For pregnancies between 4 and 7 weeks LMP options include a vacuum aspiration or a medical abortion using the pill. These can be done as soon as a woman has a positive pregnancy test. Many providers discourage vacuum aspiration earlier than 7 weeks because of concern of missing the pregnancy. This early vacuum aspiration technique was published in the medical literature in 1995 at the same time that the medical abortion with Methotrexate was introduced in the United States.
Medical abortion is a new option.
Both drugs are used in combination with Misoprostol, a prostaglandin drug that causes the uterus to contract and expel the pregnancy. Mifeprex works faster than Methotrexate but is also more expensive. Some surgical interventions are done because the woman changes her mind, not because of necessity. Compared to surgical abortion, the medical abortion requires more time from initial drug treatment to completion and the doctor is not able to control the timing of the abortion or the success rate. Unlike surgical abortion where the uterus is mechanically aspirated in a few minutes, the medical abortion is a process of expulsion over a period of up to 2 weeks.