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Medication abortion necessarily involves heavy bleeding and cramping as the pregnancy is expelled. Other transient side effects from misoprostol include nausea, vomiting, diarrhea, fever, and chills.21 At the follow-up visit, ongoing pregnancies are most commonly treated with suction curettage because of the risk of congenital anomalies. Women with persistent nonviable pregnancies may opt for expectant management, a repeat dose of misoprostol, or suction curettage.27 Mifepristone medication abortion is safe with an estimated complication rate of 2.2 per 1000 women.28 The most frequent complications are heavy bleeding requiring curettage and/or transfusion and infection. The estimated mortality rate for mifepristone abortion is 1 per 100,000 women, most commonly due to fatal sepsis.28 Where mifepristone is not available, medication abortion can be accomplished with methotrexate and misoprostol or misoprostol alone
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