This is a two-medication regimen and offers a less invasive and more affordable option compared to surgical abortion.
The abortion pill is not an over-the-counter option in Singapore. A face-to-face consultation with an abortion specialist is mandatory to confirm the presence of a viable intrauterine pregnancy, its gestational age and also to assess a patient’s suitability for the abortion pill.
Before mifepristone was introduced, the misoprostol-only regimen had a failure rate of up to 22% and frequently led to emergency department visits.
Following the 2018 research study by Tan et al (where Dr Daniel Koh is a co-investigator and co-author) on outpatient medical abortion with mifepristone and misoprostol in Singapore’s setting, most abortion practitioners in Singapore adopted the two-medication protocol as a standard of care.
The First Abortion Pill (Mifepristone) is also known as RU-486. It is available only in licensed hospitals and abortion clinics. Patients are instructed to take between one and three tablets in the abortion clinic under the supervision of an abortion specialist. Mifepristone works by blocking progesterone and softening the cervix to allow the womb to expel the fetus. Most abortion specialists allow an interval of 24 to 36 hours before commencing the second abortion medication (Misoprostol).
The Second Abortion Pill (Misoprostol) is usually taken 24 to 36 hours after Mifepristone. The tablets can be taken orally or inserted vaginally. Misoprostol causes the uterus to contract and expel the fetal sac. It causes pelvic cramps and heavy bleeding with blood clots. These symptoms start as quickly as 20 minutes from ingestion of Misoprostol and can last up to six hours. Other common side effects include transient fever, chills and rigours, nausea and vomiting and diarrhoea.
Your abortion specialist will take a comprehensive medical history to assess your suitability for a medical abortion. A pelvic ultrasound scan will be performed to confirm that the pregnancy is located within the uterus, determine its gestational age and assess its viability. Medical abortion is generally suitable for pregnancies of up to 10 weeks’ gestation. Patients with certain medical conditions, such as a history of uterine surgery (including previous Caesarean sections), may require closer assessment and supervision.
You will undergo mandatory abortion counselling by an MOH-accredited counsellor, where the abortion process, potential risks and complications, and contraception options will be discussed. This includes watching a 10-minute-long video which covers the process of abortion, its associated risks and complications and contraception planning. After this session, you have to observe a 48-hour cooling-off period. You can return to the clinic to give your written consent if you subsequently decide to proceed with an abortion. The abortion pill can only be used after all the above are completed.
Once informed consent has been obtained, the first abortion pill (mifepristone, also known as RU486) is taken at the clinic under the supervision of your abortion specialist.
At least 24 hours later, you will take the second medication (misoprostol) as instructed by your doctor. Depending on your specialist’s protocol, the tablets may be taken orally or inserted vaginally, and can usually be taken at home.
You may be prescribed pain relief, antibiotics and other medications to help manage symptoms. Your doctor will advise you on what to expect during the abortion process and explain the warning signs that require immediate medical attention, such as severe pain that does not improve with medication, heavy bleeding causing dizziness or shortness of breath, fever, or foul-smelling vaginal discharge.
Abortion may ONLY be performed if the woman meets the following criteria:
A course of mifepristone and misoprostol costs around $500, and this does not include medical consultations, ultrasound scans, abortion counselling and other essential medications.
Abortion may ONLY be performed if the woman meets the following criteria:
Although abortion can be performed for pregnancies up to 24 weeks old, the majority of the public hospitals and private clinics in Singapore restrict the option of the abortion pill to pregnancies up to 70 days old.
If you are unsure whether you meet these criteria, book a consultation with Dr Daniel Koh. He will review your situation and advise you on the most appropriate option.
Women who have had surgeries on their womb may be advised against medical abortion due to the risk of uterine scar rupture.
If the pregnancy occurs outside the womb, the abortion pills will not work and may delay appropriate treatment.
The risk of treatment failure increases with increasing gestational age.
Women with unstable health issues, such as poorly controlled heart disease, severe liver or kidney impairment, are often advised to consider alternatives such as surgical abortion.
Women on long-term medication that increases bleeding risks, such as anticoagulants, may also be advised to consider a surgical approach instead of the abortion pill.
If you are unsure whether you meet these criteria, book a consultation with Dr Daniel Koh. He will review your situation and advise you on the most appropriate option.
There is no “better” method, only the option that suits you. For more information on medical versus surgical abortion, please read our previous blog article.
