Medical Abortion Aftercare: What to Expect & When to Seek Help

Question
QUESTION: Please help Medical Abortion 14 days ago and no bleeding or passing yet.

I am 26, healthy, first abortion at 5 weeks. I went in for a medical abortion on May 10, 2011.
I was given Methotrexate (liquid) orally in the Clinic and sent home with four pills (Cyotec).
I was told to take the pills place two pills between gum and cheek on Thursday May 12 for 30 minutes and then to swallow.
I repeated these steps on May 14 as instructed with the last two pills.
I had cramps for several days and did vomit once but nothing else. There has been no blood or discharge passing.
The Clinic said to wait four weeks before retuning. I am afraid the=at the procedure failed and I do not want to be a month farther long as the decision was tough the first round. Do you believe the procedure has failed or could it still be successful after two weeks have passed? Please help as the Clinic will only tell me to wait. Thank you so much.

ANSWER: Hi Marie,
You choose a strange clinic !
Normally they give you mifepristone first, and cytotec (misoprostol) after 3 days.
Metotrexate sometimes works, but the successrate is much lower.
Mifepristone is more expensive; possibly thats the reason they did not give that to you.
They play with women there !
Go to an other clinic. You do not need to wait for using Mifepristone.
Mail dr Gluck at <elDoovster@me.com>
He has a clinic in Manhattan that I can recommend.
good luck,
Dr Shan


---------- FOLLOW-UP ----------

QUESTION: Dr. Shan
Thank you.  I went back on the 25 and was given four more cyotec pills. I repeated taking two bucally 12 hours apart yeaterday. Still nothing. At this point could I try vaginal insertion? My pregnancy  stopped growing at 6 weeks. I would like to continue this process without going to another clinic if possible. I really wanted this to work to avoid a DC. This has been a 3 week process now and not one drop  of blood. Thanks

ANSWER: Hi again,

the 4 Cytotec pills should be taken all together buccally.
Vaginally they work less as the mucus around the the pills influence the activity negatively.
I am not sure it will work this way, but give it a try.
There is no danger in waiting. Be patient .

Good luck.
Dr Shan




---------- FOLLOW-UP ----------

QUESTION: Thank you. I let all four dissolve under my tongue  and started bleeding within the hour. I think my problem could have been that placing the pills in the gumline they never dissolved the way they did under the tongue.

Now I  spotting but no large amount of blood or any tissue passed. Is there a chance this will happen without more medicine? The clinic wont provide more med but im pretty certain had I let the other doses dissolve the way I did yesterday taking all four this would have been over.

would more cyotec be dangerous considering the first eight cyotec pills were scattered and completely unsuccessful?
The process started but hasnt continued and I want this to be over.

Thanks Again your advice has been so appreciated.

Answer
Dear Marie,

be patient please.
Your body is wise enough to take care.
If the embryo is not alive anymore it will be expelled sooner or later.
The Cytotec helps the expulsion, but does not force it.
You might continue  to take it following the sceme of "Women on Waves"
(look up at Google)
Good luck,
Dr Shan