About 1 in 20 women who try medical abortion will need to have a surgical abortion because the medication does not work for her. Some women will have vaginal bleeding after the first drug. This bleeding may be light, or it may be like a heavy period. The uterine contractions caused by this medication may lead to immediate cramping that will expel the embryo, thus ending the pregnancy. A high proportion of women, however, will expel the uterine contents later, after they have left the medical facility.
Many women insert the misoprostol at home and pass the tissue later.
A woman considering medical abortion will need to be prepared for this possibility. The clinic staff can answer questions about what to expect. The most common side effects of medical abortion are caused by misoprostol, the medication taken after the methotrexate or mifepristone. The amount of bleeding that a woman has will be greater with medical abortion than with surgical abortion. Most women have cramps for several hours, and many pass blood clots as they are aborting.