ru486, ru-486: Little Rock Family Planning Services offers RU 486 at Little Rock Arkansas Abortion Clinic

RU486

We began offering medical abortion with RU-486 in January 2001. With our protocol over 95% of women complete the abortion by the afternoon of the second day.

If you live more than an hour drive outside Little Rock you must agree to stay in Little Rock (usually at a motel) for at least one night. You must also be 56 days (8 weeks) or less from your last period by ultrasound. You will be required to have at least 2 visits. Your first visit will be for ultrasound, counseling and taking the RU-486 (mifepristone). The second visit will be the following morning so that we can determine with the ultrasound that the uterus is empty.

The cost of a medical abortion is listed in the fees schedule. The fee covers RhoGam if needed and all medications except for narcotic pain medication which must be obtained at a pharmacy. The charge will cover the costs of a surgical abortion in our clinic if the drug fails to cause a complete abortion. Additionally the fee covers a follow up visit in 4 weeks. The fee does not cover medical care obtained outside our clinic. A surgical abortion is necessary in about 5% of cases (1 in 20 women have to have a surgical abortion).

Fast Facts About Mifepristone (RU486)
What is Mifepristone?
Mifepristone (formerly known as RU486) is a medication that blocks the action of the hormone progesterone. Progesterone is needed to sustain a pregnancy. Mifepristone has been used, in combination with other medications called prostaglandins, for medical abortion since 1988 in France and China, and since the early 1990's in the United Kingdom and Sweden. It has been more recently licensed in nine other European countries and Israel. Millions of women worldwide have safely used mifepristone regimens to end their pregnancies.
How Mifepristone works to end pregnancy
Mifepristone blocks the action of progesterone, which is needed to sustain a pregnancy. This results in: • Changes in the uterine lining and detachment of the pregnancy • Softening and opening of the cervix • Increased uterine sensitivity to prostaglandin Mifepristone is used in combination with another medication, a prostaglandin called Misoprostol (Cytotec). Misoprostol causes the uterus to contract, and helps the pregnancy tissue to pass.
How effective is the combination of Mifepristone and Misoprostol in terminating an early pregnancy?
Approximately 95% of women will have a complete abortion when using Mifepristone/Misoprostol up to 56 days after the first day of the last menstrual period. The remaining women will need a suction abortion.

Treatment regimen with Mifepristone/Misoprostol
Please note: After FDA approval of Mifepristone/Misoprostol there has been new clinical data about the effectiveness of various regimes that vary from the one that the FDA approved. We are using one of these regimes which has been shown to be safe, effective and is more convenient for women using the method.
Step One, at the clinic
• A medical history is taken, an ultrasound is done and a clinical exam and lab tests are performed. • Counseling is completed and informed consent is obtained. • If eligible for medical abortion, then you will swallow the Mifepristone pills.
Step Two, at home (or motel)
• Six to 8 hours after the Mifepristone pill has been swallowed you will place 4 Cytotec tablets deep inside your vagina. This will take place at your home or hotel room.
Step Three, return to the clinic the following morning
• You will return at 9 AM the following morning to have an ultrasound to see if the abortion is complete. You should not have anything to eat or drink after midnight other than sips of water to take the pain medication. If the abortion is complete you will be discharged home and asked to take a urine pregnancy test in 3 weeks. You are also encouraged to return to the clinic in 4 weeks to have a follow up examination that is done at no additional charge. • If you have not had a complete abortion you will be given 4 Cytotec to place in your vagina, at this time you may return to your motel room or remain in the clinic. You may eat a light breakfast and drink clear liquids in the first hour after you leave the clinic. You should then have nothing by mouth until after you return to the clinic in the afternoon. • You must return to the clinic by 2 PM at which time another ultrasound will be done. If you have not passed the pregnancy, you must have a surgical abortion at that time. • From past studies it is anticipated that over 95% of women will have a successful medical abortion, the remainder will require a surgical abortion. The surgical abortion is done in our clinic at no additional cost. You can have IV sedation with the surgical abortion if you have someone to drive you home. • After leaving the clinic you should have a pregnancy test in 3 weeks. You are also encouraged to return to the clinic in 4 weeks to have a follow up examination that is done at no additional charge. You should call us anytime you are having complications such as severe pain, heavy vaginal bleeding, a fever or other signs of an infection.

Possible side effects of a mifepristone abortion
Side effects, such as pain, cramping and vaginal bleeding, result from the abortion process itself, and are therefore expected with a medical abortion. Other side effects of the medications themselves may include nausea, vomiting, diarrhea, chills, or fever. Complications are rare, but may include excessive vaginal bleeding requiring transfusion (occurs in approximately 1 in 1000 cases), incomplete abortion which requires a suction abortion (see above). There have been several reports of death in the United States and Canada associated with medical abortion due to a bacterial infection. Since there have been many millions of women who have used Mifepristone without complications, this is a very rare complication. Since this type infection has not been reported with surgical abortion, surgical abortion carries less risk of death than medical abortion.
What women can expect from a Mifepristone abortion
• Medical abortion with Mifepristone/Misoprostol requires at least two visits to the clinic. • Approximately 95% of women using Mifepristone/Misoprostol up to 56 days since the last menstrual period will have a complete medical abortion. • Approximately two-thirds of women will have a complete medical abortion within 4 hours of using the misoprostol. • Approximately 90% of women will have a complete medical abortion within 24 hours of using the misoprostol. • On average, women may expect to have bleeding and/or spotting for 9-16 days. • Women may pass clots, ranging in size. • Some women may see grayish pregnancy tissue. • If the medications fail to end the pregnancy, a suction abortion must be performed. At this clinic, a woman who chooses medical abortion must be willing to have a suction abortion the following afternoon if the medical abortion is not complete.
Reasons you may not qualify to have a medical abortion
It has been more than 56 days (eight weeks) since your last menstrual period began as determined by ultrasound. • If you have an IUD, it must be taken out before you use mifepristone. • You have problems with your adrenal glands (chronic adrenal failure) or severe heart, liver, or kidney problems. • You take a medication to thin your blood. • You have a certain bleeding problems. • You take certain steroid medications. • You cannot return for the follow-up visit(s). • You cannot easily get emergency medical help should a problem occur. • You are allergic to Mifepristone, Misoprostol, or medicines that contain misoprostol (Cytotec). • You are not sure that you want to end your pregnancy and you would be unwilling to have a surgical abortion if the medication abortion fails.