Medication Abortion (Abortion Pill)

A medication abortion (also known as the “abortion pill”) is a safe and effective method for an abortion through 9 weeks.

At Falls Church Healthcare we use a combination of 2 medications to end a pregnancy: Μifepгistоnе and Μisоpгostоl

You will have an opportunity to meet with your patient educator to discuss the procedure and your feelings and concerns prior to this appointment. Our staff is here to support and help both patients and those who are with you in this experience.

Completing the medication abortion procedure itself only takes 5-10 minutes. However, you should expect to be in our center for your appointments for 1.5 to 2 hours — which includes registration, paperwork, lab services, procedure review and your actual abortion care appointment.

What to Expect:

1. At your abortion care appointment our clinician will give you the first medication, Μifepгistоnе. This blocks the hormone progesterone which sustains a pregnancy. Without this hormone, the endometrial lining and developing pregnancy shrinks from the uterine wall.
2. The second medication, Μisоpгostоl, which you will take at home, helps the cervix soften and uterine cramping and bleeding (like during your period) begins helping to expel the ended pregnancy. Cramping and bleeding be moderate to heavy.

At Our Office:  You will swallow the first pill. It is not unusual to have some spotting or even bleeding after the first medication, but the procedure is not yet complete.

At Home: You will take the Μisоpгostоl tablets as directed, helping the uterus to contract and empty. You will take these pills 12 to 48 hours later, considering your clinician’s recommendations and your personal schedule. After you take the Μisоpгostоl you will have bleeding and strong cramping that may be severe, dramatic or simply similar to one of your “bad” periods. This may last a few hours.

• A heating pad can help with the cramps.
• You may experience nausea, vomiting, diarrhea, fever, chills, or feel tired. These symptoms usually last only a short time and stop on their own. Everyone’s experience and comfort levels will be different.
• You may be given a prescription by your physician for pain management to be filled at your pharmacy.

Aftercare:  Plan to follow up by phone in 2 to 3 weeks. It is very important for patients to have a follow-up examination especially if pregnancy symptoms have not decreased.

There are options for your follow-up assessment to verify you have successfully expelled your pregnancy tissue completely which we can review with you. Additional Information on Abortion Pill (Medication Abortion):

• National Abortion Federation: I’m Pregnant:  What are the options?
• National Abortion Federation: First Trimester Abortion: A Comparison of Procedures
• “Medical Abortion” — a video from Pharmacy5in5:

Procedural Abortion:

Awake (Through 12 Weeks)
Asleep (Through 15 weeks)

Having a procedural abortion is a SAFE & EFFECTIVE option for ending a pregnancy.

A procedural abortion, also known as aspiration abortion, is usually administered by a method called vacuum aspiration. The procedure itself usually takes only five to ten minutes, and is a common in-office gynecology service.

While the procedure itself last only minutes, additional time is needed for registration, paperwork, lab services and recovery. Please plan to be in our office for 2.5 – 3 hours for your abortion care appointment. (If your last menstrual period was more than 12 weeks ago, please plan to be in our office for up to 4 hours.)

You will have an opportunity to meet with your patient educator to discuss the procedure and your feelings and concerns at your appointment. Our staff is here to support and help both patients and those who are with you in this experience.

In the video below, Dr. Jan Fruiterman, one of the board-certified gynecologists at Falls Church Healthcare Center, explains aspiration abortion:

What to Expect

You will be assigned a patient educator who serves as your advocate to assist you with paperwork, review your appointment and answer your questions.  At your appointment your sonogram will be obtained and medical history reviewed, lab work is performed and pre-medications given before you are readied for the procedure. These are important opportunities for you to meet your medical team and to relax.

The abortion procedure will be performed by one of our Board Certified Clinicians. The procedure itself takes only a few minutes and typically is not performed until the embryo is visualized by sonogram, usually after 5-6 weeks gestation.

