Mifepriston (Mifegyne®) in combination with misoprostol (Cytotec®) is the usual treatment in the Netherlands when women opt for the ‘abortion pill’. Until a pregnancy duration of 9 weeks 0 days’ amenorrhoea, the woman may choose between the abortion pill and suction curettage. The doctor does finally decide whether the woman is suitable for the abortion pill.
The pregnancy duration is determined in the clinic by ultrasound imaging. If the woman complies with the legal restrictions with respect to the consideration period, she may receive the abortion pill immediately after the discussion with the doctor. This means that the woman takes Mifegyne® in the clinic, and takes with her four tablets of Cytotec® that she herself administers vaginally two days later. The woman generally notices little from the Mifegyne®. The drug is a competitive progesterone receptor blocker and ensures in 96% of cases that the pregnancy does not develop further. It also increases the sensitivity to prostaglandins. Cytotec® is a synthetic analogue of prostaglandin E1 and causes contractions of the uterus so that the pregnancy is expelled.
Side-effects may be: gastro-intestinal symptoms, cold shivers and serious blood loss. As analgetic, the woman takes with her as standard a prescription for naproxen.
The abortion pill is often likened to a spontaneous abortion. In drug-induced abortion, the cramps and blood loss may be more than is the case after a suction curettage.