – Licensed Traditional Chinese Medicine Physician (USA)
Master’s degree holder from National Taiwan University/USA.
is the author of several health-focused books, including For Women Only, Timeless Beauty, and Nutrition for Rejuvenation. She specializes in gynecology, internal medicine, and pediatrics. With expertise in natural medicine and holistic therapies from various countries, she offers modern interpretations of traditional Chinese medicine, medicinal diets, dietary therapies, meridians, and yoga.
Her approach emphasizes the safest and most non-toxic methods to enhance beauty and youthfulness.