The Morgentaler Clinic has been offering abortion services using pills only (Medical Abortion) for more than one year. Some of the information on our web site has changed and will be updated soon.
A second visit is no longer required after the first appointment. Instead, about two weeks after you take the medications, one of our nurses will call you for an evaluation of the procedure. You will also have to do a 2nd blood test at that time, either at our clinic or at a blood test center of your choice.
We have specific appointments for medical abortions if that is your chosen method. If you are undecided as to which method you would like, we have appointments where you can choose between medical or surgical (instruments) abortion at the time of the appointment.
For many years, the Montreal Morgentaler Clinic provided medical abortion services using the medications Methotrexate and Misoprostol. We are pleased to announce that Canadian women now have access to a superior medication for medical abortions. While the medication has changed, our service remains caring and professional.
Medical abortion with Mifegymiso is now available at our clinic. Medical abortion, or abortion by medication, is done up to 9 weeks of pregnancy. A minimum of two visits to the clinic will be required. The first visit will include a discussion with the counselor, an ultrasound, blood tests, a gynaecological exam by the doctor, and an information session with the nurse. The total time at the clinic should be 1 to 2 hours. You will be given detailed information, instructions and the phone number of a nurse in case of an emergency.
A follow-up visit will take place 2 weeks after the initial visit. We will do a pregnancy test, and if necessary an ultrasound, blood test and a doctor’s exam may also be done. More visits could be required.
Medical abortion involves taking 2 oral medications. The first, called Mifepristone, blocks the production of progesterone. Without progesterone the lining of the uterus breaks down and the pregnancy cannot continue. This medication will be taken at the clinic.
A second medication called Misoprostol will be taken at home according to instructions that will be given to you. The medication causes the uterus to contract which leads to the expulsion of the pregnancy. Approximately two thirds of women abort within 4 to 6 hours after taking the Misoprostol. Most women abort within a few days.
The abortion takes place outside the clinic, either at home, or elsewhere. We recommend that you be accompanied by someone during the hours following the Misoprostol, until the end of the heavy bleeding and cramping. It is important that you have access to emergency care and you do not travel until the process is complete.
In certain cases a medical abortion is not recommended and a surgical abortion will be offered, either at our clinic or in a hospital setting.
Comparative table : Surgical vs medical abortion
|Surgical abortion||Medical abortion|
|Can be done at how many weeks at our clinic?||5.0 to 18.0* weeks**||Maximum of 9.0 weeks**|
|How?||Dilation, suction, and curettage by a doctor||1 pill (Mifepristone);
4 pills (Misoprostol) 24-48 hours after
|Where? And how many visits?||At the clinic; 1 visit||At the clinic (1 visit) and at home; 1 blood test two weeks later|
|How long does it take?||A few minutes (average 5-7 minutes); sometimes longer||From 2-6 hours after the 2nd medication (Misoprostol); sometimes longer|
|Success rate?||More than 99%||95.2%-98%|
|Do I need to be accompanied?||Ideally for the return home.||Strongly recommended to have support at home when you take the 2nd medication (Misoprostol).|
|Days off from work/school||Day of the procedure; sometimes more||Day you take the second medication (Misoprostol); sometimes more|
|Pain during procedure?
|Generally mild to moderate, sometimes more severe. Done with local anesthesia and intravenous medication for pain and anxiety||Generally moderate to strong, sometimes more severe; can last a few hours after taking Misoprostol. Treated with oral pain medications|
|Bleeding?||None or light to moderate for up to 3 weeks||Moderate to severe in the beginning with lighter bleeding for up to 3 weeks after, sometimes longer|
|Side effets of medication||Possibly nausea, drowsiness; rarely, vomiting||Nausea, chills;
rarely: vomiting, diarrhea
|Advantages||Fast; presence of medical staff||Being at home may seem more comforting and more private|
*If your pregnancy is more than 18 weeks, you can be refered to another clinic.
**Accoding to our ultrasound.
We do not offer medical abortion to women who :
- are more than 9.0 weeks pregnant.
