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Home medical termination of pregnancy

Posted Tuesday, 21 July 2026

Date issued: May 2026

Review date: March 2028

Leaflet section: SHiP

PDF: Home medical termination of pregnancy.pdf [pdf] 168KB

Pregnancy Advice Service (PAS)

Pregnancy Advice Service (PAS) 01752 431129

Ocean Suite - 24 hrs - 01752 432624

Counsellor 01752 431129

Step 1:

Oral tablet (mifepristone) administered at the PAS clinic or given to you to take at home

Step 2:

24 - 48 hours following your first dose of medication you will self-administer 4 vaginal tablets. Also take prescribed pain relief as advised. An adult must be with you for 24hrs after you start step 2.

Step 3: Same day as step 2

4 hours after step 2, please administer your final 2 tablets buccally (held under the lip for 30 minutes then swallow).

Step 4:

Start your post procedure contraception (if applicable)

Follow-up 1:

We will text you about 1-2 weeks after the procedure to remind you to contact us if you have any symptoms of ongoing pregnancy.

Follow-up 2:

Special pregnancy test after 3 weeks (provided by us)

Follow up 3:

You can complete a normal pregnancy test no sooner than 6 weeks after your procedure.

If you have booked antenatal care for this pregnancy, it is your responsibility to cancel this. If you have any questions you can discuss this with the nurse.

During the clinic appointment you will have an ultrasound scan to confirm how many weeks pregnant you are. If you are less than 9 weeks + 6 days pregnant you can choose a Medical Termination, you will be given all the medications and advice to complete this safely. We hope this information is useful for you in preparing for your chosen method.

What to expect when you take the medication

Step 1

You can take the first tablet in the medical abortion clinic today. This is taken by mouth, with water, and is called MIFEPRISTONE. This tablet works by blocking the effects of one of the main pregnancy hormones. Once you have taken this tablet the termination process has started, it is not possible to reverse it. It is not advisable to change your mind as the medication may affect an ongoing pregnancy and cause abnormalities during the development of the baby.

Some important points for after taking mifepristone:

Mifepristone can make you feel sick and there may be vomiting, diarrhea, headache, dizziness or rarely a skin rash. If you vomit within 2 hours of taking the tablet, contact us immediately on 01752 431129. We will arrange for you to return for a further dose, which is safe.
You may experience some spotting or light vaginal bleeding before the next step. This is normal.
You can eat and drink as normal and carry on with your usual activities. Please avoid alcohol.
A very small percentage of women can miscarry after taking only the Mifepristone. If you think this has occurred and you have pain or bleeding that is uncontrolled, please contact Ocean Suite for advice 01752 439877 / 430026.

Step 2: a minimum of 24 hours, and no later than 48 hours after step 1

Make sure an adult is with you before you start step 2. They should stay with you for 24 hours after you start step 2 so they can call for help in the event of an emergency.

The second part of the process involves you inserting 4 tablets of MISOPROSTOL into your vagina. They need to be pushed into the vagina as far as possible. They are given into the vagina to give you the highest possible chance of successfully ending the pregnancy. Misoprostol, in combination with the first tablet, causes the cervix to soften and the womb to contract causing the pregnancy to be passed with cramping pain and bleeding. The amount of pain and bleeding is variable and is usually less the earlier you are in pregnancy. Pain relief tablets will have been provided to you at the clinic visit so please use these as advised.

It usually takes 4 - 6 hours to pass the pregnancy but the time can range from 2 - 12 hours and occasionally longer.

Step 3

After 4 hours you should use another dose of misoprostol. Place the 2 further tablets of MISOPROSTOL under your upper lip and hold them there for 30 minutes, then swallow the tablets with water (they can leave a chalky taste in your mouth). This dose is given in this way to avoid it being washed out of the vagina if you are bleeding.

Misoprostol is not currently licensed for use in abortion but has been shown to be safe and effective and is widely used in the UK. The side effects of Misoprostol can include dizziness, vomiting, diarrhoea and temporary flushes and sweats.

You may be required to attend the hospital for the second part of the procedure if:

Your travel time is greater than 45 minutes from an Accident and Emergency Department
You have low blood count (anaemia)
You are under 16 years of age
You require an interpreter
You would not be safe at home
You prefer to complete the second part of the procedure in hospital.

You will be able to contact Ocean Suite (01752 432624) day or night if you have heavy bleeding and /or severe pain. If you vomit your first tablet (mifepristone) or you are concerned your procedure has not worked, you will need to contact PAS Level 5 to arrange an appointment during our opening hours (01752 431129).

The medication works to end the pregnancy in about 99 cases in 100 up to 9 weeks pregnant and in about 97 cases in a 100 between 9 and 10 weeks of pregnancy. We will offer you a further procedure to end the pregnancy if this happens, and most women choose a surgical procedure at this stage.

In 70/1000 cases there may be pregnancy tissue left behind in the womb that will require either further vaginal tablets or a short procedure, usually using local anesthetic, to remove the pregnancy tissue from the womb.

Signs that the procedure has not worked are:

If you do not start bleeding within 24 hours of being given the Misoprostol vaginal/buccal (top lip) tablets
You have less than 4 days of bleeding in total
You still have pregnancy symptoms a week after your procedure.

Contact (PAS) on 01752 431129 Monday to Friday as the procedure may not have worked and we will assess you to consider further follow up.

