What is MS-2 Step?

MS-2 Step is the name of the product used for medical abortion. It can be used for the termination of pregnancy up to 63 days after your last menstrual period.

MS-2 Step has 2 medicines: mifepristone and misoprostol. Both medicines need to be taken as directed.

Mifepristone blocks progesterone from having its effect. This leads to your pregnancy ending.

Misoprostol makes the muscle in the uterus contract and the cervix open. This helps push out the contents of the uterus.

When can I take MS-2 Step?

MS-2 Step is approved in Australia for medical abortion if your pregnancy is up to 63 days from the start of your last period.

You should not take MS-2 Step if you:

• are unsure about how far along your pregnancy is
• have an intra-uterine device in your uterus
• have a pregnancy that is not inside the uterus (ectopic pregnancy)
• have a bleeding problem
• have a problem with your adrenal gland
• have taken corticosteroids for a long time, or take blood thinners
• are unable to get emergency medical care in the next 14 days

Tell your doctor about any other medicines you take including any supplements you buy without a prescription.

How do I take MS-2 Step?

To take MS-2 Step:

• Step 1 — Take one mifepristone tablet by swallowing it with a glass of water. It should be taken on an empty stomach 2 hours before or 2 hours after a meal.
• Step 2 — Take 4 misoprostol tablets at the same time, 36 to 48 hours after the mifepristone. Hold the 4 tablets in your mouth between the cheek and gum for 30 minutes before swallowing any tablet fragments with water. They should be taken on an empty stomach — 2 hours before or 2 hours after a meal.

If you forget to take the step 2 tablets (misoprostol) and it is more than 48 hours after you have taken step 1 (mifepristone), contact your doctor immediately.

What can I expect after taking MS-2 Step?

Step 1. After taking mifepristone it is likely that you will be able to continue with your normal activities. Vaginal bleeding usually starts 1 to 2 days after taking the mifepristone tablet.

Step 2. After taking the misoprostol tablets, you should stay at home and rest for 3 hours. Vaginal bleeding will occur usually within 4 hours and can range from light to heavy — it is usually more than your usual period. Vaginal bleeding lasts on average for 10 – 16 days, although it may last up to 6 weeks. If bleeding does NOT occur, contact your doctor straight away.

Cramping and pain may also occur and can be mild to severe.

You should stay within a 2-hour drive of a hospital for 14 days after starting MS-2 Step in case you have heavy bleeding or complications.

Does taking MS-2 Step have any side effects or risks?

Like all medicines, MS-2 Step can have side effects. These are usually minor and temporary and can include:

• diarrhoea
• headache
• nausea and vomiting
• dizziness
• flushing
• shivering or chills

Complications and risks associated with medical abortion are rare but include:

• problem bleeding
• infections
• incomplete abortion
• continuing pregnancy

When should I see my doctor?

You should see a doctor urgently if you:

• have heavy bleeding filling more than 2 pads an hour, for 2 hours in a row
• have large clots the size of your fist
• have severe pain
• feel weak or have nausea, vomiting or diarrhoea more than 24 hours after taking the misoprostol
• have fevers or chills that are ongoing or more than 38 degrees
• have smelly or abnormal vaginal discharge
• have heavy bleeding that last more than 2 weeks

You should arrange a follow-up appointment with your healthcare practitioner 14 to 21 days after your first dose of MS-2 Step to ensure that the termination was complete.

What should I do if it doesn’t work?

If treatment with MS-2 Step doesn’t work, your healthcare practitioner can arrange another method to help terminate your pregnancy.

You doctor will discuss the options that are best for your situation.

How do I get access to MS-2 Step?

Trained healthcare professionals, including doctors, nurses and midwives, can prescribe MS-2 Step. Any pharmacy can sell you MS-2 Step with a prescription.

Depending on your location, you can find a service and health professional near you by contacting:

• MSI Australia for abortion counselling online, or call 1300 405 568 to make an appointment.
• Children by Choice: Nationwide in Australia on 1800 177 725 or Queensland (07) 3357 5377.
• 1800 My Options in Victoria Australia on 1800 696 784.
• Use the online Service Finder tool to get help finding a service near you.

How much does MS-2 Step cost?

MS-2 Step is listed on the Pharmaceuticals Benefits Scheme (PBS). This means that the Federal Government pays for part of this medicine. For the latest information on how much this medication may cost you, visit the PBS website.

Resources and support

Australia has safe and supportive abortion and family planning clinics that give advice. To find these clinics in your state or territory visit:

• Family Planning Alliance Australia
• MSI Australia
• Sexual Health and Family Planning ACT
• NSW Pregnancy Choices Helpline (1800 008 463)
• Family Planning NT
• Children by Choice (Queensland)
• Unplanned pregnancy services (SA)
• Family Planning Tasmania
• 1800MyOptions (Victoria)
• Sexual Health Quarters (WA)

You can also discuss your options with your doctor, or call Healthdirect on 1800 022 222 to speak with a nurse for information and support.

• If you are an Aboriginal or Torres Strait Islander person, Family Planning NSW has a booklet about pregnancy options.
• Children by Choice offers information about accessing abortion in community languages.
• The Victorian Government's Health Translations website has information about abortion in other languages.