• Cervical preparation takes place prior to the procedure through administration of misoprostol which softens the cervix
• Local anesthesia (awake) or IV sedation (asleep) is administered
• Sterile medical instruments, a dilator and cannula, are gently inserted through the vaginal cavity, into the cervix opening and into the uterus.
• The cannula is connected to a device that will provide the gentle suction needed to safely remove the pregnancy tissue from the uterus. This may make a slight, annoying sound.
• Following the procedure, we allow ample recovery time in our patient’s lounge. You will be discharged with written and oral instructions on how to take care of yourself and what to do if you have a problem.

If you’re NOT having I.V. Sedation you will be AWAKE – you can:

• Take Tylenol or Motrin 30 minutes prior to your appointment time.
• Drive yourself home.

If you ARE having I.V. Sedation (you will be ASLEEP) – you must:

• NOT eat, drink, chew gum (nothing by mouth) 6 hours prior to your appointment. Be sure to drink water before you begin to fast.
• Please bring someone with you to drive you home…you cannot drive yourself home.
• Plan to be at the center at least 3-4 hours. You will have a 30 minute recover time in the patient lounge.

BEFORE your abortion procedure

• Avoid sexual intercourse the day before the procedure
• Avoid douches 48 hours before the procedure
• Avoid vaginal creams or medications 1 week before the procedure
• Please do not wear fingernail polish

AFTER your abortion procedure

• Harmless vaginal bleeding and some discomfort is possible immediately after the procedure.
• Some women may need to use a pad for a few days after the procedure.
• Comply with the clinician’s instructions for follow-up visits and any needed re-tests.
• You will be given aftercare instructions that includes no sexual activity for at least 1 week.

About 3 weeks after your procedure, please contact FCHC to provide follow-up status. You can do so by calling us or filling out our follow-up form at https://www.fallschurchhealthcare.com/follow-up .

Please Note: Completing a urine pregnancy test prior to calling will help our nurse in your follow-up assessment.

We encourage and will assist you in exploring various family planning / birth control options.

Additional Information about Procedural Abortion using Vacuum Aspiration

• National Abortion Federation: I’m Pregnant:  What are the options?
• National Abortion Federation: First Trimester Abortion: A Comparison of Procedures
• How does procedural abortion work?

The privacy standards established by 2003 HIPPA Provisions address the privacy and security of patient data.

Part II. Medical Care Information

Part III. Declarations and Consent

You indicated an interest in Medication Abortion. Please see the aftercare instructions below. If you have any questions you will have an opportunity to discuss this with your patient educator.

Your Care at Home

Medication Abortion

You can also download a PDF of this form locally here.

WHAT TO EXPECT

• At FCHC:  The Abortion Pill (Μifepгistone), was taken during your appointment at FCHC. This may cause bleeding
• At Home:  Μisopгostol: Take as directed at home, even if bleeding has started

IMPORTANT NOTES:

• Cramping, bleeding and/or spotting are expected
• 2 to 48 hours after taking Μisopгostol at home you will experience severe-to-mild bleeding and increased cramping, lasting 4-8 hours
• Very severe cramping, much more than a usual period is common, especially when clots and pregnancy tissue are expelled
• Chills, fever, nausea, vomiting and/or diarrhea are common
• Bleeding decreases within 48 hours. Irregular bleeding and spotting may continue for 6-8 weeks. Please report persistent spotting and bleeding in your Online/Phone Follow-up Assessment
• Pregnancy hormones gradually decrease, and pregnancy symptoms subside within 10-14 days

How to Manage

• 4 Μisopгostol tablets provided – Take as instructed by our physician
• Choose a time when you have privacy, access to the bathroom, and can take care of yourself
• We recommend taking over-the-counter ibuprofen: four (4) 200mg tablets before taking Μisopгostol
• You can also continue to manage pain with over-the-counter ibuprofen while cramping
• The prescribed pain reliever may be safely added to ibuprofen
• Wear a maxi pad – Drink fluids – Eat well – Rest

  COMPLETING YOUR FOLLOW-UP ASSESSMENT THREE WEEKS AFTER YOUR IN-PERSON APPOINTMENT:

• Online: go to fallschurchhealthcare.com/follow-up or Call 703-532-2500.
• During the COVID pandemic Falls Church Healthcare Center provides Online/Phone Follow-up Assessment.
• Prior to your Follow-up Assessment complete the urine pregnancy hCG hormone test you were given.

