It can be normal to experience ambivalence after beginning the medical abortion process. If you have taken the first medication (mifepristone) but now feel uncertain about proceeding with Step 2 (misoprostol) of the medical abortion, it’s important to understand the possible effects on the pregnancy and the next steps for care.
How Mifepristone Affects an Ongoing Pregnancy
Mifepristone works by blocking progesterone, the hormone that supports early pregnancy. Without progesterone, the pregnancy may stop developing, and in many cases, the body will miscarry naturally. However, some pregnancies may continue after mifepristone is taken. In these cases, there may be potential risks to the developing fetus, although the evidence is limited and not yet well understood.
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Some case reports have described birth defects, particularly affecting the limbs, head, or nervous system, but these outcomes are rare and not consistently observed.
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There may be a higher chance of complications such as miscarriage or preterm birth.
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Long-term outcomes remain uncertain, as few pregnancies have been studied after partial or incomplete medical abortion.
The truth is, we don’t know enough about how mifepristone may affect a fetus if the pregnancy continues—and that uncertainty can make ambivalence feel even more overwhelming. What we do know is that many people have gone on to have healthy pregnancies, births, and children after exposure to mifepristone. If you’re in this space of uncertainty, you’re not alone—and support is available to help you navigate your next steps.
Because of these potential risks and unknowns, specialist antenatal care and additional monitoring are recommended if you decide to continue the pregnancy.
What to Do Next
If you are feeling ambivalent about continuing or ending the pregnancy, take action now to ensure the best possible care:
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Seek urgent medical care- Attend your local Early Pregnancy Assessment Service (EPAS). Depending on where you live in Australia and what services are available, you may need to contact a hospital. Aunty Jane can help you find your closest local EPAS and arrange referral to these services.
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See a GP or antenatal care provider – If planning to continue with the pregnancy, you will need a care provider and to be allocated to a chosen model of care.
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Prepare for additional monitoring – You may be offered more frequent ultrasounds to assess fetal growth and development.
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Be aware of miscarriage risks – Some pregnancies may not continue, even if misoprostol is not taken.
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Seek support for emotional distress – Feelings of ambivalence, regret, or anxiety are valid, and help is available.
Final Thoughts
If you are experiencing ambivalence about your decision, you are not alone. Whether you choose to continue or end the pregnancy, seeking medical care and emotional support is crucial. A healthcare provider can help you navigate the next steps safely.
Mental Health and Crisis Support Lines
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National – 1800 RESPECT (1800 737 732) – 24/7 counselling and crisis support
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New South Wales – NSW Mental Health Line: 1800 011 511
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Victoria – Safe Steps Family Violence Response Centre: 1800 015 188
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Queensland – 1300 MH CALL (1300 642 255) – 24/7 mental health support
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Western Australia – Women’s Domestic Violence Helpline: 1800 007 339
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South Australia – Mental Health Triage Service: 13 14 65
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Tasmania – Mental Health Helpline: 1800 332 388
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Northern Territory – NT Mental Health Line: 1800 682 288
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Australian Capital Territory – Access Mental Health: 1800 629 354
The information provided on this website by Aunty Jane in any format or medium, are for general information purposes only and are not intended as medical advice or as a substitute for consultation with a qualified healthcare professional. The information made available by Aunty Jane do not provide personalised medical advice, diagnosis, or treatment. To the extent permitted by law, Aunty Jane disclaims all liability for any outcomes resulting from reliance on the information provided. For specific medical concerns, please consult a qualified healthcare professional.
References:
1. American College of Obstetricians and Gynecologists. (2020). Medication abortion up to 70 days of gestation: Practice bulletin No. 225. Obstetrics & Gynecology, 136(4), e31-e47. https://doi.org/10.1097/AOG.0000000000004082
2. British Pregnancy Advisory Service. (2023). Can you continue a pregnancy after taking the first abortion pill (mifepristone)? https://www.bpas.org
3. Creinin, M. D., & Grossman, D. (2019). Medical abortion in the first trimester. UpToDate. Retrieved from https://www.uptodate.com
4. Gronlund, A. L., Gronlund, L., Cleeve, A., & Gemzell-Danielsson, K. (2019). Medical abortion at very early gestation: A systematic review. Contraception, 99(2), 77-82. https://doi.org/10.1016/j.contraception.2018.11.005
5. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. (2023). Early pregnancy loss. RANZCOG Guidelines. https://www.ranzcog.edu.au
6. World Health Organization. (2022). Abortion care guideline. https://www.who.int/publications/i/item/9789240039483
7. Niinimäki, M., Mentula, M., Jalava, J., Mäkelä-Kaikkonen, J., Suhonen, S., & Heikinheimo, O. (2009). Medical abortion: A systematic review. Human Reproduction Update, 15(5), 500–514. https://doi.org/10.1093/humupd/dmp019
8. Gemzell-Danielsson, K., & Lalitkumar, P. G. L. (2008). Second trimester medical abortion with mifepristone–misoprostol and the risk of teratogenicity. Contraception, 78(6), 405–407. https://doi.org/10.1016/j.contraception.2008.07.003
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