Since the Mid-1990s, It Has Been Possible to Terminate Unwanted Pregnancies with Pills. In Austria, Mifepristone (brand name Mifegyne®) has been approved since 1999. Mifepristone can only be dispensed through hospitals or gynecological practices like ours (meaning it cannot be obtained with a prescription at pharmacies).

Two medications are used in this method. First, Mifepristone is taken orally. It works by blocking the effects of the pregnancy hormone progesterone, produced in the body of the pregnant woman, so that it can no longer function. This makes the uterus sensitive to the second drug, Mifepristone (known as Cyprostol® in Austria, Cytotec® in most other countries), which induces expulsion. Mifepristone is inserted vaginally 24 to 48 hours after taking Mifepristone.

This process is similar to a natural miscarriage.

This method can be used immediately after a missed period, or even before it. Along with the copper and gold IUDs, it is one of the most effective forms of post-coital contraception (contraception after intercourse where there is a risk of pregnancy) and is significantly more effective than the morning-after pill (see morning-after pill or post-coital contraception).

 

Requirements

• No more than 63 days must have passed since the last period.
• Additionally, you must not suffer from certain rare underlying conditions, including:
  • Adrenal gland disorders,
  • Severe untreated asthma, or
  • A genetic blood disorder called porphyria.

 

Advantages of This Method

• In the vast majority of cases (97–99%), no surgical intervention is required, thus avoiding possible complications associated with surgery.
• You retain control over the process. You decide:
  • When to use the second tablets,
  • The location where you wish to take them,
  • Who will be with you during the process, if you prefer to go through it alone, and
  • You remain conscious and aware.

There is also a significant physical advantage: after a medical abortion compared to a surgical abortion, the likelihood of premature birth or a baby with low birth weight is reduced by two-thirds (Source: Der Frauenarzt 8/21, Matthias David, The Consequences of Abortion for the Affected Woman: What Do We Know? Situ KC et al., Perinatal Outcomes After Induced Termination of Pregnancy by Methods: A Nationwide Register-Based Study of First Births in Finland 1996-2013).

 

Disadvantages

• Some women see it as a drawback that the process spans two days.
• However, the time between the first and second tablets is symptom-free.
• In 1–3% of cases, a curettage is necessary.
• In about half of cases, the abortion resembles a heavy period, and
• Many women worry due to frequent reports of severe pain shared by other women on online forums.
• Yes, that is possible. However, about 50% experience the abortion with mild period-like symptoms. Should stronger pain occur, it is generally manageable with pain relief and rarely lasts more than 2–3 hours.
  Remember: women with negative experiences are often the ones who post online.

 

Follow-Up

In all cases, a follow-up is conducted approximately two weeks later, including an ultrasound and a final discussion.

As mentioned, there are sometimes negative reports about this method online. It may help to know that the World Health Organization (WHO) included both active ingredients (Mifepristone and Misoprostol) in its Model List of Essential Medicines in 2005.

 

Cost

The cost is €450.

This includes the procedure, care for any possible complications, follow-up examination, and a final consultation.

More details on medical abortion can be found on Wikipedia.

My team and I are always available for information and advice. Information on the most important questions can also be found on this website.

 

A Personal Note

Since Mifegyne was approved in Austria in 1999, I have had the opportunity to gain experience with this method. There is likely no gynecologist in the country with more experience in this method than myself.

This experience has led me to stop offering surgical abortions because, the longer I accompanied women through this crucial time, the more convinced I became that medical abortion is the better method for most women.

The Key Reasons Summarized:

• No surgical intervention.
• Empowers women by allowing them to actively take part in the process.
  According to scientific research, this results in a better emotional outcome, on average.
• It is also easier to integrate into daily life, as the woman determines when the abortion takes place. This is often very important, for example, in relation to work or childcare.
• Time commitment is lower, as one less appointment is needed.