What to Expect Before, During and After Abortion Care
This guide explains what happens before, during and after medication abortion, vacuum aspiration and dilatation and evacuation. It also separates WHO clinical guidance from the legal requirements that apply in the UAE.
Short answer: the procedure starts with assessment, not pills
A complete abortion pathway has four parts: confirm the pregnancy and gestational age, check medical and legal eligibility, choose the appropriate method, and arrange follow-up and emergency access. The safest method depends on pregnancy duration, pregnancy location, health history, patient preference, local law and the services available at an authorised facility.
UAE Cabinet Resolution No. 44 of 2024 does not create abortion on demand. It requires a regulated process, an authorised health facility and a UAE-licensed obstetrician-gynecologist, together with the consent, documentation and approvals that apply to the case.
Before any medication or clinical procedure
Pregnancy confirmation and dates
A clinician reviews the first day of the last menstrual period, pregnancy-test results and symptoms. An examination, ultrasound or blood test may be used when dates are uncertain or there are symptoms or risk factors for ectopic pregnancy.
Medical history
The review should cover anaemia, bleeding or clotting problems, anticoagulants, adrenal disease, long-term steroid treatment, porphyria, serious asthma, allergies, an IUD, previous ectopic pregnancy and prior uterine surgery.
UAE legal eligibility
The facility must confirm the permitted ground, pregnancy-duration condition, residence status where relevant, written consent, supporting records and committee approval requirements.
Follow-up and emergency plan
Before treatment begins, the patient should know what effects to expect, how completion will be assessed, who to contact and where to obtain urgent imaging, laboratory tests, medication or a procedure if needed.
Medication abortion: how the medicines work
Mifepristone blocks progesterone, a hormone that supports an ongoing pregnancy, and helps soften the cervix. Misoprostol is a prostaglandin medicine that causes the uterus to contract and the cervix to open. The combination is more effective than misoprostol alone in WHO-reviewed evidence.
WHO also describes misoprostol-only care and suggests letrozole followed by misoprostol as an alternative in specific contexts. Letrozole is not the standard first choice, and the evidence base is smaller than for mifepristone plus misoprostol.
WHO reference regimens before 12 weeks
| Regimen | WHO reference | Important context |
|---|---|---|
| Mifepristone plus misoprostol | 200 mg mifepristone by mouth, followed 24–48 hours later by 800 micrograms misoprostol by the buccal, sublingual or vaginal route. | The combination is more effective than misoprostol alone. Repeat misoprostol may be considered when clinically needed. |
| Misoprostol alone | 800 micrograms by the buccal, sublingual or vaginal route. | Repeat doses may be needed. A clinician should explain timing, route, limits and follow-up for the individual case. |
| Letrozole plus misoprostol | WHO suggests letrozole 10 mg daily for three days, followed by 800 micrograms misoprostol sublingually on day four. | This is a suggested alternative with less evidence than the standard combination and was not included in WHO’s self-management evidence review. |
For pregnancy at 12 weeks or later, regimens, monitoring, pain needs and risks change. WHO recommends clinician-led care with appropriate infrastructure and surgical back-up. This page does not provide a later-pregnancy home regimen.
When can medication abortion be managed at home?
WHO recommends the option of self-management before 12 weeks when the person can determine eligibility, use quality-assured medicines correctly, understand expected effects and warning signs, obtain trained support, and reach a health facility or referral service if needed. More evidence is available before 10 weeks.
That clinical recommendation is not permission to bypass local law. In the UAE, abortion care, prescription and supply remain subject to the authorised pathway. A licensed clinician and facility must determine what can lawfully and safely happen outside the facility.
Preparation for clinician-approved home care
- Keep the written prescription and instructions for the exact medicines supplied.
- Confirm that the product is quality-assured, correctly labelled, stored properly and within its expiry date.
- Have the clinician-approved pain and nausea medicines available before cramping starts.
- Use sanitary pads so the amount of bleeding can be monitored.
- Keep a charged phone, transport plan and emergency contact ready. If possible, have a trusted adult nearby.
- Know the facility responsible for follow-up and the nearest emergency department.
What usually happens
- Mifepristone is taken as prescribed. Some people have little immediate change; light bleeding, nausea or cramping can occur.
- Misoprostol is used at the prescribed interval and by the instructed route. Cramping and bleeding usually become stronger as the uterus empties.
- Bleeding, clots and pregnancy tissue may pass. Nausea, vomiting, diarrhoea, chills, headache and tiredness can also occur. The intensity varies.
- Symptoms should begin to settle. Bleeding or spotting can continue, but bleeding alone does not prove the abortion is complete.
- Completion is assessed. Depending on the plan, this may use symptoms, a pregnancy test at the advised time, ultrasound or pregnancy-hormone testing.