If you experience any of the following

please contact NHS Advice Service 111 / Ocean Suite Derriford 01752 432624 / Emergency Department

You have excessive abdominal pain
There is heavy vaginal bleeding (using more than 2 pads an hour for 2 hours) Call an ambulance (999) if you are very concerned about the amount of bleeding
You have a temperature and feel unwell
Feeling sick, diarrhea, vomiting or weakness more than 24 hours after taking Misoprostol (vaginal tablets) could be a sign of a serious infection - seek help immediately

After the procedure

Bleeding may last up to 3 weeks following the procedure. It should gradually get lighter and lighter. Use sanitary towels (not tampons). The bleeding should be no more than a period but can be heavy in 5% of women. Seek help if the bleeding is still heavy beyond the first week or if you have any symptoms of infection.

Follow up 1: Text for a home procedure

You will be sent a text reminder by a member of the team the following week to check that all is well. If you have had insufficient bleeding or pregnancy symptoms remain, please call us to arrange an appointment to have a repeat scan.

Follow-up

Pregnancy test: 3-week post procedure

You have been provided with a special “low sensitivity” pregnancy test. This is designed to pick up on a continuing pregnancy after a termination. A normal pregnancy test can continue to be positive for 4 weeks after your procedure. The low sensitivity test will become negative sooner provided the hormones are dropping and give some reassurance that your procedure has been successful.

If this low sensitivity pregnancy test is positive or faint positive, please telephone 01752 431129. We will arrange to re-scan you to see if the pregnancy is continuing or if there is some tissue remaining in the womb.

If you have chosen but not already booked to have an IUD or IUS fitted following a medical procedure, your low sensitivity pregnancy test is negative and your bleeding is settling, please arrange this with SHiP 01752 431124 or your GP.

If you have any concerns (even with a negative test) please call us on 01752 431129 and we can arrange further follow up.

Sensitive disposal of pregnancy remains

If managing your procedure at home, you can dispose of sanitary pads as you would when having a menstrual period. Many people choose to sit on the toilet as the bleeding may be heavy at the time of passing the pregnancy and blood clots can be flushed away.

We can arrange for you to bring any tissue back for sensitive disposal, if you wish, but it needs to be arranged by telephone beforehand. If you have any concerns about this you can discuss it with the nurse or doctor in clinic and they can let you know what your options are.

Confidential counselling service

Counsellor: 01752 431129

This service is provided for Pregnancy Advice Service (PAS) by a professional counsellor. Counselling may be helpful to address the emotions and thoughts that can arise prior to a termination. The counsellor can also talk with you about the emotional processes that might follow the termination and what signs to watch out for indicating that further counselling may be of benefit to you. Some women may wish for a further opportunity to speak to the counsellor after their clinic visit and before their procedure. This can be arranged and will take place at the clinic premises or over the telephone.

The Pregnancy Advice Service (PAS) also offers a post termination counselling session for up to a year after your procedure; you may arrange this by telephoning the Pregnancy Advice Service (PAS) on the telephone number below. You could also ask your GP if confidential counselling is available through the surgery.

Patients who live in Cornwall can use the services of the Brook Advisory Centre who provide post termination counselling for all women who request this service.

GP letter: recommended

You will have been asked when you make your appointment whether a letter outlining the details of your treatment can be sent to your GP. If you agree to this, a letter will be sent after your clinic appointment. Please retain this leaflet in the event you have any problems, you can show your GP so they are aware of the medications that have been administered. If your GP has signed up to GP Connect they will have the ability to view your full medical records if appropriate, we cannot remove this care from your medical records.

Future contraception

You will have had the opportunity to discuss contraception at your clinic appointment.

You must start your chosen method of contraception as soon as possible after your procedure as you are fertile immediately. If you decide to take the oral contraceptive pill or the patch you need to start within 5 days of the procedure to be protected immediately, but please remember if you suffer from sickness and diarrhoea, this will affect the way the pill works. You must follow the instructions for your particular pill if you suffer from vomiting and/or diarrhoea and use extra protection (condoms) during this time.

If you request the injection, called Depo Provera this can be given to you at the clinic and should be repeated at 12-14 weekly intervals by SHiP or your GP. Please note there may be a slightly higher risk of failed abortion (continuing pregnancy) if Depo Provera is given at the same time as the first tablet (mifepristone) and we are happy to delay giving this to you for a few days.

The IUD / IUS is not fitted until after your special pregnancy test is negative or you have had a scan following your procedure or after your first normal period. It is advisable to abstain from sex until you have adequate contraception. If you wish to have sex before starting additional contraception, we recommend using condoms. You can be given a small supply of condoms for free in clinic.

If you or your partner is considering sterilisation, please see your GP for a referral for this procedure.

Emergency contraception can be obtained from many local pharmacies, the SHiP or your GP. If taken correctly it can be effective at preventing pregnancy, but we would recommend alternative methods for the longer term. We can support you to find something appropriate for your circumstances.

Antenatal cancelling

If you had booked antenatal care for this pregnancy, you are responsible for cancelling this. You can do this by calling the Midwifery administration team on 01752 433256 and letting them know you are no longer pregnant. We do not share information with any other services as routine.

If you need our team to inform the antenatal booking team please inform the nurse and give your consent for us to share that you have been into our service and no longer require antenatal care.

Other formats

If you need this leaflet in another format such as Braille, large print, high contrast, British Sign Language or translated into another language, contact the Patient Advice and Liaison Service (PALS):

01752 439694
plh-tr.PALS@nhs.net