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Candidates for medication abortion must be able to adhere to the treatment regimen as well as have access to a telephone and transportation to a medical facility in case of emergency. Multiple gestation is not a contraindication to medication abortion provided that the pregnancy is no more than 49 to 63 days, depending on the regimen being used.22 Contraindications to mifepristone medication abortion include hemorrhagic disorder; concurrent anticoagulant therapy; inherited porphyrias; chronic adrenal failure; concurrent long-term systemic corticosteroid use; confirmed or suspected ectopic or molar pregnancy; allergy to mifepristone, misoprostol, or other prostaglandin; and unwillingness to undergo a vacuum aspiration if needed.26 If the woman has an intrauterine device in place, it must be removed before treatment. Women with serious systemic illnesses (eg, severe cardiac, renal, or liver disease or severe anemia) should be evaluated individually to determine which method of abortion is safest. Rhesus (Rh)-negative women typically receive Rh immune globulin on the day of mifepristone administration
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