- have an IUD in place (the IUD would need to be removed prior to a medical abortion).
- cannot come to follow-up appointments or must travel before the process is complete.
- do not have access to a telephone, transportation and nearby medical care.
- are not willing to have a surgical abortion in the event of a medical abortion failure.
- have uncontrolled extreme nausea and vomiting due to their pregnancy.
Have the following medical conditions :
- bleeding disorders, including severe anemia
- allergies to the medications used
- long term use of corticosteroids
- chronic adrenal failure
- inherited porphyrias
- asthma (daily use of pumps)
- confirmed or suspected ectopic pregnancy or molar pregnancy
You can get pregnant again immediately after a medical abortion.
To make an appointment
We do not give appointments based on type of abortion procedure. Once you arrive at the clinic, you will be given information on surgical and medical abortion. If your pregnancy is 9.0 weeks or under (based on our ultrasound), you will be able to choose between medical and surgical abortion. Please be aware that there are circumstances where we will not be able to offer a medical abortion (upcoming travel, high levels of anxiety, ability to follow procedures, etc).
Before making an appointment you must do a urine pregnancy test to confirm that you are pregnant. This test can be done at home, at a pharmacy, or at the doctor’s office.
When you call to book the appointment, we will need certain information.
Please have the following information at hand when you call.:
- Name and birth date of the person requiring the appointment, as well as a telephone number at which we can leave a message.
- The date of the first day of the last menstrual period.
- Pertinent medical history related to chronic illnesses (anemia, epilepsy, diabetes, cardiac problems, renal problems, porphyria, bleeding disorders, etc).
- History of asthma (the client must bring her pumps to the appointment).
- Allergies to medication (know which medication).
- Names of any medication that is currently being taken.
Information for the day of the appointment: preparation
We will ask you to :
- bring all pertinent documents (an ultrasound report if you have one).
- stop eating and drinking 3 hours before your appointment.
- plan to be at the clinic for about 2-3 hours.
- confirm your appointment three week days before.
- present your valid Québec medicare card (RAMQ) at the reception.
- present photo ID if you do not have a medicare card. We will ask the person coming with you to do the same for security reasons (medicare card, Canadian driver’s licence or passport).
Directions to the Morgentaler clinic
Our telephone number is 514.844.4844
Our toll-free number is 1.888.401.4844
The clinic is located on St-Hubert Street, close to the Crémazie metro station.
Indoor parking available: $
Information about the procedure
The appointment will last about 1-2 hours. The time required includes filling out the medical file, admission, counselling, blood tests, and the ultrasound, as well as a medical exam by a doctor and an information session with the nurse.
The woman presents her medicare card or other valid ID at reception to have access to the clinic. The person accompanying her also provides photo ID. No one is allowed to wait inside the clinic without valid ID. She fills out her medical file and is given information about the procedure. She meets with a nurse/counsellor alone to review her file, unless she requires the assistance of a translator. The nurse will do an ultrasound.
If the pregnancy is 9.0 weeks or less, you will be able to choose between a surgical or a medical procedure. If the pregnancy if more than 9.0 weeks, the procedure will be surgical.
The client will have an opportunity to discuss contraception methods if she wishes. After receiving all necessary information, she signs the consent form for the medical abortion before proceeding.
If there is a positive urine pregnancy test, but the location of the pregnancy cannot to be determined via ultrasound, a blood test will be drawn. In this case one or more follow-up blood tests will be required. We might not be able to proceed on that day.
The doctor reviews the medical history and begins with a modified gynaecological exam. She will not do a Pap test, but will take a swab for chlamydia and gonorrhea screening. Laboratory analyses are done at Maisonneuve-Rosemont Hospital. The doctor will explain how the medications act on the body as well as possible side-effects. Afterwards, the woman will take the first medication, Mifepristone.
