Medical Abortion:

Methotrexate and Vaginal or Oral Misoprostol

In Canada, methotrexate and misoprostol are used together for medical abortion up to 49 days of pregnancy. Methotrexate breaks down the cell layer that attaches the embryo to the wall of the uterus, depriving the embryo of essential nutrients and resulting in its death. Misoprostol is a synthetic prostaglandin that causes the cervix to soften and dilate, and the uterus to contract and expel the embryo or fetus. 

Abortion with methotrexate and misoprostol requires several clinic visits. During the first visit, methotrexate is injected, followed at 2-7 with misoprostol pills at home or at a clinic, either inserted into the vagina or taken by mouth. A follow-up visit is required after 1 to 3 weeks to determine if the abortion has occurred. 

The methotrexate and misoprostol abortion regimen causes complete abortion in 70-97% of cases. While most of the abortion occur within the first hours or days after taking the misoprostol, 20 to 35% will take up to several weeks. A surgical abortion is scheduled to complete the abortion if the abortion has not occurred by that point because the drug can cause birth defects.

Side effects of medical abortion using methotrexate and misoprostol include: significant cramping pain and heavy bleeding during the abortion, along with nausea, vomiting, diarrhea, headache, fever, chills; prolonged bleeding for one to seven weeks afterwards, and infection; birth defects if the pregnancy is ongoing and the fetus survives.

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All information provided regarding medical and surgical abortions in Canada has provided by:
Abortionincanada.ca, (2014). Methods | Abortion in Canada. [online] Available at:  http://abortionincanada.ca/methods/

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