The state of Arizona requires that you review the following information at least 24 hours prior to obtaining an abortion:

1. Name of physician to perform the abortion: Your abortion will be performed by Dr. Richardson.

2. The nature of the proposed procedure or treatment: Because you are fewer than 7 weeks pregnant, you are eligible to and have decided to have an abortion with the medications MIFEPREX™ and misoprostol. These medications will cause an abortion by causing cramping and bleeding from your vagina like a very heavy period or miscarriage. This method allows a pregnant woman to have an abortion without putting instruments into the uterus and, in some instances, earlier in the pregnancy than would be possible for a surgical abortion.

MIFEPREX™ is a drug which blocks the action of progesterone, a hormone needed to continue pregnancy. MIFEPREX™ has been approved by the U.S. Food and Drug Administration (FDA) for early abortion, and has been used by millions of women in Asia and Europe (it has been referred to as “RU486” or the French abortion pill”). Misoprostrol is a drug used in the United States to prevent irritation or ulcers in the stomach of people using aspirin or aspirin-like pain medicine. When the FDA approved MIFEPREX™, it was approved for use in combination with misoprostol when used together they are approximately 95% effective in causing an abortion in early pregnancy.

Recent research shows that 200mg of mifepristone (1 pill) followed in 24 to 48 hours by 800mcg misoprostol administered buccally effects complete abortion at rates >95% through 49 days’ gestation. Although this method is NOT approved for use by the Food and Drug Administration, it has been shown to be effective in clinical research trials.

The Procedure will take place in the following way:
• The provider will take your medical history, and examine you to assess how many weeks pregnant you are. An Ultrasound will be done to determine how far along your pregnancy is. The ultrasound may be done by putting the ultrasound probe in your vagina or on your abdomen. Your blood will be drawn to check your blood type. Your blood will also be tested for anemia.
• You will swallow mifepristione 200 mg (one tablet). This day will be called “day 1”.
• Unless your abortion has already occurred and is confirmed by a clinical examination or ultrasound, you will take misoprostol 800 mcg (four 200 mcg tablets) buccally (placed successively between the cheeks and gums) on day 2 at home. Mifepristone is not known to increase the risk of teratogenesis in humans, but fetal malformations have been reported after first trimester use of misoprostol.
• Because bleeding or cramping will likely occur over the next 3-6 hours, you should relax during that time. You should have access to a telephone and Tucson Women’s Center 24-hour emergency contact information (520-323-9682).
• You should contact my provider immediately at 520-323-9682 if: you soak 2 or more maxi pads per hour for 2 consecutive hours; you have a sustained fever (100.4° F) or onset of fever in the days after misoprostol; you have severe abdominal pain not helped by pain medications; you have no bleeding within 24 hours after misoprostol, or if you have abdominal pain or discomfort, or am “feeling sick”, including weakness, nausea, vomiting, or diarrhea, more than 24 hours after taking misoprostol
• If you have cramping in my lower abdomen, you can take Tylenol (acetaminophen) or Motrin (ibuprofen) as needed every 4-6 hours. You may also be given a prescription for Vicodan (Atetaminophin/Hydrocodon).
• You should return to the office around day 14. This follow-up visit is very important to confirm that termination of my pregnancy has occurred and that there have been no complications. At this visit you will have an ultrasound, a physical examination and/or another blood test. If your abortion has occurred, then you will be finished. If the Pregnancy is still progressing, then Dr. Richardson will perform a surgical abortion.

3. The immediate and long-term medical risks associated with the abortion are:
• Incomplete abortion: As with a surgical abortion, some pregnancy tissue may remain in your uterus. If this occurs, Dr. Richardson will discuss with you your treatment options, which include waiting one or more weeks, using more misoprostol, or having an aspiration, which is similar to a surgical abortion. If you decide to wait or use more misoprostol, and the abortion still is not complete, you will need an aspiration curettage.
• Vaginal bleeding: As with a surgical abortion, heavy bleeding can occur and blood clots may come out of your vagina. If you have extremely heavy vaginal bleeding or dizziness, an aspiration curettage may be necessary to stop the bleeding. The risks of an aspiration curettage are stated above. The chance of having very heavy vaginal bleeding after using MIFEPREX™/misoprostol is about 1 per 1000 (0.1%).
• Continued pregnancy and birth defects: Your pregnancy may not end after receiving the medications. If this happens, birth defects are possible. Because of the risk of birth defects, surgical abortion is strongly recommended to end the pregnancy.
• Side effects: The following side effects of a medical abortion are possible: nausea, vomiting, diarrhea, fever, headaches, and chills. Most of these side effects last less than a day. You will have cramping in my lower abdomen and you may need pain medication to resolve this condition.
• Ectopic pregnancy: A rare condition which is a complication of pregnancy rather than abortion is a pregnancy in the fallopian tube. If the pregnancy is in the fallopian tube or outside the uterus, neither surgical abortion nor a MIFEPREX™/misoprostol abortion, will remove the pregnancy, and that due to the possible threat of rupture of the fallopian tube, hospitalization and/or hospitalization may be necessary as soon as it is discovered.
• The incidence of toxic shock following medical abortion is approximately 1 in 100,000 and may be include symptoms of nausea, vomiting diarrhea, abdominal pain, fever or other signs of infection more than 24 hours after taking misoprostol.

