Q: How does a person know that the pills worked?

Most people are able to tell that the abortion was successful soon after using the medicines, because pregnancy symptoms disappear quickly and/or they might see the embryonic sac. However, even if the person feels they are not pregnant anymore, it is important to make sure the abortion was successful. They should either do an ultrasound 10 days after the medical abortion or take a pregnancy test 3 to 4 weeks after the abortion.

Urine pregnancy test: Even though HcG (human chorionic gonadotrophin, the pregnancy hormone) drops rapidly after abortion, this hormone can stay in a person’s body for several weeks after a pregnancy. Pregnancy tests are still inconclusive or falsely positive several weeks after the abortion. As many as 66% of the pregnancy tests done 2 weeks after abortion are positive, even when the person is no longer pregnant. It is better to wait 3 to 4 weeks before doing a pregnancy test to avoid a false positive. 

Ultrasound: Although an ultrasound can confirm if the abortion was successful (pregnancy was expelled) right after the abortion, people are advised to wait 2 weeks before having a scan. An early ultrasound may lead to a wrong diagnosis of incomplete abortion and unnecessary vacuum aspiration or curettage. Medical abortion involves a process that can last for several weeks before the uterus is empty, so remains in the uterus are not a sign of an incomplete abortion.  There is no need for medical attention if there are no other signs of complication.

Blood pregnancy test: Blood pregnancy tests are a good alternative to ultrasound, especially if it is possible to do two blood pregnancy tests. A person can do a blood pregnancy test when they do the abortion (it can also be done just before or after the abortion) and then repeat the test 4 to 5 days after the abortion. If the level of hormone called HcG decreases, the abortion was successful.