You indicated an interest in Procedural Abortion. Please see the aftercare instructions below. If you have any questions you will have an opportunity to discuss this with your patient educator.

Your Care at Home

Procedural Abortion

You can also download a PDF of this form locally here.

WHAT TO EXPECT AT HOME

Cramping, spotting and/or bleeding are expected.

• Cramping similar to menstrual cramps is normal
• Bleeding may stop and start for a few days at a time, or there may be no bleeding at all
• Passing clots while bleeding is normal
• Irregular bleeding & spotting may continue for 6-8 weeks
• Discuss persistent spotting and bleeding at your Online/Phone Follow-up Assessment
• Pregnancy hCG hormones gradually decrease and pregnancy symptoms subside within 10-14 days

COMPLETE YOUR FOLLOW-UP ASSESSMENT THREE WEEKS AFTER YOUR IN-PERSON APPOINTMENT:

• Online: go to fallschurchhealthcare.com/follow-up or Call 703-532-2500.
• During the COVID pandemic Falls Church Healthcare Center provides Online or Phone Follow-up Assessment
• Prior to your Follow-up Assessment complete the urine pregnancy hCG hormone test you were given

You indicated that you're not yet sure which type of abortion is right for you. Below are the aftercare instructions for both Medication (Abortion Pill) and Procedural abortion. You'll have an opportunity to discuss your options further with your patient educator to help you make the best decision.

Your Care at Home

Medication Abortion

You can also download a PDF of this form locally here.

WHAT TO EXPECT

• At FCHC:  The Abortion Pill (Μifepгistone), was taken during your appointment at FCHC. This may cause bleeding
• At Home:  Μisopгostol: Take as directed at home, even if bleeding has started

IMPORTANT NOTES:

• Cramping, bleeding and/or spotting are expected
• 2 to 48 hours after taking Μisopгostol at home you will experience severe-to-mild bleeding and increased cramping, lasting 4-8 hours
• Very severe cramping, much more than a usual period is common, especially when clots and pregnancy tissue are expelled
• Chills, fever, nausea, vomiting and/or diarrhea are common
• Bleeding decreases within 48 hours. Irregular bleeding and spotting may continue for 6-8 weeks. Please report persistent spotting and bleeding in your Online/Phone Follow-up Assessment
• Pregnancy hormones gradually decrease, and pregnancy symptoms subside within 10-14 days

How to Manage

• 4 Μisopгostol tablets provided – Take as instructed by our physician
• Choose a time when you have privacy, access to the bathroom, and can take care of yourself
• We recommend taking over-the-counter ibuprofen: four (4) 200mg tablets before taking Μisopгostol
• You can also continue to manage pain with over-the-counter ibuprofen while cramping
• The prescribed pain reliever may be safely added to ibuprofen
• Wear a maxi pad – Drink fluids – Eat well – Rest

  COMPLETING YOUR FOLLOW-UP ASSESSMENT THREE WEEKS AFTER YOUR IN-PERSON APPOINTMENT:

• Online: go to fallschurchhealthcare.com/follow-up or Call 703-532-2500.
• During the COVID pandemic Falls Church Healthcare Center provides Online/Phone Follow-up Assessment.
• Prior to your Follow-up Assessment complete the urine pregnancy hCG hormone test you were given.

Your Care at Home

Procedural Abortion

You can also download a PDF of this form locally here.

WHAT TO EXPECT AT HOME

Cramping, spotting and/or bleeding are expected.