Following the visit with the doctor, a nurse will take a blood test to verify the pregnancy hormone levels and the blood type Rh factor. Women with the Rh negative factor receive an injection of the WinRho SD immunoglobulin to protect complications during future pregnancies. The nurse will also give the necessary instructions for the following days and answer questions. The client will then spend about 20 minutes in the recovery room to ensure that she is not having a reaction to the medications. During that time, a nurse will provide information on the chosen method of contraception et go over the instructons for at home. Prior to departure, a follow-up appointment will be scheduled two weeks later, or sooner if necessary.
During the follow-up appointment, the woman will meet with a nurse and the doctor. There will be a blood test done as well as an ultrasound. Depending on the results, further tests and appointments might be necessary.
How to reach the clinic
The clinic is open Monday to Friday from 9 a.m. to 5 p.m. If you have a question, please phone the clinic (514.844.4844). In case of an urgent question outside these times, you can call the afterhours emergency line (the number will be provided at the clinic) and speak with a nurse. If you are unable to reach our nurse, you can call 811 (Info-Santé).
Misoprostol (2nd medication)
Between 24-48 hours after taking the Mifepristone (1st medication) at the clinic :
- Place the 4 Misoprostol tablets between your cheek and your gum. After 30 minutes, swallow what's left with water.
- Plan to be at home in a restful environment when you take the Misoprostol and for the following hours.
- You should have a supportive adult with you during the heavy bleeding and cramping.
What to expect
Bleeding usually begins within 4-6 hours after taking Misoprostol. It can be heavy and with large clots and tissue. Heavy bleeding can last 7-10 days.
Bleeding usually decreases over the next 10 days. Intermittent light bleeding and spotting can last up to 2-4 weeks and up to 6 weeks.
It is normal to have heavy cramping after taking the Misoprostol. Cramps may be worse than period cramps.
- You take Ibuprofen (Motrin, Advil) 600 mg every 6 hours for a maximum of 2400 mg per day for a maximum of 3-5 days. You can also add Tylenol 1000 mg every 6 hours for a maximum of 4000 mg per day for a maximum of 3-5 days.
- You can also take the pain medication our doctor prescribed as directed.
- You can also do the following: drink warm fluids, apply a heating pad on the cramping region, changing position frequently.
- Do not take aspirin.
Some women might experience the following: chills, diarrhea, nausea, vomiting, headaches, fainting, hot flushes, skin rashes or itching. These are short term and usually last less than 24 hours.
- Both medications can cause birth defects. You need to take both medications to complete the abortion.
- Avoid getting pregnant again before your next period in order to prevent birth defects.
- Your regular period can take up to 8 weeks (sometimes longer) to appear.
- You can resume sexual activity when bleeding decreases.
- You can use tampons when bleeding decreases.
- You can become pregnant immediately after a medical abortion. This should be avoided before your next period.
- Follow the instructions given for your chosen method of contraception.
- An appointment was given to you for a follow-up visit. This appointment is to confirm that the abortion is complete. You must come to this appointment.
- If you were given an appointment for a second blood test. It is ABSOLUTELY NECESSARY for your health that you come to this appointment. This is to eliminate the possibility of a pregnancy outside of the uterus (ectopic pregnancy).
IMMEDIATELY CALL THE CLINIC, AFTERHOURS EMERGENCY NUMBER, 811, OR GO TO THE EMERGENCY ROOM IF YOU EXPERIENCE THE FOLLOWING SYMPTOMS:
- Heavy vaginal bleeding (soaking two or more) sanitary pads per hour for two consecutive hours or have large fist-sized clots).
- Prolonged bleeding (more than 21 days) or severe cramping.
- Cramping/pain which is not improved by pain relief medication.
- Fever above or equal to 38ºC; chills or malaise lasting 4 hours or more.
- Any abnormal vaginal discharge
- Immediately call the clinic, the afterhours emergency number, 811, or go to the ER if you experience the following 24 hours after taking the 2nd medication (Misoprostol): weakness, nausea, vomiting, diarrhoea, abdominal discomfort, cramps, fatigue, chills, with or without a fever
- Contact the clinic if you forget to take the dose of Misoprotol tablets within the 24-48 hours after taking the 1st medication (Mifepristone).