Below is a table for comparing the two methods:
|
Medical Abortion (Abortion Pill) |
Surgical abortion (Vacuum Aspiration) |
|
|---|---|---|
|
Pregnancy Age Limit
|
Up to 10 weeks |
Up to 12 weeks |
|
Procedure Type
|
Non-surgical |
Minor surgical procedure |
|
Anaesthesia Provided
|
Oral pain medications |
General anaesthesia or sedation |
|
Pain and Discomfort
|
Severe abdominal cramps and heavy bleeding |
Mild cramps and light bleeding |
|
Recovery Timeline
|
Most people can resume light activity within 24 hours, but should avoid swimming, sexual intercourse, and tampons until cleared by their abortion specialist. |
|
|
Bleeding Duration
|
Heavy bleed for 4 to 6 hours, followed by spotting and staining for the next few weeks |
Generally, light bleeding for up to two weeks |
|
Follow-Up |
Usually one to two visits post-ingesion of abortion pills |
Usually one visit post-procedure |
Obstetrician & Gynaecologist Singapore
BMBS (AUS), M.MED (O&G, SG), FRCOG (UK), FAMS (SG)
Dr Daniel Koh is a highly respected obstetrician and gynaecologist based at Gleneagles Medical Centre, with extensive experience in both medical and surgical termination of pregnancy (TOP) in Singapore.
He is a Ministry of Health-accredited abortion provider and counsellor, known for his commitment to evidence-based care, patient autonomy, and confidentiality. Dr Koh provides clear, non-judgmental guidance to individuals navigating unplanned pregnancies, ensuring that every patient is fully informed and supported throughout the process.
His clinical interest in abortion care is backed by published research and protocol development in Singapore. Dr Koh has contributed to studies evaluating the safety and effectiveness of medical abortion regimens, including the outpatient use of mifepristone and misoprostol up to 70 days of gestation.
Selected research contributions include:
With almost two decades of clinical experience, Dr Koh continues to advocate for patient-centred reproductive healthcare within a regulated and compassionate framework.
Providing a comprehensive suite of services to prioritise your needs and comfort at every step of the way in your fertility journey.
Antenatal care & delivery, maternal & fetal medicine including high-risk pregnancies and fetal screening
Abortion, family planning, abnormal Pap smears, fibroid and ovarian cyst management
Heavy menstrual bleeding (menorrhagia), prolonged menstruation, intermenstrual bleeding, painful menstruation (dysmenorrhea), post menopausal bleeding
Singapore law requires strict confidentiality for all abortion care. Abortion specialists, nurses and clinics may share details only with your explicit written consent.
Every consultation, scan and follow-up at our clinic follows Ministry of Health guidelines, and your records are protected under the Private Hospitals and Medical Clinics Act. Only authorised clinical staff can access them.
Below you will find answers to common questions about abortion in Singapore.
Yes, when taken under medical supervision within the first 10 weeks, medical abortion is effective for most women, and serious complications such as endometritis or infection are uncommon.
You may start as soon as an ultrasound confirms that the pregnancy is inside the womb, typically at six weeks from the first day of your last period.
No. Selling or purchasing abortion pills outside a licensed clinic is illegal in Singapore. It is also unsafe. Always obtain abortion pills through a licensed abortion specialist who will provide the appropriate care.
The medical abortion protocol has a success rate of 90% to 95%. For patients who failed to abort the pregnancy, your abortion specialist will reassess your situation and provide the most appropriate advice. This may include completing the abortion using the vacuum method.
Current evidence shows no reduction in fertility after a complete, uncomplicated medical abortion. Regular periods usually return within four to six weeks post abortion. For more information, read our blog article written on this topic.
Mifepristone works by blocking progesterone, a hormone essential for maintaining the pregnancy. Once you take mifepristone:
Because of these effects, you must be absolutely certain before starting the abortion pill. If you are unsure, discuss your concerns with your abortion specialist or counsellor before proceeding.
Yes, you may bring one support person to the consultation and counselling session. Clinic policies vary, so let your abortion clinic know in advance if you would like to have someone accompany you.
There is no option for sedation for the medical abortion option. Your abortion clinic will provide you with the medications to manage the potential side effects of misoprostol.
Our friendly team is looking forward to serving you. For urgent enquiries and appointment requests, please call or WhatsApp us directly.
