After the patient and the health provider determine that medication abortion (MA) is the right option, the health provider should[2,6,7,10].
- Obtain written or verbal informed consent (see examples by [CAPS-CPCA platform](C78) and the [Bay Center for Birth Control](C83)) and document it in the patients’ chart.
- Prescribe:
- Mifepristone 200 mg (MIFE) orally and misoprostol 800 mcg (MISO) buccally or vaginally (this combination is packaged and branded as Mifegymiso).
- Additional dose of MISO buccally or vaginally in case of incomplete or failed abortion.
- Analgesics and antiemetics as per health provider / facility protocol.
- Antibiotic prophylaxis, if needed, as per health provider / facility protocol.
- Provide instructions on how to take the medication.
- Ensure patients know how to manage side effects and when and where to seek care for complications.
- Consider informing patients if the MA procedure involves off-label, evidence-based practices.
- Much of the MA off-label practices are based on low-resource availability and require a balance between health providers’ experience, patients’ safety and patients’ needs.
- It is recommended to inform patients about off-label practices so patients understand the risks involved and understand that off-label practices might vary depending on prescribers’ experience and comfort level.
- Discuss post-abortion contraception options. Emphasize that patients can quickly return to fertility following the abortion.
- Set up follow-up appointment(s), either in-person or via phone/video. Do discuss any safety or privacy plan if needed.
- Provide patients with patient instruction manuals (see an example by the [SHORE center and the Planned Parenthood Ottawa](C73)) and the contact details of healthcare providers and emergency health services.
- Take note of patients’ preferred phone numbers and emergency contacts in case providers are unable to reach patients directly. Be mindful that the emergency contact that the patient gives during their visits for MA may be different from the emergency contact on file. Be sure not to contact any other individuals without the patient’s expressed consent.
