September 19, 2021
Being able to access safe pregnancy terminations is an important part of every woman’s healthcare – and a necessary right. We’re fortunate to live in Victoria where we have some of the country’s most liberal abortion laws. We are passionate at Eleanor Clinic about providing women with the best healthcare. This includes help regarding their fertility choices and contraceptive options. We are using a woman-centred approach to pregnancy options, following the expert guidelines of the Royal Women’s Hospital, Melbourne.
Our approach is based on the belief that women are the experts in their own lives, so they should be making decisions about their pregnancy. Women are in the best position – morally, legally and practically – to make a decision based on their strengths, limitations and resources. If you find yourself in a situation where you are considering your options, we are here to support you in whatever choice you make. If you are not sure what to do, we are happy to discuss your options and can also refer you to a psychologist, trained in non-judgmental pregnancy counselling, for further support if needed.
What is A Medical Termination?
Some people still believe that a surgical termination is the only choice for a termination of pregnancy. In fact, there is another reliable option available for women who are pregnant up to nine weeks gestation (or 63 days).
Known as a medical abortion or medical termination, this non-invasive method involves taking a course of tablets over two days.
If you choose this method, you can go through the process at home and avoid a surgical procedure and anaesthetic. Doctors in Australia undergo additional training to qualify for prescribing these medications.
If you are seeking a medical abortion, we would recommend that you call our friendly Eleanor Clinic reception team and let them know that a termination is the reason for your appointment. This enables our switched on reception team to book you in for a long consult with one of our specially trained women’s health doctors as soon as possible. We understand that this can be a sensitive matter and our reception team will handle your call with respect and discretion.
How Are Medical Abortions Performed?
Medical abortions are carried out over four main stages:
Stage 1 — Initial Consultation and Pregnancy Test
You and your doctor will discuss your options and ensure that a medical abortion is safe for you. Your doctor will then organise tests, including:
- A blood test to check your b-hCG (pregnancy hormone) level – this can be done at any pathology collection service of your choice. For convenience, there is a Melbourne Pathology branch located a few minutes’ walk from Eleanor Clinic.
- An ultrasound to check the gestation (date) of the pregnancy. This also verifies that the pregnancy is inside the uterus and not in the wrong place outside the uterus, known as an ectopic pregnancy.
- Optional: you may wish to include screening for sexually transmitted infections (STIs).
Stage 2 — Pregnancy Results and Prescription
When you come back for your second appointment we’ll look at your test results together to confirm your gestation period. If you’re up to nine weeks pregnant and decide to proceed, we will give you a prescription for the medication (MS-2 Step). You can fill this prescription at any pharmacy.(and we will tell you which pharmacy always stocks it.)
Stage 3 — Taking the Medication
You take this medicine at home.
You take one tablet containing mifepristone, followed by four tablets of misoprostol between 36 to 48 hours later. Don’t worry – they are clearly labelled and come with easy instructions to follow.
Mifepristone, also called RU486, blocks progesterone – the hormone that allows your pregnancy to grow.
The other medicine, misoprostol, softens your cervix to help your uterus expel the pregnancy.
You will experience cramping, which usually starts within 4 hours of taking misoprostol. Women usually find the pain and bleeding that follows heavier than their normal period; we can prescribe pain relief to help you through this process. Pain and bleeding usually get better after the first 24 hours and subside after the pregnancy tissue has passed. It’s a good idea to take it easy for a couple of days and have a friend or family member around for support.
During the termination you have access to 24/7 phone support with a nurse who can answer questions and give guidance. Should a complication occur, such as excess pain or bleeding, you will be advised to attend the nearest emergency department staffed with a 24/7 gynaecology team (usually Sunshine Hospital or the Royal Women’s Hospital).
Stage 4 — Follow Up
We will arrange for a follow up appointment 2-3 weeks later to ensure that the termination was successful and there are no complications. We also use this opportunity to discuss contraception as fertility can return within 2 weeks of the termination. And we will make sure you are doing okay.
Up to 5% of women who have a medical termination retain a small amount of pregnancy tissue in the uterus. This requires further management – usually a minor surgical procedure under a general anaesthetic. Medical abortions may fail in about 1% of women. If this was the case, you would then go on to have a surgical abortion.
Good resources are available for women seeking objective information and advice, including: