Early Medical Abortion at Home (EMAH) (Up to 11w 6d)

This leaflet provides you with instructions on how to use the medications that are needed for EMAH.

Before you start the procedure we would strongly recommend that you have a supply of sanitary towels and a hot water bottle available. If you are not asthmatic, and you can take ibuprofen, you may wish to take it along with the painkillers included in the pack.

You will be given a package of medication which contains:

• Mifepristone 200mg – 1 tablet (you may have already taken this in hospital)
• Misoprostol 200mcg – 8 tablets
• Co-Codamol 8mg/500mg – 32 tablets
• Doxycycline 100mg – 6 tablets (these are antibiotics and we will only include them if you need them)
• Desogestrel 75mcg – 3 months supply (these are oral contraceptive pill, and we will only include them if you have asked for them)
• Biostat low sensitivity urine pregnancy test – you should do this test 2 weeks after the abortion

Mifepristone Day

• Swallow the Mifepristone tablet (200mg) with some water
• If you are sick within 1 hour of taking this tablet then please contact the Women’s Health Unit on 01698 366317 as you may need a 2nd tablet.

Misoprostol Day

• Make sure there is an adult at home to support you throughout the procedure.
• Try to eat and drink as normal throughout the day, and have breakfast before beginning the procedure.
• Take Co-Codamol 1-2 tablets before the procedure as pain relief. You can continue to use this throughout the day as directed. Don’t take more than 8 tablets within 24 hours. You may also wish to use Ibuprofen for additional pain relief. You should not take this if you have asthma, or cannot take Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) for another reason.
• If there are antibiotics in the pack then start taking these today – take Doxycycline 100mg and complete the 3-day course as directed.
• Misoprostol – You can either put 4 tablets (800mcg) high into your vagina and insert the tampon for 1 and a half hours or put them under your tongue and keep them there for 30 minutes, after 30 minutes you can swallow any of the tablet that’s still left under your tongue.
• After 4 hours you should put another 2 misoprostol tablets (400mcg) high into your vagina, or underneath your tongue for 30 minutes. Swallow any of the tablet that’s left under your tongue.
• After a further 4 hours you should put the remaining 2 misoprostol tablets (400mcg) high into your vagina or underneath your tongue for 30 minutes. As before, swallow any of the tablet that’s left under your tongue.
• If Desogestrel (Cerazette-Cerelle) progesterone only pills are included in the pack for contraception, then these should be started on the same day as the procedure.

If you have bleeding after the procedure then you should do the enclosed Biostat low sensitivity urine pregnancy test and follow the instructions on the box. You should do this test 2 weeks after the abortion. If the test is negative then you don’t need to do anything else as the procedure has been successful and you are not pregnant.

If the test is positive then please contact us by telephone as soon as possible, and we will arrange to see you for a further assessment.

If you don’t have any bleeding within 72 hours of completing the misoprostol tablets then there is a possibility that you may still be pregnant. The risk of this is low though. Please contact the Women’s Health Unit on 01698 366317 as soon as possible if this is the case, and we will arrange to see you for a further assessment

If you have questions or concerns, please contact Women’s Health Unit at University Hospital Wishaw on 01698 366317.
Staff are available within the unit Monday to Friday 9am – 5pm. If you need assistance outside of our working hours then you can contact NHS24 on 111 for advice. If you have a medical emergency you should attend your nearest A&E department for assessment urgently.

If you need this information in another language or format, please e-mail:

Translation.Services@lanarkshire.scot.nhs.uk