• Cramping similar to menstrual cramps is normal
• Bleeding may stop and start for a few days at a time, or there may be no bleeding at all
• Passing clots while bleeding is normal
• Irregular bleeding & spotting may continue for 6-8 weeks
• Discuss persistent spotting and bleeding at your Online/Phone Follow-up Assessment
• Pregnancy hCG hormones gradually decrease and pregnancy symptoms subside within 10-14 days

COMPLETE YOUR FOLLOW-UP ASSESSMENT THREE WEEKS AFTER YOUR IN-PERSON APPOINTMENT:

• Online: go to fallschurchhealthcare.com/follow-up or Call 703-532-2500.
• During the COVID pandemic Falls Church Healthcare Center provides Online or Phone Follow-up Assessment
• Prior to your Follow-up Assessment complete the urine pregnancy hCG hormone test you were given

Insurance Participation and Authorization Agreement

Using my Insurance: Falls Church Healthcare Center (FCHC), as a service for you, will file your claim for payment of your medical care with your listed Insurance Carrier. Although we rely on your insurance company’s good faith pre-authorizations, verifications, certifications and coverage approvals and their reported co-pay, co-insurance and deductible amounts the claim may still be denied by your insurance company or some services not covered once FCHC files your claim. Your insurance plan is a contract between you and your insurance company. We must hold you responsible for any balances due. If your policy includes a co-insurance, a co-pay or deductible amount, that is determined by your insurance company and collected by FCHC at the time of service. If our office does not hear from your insurance company within 30 days, we may request your help in contacting your insurance company to resolve the payment delay. Please supply your insurance card and a photo I.D. at each office visit.

 As of February 22, 2021, Falls Church Healthcare Center accepts the following Insurance Carriers:

If you are not sure if your Insurance Policy includes pregnancy or gynecology benefits, we recommend that you call your policy customer service number on the back of your insurance card for clarification.

• Medicare, Medicaid and federal government insurance plans do not cover abortion care unless medically necessary.
• First Health Network International is travel Insurance so only covers injury or illness not related to routine gynecological wellness services.
• Carriers we currently are unable to accept for abortion care or GYN services include:
  • Cigna – EPO Connect
  • Golden Rule
  • United Health Care
  • One Net Alliance
  • Optimum Choice
• If you are not sure if your Insurance Policy includes pregnancy or gynecology benefits, you can call your policy customer service number on the back of your insurance card for clarification.

Authorization for Release of Information: I authorize Falls Church Healthcare Center to disclose all or any parts of my medical record to my listed insurance company(s) and any review agency which conducts practice utilization review under a HIPPA agreement with patient’s payment source. I also understand that I may revoke this authorization by providing written notice to Falls Church Healthcare Center.

Laboratory Billings: Your services may include laboratory studies required by your insurance company and or requested as a standard of care by your clinician. Your clinician will discuss the recommended additional tests as part of your care. Though the specimens may be collected at FCHC, these studies are NOT conducted at FCHC but sent to and conducted by an independent laboratory. That independent laboratory will file a claim to your insurance company separately. Any unpaid deductibles, co-insurance and copay as well as denials by your insurance company for those laboratory studies will be billed to you separately by the independent laboratory and will be your financial responsibility.

Payment of Services: I understand I am financially responsible for all charges and fees related to the services provided to me by FCHC. I understand that laboratory services if any that are provided by other than FCHC may incur charges separately billed by the laboratory. I further understand that payment in full for any unpaid amount is expected upon receipt of Falls Church Healthcare Center’s first invoice. The invoiced charges may include unpaid co-payments, to be billed co-insurance amounts, unpaid deductibles and any fees for services not covered or denied by your insurance company such as medications and anesthesia. I understand I can request a payment plan to be arranged. I understand that 10% late fees may be attached to unpaid balances. I understand I am financially responsible for any legal fees and collection service fees related to the collection of my overdue outstanding balances.

Assignment of Benefits: I hereby authorize and request that my insurance company(s) make payment for my medical care directly to the Falls Church Healthcare Center or its assigns. In the event an overpayment is made from more than one insurance company, I understand the overpayment will be sent to the appropriate payor.

HIPAA PRIVACY PRACTICES:

SUMMARY OF PATIENT RIGHTS AND RESPONSIBILITIES

Please confirm that you acknowledge all of the above information by supplying your signature (which you can draw with your finger or the mouse) and today's date.

You will have an opportunity to review these forms and your signature at your in-person appointment.