The Abortion Pill (Medication Abortion)

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  What Is the Abortion Pill?

  The abortion pill is a medicine that ends an early pregnancy. In general, it can be used up to 63 days — 9 weeks — after the first day of a woman's last period. Women who need an abortion and are more than 9 weeks pregnant can have an in-clinic abortion.

  The name for "the abortion pill" is mifepristone. It was called RU-486 when it was being developed.

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  How Effective Is the Abortion Pill?

  You can feel confident in knowing that medication abortion with the abortion pill is very effective. It works about 97 out of every 100 times. You'll follow up with your health care provider after your abortion so you can be sure that it worked and that you are well.

  Some of the medicines used in medication abortion may cause serious birth defects if the pregnancy continues. So, in the unlikely case that it doesn't work, you will need to have an aspiration abortion to end the pregnancy.

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  What Happens During a Medication Abortion?

  It's common for women to be nervous about having a medication abortion — or any other medical procedure. But many of us feel better if we know what to expect. Your health care provider will talk with you and answer your questions. Here's a general idea of how it works and what to expect.

  Before taking the abortion pill, you will need to

  • discuss your options
  • talk about your medical history
  • have laboratory tests
  • have a physical exam. This usually includes an ultrasound.
  • read and sign papers

   

  You will also be given a medication guide, instructions, and other information to take home with you, including a 24-hours-a-day, seven-days-a-week telephone number you can call if you have any questions or concerns.

  Medication abortion is a process that begins immediately after taking the abortion pill.

  There are three steps:

  STEP ONE — THE ABORTION PILL

  Your health care provider will give you the abortion pill at the clinic. You will also be given some antibiotics to start taking after the abortion pill.

  The abortion pill works by blocking the hormone progesterone. Without progesterone, the lining of the uterus breaks down, and pregnancy cannot continue.

  STEP TWO — MISOPROSTOL

  You will take a second medicine — misoprostol. It causes the uterus to empty.

  You and your health care provider will plan the timing and place for the second step. You'll take the second medicine up to three days after taking the abortion pill. Your health care provider will give you instructions on how and when to take the second medicine.

  The second medicine — misoprostol — will cause you to have cramps and bleed heavily. Some women may begin bleeding before taking the second medicine. But for most, the bleeding and cramping begin after taking it. It usually lasts a few hours. You may see large blood clots or tissue at the time of the abortion.

  More than half of women abort within four or five hours after taking the second medicine. For others, it takes longer. But most women abort within a few days.

  It's normal to have some bleeding or spotting for up to four weeks after the abortion. You may use sanitary pads or tampons. But using pads makes it easier to keep track of your bleeding.

  How Does Medication Abortion Feel? For most women, medication abortion is like an early miscarriage. It is normal for you to have bleeding and cramping. You might also feel dizzy feel strong cramps feel nauseous or vomit have diarrhea feel temporary abdominal pain have temporary mild fever or chills Acetaminophen (like Tylenol) or ibuprofen (like Advil) can reduce most of these symptoms. Do not take aspirin.   You may feel more at ease if you have a trusted loved one with you during the abortion.

  STEP THREE — FOLLOW-UP

  You will need to follow up within two weeks. Follow-up is important to make sure your abortion is complete and that you are well. You will need an ultrasound or blood test.

  In the unlikely event that you are still pregnant, your health care provider will discuss your options with you. It's likely you will need to have an aspiration abortion if the medication abortion did not end the pregnancy.

  To learn more about medication abortion, watch this short video.

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  How Safe Is the Abortion Pill?

  Most women can have a medication abortion safely. But all medical procedures have some risks, so safety is a concern.

  Rare, but possible risks include

  • an allergic reaction to either of the pills
  • incomplete abortion — part of the pregnancy is left inside the uterus
  • failure to end the pregnancy
  • infection
  • blood clots in the uterus
  • undetected ectopic pregnancy
  • very heavy bleeding

  Most often, these complications are simple to treat with medicine or other treatments.

  In extremely rare cases, very serious complications may be fatal. The risk of death from medication abortion is much less than from a full-term pregnancy or childbirth.