Seek urgent medical help for:
- persistent heavy bleeding, such as soaking more than two large sanitary pads per hour for two consecutive hours;
- fainting, collapse, confusion, shortness of breath, pale or clammy skin;
- severe, persistent, increasing or one-sided abdominal or pelvic pain, or shoulder-tip pain;
- a temperature of 38°C or higher that persists, worsening chills, foul-smelling discharge, a fast heartbeat, muscle pain, marked weakness or feeling seriously unwell;
- no bleeding after misoprostol, ongoing pregnancy symptoms, or any symptom the treating clinician told you requires review.
Clinical abortion procedures
Clinical procedures take place in an appropriately equipped, authorised health facility. The team confirms consent and eligibility, reviews investigations, provides pain management, prevents infection and monitors recovery.
Vacuum aspiration before 14 weeks
WHO recommends vacuum aspiration for surgical abortion before 14 weeks and recommends against routine sharp dilatation and curettage. The cervix may be prepared with medicine when clinically appropriate. A clinician then passes a narrow cannula through the cervix and uses manual or electric suction to empty the uterus.
The procedure itself is usually brief, but total visit time includes assessment, consent, pain management, preparation and recovery. WHO recommends local cervical anaesthesia and says conscious sedation can be offered where available. Routine general anaesthesia is not recommended.
Dilatation and evacuation at 14 weeks or later
WHO recommends dilatation and evacuation, often shortened to D&E, for surgical abortion at 14 weeks or later. Cervical preparation is important and may use medicines, osmotic dilators or both, depending on gestational age and clinical judgement. Trained clinicians use suction and specialised instruments in a facility prepared to manage bleeding, infection and other complications.
Medication care at 12 weeks or later
Later medication abortion uses different doses and repeated administration, and pain usually increases with gestational age. WHO recommends clinician-led care with easy access to surgical back-up and appropriate infrastructure. Previous caesarean delivery or other uterine surgery requires particular clinical judgement because uterine rupture, although rare, is a recognised risk later in pregnancy.
Aftercare and confirmation of completion
WHO states that a routine follow-up visit is not medically required after an uncomplicated abortion when the person has adequate information and can access care if needed. A treating facility may still recommend follow-up because of symptoms, the chosen protocol, UAE documentation requirements or uncertainty about completion.
- Pregnancy symptoms should reduce, but the timing varies.
- A standard home pregnancy test can remain positive for a period after a completed abortion; follow the testing schedule provided by the clinician.
- Persistent pregnancy symptoms, prolonged heavy bleeding, no bleeding after medical management, fever or pain not controlled by medicine require review.
- Fertility can return quickly. Discuss contraception if pregnancy is not desired.
What medicines are not substitutes for abortion care?
- Emergency contraception prevents or delays pregnancy after sex; it does not end an established pregnancy.
- Pain medicines and anti-nausea medicines support comfort but do not end the pregnancy.
- Antibiotics treat or prevent selected infections; they do not complete an abortion.
- Oxytocin has obstetric uses in hospitals but is not a reliable home method for early abortion.
- Herbal products, injections or unlabelled tablets should not be used as substitutes for evidence-based care.
Related UAE guides
Legal eligibility
Read the permitted cases, 120-day condition, residence rule and committee process.
UAE abortion law →Medicine safety
Review contraindications, ectopic-pregnancy risk, brand verification and counterfeit warnings.
Mifepristone and misoprostol →Positive pregnancy test
Use the first-step checklist for symptoms, dates, records and licensed care.
What to do next →International patients
Check the UAE residence rule and avoid planning travel before eligibility is confirmed.
International-patient guide →Frequently asked questions
Is medication abortion the same as the morning-after pill?
No. Emergency contraception prevents or delays pregnancy after sex. Mifepristone and misoprostol are used to end an established intrauterine pregnancy or manage selected pregnancy loss under an appropriate protocol.
Can mifepristone and misoprostol treat ectopic pregnancy?
No. An ectopic pregnancy requires a different treatment pathway. Severe or one-sided pain, shoulder-tip pain, dizziness, collapse or fainting require urgent assessment.
Is vacuum aspiration the same as D&C?
No. Vacuum aspiration uses suction. WHO recommends vacuum aspiration before 14 weeks and recommends against routine sharp D&C for surgical abortion.
How do I know a medication abortion is complete?
Bleeding alone is not proof. Completion may be assessed through symptoms, pregnancy testing at the advised time, ultrasound or pregnancy-hormone tests, depending on the clinical plan.
Primary sources
- WHO Abortion care guideline, 2nd edition
- WHO Clinical practice handbook for quality abortion care
- WHO self-management of medical abortion update
- UAE Cabinet Resolution No. 44 of 2024
- MOHAP summary of UAE controls and procedures
Last reviewed: 27 August 2026. This page provides general clinical education. It is not a diagnosis, personal prescription, legal decision or substitute for an authorised facility.
Related UAE guides
Verify licensed abortion-related care · Abortion-pill access, cost and safety · Mifepristone availability and safety · Misoprostol price and pharmacy access · UAE legal requirements