4. Alternatives to abortion: Your three options regarding this pregnancy are parenthood, adoption, and abortion.

5. Approximate gestational age: The medical community uses menstrual weeks when discussing the length of pregnancy, or gestational age. To determine the gestational age of a pregnancy in menstrual weeks, you need to calculate how many weeks it has been since the first day of your last period. For example, if the first day of your last menstrual period is January 1st, and you had intercourse on January the 14th and became pregnant, then on February the 1st, you are 4 weeks (and a few days) pregnant, NOT 2 weeks pregnant. Determine the gestational age of your pregnancy in menstrual weeks by making these calculations now. If you cannot determine when your last period began, or if you are unsure about the length of your pregnancy for any other reason, contact our office for assistance. You may need to schedule a free ultrasound.

6. The probable anatomical and physiological characteristics of the fetus at the time the abortion is to be performed, based on organogensis (the process by which fetal organs develop) is described in the chart below by menstrual week:

Week 6
• The fertilized egg is called an embryo at this stage.
• The head has formed and buds begin to grow at the limbs forlegs and arms.
• The heart and lungs are the first organs to form, and by the 25th day the heart will start to beat.
• The brain and spinal cord begin to form as the neural tube.
• The embryo weighs less than one ounce and is approximately .014 inches long by the end of Week 4.
A standard staple is approximately 0.014 inches thick.

Week 8
• The head, mouth, liver, and intestines begin to take shape.
• Brain activity can be recorded; the skeleton forms, and reflexes develop.
• The eyes open, with no eyelids. • Fingers grow to the first joint.
0.16 inches is about the thickness of two nickels put together.

Week 10
• Formation of all major body organs and systems begin.
• Eyes, ears, nose, lips, tongue and buds for teeth are formed.
• Organs begin to be controlled by the brain.
• Fingers, toes, ankles and wrists are completely formed.
• The fetus weighs less than one ounce and is approximately .68 inch long by the end of Week 8.
A dime is approximately 0.68 inches in diameter.

Week 12
• All body parts are present: arms, legs, eyes, genitals and organs even though not fully formed.
• The fetus is now 1-2 inches and weighs a little under an ounce.
• The lungs are developing and the stomach and intestines are forming rapidly.
• The umbilical cord is fully fashioned.
A golf ball is 1.68 inches in diameter.

Week 14
• Soft nails have grown on the fingers and toes.
• The fetus now has 20 buds for teeth.
• The complete formation of all major organs will now begin to mature and the fetus begins to gain weight throughout the pregnancy.
• fetus can now move its arms and legs.
• The fetus weighs more than one ounce and is approximately 2-3 inches long by the end of Week 12.
A baseball is approximately 2.6 inches in diameter.

Week 16
• The fetus' gender can be determined.
• The fetus' hair begins to grow and nails on the fingers and
• The baby's head and body become proportional and the neck takes shape.
• Arms and legs begin to lengthen.
A softball is 4 inches in diameter.

7. Medical risks associated with continuing pregnancy: The medical risks associated with continuing the pregnancy to term are approximately 12 times greater than the risks associated with first trimester abortions (up to 14 menstrual weeks).

8. Medical assistance benefits may be available for prenatal care, childbirth and neonatal care for you if you carry your pregnancy to term.

9. If you were to carry your pregnancy to term, the father of the unborn child is liable to assist in the support of the child, even if he has offered to pay for the abortion

10. Agencies and Services: Public and private agencies and services are available to assist you during my pregnancy and after the birth of your child if you choose not to have an abortion, whether you choose to keep the child or place the child for adoption

11. It is unlawful for any person to coerce a woman to undergo an abortion.

12. You are free to withhold or withdraw your consent to the abortion at any time without affecting your right to future care or treatment and without the loss of any state or federally funded benefits to which you might otherwise be entitled.