  Serious complications may have warning signs. Call your health care provider right away if at any time you have

  • heavy bleeding from your vagina and are soaking through more than two maxi pads an hour, for two hours or more in a row
  • clots for two hours or more that are larger than a lemon
  • severe abdominal pain or discomfort that is not helped by medication, rest, a hot water bottle, or a heating pad
  • chills and a fever of 100.4°F or higher after the day of the procedure
  • nausea, vomiting, and/or diarrhea that lasts more than 24 hours
  • an unpleasant smelling discharge from your vagina
  • signs that you are still pregnant

  You should start to feel better each day after the abortion. Feeling sick — having abdominal discomfort, diarrhea, nausea, vomiting, or weakness — more than 24 hours after taking misoprostol could be a sign of serious infection. Contact your health care provider right away if you have any of these symptoms. Do not wait until your scheduled follow-up.

  You may need another visit with your provider. Rarely, women need vacuum aspiration or hospitalization. Take your medication guide with you if you need to visit an emergency room, a hospital, or a health care provider.

  The abortion pill may not be right for all women. You shouldn't use the abortion pill if you are more than 63 days — nine weeks — pregnant are not willing to have an aspiration abortion in the unlikely case that the medicines do not end your pregnancy cannot come to follow-up appointments do not have access to a telephone, transportation, and backup medical care have a known or suspected molar pregnancy — one in which the placenta develops abnormally have severe adrenal gland, heart, kidney, or liver problems take any medicine that should not be combined with the medications used in medication abortion — mifepristone or misoprostol take anti-clotting medication or have a blood-clotting disorder currently have an IUD. You will need to have it removed before having a medication abortion. Talk with your health care provider to find out if medication abortion is likely to be safe for you. If medication abortion isn't right for you, don't worry. Another abortion method is likely to be safe for you.

  Breastfeeding During Medication Abortion A little bit of misoprostol will be present in breast milk after you take it. If you are breastfeeding, the misoprostol may cause your infant to have diarrhea. Let your health care provider know if you are breastfeeding so you can work out the best plan together.

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  Why Do Women Choose the Abortion Pill?

  • It can be done early — women can begin treatment as soon as they know they are pregnant.
  • It's private — women may complete the process of abortion at home.
  • There's usually no anesthesia.
  • Many women feel it's more "natural" — they feel it is more like miscarriage.
  • Women may feel more in control — many feel it is less invasive.

  Nearly all women who have used the abortion pill would recommend the method to a friend.

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  What Can I Expect After Using the Abortion Pill?

  Your health care provider will let you know what to do and what not to do after your abortion. Many of us feel shy about asking questions, but your provider is there to help you. Feel free to get answers to all of your questions. You might even find it helpful to make a list before you see your health care provider so you remember the questions you want to ask.

  YOUR FEELINGS AFTER MEDICATION ABORTION

  You may have a wide range of feelings after an abortion. Most women ultimately feel relief. Some women feel anger, regret, guilt, or sadness for a little while. Sudden shifts in hormones may make these feelings stronger.

  Serious, long-term emotional problems after abortion are about as uncommon as they are after giving birth. You may be more likely to have emotional problems after abortion for certain reasons. Some of these reasons are

  • having a history of emotional problems before your abortion
  • having important people in your life who aren't supportive of your decision to have an abortion
  • having to terminate a wanted pregnancy because your health or the health of your fetus is in danger

  If you want to talk with someone after an abortion, abortion providers can talk with you or refer you to a licensed counselor or to support groups.  You could also contact Exhale, a free, after-abortion talkline, that provides confidential and nonjudgmental emotional support, information, and resources for women who have had abortions.

  GETTING YOUR PERIOD AFTER MEDICATION ABORTION

  Abortion begins a new menstrual cycle. You should have a regular period in 4 to 8 weeks.

  SEX AND BIRTH CONTROL AFTER MEDICATION ABORTION

  Many health care providers recommend that you not have vaginal intercourse or insert anything except a tampon into your vagina for one week after the abortion.

  You can get pregnant very soon after an abortion. So, birth control is an important and common concern for many women after abortion. Talk with your health care provider about getting a birth control method that's best for you.

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  Where Can I Get a Medication Abortion? How Much Does Medication Abortion Cost?

  Visit a Planned Parenthood health center, a clinic, or a private health care provider to find out where you can get the abortion pill. Planned Parenthood centers that do not provide it can refer you to someone who does.

  Nationwide, the cost ranges from $300 to $800. Costs may be more or less, depending on whatever additional tests, visits, or exams are needed.

  Medication Abortion with Methotrexate Another medication that can be used instead of mifepristone is called methotrexate. It is not often used in the U.S. because mifepristone is somewhat more effective and quicker.