Do I Need an Ultrasound Before Taking the Abortion Pill?

The ultrasound is included in your appointment because it provides three important pieces of information the provider needs before prescribing the abortion pill.

First, it confirms your gestational age — how far along you are. The abortion pill is used for pregnancies up to 10 weeks. Knowing the exact gestational age helps the provider confirm you are eligible and ensures the medication will be effective.

Second, it confirms the pregnancy is located inside the uterus. In rare cases (about 1 to 2% of pregnancies), the fertilized egg implants outside the uterus, usually in a fallopian tube. This is called an ectopic pregnancy. An ectopic pregnancy is a medical emergency that cannot be treated with the abortion pill and requires different care. The ultrasound rules this out.

Third, the ultrasound helps the provider assess whether there are any other factors — such as fibroids or an IUD in place — that could affect your care plan.

The ultrasound at your appointment is quick and straightforward. It typically takes less than 5 minutes. Depending on how far along you are, the provider may use a transabdominal ultrasound (on your belly) or a transvaginal ultrasound (a small, slim wand inserted into the vagina). The transvaginal approach is more common in very early pregnancy because it provides a clearer image.

The ultrasound is not painful. A transvaginal ultrasound may cause mild pressure, similar to the feeling during a pelvic exam. The provider will explain what they are doing and what they see. You can ask questions at any point.

You are not required to look at the ultrasound screen. Illinois does not have a mandatory ultrasound viewing law. The ultrasound is a medical tool, not a requirement designed to change your mind.

Not all clinics include an ultrasound. Some mail-order and telehealth services prescribe the abortion pill based on your last menstrual period and medical history alone, without an ultrasound. This approach can work for patients who are confident about the timing of their last period and have no risk factors for ectopic pregnancy.

The Center for Women includes an ultrasound at every appointment because the provider sees you in person and can perform this quick check as part of your visit. This is a safety advantage of in-person care. The ultrasound removes guesswork about gestational age and provides direct confirmation that the pregnancy is in the uterus.

Neither approach is wrong. Both in-person care with an ultrasound and telehealth without an ultrasound are accepted medical practices. The Center for Women's approach simply provides an additional layer of confirmation.

An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in a fallopian tube. Ectopic pregnancies happen in about 1 to 2% of all pregnancies. They are not viable — the pregnancy cannot develop normally outside the uterus.

An ectopic pregnancy is a medical emergency if left untreated, because the growing tissue can rupture the fallopian tube and cause life-threatening internal bleeding. The abortion pill does not treat ectopic pregnancies. Mifepristone and misoprostol work on the uterus and will not end a pregnancy located elsewhere.

The ultrasound at your appointment checks for ectopic pregnancy before the provider prescribes the abortion pill. If the ultrasound shows an ectopic pregnancy, the provider will explain what that means and connect you with the appropriate emergency care right away.

Symptoms of ectopic pregnancy to watch for: Severe pain on one side of the lower abdomen, shoulder pain, dizziness, fainting, or unusual bleeding patterns. If you experience any of these symptoms, go to your nearest emergency room immediately — do not wait to call the clinic. An ectopic pregnancy can be life-threatening if not treated promptly.

The ultrasound measures the size of the gestational sac or the embryo to determine how far along the pregnancy is. This measurement is more precise than counting from the first day of your last period, especially if your periods are irregular or you are unsure of the date.

Accurate gestational age matters because the abortion pill is most effective in the first 10 weeks of pregnancy. Effectiveness decreases slightly as the pregnancy progresses: about 98% at 7 weeks or less, 95 to 97% at 7 to 9 weeks, and 93 to 95% at 9 to 10 weeks. Knowing exactly where you are in this range helps the provider give you the best care.

If the ultrasound shows you are past 10 weeks, the provider will discuss your options. The Center for Women only provides the abortion pill but can refer you to a facility that offers care later in pregnancy.

Yes. The ultrasound is included in the $380 cost of your appointment at The Center for Women. This price covers everything: your consultation with the provider, the ultrasound, both medications (mifepristone and misoprostol), and your follow-up visit. There are no hidden fees or separate charges for the ultrasound.

At some other clinics or hospitals, an ultrasound can be billed separately and cost $200 to $500 or more. At The Center for Women, it is built into your comprehensive care.

Call The Center for Women at (708) 450-4545 to schedule your appointment. Same-day, evening, and weekend appointments are available. Your appointment will include the ultrasound, a consultation with the provider, your first medication, and instructions for taking the second medication at home.

The Center for Women is located at 10215 W. Roosevelt Rd. #101, Westchester, IL 60154. The total cost is $380 and includes everything — appointment, ultrasound, medications, and follow-up visit.