A Reduced Dose of Cabergoline for Lactation Inhibition After Second-Trimester Abortion or Pregnancy Loss

Most patients seeking abortion care or management of pregnancy loss in the second trimester will lactate, which can be physically and emotionally painful. The efficacy of a one-time dose of cabergoline has been previously demonstrated to prevent breast symptoms for these patients. This study seeks to determine if investigators can more precisely manage these patients with a reduced dose appropriate for the physiology of the second trimester, thereby reducing the medication cost and reducing or eliminating the uncomfortable medication side effects.

Inclusion Criteria: * Pregnant people, ages 18 years or older * Intrauterine pregnancy between 16/0-25/6 weeks of gestation age (by ultrasound dating performed prior to or same day of enrollment visit) * Consented for an induced, elective abortion or undergoing management of fetal demise * English or Spanish speaking * Able to consent for a research study, literate in English or Spanish * Willing to comply with study procedures and follow-up * Access to smart phone throughout study Exclusion Criteria: * Prior mastectomy (breast reduction or chest masculinization surgery acceptable) * Currently breastfeeding * Currently receiving dopamine agonist or antagonist therapy for other indication leg syndrome) * Contraindication to cabergoline (as per package insert) * Uncontrolled hypertension - defined as baseline BP \> 160/110, or chronic hypertension requiring more than one baseline medication, or current pregnancy-induced hypertension spectrum disorders (gestational hypertension, preeclampsia, eclampsia) * History of cardiac valvular disorders or valvular repair * History of pulmonary, pericardial, or retroperitoneal fibrotic disorders