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Reproductive Health Access Project
 
 

Instructions

This page is to remind you what we discussed in the office. You may start to have vaginal bleeding before you use the pills I have given you. If the bleeding is heavy, you do not need to use the pills. If you are just spotting, you can go ahead and use them to help the process.

Choose a time that is convenient for you, _____am/pm, when you will use the pills, Misoprostol (also called Cytotec). Choose a time when you have had a good meal and plenty of rest. Swallow one Ibuprofen pill (800 mg.) one hour before you take the Misoprostol – this will help decrease your cramps.

Each misoprostol pill is 200 micrograms. Wash your hands and lie down first. Place four misoprostol pills in your vagina. Continue to lie down for 30 minutes, after that you can move around as usual. If the tablets come out after 30 minutes, it is OK.

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Symptoms to Expect:
Misprostol causes cramping and bleeding with clots. The cramps and bleeding may be much more than you get with a period. The cramps usually start 2 to 4 hours after you insert the pills, and may last for 3 to 5 hours. This heavy bleeding is not risky, it means the treatment is working. The bleeding often lasts 1 to 2 weeks, and it may stop and start a few times. If you do not start to bleed from the pills, you may insert 4 more pills 24 hours later.

You may have a lot of pain or cramps – if so, take pain medicine. You can take ibuprofen (Motrin or Advil) up to 800 milligrams every 8 hours and/or Vicodin up to 2 pills every 4-6 hours. You can also use a heating pad to relieve the pain. Some women get nausea, diarrhea or chills soon after using the misoprostol. This should get better in a few hours.

You should call me if:
— Your bleeding soaks through more than 2 maxi pads per hour for 2 hours in a row,
— You have a fever over 102
— You start to feel very ill with lower abdominal pain several days after the heavy cramping and bleeding is over.

To contact me:
Call my 24-hour number: _________________________. If you have any questions, think something is going wrong, or think you have an emergency, call this number and I will call you back. It may take me 10 to 15 minutes to return your call. Please feel free to call me. No question is too small. I know this may be a tough time for you and I have given you a lot of instructions, so if you forget something, CALL ME!

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Sadness or very emotional: Most women feel mixed emotions after a miscarriage. It often depends upon how much time you had to adjust to the news of the pregnancy loss. These up and down feelings are partly from the changes in hormones, now that you are no longer pregnant. Feeling emotional at this time is normal. If you think your emotions are not what they should be, please talk to us.

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Follow-up:
You have an appointment to come back to the health center on __________at _________ am/pm. At this visit I will make sure that the miscarriage is complete and we will discuss birth control and when you might want to start trying to get pregnant again.

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These forms are not intended to provide legal, medical or other professional advice. They are not a substitute for consultation with a healthcare provider or for independent judgment by healthcare providers or other professionals regarding individual conditions and situations.